Table of Content

28 June 2017, Volume 6 Issue 2 Previous Issue    Next Issue

Original article

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Choice of surgeries for low lumbar burst fractures HU Xiao, ZENG Zhili, JIA Yongwei, XU Wei, WANG Jianjie, ZHAN Xinhua, ZHAO Jingwei, CHENG Liming 2017, 6 (2):  73-77.  doi: 10.3969/j.issn.2095-378X.2017.02.001 Abstract ( 195 )   PDF (8205KB) ( 381 )   Save Objective To analyze the characteristics of low lumbar burst fractures and the choice of surgery plans.Methods Twenty-two patients with low lumbar burst fractures were included in the study and classified into two groups.Specifically,12 patients who had bone fragment in canal were treated with posterior decompression and short segmental pedicle screw fixation,in which 4 patients were treated in combination with vertebral augmentation; 10 patients had simple vertebral fracture,in which 6 patients received percutaneous pedicle screw fixation and other 4 patients received open surgery with pedicle screw fixation.Average height of anterior vertebral border,average height of injured vertebral body,and Cobb’s angle were evaluated before and after operation with X-ray.Intraspinal mass rate was evaluated on CT scan,neurofunction with American Spinal Injury (ASIA) Association impairment scale (AIS),and clinical outcomes using visual analogue score (VAS) and oswestry disability index (ODI).Results All patients were followed up for 24-56 months after successful operations,with an average of (32.9±11.4) months.The average height of anterior vertebral border changed from preoperative (23.8±5.3) mm to (31.9±3.4) mm two weeks after operation and (30.2±4.0) mm in the last follow-up (P<0.05).The average height of injured vertebral body changed from preoperative (24.3±4.6) mm to (30.3±2.9) mm two weeks after operation and (29.7±3.1) mm in the last follow-up (P<0.05).The Cobb’s angle increased from preoperative (9.2°±9.6°) to (18.5°±7.0°) two weeks after operation and (16.3°±7.3°) in the last follow-up (P<0.05).The intraspinal mass rate decreased from preoperative 43.6% (30%-70%) to postoperative 7.72% (0%-15%).AISA scores increased 0-1 grade.VAS score and ODI score of low back pain showed significant improvement after operation (P<0.01).Conclusion Low lumbar burst fractures,which are unstable,should be treated with surgeries as early as possible.The best choice of surgery depends on the stability of spine,nerve injury,intraspinal mass,and complications. References | Related Articles | Metrics

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Clinical efficacy of hinged external fixator in the treatment of acute complex elbow fracture and instability WANG Xiuhui, WANG Zhe, WANG Minghui 2017, 6 (2):  78-81.  doi: 10.3969/j.issn.2095-378X.2017.02.002 Abstract ( 206 )   PDF (10620KB) ( 310 )   Save Objective To analyze the clinical efficacy of hinged external fixator on acute complex elbow fracture and instability.Methods Fifty-three cases were selected from March 2012 to March 2014,who were diagnosed with acute complex elbow fracture and instability and underwent surgical therapies with single-armed hinged external fixators.They were then followed up after one year to evaluate Japanese Orthopaedic Assoiation (JOA) score and bone union based on radiological results.Results Average follow-up lasted for (16.5±5.0) months and average fracture healing took (12.5±1.5) weeks.The flexion and extension range of elbow joint was 113.34°±26.33° and the rotation range of forearm was 105.35°±26.23°.Post-operative function and range of motion were recovered as expected in general,with a total JOA score of 84.02±19.13.In addition,three cases were recovered from complications.Conclusion A high clinical efficacy is found of applying hinged external fixator to the treatment of acute complex elbow fracture and instability,which would be beneficial to the recovery of elbow joint function after surgical therapies. References | Related Articles | Metrics

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Clinical analysis of different digestive tract reconstructions after laparoscopic gastric cancer surgery ZHENG Zhihua, HUANG Wenchang, SU Yibin, CHEN Guobao, LIU Jiangrui 2017, 6 (2):  82-84.  doi: 10.3969/j.issn.2095-378X.2017.02.003 Abstract ( 160 )   PDF (384KB) ( 386 )   Save Objective To analyze the clinical effects of different digestive tract reconstructions after laparoscopic gastric cancer surgery.Methods The clinical data of 82 cases who underwent laparoscopic gastric cancer surgery were retrospectively analyzed.After the surgery,45 cases in observation group received jejunal interposition,and 37 cases in control group recieved esophageal residual stomach anastomosis.Surgical conditions,surgical related complications,postoperative serum albumin,and body weight were compared between the two groups.Results No significant differences in operation time,intraoperative blood loss,and incidence rates of postoperative anastomotic leakage and anastomotic stenosis were observed between the two groups.The esophageal reflux rate in the observation group was significantly lower than that in the control group (P<0.05),and the serum albumin level was higher and the body mass improvement was bigger in the observation group than in control group (P<0.05).Conclusion Jejunal intercost,as a reconstruction method after laparoscopic gastric cancer surgery,Results in less complications,benefits the improvement of nutritional status and body weight,and has clinical significance. References | Related Articles | Metrics

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Clinical analysis of laparoscopy in combination with choledochoscopy in treatment of cholecystolithiasis with choledocholithiasis FENG Shukai, GUAN Liqing, XU Tuo, WANG Jun, FENG Shujuan, LIN Yunnian 2017, 6 (2):  85-86.  doi: 10.3969/j.issn.2095-378X.2017.02.004 Abstract ( 177 )   PDF (245KB) ( 355 )   Save Objective To observe the clinical effect of laparoscopy in combination with choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis.Methods A total of 134 patients with cholecystolithiasis and choledocholithiasis admitted to Yangdong People’s Hospital from April 2014 to August 2016 were selected and divided into observation group (n=67) and control group (n=67) according to the odd or even number of bed.The observation group received laparoscopy in combination with choledochoscopy,while the control group received conventional laparotomy.The postoperative indices and the incidence of complications in the two groups were observed.Results Operation time,intraoperative blood loss,first anal exhaust time,and postoperative hospital stay duration in the observation group were significantly lower than those of the control group; and the incidence rate of complications in the observation group was also significantly lower than that in the control group (10.45% vs. 23.88%,P<0.05).Conclusion Laparoscopy in combination with choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis features short operation time,quick postoperational recovery,and high safety level,and is worthy of clinical application. References | Related Articles | Metrics

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The effect of huganjiexian decoction on related factors in liver fibrosis BAI Shanshan, WANG Yanshuang, ZHANG Xiaoyan, HE Yajun 2017, 6 (2):  87-90.  doi: 10.3969/j.issn.2095-378X.2017.02.005 Abstract ( 159 )   PDF (9660KB) ( 280 )   Save Objective To observe the effect and possible mechanism of Huganjiexian Decoction on liver fibrosis-related cytokines CTGF,TGF-β 1,and PDGF.Methods Liver fibrosisr at models wereestablished by intraperitoneal injection of carbon tetrachloride for eight weeks.The rats were divided into control group,model group,Minor Bupleurum Decoction group,and Huganjiexian Decoction group (administered with high,middle,and low doses of turmeric containing 15,9 and 6 g respectively,from week 9-12).Immunohistochemical staining was used to detect the expression of CTGF,TGF-β1,and PDGF in liver tissues.Results The expression levels of CTGF and PDGF in liver tissues in the high and middle dose groups significantly decreased compared to the model group(P<0.05),while the expression level of TGF-β1 decreased significantly only in the high dose group (P<0.05).Conclusion Huganjiexian Decoction could downregulate the expressions of fibrosis-promoting cytokines CTGF,TGF-β1,and PDGF,which might be one of the important mechanism protective effects of against liver fibrosis. References | Related Articles | Metrics

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Experience of diagnosis and treatment for stone and carcinoma of intrahepatic bile duct LIU Pengfei, LIU Kai, YE Chun, XU Wen 2017, 6 (2):  91-93.  doi: 10.3969/j.issn.2095-378X.2017.02.006 Abstract ( 172 )   PDF (335KB) ( 379 )   Save Objective To discuss the diagnosis and treatment for stone and carcinoma of intrahepatic bile duct.Methods This article analyzed the effect of serum CA199,CEA,anemia degree,and intrahepatic bile duct stone course on diagnosis and the effect of different surgical Methods on prognosis of patients with stone and/or carcinoma of intrahepatic bile duct.Results In carcinoma + stone group,serum CA199 (71.43% vs.16.67%,P=0.001) and CEA (14.29% vs.0%,P=0.001) levels were higher than those of stone group; anemia degree was more serious (<10 g/L,66.67% vs.20.0%,P=0.001); the course of intrahepatic bile duct stone was longer (17.62 vs.11.30 years,P=0.001).The patients who received half liver resection with lymph node cleaning of hilus had a longer survival time compared with the patients who received local resection with lymph node cleaning of hilus (31.67 vs.17.4 months,P=0.042). Conclusion Observation of serum CA199,CEA,hemoglobin,and stone course in patients with intrahepatic bile duct stone may help diagnose whether intrahepatic bile duct carcinoma is combined.In addition,half liver resection with lymph node cleaning of hilus is recommended to patients with intrahepatic bile duct stone combined with intrahepatic bile duct carcinoma. References | Related Articles | Metrics

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Experience of applying purse-string suture in securing appendix base in laparoscopic appendectomy CHEN Yadong 2017, 6 (2):  94-95.  doi: 10.3969/j.issn.2095-378X.2017.02.007 Abstract ( 189 )   PDF (301KB) ( 361 )   Save Objective To report the experience of applying purse-string suture in securing the base of appendix in laparoscopic appendectomy.Methods A total of 128 cases who underwent laparoscopic appendectomy assisted by purse-string suture for appendix stump from May 2013 to May 2016 were retrospectively analyzed.Results All 128 surgeries succeeded and no patients got secondary injury or complication.Conclusion Purse-string suture in securing the base of appendix in laparoscopic appendectomy is safe,reliable,and economical,and thus deserves wide application in clinic. References | Related Articles | Metrics

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Evaluation of efficacy and safety of preperitoneal space tension-free hernioplasty in treatment of inguinal hernia CAI Desheng, WU Ji 2017, 6 (2):  96-98.  doi: 10.3969/j.issn.2095-378X.2017.02.008 Abstract ( 172 )   PDF (366KB) ( 496 )   Save Objective To evaluate the efficacy and safety of preperitoneal space tension-free hernioplasty in the treatment of inguinal hernia.Methods Totally 166 patients with inguinal hernia in The Second People’s Hospital of Wuxi City Huishan District from September 2013 to March 2017 were randomly divided into control group (mesh plug inguinal repair,n=83) and observation group (preperitoneal space tension-free hernioplasty,n=83).Postoperative complications and curative effect of each group were observed.Results The postoperative complication rate in the observation group were lower than that of the control group; and the total therapeutic efficiency rate of the observation group (95.18%,79/83) was higher than that of control group (85.54%,71/83,P<0.05).Conclusion Preperitoneal space tension-free hernioplasty is more effective in the treatment of inguinal hernia than mesh plug inguinal repair,thus it is worthy to be widely used in clinic. References | Related Articles | Metrics

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Clinical efficacy of aescuven forte in combination with hemorrhoids lotion on petients with edema and pain after mixed hemorrhoid surgery HUANG Chenrong, SHI Jianming 2017, 6 (2):  99-101.  doi: 10.3969/j.issn.2095-378X.2017.02.009 Abstract ( 442 )   PDF (383KB) ( 512 )   Save Objective To assess the efficacy of aescuven forte in combination with hemorrhoids lotion on patients with edema and pain after mixed hemorrhoids surgery.Methods A total of 120 cases after mixed hemorrhoid surgery were randomly divided into treatment group,who received oral aescuven forte and hemorrhoids lotion,and control group,who received hemorrhoids lotion only.Curative effects were compared between the two groups.Results The treatment group showed a higher cure rate of edema and greater changes in edema and pain scores than the control group (P<0.05).Conclusion Aescuven forte in combination with hemorrhoids lotion is effective for the treatment of edema and pain after mixed hemorrhoid surgery and has no adverse effects; therefore,it is worth to clinical application. References | Related Articles | Metrics

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Analysis on clinical effect of hardener injection combined with automatic ligation of hemorrhoids in the treatment of hemorrhoids ZHU Zhanqiu 2017, 6 (2):  102-104.  doi: 10.3969/j.issn.2095-378X.2017.02.010 Abstract ( 187 )   PDF (402KB) ( 321 )   Save Objective To improve the life quality of patients with hemorrhoids through assessing the effectiveness of hardener injection combined with automatic ligation of hemorrhoids in the treatment of hemorrhoids.Methods A total of 126 patients with hemorrhoids admitted to People’s Hospital of Luhe County in Shanwei City of Guangdong Province from March 2015 to January 2017 were enrolled as study subjects and randomly divided into a general group (even number) and an observation group (odd number) according to the last digit of visit number,with 63 cases in each group.The general group was treated with automatic ligation of hemorrhoids,and the observation group received hardener injection additionally.Postoperative recovery and postoperative complications were compared between patients with different operations.Results Less hematochezia,pain,and hospitalization time were observed in the observation group than in the general group (P<0.05),and there was no significant difference regarding the improvement of haemorrhoids reduction between the two groups (P>0.05).The rates of postoperative dysuresia and secondary bleeding were 3.2% and 0% in the observation group,which were significantly lower than 11.1% and 4.8% of the general group,and postoperative complications were fewer in the observation group (P<0.05).Conclusion Clinical treatment for patients with hemorrhoids using hardener injection combined with automatic ligation of hemorrhoids could result in low postoperative bleeding rate,fast recovery,and good treatment effect. References | Related Articles | Metrics

Review

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New progress on assisted technologies for minimally invasive treatment of tibial plateau fracture YIN Peipei, YU Xiaowei 2017, 6 (2):  105-109.  doi: 10.3969/j.issn.2095-378X.2017.02.011 Abstract ( 161 )   PDF (640KB) ( 519 )   Save The treatment of tibial plateau fracture is divided into conservative treatment and surgical treatment.Except for the patients with severe cardiovascular and cerebrovascular diseases and the patients without obvious displacement and involvement of articular surface,generally open reduction and internal fixation (ORIF) should be the first choice for tibial plateau fracture instead of conservative treatment.However,the weakness of traditional ORIF such as surgical trauma and high rate of infection has turned clinicians’ attention to minimally invasive treatment.With the development of three-dimensional printing,arthroscopy,and other technologies,we have a better way for the treatment of tibial plateau fracture-minimally invasive internal fixation which is always a clinical research hotspot.And these auxiliary technologies for minimally invasive treatment of tibial plateau fracture to achieve adequate exposure are more and more approbated by surgeons because of good clinical results.This article reviewed new progress on assisted technologies for minimally invasive treatment of tibial plateau fracture. References | Related Articles | Metrics

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Research status of pedicle screw insertion guiding devices YANG Zhenyuan, SHI Wenyu, DENG Qiang 2017, 6 (2):  110-112.  doi: 10.3969/j.issn.2095-378X.2017.02.012 Abstract ( 289 )   PDF (464KB) ( 639 )   Save With the wide application of pedicle screw technique in spinal surgery,a higher requirement is put forward for precise placement of pedicle screws.To this end,constant research have been conducted by spine surgeons,and with the aid of a variety of modern technologies many auxiliary guiding devices are created,including simple pedicle screw guide,navigation system,and 3D navigation template.In this paper,the researches on application of pedicle screw navigation devices were reviewed,and the developmental trends were prospected. References | Related Articles | Metrics

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Effect and treatment of blood-material-interface interaction during extracorporeal membrane oxygenation WANG Yuliang, WANG Qi, ZHANG Yangyang 2017, 6 (2):  113-117.  doi: 10.3969/j.issn.2095-378X.2017.02.013 Abstract ( 186 )   PDF (586KB) ( 451 )   Save Extracorporeal membrane oxygenation (ECMO) is a sustainable technique with gas exchange and circulation support.It is extensively used in patients who are so severe that need cardiopulmonary support.Blood-material-interface interaction (BMII) during ECMO initiates adsorption between plasma proteins and material surface,activates blood coagulation pathway,and leads to coagulopathy and complications such as bleeding and thrombosis.Systematic application of anticoagulant drugs,anti-fouling coating on material surface,and anti-clotting drug release coating can partially relieve and solve the problem of BMII.Raising new concepts and developing new techniques will help reduce BMII and improve the therapentic effects of ECMO. References | Related Articles | Metrics

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Progress on application of optical coherence tomography to interventional treatment of chronic total occlusion of coronary heart disease CAI Bin, XU Jiahong 2017, 6 (2):  118-120.  doi: 10.3969/j.issn.2095-378X.2017.02.014 Abstract ( 158 )   PDF (356KB) ( 326 )   Save Chronic total occlusion is the most severe type of coronary heart disease,featuring many difficulties in performing interventional techniques and postoperative complications.Optical coherence tomography is characterized by high resolution ratio and good correlation.The application of optical coherence tomography in clinical settings can evaluate chronic total occlusion of blood vessels before interventional therapy,guide guidewires getting through lesions during operation,and evaluate complications such as bad limbic dissection and incomplete stent apposition after operation,providing more clinical information for stent apposition.Now a brief introduction was presented on the application of optical coherence tomography to interventional treatment of chronic total occlusion of coronary heart disease (CHD). References | Related Articles | Metrics

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Advances on diagnosis and treatment of triangular fibrocartilage complex injury ZHANG Xin, FAN Jian 2017, 6 (2):  121-124.  doi: 10.3969/j.issn.2095-378X.2017.02.015 Abstract ( 599 )   PDF (547KB) ( 661 )   Save Triangular fibrocartilage complex (TFCC) is located on the ulnar side of wrist,and is composed of triangular fibrocartilage and its surrounding ligaments.It is an important structure to stabilize distal radioulnar joint.Traumatic or degenerative injury of TFCC is one important cause of wrist pain.In the treatment of clinical wrist joint injury and pain,the factors of TFCC lesions are easily neglected by clinicians,and there are no systematic and standard diagnosis and treatment,which may have adverse effects on the treatment of wrist joint injury and pain.Researches on the diagnosis and treatment of TFCC injury in recent years in this paper were reviewed. References | Related Articles | Metrics

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Research progress on botulinum toxin for the treatment of cervical dystonia LI Bing, JIN Lingjing 2017, 6 (2):  125-127.  doi: 10.3969/j.issn.2095-378X.2017.02.016 Abstract ( 184 )   PDF (389KB) ( 310 )   Save Cervical dystonia is the most common type of focal dystonia,and botulinum toxin is accepted as the preferred treatment for cervical dystonia.The changes of phenomenological classification and guidance approach for the treatment of cervical dystonia were reviewed in this article. References | Related Articles | Metrics

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Research progress on effects of sevoflurane and propofol anesthesia on postoperative pain and related analgesic mechanisms LI Dong, ZHANG Xiaoqing 2017, 6 (2):  128-132.  doi: 10.3969/j.issn.2095-378X.2017.02.017 Abstract ( 179 )   PDF (580KB) ( 481 )   Save Postoperative pain is an acute pain occurring after operation,usually as a nociceptive pain and lasting no more than seven days,and is a common clinical syptom that needs urgent treatment.It not only hurts patients,but also causes pathological and physiological changes in various systems of the body and leads to a series of complications,thus affecting prognosis.In order to find a superior maintenance of anesthesia,a lot of researchers have compared between propofol (a main intravenous sedative-hypnotic agent) and sevoflurane (a main inhaled anesthetics).After nearly a decade of research,disagreements still exist over the effect of sevoflurane inhalation for maintenance of anesthesia versus propofol intravenous anesthesia on postoperative pain. In this article,Published literatures were reviewed in this field,in an attempt to reveal possible underlying reasons. References | Related Articles | Metrics

Education

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Thoughts and opinions on animal surgery teaching ZOU Qun, LU Xingsui, FAN Yuezu 2017, 6 (2):  133-136.  doi: 10.3969/j.issn.2095-378X.2017.02.018 Abstract ( 175 )   PDF (653KB) ( 389 )   Save Objective To improve students’ operation skills through animal surgery teaching,and to achieve integration of theory and practice.Methods Based on the status of animal surgery teaching,the article analyzed teaching contents,teaching methods,teaching characteristics,teachers’ responsibilities,students’ characteristics,and medical ethics,and summarized merits and defects of the course,aiming to promote the development of teaching principles and methods.Results Teachers and students should play their subjective initiative roles in the course of animal surgery.The ultimate goal is to develop students’ interests in the course and team spirit,strengthen medical ethics and humanities,and encourage outstanding clinical medical talents.Conclusion Animal surgery is an important discipline that connects basic medicine and clinical medicine.It is also crucial to the integration of surgical theory and practice. References | Related Articles | Metrics

Medical instrument

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Thinking in systems on developing characterized digital integrated operating rooms WANG Yunlong 2017, 6 (2):  137-140.  doi: 10.3969/j.issn.2095-378X.2017.02.019 Abstract ( 199 )   PDF (583KB) ( 455 )   Save The focus of operating room (OR) development has always been to improve OR workflow and efficiency.In this paper,we analyzed our OR equipment based on “Development and Industrialization of Digital Integrated Operating Rooms” project which was funded by Shanghai Science and Technology Commission’s Key Technology R&D Programme.We also proposed to have a centralized control across operation devices from different manufactures by redesigning the digital ports and central control systems in ORs,and finally formulate a characterized design plan of digital integrated OR,aiming for a better support to clinical surgeries. References | Related Articles | Metrics

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Design and implementation of surgical specialist mapping system LIU Chang, WU Xiaofen 2017, 6 (2):  141-144.  doi: 10.3969/j.issn.2095-378X.2017.02.020 Abstract ( 146 )   PDF (6970KB) ( 207 )   Save To elevate the service quality of hospitals,improve the patients’ medical environment,and reduce the contradiction between doctors and patients,we design and develop the outpatient information of surgical specialist mapping system,by using the tools like cloud computing technology,C/S architecture,Oracle database,C# object-oriented language.The screen display system can provide a clear guidance of treatment direction to surgical patients and optimizes the service process of surgical outpatient,so that it improves the overall efficiency and service quality of hospital,to elevate surgical patients’ satisfaction and offers a more convenient treatment process for patients. References | Related Articles | Metrics

Nursing

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New progress on surgical treatment and nursing of stroke patients complicated with urinary incontinence PENG Lei, CHEN Xuemei, XU Fanglei 2017, 6 (2):  145-148.  doi: 10.3969/j.issn.2095-378X.2017.02.021 Abstract ( 185 )   PDF (667KB) ( 491 )   Save This review summarized surgery types for stroke patients complicated with urinary incontinence,analyzed the advances on the treatment of urinary incontinence and related surgeries,and advised some tips on patients’ rapid recovery using preoperative,intraoperative,postoperative,and continuing nursing.To improve the treatment effect on postoperative recovery nursing approaches,such as observing patient’s vital signs,predictive care,wounds and pain management,individualized nutrition care,and individualized rehabilitation exercise are applied.Medical staffs are suggested to study on the joint approaches of several nursing intervention measures to formulate a simple and practicable set. References | Related Articles | Metrics