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ObjectiveTo explore the clinical characteristics and surgical treatment outcomes of spinal cord injury without radiographic abnormality (SCIWORA) in children.MethodsA retrospective analysis was conducted on the clinical data of four children diagnosed with SCIWORA who were admitted to the Neurosurgery Department of Qingdao Women and Children's Hospital from November 2022 to June 2024. All four pediatric patients underwent laminectomy for spinal canal decompression along with resection of the filum terminale. Postoperatively, a regimen including corticosteroids and mannitol was administered. Following hospital discharge, each child was subjected to clinical follow-ups, and the neurological recovery from spinal cord injury was evaluated utilizing the American Spinal Injury Association (ASIA) impairment scale.ResultsAmong the four patients, there was one male and three females, aged from 3 years and 2 months to 8 years. Two cases were due to low falls, one from a lower back injury, and one from a lumbar sprain. All patients had thoracolumbar injuries, with rapid progression of symptoms, including paralysis, sensory impairment, and urinary and fecal retention. Follow-up duration ranged from 3 to 24 months; three patients showed varying degrees of recovery in muscle strength and/or sensory function and bowel and bladder control, while one showed no improvement. One patient developed scoliosis and another presented with neurogenic bladder.ConclusionTethered cord syndrome may be a potential underlying cause of SCIWORA. For children with SCIWORA accompanied by tethered cord syndrome, we recommend early surgical intervention to perform laminectomy and release the tethered cord, which may aid in the recovery of neurological function.

This paper summarized the integrated traditional Chinese and western medicine nursing of a patient undergoing toe amputation for diabetic foot ulcers. Comprehensive nursing interventions including low extremity position care, medication care, pain control and health education were enhanced after toe amputation for diabetic foot ulcers. Based on the Traditional Chinese Medicine syndrome differentiation, Traditional Chinese Medicine ointment rubbing, Tuina on meridian and acupoints, five-element music therapy were carried out to relieve pain, eliminate lower limb swelling, promote wound healing, reduce the incidence of local infection and complications, improve peripheral circulation and neurotrophic status, improve patients' self-care ability and quality of life. . (本文总结1例糖尿病足截趾术后患者的中西医结合护理经验。术后在加强下肢体位护理、针对性用药指导、疼痛护理、健康宣教等护理措施基础上, 基于辨证施护, 开展中药膏摩、经穴推拿、五音疗法等中医疗法, 旨在缓解疼痛, 消除下肢肿胀, 促进创面愈合, 降低局部感染及并发症发生率, 改善患者周围循环及神经营养状态, 提高患者自理能力及生活质量。)

Objective To reduce the incidence of blood return in indwelling needle placement by targeted training based on Quality Control Circle (QCC) activity. Methods By using the quality control circle to accurately analyze the causes of blood return, determine the main factors, formulate corresponding solutions and implement, reduce the incidence of blood return of indwelling needle. Results Through precise "targeted" training, the blood return rate of indwelling needle decreased from 53. 60% to 8. 45%. After the implementation of the activity, the operation procedure of indwelling needle placement became more refined and standardized. Conclusion By using QCC tools to explore the root cause and key factors of blood return, targeted training is effective to improve the professional ability of nurses, reduce the incidence of blood return of indwelling needle placement, and increase transfusion safety. (目的 运用品管圈进行“靶向”培训, 旨在减少留置针回血发生率。方法 运用品管圈精准分析留置针回血原因, 确定主要因素, 制定相应的解决措施并实施, 减少留置针的回血发生率。结果 通过精准“靶向”培训, 留置针回血率由开始时53. 60%下降至8. 45%, 活动实施后留置针操作更加精细化、规范化。结论 通过运用品管圈探寻真因, 找出关键问题并进行“靶向”培训, 能够提高护士的专业能力, 减少留置针回血的发生率, 增加输液安全。)

Abstract Objective Frontotemporal dementia (FTD) encompasses a spectrum of neurodegenerative disorders, including behavioural variant FTD (bvFTD), semantic variant primary progressive aphasia (svPPA) and non‐fluent variant PPA (nfvPPA). While a strong genetic component is implicated in FTD, genetic FTD in Asia is less frequently reported. We aimed to investigate the frequency of Southeast Asian FTD patients harbouring known genetic FTD variants. Methods A total of 60 FTD‐spectrum patients (25 familial and 35 sporadic) from Singapore and the Philippines were included. All underwent next‐generation sequencing and repeat‐primed PCR for C9orf72 expansion testing. Neurofilament light chain (NfL) levels were measured in a subset of patients. Results Overall, 26.6% (16/60 cases) carried pathogenic or likely pathogenic variants in a FTD‐related gene, including: MAPT Gln351Arg (n = 1); GRN Cys92Ter (n = 1), Ser301Ter (n = 2), c.462 + 1G > C (n = 1); C9orf72 expansion (35–70 repeats; n = 8); TREM2 Arg47Cys (n = 1); and OPTN frameshift insertion (n = 2). Genetic mutations accounted for 48% (12/25) of patients with familial FTD, and 11.4% (4/35) of patients with sporadic FTD. C9orf72 repeat expansions were the most common genetic mutation (13.3%, 8/60), followed by GRN (6.7%, 4/60) variants. Within mutation carriers, plasma NfL was highest in a C9orf72 expansion carrier, and CSF NfL was highest in a GRN splice variant carrier. Interpretation In our cohort, genetic mutations are present in one‐quarter of FTD‐spectrum cases, and up to half of those with family history. Our findings highlight the importance of wider implementation of genetic testing in FTD patients from Southeast Asia.

This paper summarized the treatment and nursing measures for a patient with limb pain caused by arteriosclerosis obliterans. Based on the nursing risk assessment and routine nursing, the intradermal needling and digital acupoint pressure therapy were adopted to relieve the limb pain caused by arteriosclerosis obliterans, improve the patient’s quality of life and rehabilitation. (本文回顾1例闭塞性动脉硬化症患者肢体疼痛的治疗和护理体会。在完善护理评估的和常规护理的基础上, 运用中医特色护理技术皮内针联合手指点穴治疗, 能够减轻患者肢体疼痛, 提高生活质量, 促进康复。)

This paper summarized the integrated traditional Chinese and western medicine nursing based on integration of medical care for pain management in a patient with diabetic foot disease complicated with erysipelas. An integration team of medical care specialists was established for consultation instruction, evaluation, diagnosis, treatment and nursing. Based on the syndrome differentiation, integrative nursing measures included Chinese herbal medicine application, Traditional Chinese Medicine collapse stains, acupuncture and health education before discharge from hospital were carried out to relieve the pain and improve the quality of life of the patient. (本文总结医护一体化模式下1例糖尿病足合并丹毒患者的中西医结合疼痛护理经验。组建医护一体化小组, 医护相互协作, 根据医生的中医辨证, 从专科方面进行指导, 制订中西医结合护理措施, 开展中药贴敷、中药塌渍、针刺治疗、出院指导等全方面、整体连续性的护理措施, 有效减轻患者疼痛, 提高生活质量。)

Objective This study aimed to systematically evaluate the level of medical equipment alarm fatigue and its influencing factors among clinical nurses. Methods PubMed, Embase, CNKI, and Wanfang databases were systematically searched to identify articles on alarm fatigue of clinical nurses published before September 25, 2022. According to the evaluation criteria of prevalence studies recommended by JBI Evidence-Based Health Care Center, the quality of the literature meeting the inclusion criteria was evaluated, and Stata MP17 software was used for meta-analysis. Results A total of 14 cross-sectional studies were included, with a total sample of 2,848 nurses. The results showed that the alarm fatigue score of clinical nurses was 21.76 (95% CI [20.27, 23.25]). Subgroup analysis showed that the nurses who worked night shift and had lower professional title had higher alarm fatigue. Conclusion The alarm fatigue of clinical nurses was at a moderate level. To reduce the alarm fatigue level of clinical nurses, nursing managers should strengthen the alarm safety awareness of nurses, rationally arrange nurse manpower, carry out training to actively improve the alarm management ability of nurses, and optimize the alarm level and frequency of alarm equipment.

To investigate the effect of integration of medical care for pain control of a patient with diabetic foot gangrene complicated with infection. The clinical data of a patient with diabetic foot gangrene complicated with infection were retrospectively analyzed. Based on the integration of medical care, integrated Traditional Chinese and western medicine nursing interventions such as integration nursing ward round, Traditional Chinese Nursing technique, emotion nursing and health education were carried out to relieve the pain caused by diabetic foot gangrene and improve the patients’ quality of life. (探讨医护协作护理模式在脱疽(糖尿病足坏疽合并感染)患者疼痛护理中的应用效果。回顾性分析科室收治的1例糖尿病足坏疽合并感染患者的临床资料, 通过运用医护一体化护理模式, 给予患者中西医结合护理, 包括医护一体化查房、中医护理技术、情志护理和健康指导, 旨在有效缓解疼痛, 提高患者生活质量 。)

This paper summarized the nursing of integrated Traditional Chinese and western medicine for a patient with ankylosing spondylitis(AS) complicated with ecthyma. Based on the Traditional Chinese Medicine syndrome differentiation, TCM-characterized nursing technology such as Chinese Medicine collapse stains, moxibustion, acupoint massage, auricular acupoint sticking and pressing, dietary guidance were used jointly. Implementation of integrative nursing is potentially effective to relieve the pain and improve the ulcer healing. (本文总结1例强直性脊柱炎并发臁疮患者的中西医结合护理措施。在常规护理的基础上辨证施护, 合理应用中药塌渍、艾灸、穴位按摩、耳穴贴压、膳食指导等中医特色护理技术, 能有效缓解患者疼痛, 促进溃疡的早期愈合。)

ABSTRACT: Rhododendron fortune belongs to a scented Rhododendron species native to China, which produces fragrant flowers of great ornamental and environmental values for landscaping or indoor beautification. However, the scents in Rhododendron fortuneihave not yet been investigated, let alone the mechanism of the formation of these fragrance in the flowers. In this study, we measured the scents in terms of its volatile components and contents (VOC) in Rhododendron fortuneiat four different flowering stages and in different tissues of the plant by headspace solid-phase micro-extraction combined (HS-SPME) with gas chromatography-mass spectrometry (GC-MS). Then the characteristic aromatic values, which reflects the degree of scent perception by human, of each VOC in the plant was calculated according to its respective aromatic thresholds. Results showed that three main VOCs measured from highest to lowest are methyl benzoates, terpenes and fatty acid derivatives. Their content increased after the flower bud opening and reached the highest at half to full blossom. In a flower most VOC contents were measured in petals and only trace amount in other tissues such as stamen, pistil. A small amount of VOCs was determined in leaves as well.All aromatic values were almost corresponded to the contents of three main VOCs, indicating that the flower fragrance arises truly from these VOC components. S-adenosyl-L-methionine: benzoic acid carboxyl methyl transferase (BAMT) catalyzes the final step to form methyl benzoates. To understand the mechanism of the formation of this main type fragrance and its regulation, we firstly isolate a gene of RfBAMT from petal of Rhododendron fortuneiby using homologous cloning and RACE technology. The full length of its cDNA was 1383 bp，with an open reading frame of 1104 bp, encoding a total of 368 amino acids. The phylogenetic tree analysis showed that RfBAMT was the closest to the BSMT of Camellia japonica, belonging to methyltransferases family. Then we measured the expression level of RfBAMT again at four flower developmental stages and in different flower tissues and leaves. The results showed that the expression level of this gene was highly positively correlated with the emitted content of methyl benzoates in the flowering, implying that RfBAMT plays a pivotal role in the formation and regulation of methyl benzoates in Rhododendron fortune.Thisresearchshowed that the RfBAMT was cloned and identified in our study and its expression level was highly positively correlated with the emitted content of methyl benzoates in the flowers and leaves, which indicated this gene may play an important role on regulation of methyl benzoate synthesis in Rhododendron fortunei.

This paper summarized the nursing experience of a case of lower extremity arteriosclerosis obliterans treated with Chinese herbal ointment and massage combined with intradermal acupuncture. Based on the nursing evaluation on pain, skin temperature, intermittent claudication, arteriopalmus of dorsalis pedis artery and other indicators, the application of Chinese herbal ointment and massage combined with intradermal acupuncture is effective to relieve the symptom of the lower-limb ischemia. (本文总结中药膏摩联合皮内针辅助治疗1例下肢动脉硬化闭塞症住院患者的护理体会。在完善疼痛、皮肤温度、间歇性跛行、足背动脉搏动等指标的评估的基础上, 运用中药膏摩联合皮内针辅助治疗, 能有效改善患者下肢缺血症状和体征。)

Objective To investigate the effects of integrated Traditional Chinese and Western medicine nursing on treatment outcome, quality of life and prognosis of high-risk patients with diabetic foot, and provide evidence for more reasonable nursing intervention program. Methods From January 2021to January 2022, 200 patients with type 2 diabetes mellitus were screened; 40 high-risk patients with diabetic foot were eligible and randomly divided in to observation group and control group, with 20 cases in each group. The control group received routine care during the treatment, and those in the observation group received integrated traditional Chinese and Western medicine intervention based on routine care. The treatment outcome, patient quality of life and prognosis of disease were compared between two groups. Results The overall effective rate in the observation group was higher than that in the control group (P＜0. 05). According to the outcome of General Quality of Life Inventory-74(GQOL-74) assessment, the improvement rate in the observation group was 85. 00%(17/20), showing no significant difference compared with 65. 00%(13/20) in the control group (P＞0. 05). The incidences of foot infections and foot ulcers in the observation group were lower than those in the control group (P＜0. 05). Three cases of amputation were reported in the control group. Conclusion The integrated Traditional Chinese and Western medicine nursing showed positive effect on treatment outcome, patient quality of life and prognosis of disease, and the effect of integrative nursing intervention was superior to routine nursing. (目的 观察中西医结合护理干预高危糖尿病足患者的效果, 及对患者生活质量及预后的影响, 为高危糖尿病足患者采取更好的护理策略、制定更为合理的护理干预方案提供依据。方法 从医院2021年1月—2022年1月收治的200例2型糖尿病患者中筛查出40例高危糖尿病足患者, 随机分为现察组与对照组, 各20例。对照组采取常规护理干预, 观察组在常规护理基础上, 给予中西医结合护理干预。评价两组干预效果, 以及对患者生活质量以及足部状况影响。结果 观察组干预效果优于对照组, 差异有统计学意义(P＜0. 05); 观察组生活质量评定问卷(GQOL-74)评分改善率85. 00%(17/20), 高于对照组的65. 00%(13/20), 但差异无统计学意义(P＞0. 05); 观察组足部感染和足部溃疡发生率低于对照组, 差异有统计学意义(P＜0. 05), 观察组无1例患者截肢, 对照组3例患者截肢。结论 中西医结合护理干预能进一步提高高危糖尿病足患者的治疗效果, 改善患者生活质量及预后, 干预效果要优于常规护理干预。)

Objective To investigate the effect of Traditional Chinese Medicine (TCM) acupoint application in relief of symptoms in patients with peripheral deep venous thrombosis of the lower extremity (LEDVT). Methods Totally 60 patients with peripheral LEDVT were divided into the control group and study group, with 30 cases in each group. The control group received the routine treatment and nursing, and the study group received TCM acupoint application on the basis of routine treatment and nursing. The changes of edema degree, leg circumference and pain degree in the two groups were observed. Results Better outcomes of pain relief and edema regression were observed in the study group than those in the control group after treatment(P＜0. 05). There was no significant difference in lower limb circumferences between two groups after treatment(P＞0. 05). Conclusion TCM acupoint application is safe and effective in relief of symptoms in patients with peripheral LEDVT. (目的 探讨穴位贴敷改善周围型下肢深静脉血栓形成患者临床症状的效果。方法 将60例周围型下肢深静脉血栓形成患者随机分为对照组和研究组, 各30例, 对照组接受常规治疗和护理, 研究组在常规治疗的基础上实施穴位贴敷干预。观察患者患肢症状体征的改变。结果 治疗后, 研究组患者肢体疼痛程度较对照组轻, 差异有统计学意义(P＜0. 05); 研究组患者患肢水肿程度较对照组轻, 差异有统计学意义(P＜0. 05); 两组患者患肢小腿周径改善程度差异无统计学意义(P＞0. 05)。结论 穴位贴敷能改善周围型下肢深静脉血栓形成患者临床症状和体征, 且具有临床安全性。)

This paper summarized the prevention of blood return after indwelling needle placement and related nursing for a gangrene patient. Key issues of prevention and nursing included risk factors assessment, standard process, selection of proper puncture sites, tube-sealing method, selection of tube-sealing solution and health education. It is considered that taking effective preventive measures can reduce the occurrence of blood return after indwelling needle and improve the clinical therapeutic effect of indwelling needle. (本文总结1例外脱疽患者留置针置入后预防回血的护理经验, 包括风险因素评估、规范操作、选用合适的穿刺部位、封管方法、封管液的选择以及健康宣教等预防措施。通过科学的预防措施, 有效避免留置针置后的回血现象, 提高留置针临床的治疗效果。)

This paper reviewed the analgesic treatment and nursing for a patient with diabetic peripheral vascular disease complicated with post-herpetic neuralgia. Based on the analgesic treatment, psychological nursing and health education and other intervention measures were carried out to relieve the clinical symptoms of disease and improve the treatment adherence of the patient. (本文回顾1例糖尿病性周围血管病合并带状疱疹后遗神经痛患者的镇痛治疗与护理经验。在配合完成镇痛治疗同时, 护理人员给予患者心理护理及健康宣教等干预措施, 提高患者依从性)

Multi Jet Fusion (MJF) has gradually been utilised for the commercial fabrication of final products. In particular, the mechanical properties of MJF-printed polyamide 12 (MJF PA12) parts have been widely investigated by manipulating the process parameters such as the printing orientation and the cooling rate. In this work, the effects of build positions on the thermal history, crystallization, and mechanical properties of MJF PA12 parts were investigated. The thermal history of printed parts was obtained using the MJF Thermal Prediction Engine software developed by Hewlett-Packard HP Labs (HP Inc.). As compared to the parts printed at the boundaries, those in the centre region experienced a slower cooling rate, which was favourable for crystal growth. Both the crystallite size and crystallinity of the parts in the centre region were larger than those of the parts at the boundaries. The parts printed in the centre region had slightly higher tensile modulus and significantly smaller elongation at break and strain energy density than those printed at the boundaries. The tensile strength of the parts at different locations was comparable. This work serves as a guide to selecting the build position of MJF-printed parts to achieve desirable mechanical properties.

Objective To investigate the clinical application value of air-lock method in the deltoid intramuscular injection of COVID-19 vaccine. Methods From January 27, 2021 to February 1, 2021, 780 recipients of vaccine were selected as subjects, and they were divided into a control group and a test group, with 390 cases each using a digital sampling method. The control group adopted the conventional injection method, and the test group adopted the air-lock injection method. The rate of blood extravasation or injection solution extravasation and pressing time of the two groups after injection were compared. Results The rate of blood extravasation and injection solution extravasation in the observation group were lower than those in the control group(P＜0. 01). The pressing time after the injection in the observation group was shorter than that of the control group(P＜0. 01). Conclusion The air-lock method in the deltoid intramuscular injection of COVID-19 vaccine can effectively reduce the incidence of bleeding at the injection site and the extravasation of the injection solution, ensure the vaccine injection dose, shorten the pressing time, and reduce the environmental pollution caused by the drug solution extravasation. It is an simple and efficient injection method, which is worthy of promotion and application. (目的 探讨空气闭锁(Air-lock)肌肉注射法在新型冠状病毒灭活疫苗注射中的临床实践与应用价值。方法 2021年1月27日—2月1日, 选取780例接种者作为受试对象, 随机分为对照组(n=390)和研究组(n=390)。对照组采用常规排气注射法, 研究组采用Air-lock注射法。比较两组注射后发生血液和药液渗出情况及按压时间。结果 研究组血液渗出率和药液渗出率均低于对照组, 差异有统计学意义(P＜0. 01)。研究组注射完毕后按压时间短于对照组, 差异有统计学意义(P＜0. 01)。结论 在注射新型冠状病毒灭活疫苗中实施Air-lock注射法, 可以有效的降低注射位置出血及药液外渗, 保证新型冠状病毒灭活疫苗注射剂量、缩短按压时间, 减少药液外渗所致环境污染, 同时操作简单、接种高效的特点, 具有推广应用价值。)

The femoro-popliteal artificial vessel bypass surgery is an effective operation for the treatment of aeriosclerosis obliterations, and related perioperative nursing is critical to the patient. This paper summerzied the perioperative nursing experience in a patient undergoing femoro-popliteal artificial vessel bypass surgery for aeriosclerosis obliterations. Key issues of perioperative nuring included psychological intervention, illness observation, prevention of postoperative complications, dietary guidance, rehabilitation exercise, pain control. The goal of appling Integrated Traditional Chinese and Western medicine nursing is to relieve neagaive emotions of the patient, improve the treatment compliance and prevent the postoperative complications. (股-腘动脉人工自体血管转流术是治疗动脉硬化性闭塞症(ASO)的有效术式, 其围手术期的护理至关重要。本文总结1例股-腘动脉人工自体血管转流术合并抑郁症患者的围手术期护理经验, 包括心理干预、病情观察、并发症预防、饮食指导、康复锻炼、疼痛干预等。通过采用中西医结合的护理方法, 进而起到改善患者负性情绪、提高治疗依从性和预防并发症的积极作用。)

This paper summarized the nursing of integrated Traditional Chinese and western medicine for a patient undergoing thrombolytic therapy for acute mesenteric venous thrombosis. The emergency interventional surgery was performed, and patient’s hemorrhage condition and vital signs were observed during thrombolytic therapy. Comprehensive nursing interventions were carried out to enhance the catheter maintenance, anticoagulant therapy and prevention of short bowel syndrome. In the mean time, Traditional Chinese Medicine external treatment such as acupoint massage; auricular acupoint pressing therapy, Chinese herbal medicine external application were carried out to improve the prognosis and quality of life of the patient. (本文回顾1例急性肠系膜静脉血栓患者溶栓后的中西医结合护理经验。给予患者急诊介入置管溶栓术, 密切观察患者在使用溶栓药物时的出血情况及生命体征; 溶栓后完善导管护理和抗凝治疗的护理, 积极预防短肠综合征; 同时配合穴位按摩、耳穴贴压、中药贴敷等中医外治法, 加强饮食和情志调护, 改善患者预后和生活质量。)

Objective To investigate the effect of Traditional Chinese Medicine(TCM) collapse stains in the treatment of lower extremity. Methods Totally 60 patients with lower-extremity erysipelas were randomly divided into the control group and observation group, with 30 cases in each group. All patients received basic treatment and routine care, and those in the observation group were given TCM collapse stains. The treatment effect and patient satisfaction were evaluated and compared between groups. Results The total effective rate of intervention was 96. 67%(29/30)in the observation group, which was significant higher than 86. 67%(26/30) in the control group(P＜0. 05). The patient satisfaction rate of the observation group was higher than that of the control group(P＜0. 05). Conclusion Based on the basic treatment and routine care, the TCM collapse stains is potentially effective to improve the treatment outcome of lower-extremity erysipelas and patient satisfaction. (目的 探讨中药塌渍治疗下肢丹毒的效果。方法 60例下肢丹毒患者随机分为对照组和观察组, 各30例。两组患者均接受基础治疗, 对照组给予常规护理, 观察组在对照组基础上加用自拟中药配方颗粒进行中药塌渍治疗。比较两组干预效果, 采用自制量表评价护理满意度。结果 对比两组干预效果, 观察组总效率96. 67%(29/30), 高于对照组的86. 67%(26/30), 差异有统计学意义(P＜0. 05)。观察组护理满意度高于对照组, 差异有统计学意义(P＜0. 05)。结论 在基础治疗和常规护理的基础上, 中药塌渍干预能有效提高下肢丹毒治疗效果, 提升患者满意度。)

Objective To observe the effect of moxibustion on pain relief in patients with lower extremity arteriosclerosis obliterans (ASO)of cold coagulation and blood stasis type. Methods Totally 60 patients with lower extremity ASO of cold coagulation and blood stasis type were randomly divided into the control group and the observation group, with 30 cases in each group. Patients in both groups received routine care during the hospitalization, and those in the observation group were given moxibustion by Traditional Chinese Medicine (TCM) syndrome differentiation. The Visual Analogue Scale (VAS)was used to assess the degree of pain. Results The VAS score of the two groups decreased after nursing intervention, and VAS score in the observation group was lower than that in the control group (P＜0. 01). Conclusion The moxibustion by TCM syndrome differentiation is effective to relieve the pain of patients with lower extremity ASO of cold coagulation and blood stasis type. (目的 观察艾灸缓解下肢动脉硬化性闭塞症寒凝血瘀型患者疼痛的效果。方法 60例下肢动脉硬化性闭塞症寒凝血瘀型患者随机分为对照组和观察组, 各30例。对照组给予常规护理, 观察组在常规护理基础上增加中医护理干预, 根据中医辨证分型实施艾灸。采用视觉模拟评分(VAS)评估治疗前后患者疼痛程度。结果 干预后两组VAS评分均较干预前下降, 且观察组VAS评分低于对照组, 差异有统计学意义(P＜0. 01)。结论 基于中医辨证分型实施艾灸, 能进一步缓解下肢动脉硬化性闭塞症寒凝血瘀型患者疼痛。)

Traditional sandstorm detection methods use radiation differences among dust, underlying surface, and cloud to distinguish them by setting appropriate thresholds. Owing to the complex structure of the underlying surface, dust, and cloud, it is difficult to set a uniform threshold to achieve high-precision separation. Deep learning (DL) has powerful information mining capabilities and can fully use spectral differences between dust, land surface, and clouds. However, under the limited band information provided by satellite sensors, DL cannot easily distinguish highly heterogeneous land surfaces from multi-modal dust and cloud. This study proposes a sandstorm detection algorithm with DL supported by a land surface reflectance (LSR) dataset. The clear sky LSR dataset was obtained based on the MOD09A1 product. Based on the dataset, the difference between the reflectance observed by the satellite and the corresponding LSR is generated, which is used as a characteristic parameter of sandstorm detection with the deep learning method. The sandstorm detection of MODIS data is realized using multi-band radiation and radiation difference with DL. Results showed that the sandstorm detection algorithm used in this study was consistent with the OMI AI product with a detection accuracy of 84.6%. Compared with the detection results without the LSR dataset, this method effectively improves the accuracy of sandstorm identification.

This paper reviewed the standard flushing and sealing of venous indwelling catheter and related nursing management in a patient with gangrene. According to the Infusion Therapy Standards of Practice, the catheter flushing and sealing operation was performed, and blood return and catheter blockage after catheter sealing were observed. Standard use of venous indwelling catheter can effectively reduce the risk of related complications, prolong the indwelling time of peripheral indwelling needle, and achieve the purpose of safe infusion. (本文回顾1例脱疽患者静脉留置导管冲封管操作规范及护理措施。护理人员严格遵守冲封管操作规范, 观察患者留置针封管后回血及导管堵塞情况。规范使用静脉留置导管冲封管, 对降低静脉留置导管相关并发症发生风险、延长外周留置针留置时间具有积极意义, 确保患者输液安全。)

This paper summarized the nursing measures of integrated traditional Chinese and Western medicine for a diabetic patient with stage II pressure ulcers. Based on the systemic treatment such as local decompression, blood glucose control and nutrition intervention, targeted therapy and nursing of integrated traditional Chinese and Western medicine were carried out at different stage of wound surface healing, aiming to relieve the pain and shorten the healing time of wound surface. (本文总结1例糖尿病合并II期压疮患者的中西医结合护理体会。在局部减压、控制血糖、营养干预等全身治疗的基础上, 结合伤口愈合不同阶段的特点, 实施针对性治疗和中西医结合护理干预, 以减轻患者痛苦, 缩短压疮创面愈合时间。)

Abstract Background Mechanical ventilation (MV) with positive end-expiratory pressure (PEEP) is commonly applied in patients with severe traumatic brain injury (sTBI). However, the individual responsiveness of intracranial pressure (ICP) to PEEP varies. Thus, identifying an indicator detecting ICP responsiveness to PEEP is of great significance. As central venous pressure (CVP) could act as an intermediary to transduce pressure from PEEP to ICP, we developed a new indicator, PICGap, representing the gap between baseline ICP and baseline CVP. The aim of the current study was to explore the relationship between PICGap and ICP responsiveness to PEEP. Methods A total of 112 patients with sTBI undergoing MV were enrolled in this prospective cohort study. ICP, CVP, cerebral perfusion pressure (CPP), static compliance of the respiratory system (Cst), and end-tidal carbon dioxide pressure (PetCO2) were recorded at the initial (3 cmH2O) and adjusted (15 cmH2O) levels of PEEP. PICGap was assessed as baseline ICP - baseline CVP (when PEEP = 3 cmH2O). The patients were classified into the ICP responder and non-responder groups based on whether ICP increment with PEEP adjusted from 3 cmH2O to 15 cmH2O was greater than 20% of baseline ICP. The above parameters were compared between the two groups, and prediction of ICP responsiveness to PEEP adjustment was evaluated by receiver operating characteristic (ROC) curve analysis. Results Compared with the non-responder group, the responder group had lower PICGap (1.63 ± 1.33 versus 6.56 ± 2.46 mmHg; p

Objective To observe the effect of four-finger lifting method in reducing the pain after deltoid intramuscular injection of COVID-19 vaccine. Methods Totally 180 recipients who required COVID-19 vaccine injection were randomly divided into the observation group and control group, with 90 cases in each group. Routine injection method was adopted in the control group, while the four-finger lifting method was used in the observation group. The duration of pain and recipient satisfaction were measured. Results The duration of pain after injection was shorter in the observation group than that in the control group (P＜0. 05). The satisfaction rate in the observation group was higher than that in the control group (P＜0. 05). Conclusion Application of four-finger lifting method is potentially effective to shorten the duration of pain after deltoid intramuscular injection of COVID-19 vaccine and improve recipient satisfaction. (目的 探讨在新型冠状病毒疫苗接种时运用四指提拉注射法减轻接种者疼痛的效果。方法 选取180例接种者为研究对象, 采用随机数字表法分为对照组和观察组, 各90例。对照组采用常规定位注射法, 观察组采用四指提拉注射法。观察2组注射后疼痛时长, 评价接种者满意度。结果 观察组接种者疼痛时长短于对照组, 差异有统计学意义(P＜0. 05)。观察组接种者满意度评价高于对照组(P＜0. 05)。结论 在疫苗接种中运用四指提拉注射法, 可有效缩短注射后疼痛时长、提高接种者满意度。)

The continuous innovation in the medical technology sector is helping to the application of infrared vein finder in peripheral venipuncture. This paper summarized the factors causing peripheral venipuncture failure in the clinical setting and principles of vascular visualization technology, briefly introduce the application process of infrared vein finder in peripheral venipuncture, and discuss related standardized management procedure. (随着医疗技术的不断进步, 血管成像仪逐渐被应用于外周静脉穿刺操作中。本文初步总结了临床外周静脉穿刺失败的原因, 阐述血管可视化技术的原理, 简要介绍了外周静脉穿刺中投影式血管成像仪的应用流程, 并探讨血管成像可视化系统的应用标准。)

Abstract Background Double lumen intubation and one-lung ventilation should be applied without delay in cases of traumatic main bronchial rupture. In most cases, when the patients’ vital signs have been stabilized, the repair can be performed. However, when one-lung ventilation is complicated by traumatic wet lung, the mortality rate is likely to be much higher. Case presentation In this case, the patient experienced a left main bronchial rupture, bilateral traumatic wet lung, and acute respiratory distress syndrome (ARDS) because of severe thoracic trauma. Though the patient was treated with intubation and mechanical ventilation (MV), his oxygenation was still not stable. Thus, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was initiated; upon improvement of oxygenation, the patient received an exploratory thoracotomy. Unfortunately, the rupture proved to be irreparable, resulting in a total left pneumonectomy. As there was severe ARDS caused by trauma, ECMO and ultra-low tidal volume (VT) MV strategy (3 ml/kg) were utilized for lung protection post-op. ECMO was sustained up to the 10th day, and MV until the 20th day, post-operation. With the support of MV, ECMO and other comprehensive measures, the patient made a recovery. Conclusion V-V ECMO and ultra-low VT MV helped this thoracic trauma patient survive the lung edema period and prevented ventilator associated pneumonia (VAP). In extreme situations, with the support of ECMO, the tidal volume may be lowered to 3 ml/kg.

Abstract Background Ventana ALK (D5F3) screening of anaplastic lymphoma kinase (ALK) gene rearrangement in tissue specimens has been approved by US FDA (Food and Drug Administration) to select treatment for non–small-cell lung carcinoma (NSCLC). However, tumor tissues are often not readily obtainable, and cytology specimens and may be the only tumor material available for diagnosis and molecular marker analysis. In this study, we evaluated the feasibility of ALK immunocytochemistry (ICC) on ThinPrep slides and determined a suitable scoring system for interpretation of the results. Methods One hundred twenty-one fine-needle aspirate (FNA) specimens from metastatic lesions of NSCLC were analyzed. ALK rearrangement was detected on ThinPrep cytology slides using the Ventana immunocytochemistry ALK-D5F3 system, which adopts two scoring systems for interpretation of the ICC results. The results were subsequently confirmed by reverse transcription polymerase chain reaction (RT-PCR) analysis and fluorescence in situ hybridization (FISH). Results Among the 121 ICC specimens, 16 that were considered ALK-positive by either scoring system were referred for PCR analysis. Among the ALK ICC-negative cases, 33 had correlated FISH ALK results. A total of 49 specimens that exhibited either a positive or negative ICC result with a correlated ALK status were analyzed statistically. ICC results showed a high concordance rate with the results of PCR/FISH analysis. The sensitivity and specificity of ALK ICC by the binary scoring algorithm were 68.75 and 96.97%, respectively. These values increased to 93.75 and 96.97%, respectively, when interpreted by the semiquantified interpretation system. Conclusions ALK ICC analysis on ThinPrep slides is a reliable ALK testing method, and the semiquantified interpretation system on cytology specimens is recommended rather than the binary scoring algorithm on tissue specimens.