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Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article discusses a 62-year-old woman who has a long term diagnoses of Rheumatoid Arthritis, and had frequent hospitalization for recurrent pneumonia. In the current hospitalization, she suffered from severe pneumonia complicated with respiratory failure, and received endotracheal intubation with mechanical ventilator use. After treatment, she was extubated and high-flow nasal cannula was applied afterwards for avoiding re-intubation. Data was collected from October 19th to November 3rd, 2020, through direct care, observations, physical assessments, conversation and chart reviews, and comprehensive assessments of the physical, psychological, social and spiritual aspects were implemented. Three health problems were identified: ineffective respiratory patterns, impaired skin integrity and anxiety. During the intensive care period, the writer established a healthy nurse-patient relationship, leading the patient to perform lung rehabilitation for improving respiratory pattern. Also, observing and listening to the patient with positive feedback minimized her anxiety. Meanwhile, using cross-team cooperation to draw up caring strategies. Owing to individualized nursing intervention, the patient successfully weaned from the mechanical ventilator. The writer hopes this nursing experience could assist nurses in taking care of these types of patients in the future. [ABSTRACT FROM AUTHOR]

This article describes the caring experience of a male patient with oral cancer who was admitted to the intensive care unit due to massive bleeding after endotracheal tube placement. The care period was from May 7th to May 10th, 2022. Data was collected through communication via writing, observation, physical assessment, and medical record review. The patient's health problems were identified as ineffective airway clearance, anxiety, and sleep disturbance by using Kolcaba's Theory of Comfort as an evaluation framework. Chest physiotherapy, pulmonary rehabilitation exercises, and teaching of deep breathing and coughing were provided to improve respiratory clearance function. In addition, music therapy and adjustment of the sleep environment were provided to improve the patient's overall comfort. Finally, the patient's extubation was successful and they were transfer out of the ICU. We suggested that the Theory of Comfort can be used more extensively as an assessment tool in the future to evaluate the physiological, psychological, social-cultural, and environmental factors that affect patients and promote a balance and comfort in their physical and mental health. [ABSTRACT FROM AUTHOR]

In patients with intubation, the endotracheal tube oppresses the throat for a long time, causing laryngeal ulcers or paralysis of the recurrent laryngeal nerve, resulting in reduced swallowing efficiency. After extubation, evaluation of swallowing and oral rehabilitation exercises should be performed as soon as possible to strengthen swallowing muscle strength and reflex, so as to achieve safe eating. Based on the analysis of the current practices, it was established that the completeness of swallowing care performed by nursing staff in extubated patients is 34.3%. Contributing reasons include: the nursing staff's swallowing care cognition is 55%; the in-hospital evaluation form is not applicable; the swallowing care process is incomplete; there is no swallowing care guide and unified assessment tool for patients after extubation. In order to improve current practice, the following steps were taken: revising the swallowing training evaluation form and swallowing care flow chart; the production of swallowing assessment kits and oral rehabilitation exercise videos covering the five steps of swallowing care; and holding educational courses on swallowing care. After the implementation of the project, the completeness of swallowing care performed by nursing staff increased from 34.3% to 92.3%. The cognitive accuracy increased from 55% to 95.3%, thus reaching the project goal to maintain patient safety and improve nursing quality. [ABSTRACT FROM AUTHOR]

Objective：To observe the effect of personalized respiratory breathing training on pulmonary function in patients with tracheotomy after stroke. Method：Fifty-two post-stroke tracheotomy patients who met the inclusion criteria were divided into a control group （n=26) and an intervention group （n=26). During the observation period, one patient in the control group and one in the intervention group each was lost to follow-up. The control group was given the postural drainage combined with vibration expectoration on the basis of routine rehabilitation, while the intervention group was given individualized breathing training on the basis of the control group. The observation period was 6 weeks, and the pulmonary function, diaphragmatic muscle mobility, diaphragmatic muscle thickening rate, extubation time and extubation success rate were compared between the two groups. Result：Before training, there were no significant differences in pulmonary function indexes （FVC, FEV1 and PEF), diaphragmatic activity（DEq, DEd), and diaphragm thickening rate（DTF)between the two groups（P> 0.05). After 6 weeks of training, the FVC, FEV1, PEF, DEq, DEd and DTF of the two groups were significantly improved compared with those before training （P<0.05)；and the intervention group was more significantly improved than the control group （P<0.05)；The extubation time in the intervention group was significantly shorter than that in the control group （P<0.05)；and the success rate of extubation in the intervention group was 92%, which was significantly higher than that in the control group （68.0%), and the difference was statistically significant（P<0.05). Conclusion: Personalized respiratory training can more effectively improve the pulmonary function of tracheotomy patients after stroke, shorten the removal time of tracheal cannula, and improve the success rate of extubation. [ABSTRACT FROM AUTHOR]

Objective To analyze the causes and risk factors of extubation in peritoneal dialysis (PD) patients, and to find the countermeasures to improve the technical survival rate and reduce the exit rate. Methods A retrospective analysis was performed on 682 patients with PD admitted to this center from January 1, 2007 to December 31, 2020, excluding patients with dialysis age less than three months, incomplete data, death, kidney transplantation. and cure. General data of the patients were collected, including demographic data (gender, age, etc.), clinical data (primary disease, combined disease, urine volume, etc.) and laboratory data (blood creatinine, blood urea, etc.). The patients who withdrew from PD were set into the extubation group (224 cases), and their withdrawal time and reasons were recorded. The remaining patients were set into the dialysis group(458 cases), and the causes and risk factors of extubation were analyzed. Results Pd-related peritonitis. patients requiring hemodialysis, thoracoabdominal fistula were important reasons for extubation. Hypoalbuminemia, low education and male were the risk factors for extubation in PD patients. Conclusion Prevention and management of peritonitis, improvement of nutritional and inflammatory status of patients, more social support, strengthening family management, publicity and education, follow-up, and retraining after dialysis can reduce the extubation rate of PD patients and improve the technical survival rate and prognosis of PD patients. [ABSTRACT FROM AUTHOR]

This paper summarized the nursing management of successful extubation in a critically ill patient receiving mechanical ventilation for intractable laryngeal edema. An emergency plan and procedure for extubation after mechanical ventilation for intractable laryngeal edema was made and strictly implemented. Comprehensive nursing interventions such as illness condition observation, airway management, medication care, nutrition support, basic care and health education were carried out to ensure the successful extubation and postoperative rehabilitation. (本文总结1例顽固性喉头水肿且持续人工辅助通气的重症患者成功脱机拔管的护理经验。通过制定顽固性喉头水肿脱机拔管的应急预案及流程, 积极准确落实各项护理措施, 密切观察病情变化, 做好人工气道机械通气管理、用药护理、营养支持、基础护理以及健康教育等, 经过个性化治疗和护理干预, 确保患者成功脱机拔管, 痊愈出院。)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objective With the extensive application of segmental lung resection in the treatment of early-stage lung cancer, how to complete segmentectomy more accurately and minimally invasively has become a research hotspot. The aim of this study is to explore the application of three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with perfusion area recognition technique in single-hole thoracoscopic complex segmentectomy. Methods From January 202 to January 2022, the clinical data of 2 consecutive patients undergoing single-port thoracoscopic complex segmentectomy in the Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The three-dimensional reconstruction combined with perfusion area identification technique was used to perform the operation and the clinical data were analyzed. Results The average operation time was (141.1±35.4) min; the initial time of intersegmental plane display was (12.5±1.7) s; the maintenance time of intersegmental plane was (114.3±10.9) s; the intersegmental plane was clearly displayed (100%); the amount of bleeding was [10 (10, 20)] mL; the total postoperative drainage volume was (380.5±139.7) mL; the postoperative extubation time was (3.9±1.2) d; and the postoperative hospitalization time was (5.2±1.6) d. Postoperative complications occurred in 8 cases. Conclusion The advantages of 3D-CTBA combined with perfusion area recognition technique are fast, accurate and safe in identifying intersegmental boundary in single-port thoracoscopic complex segmentectomy, which could provide guidances for accuratding resection of tumors, shortening operation time and reducing surgical complications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate risk predictors and preventive measures of initial extubation failure after transurethral plasma kinetic resection of the prostate (TUPKP). Methods Clinical data of 302 patients with benign prostatic hyperplasia (BPH) who underwent TUPKP in our hospital from January 2018 to May 2021 were retrospectively analyzed. The computer-generated random number method was used to divide the patients into the training set (226 cases) and test set (76 cases) in a ratio of 3:1. The patients in the test set were classified into successful extubation group and failed extubation group according to the micturition after the initial extubation, LASSO regression model and 10× cross validation method were used to obtain the best subset of risk predictors of postoperative extubation failure. Multivariate logistic regression model was used to determine the risk predictors of extubation failure. The nomogram prediction model was constructed by R software and verified in the validation set. Results Among 302 patients with BPH, 38（12.58%）failed to extubate. LASSO regression model and multivariate Logistic regression analysis showed that acute urinary retention history, urinary tract infection, preoperative medication, IPSS score, prostate volume, IPP, postoperative catheter pull time and postoperative complications were independent risk factors for postoperative extubation failure in BPH patients (P＜0.05). The Nomogram model which was verified by receiver operating characteristic curve (ROC), GiViTI calibration curve band and decision curve analysis, showed good prediction efficiency. Conclusion Acute urinary retention history, urinary tract infection, preoperative medication, IPSS score, prostate volume, IPP, postoperative catheter pull time and postoperative complications were risk predictors affecting postoperative extubation failure in BPH patients. For the patients with large prostate volume, preoperative urinary tract infection and history of acute urinary retention, intervention measures should be actively taken to treat urinary tract infection, and hemostasis should be done during operation to reduce the traction time of postoperative urinary catheter, so as to improve the success rate of postoperative extubation and avoid repeated retention of urinary catheter. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effect of dexmedetomidine combined with different doses of midazolam on hemodynamics, postoperative inflammatory mediators and cognitive function in patients with non-small cell lung cancer (NSCLC). Methods: NSCLC patients (n=120) who came to the First Affiliated Hospital of Zhengzhou University for surgical treatment from January 2019 to February 2021 were included and divided into low-dose group (n=60) and high-dose group according to different anesthesia regimens Group (n=60), both groups were given dexmedetomidine, on this basis, the low-dose group was given 0.05 mg/kg midazolam, and the high-dose group was given 0.10 mg/kg midazolam. The hemodynamics, inflammatory mediators, cognitive function, recovery quality and incidence of adverse reactions were compared between the two groups. Results: The heart rate (HR) and mean arterial pressure (MAP) increased and then decreased at the time points from 10 minutes after induction of anesthesia (T1) to 5 minutes after extubation (T3) in the two groups, and immediately after extubation (T2) and T3 time points The high-dose group was lower than the low-dose group (P<0.05). The visual analogue scale (VAS) score of pain after awakening in the high-dose group was lower than that in the low-dose group, and the eye opening time, extubation time, and anesthesia recovery room (PACU) stay time were all shorter than those in the low-dose group (P<0.05). The levels of interleukin-1 (IL-1), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) in the two groups increased before operation, 3 days after operation, and 7 days after operation, and then decreased, and 3 days after operation., 7 days after operation in the high-dose group was lower than that in the low-dose group (P<0.05). There was no significant difference in the Mini Mental State Scale (MMSE) scores between the two groups at 1 day, 3 days and 7 days after operation (P>0.05). There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with 0.05 mg/kg midazolam, dexmedetomidine combined with 0.10 mg/kg midazolam in patients with NSCLC surgery can maintain hemodynamic stability, improve the quality of recovery, and reduce inflammatory stress. The effect is more significant, and it does not increase the incidence of cognitive impairment and adverse reactions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patients with chewing disorders and dysphagia often take nutrition via nasogastric tube feeding. Patients with indwelling nasogastric tubes often experience discomfort, resulting in increased incidences of self-extubation and slippage. Frequent changes or misplacement of the nasogastric tube may also cause patient safety issues such as aspiration pneumonia, gastrointestinal trauma, and pneumothorax. Collaboration within the interdisciplinary team is needed to provide proper nasogastric tube care prior to placement, during the indwelling process, and during the removal of the nasogastric tube. Interdisciplinary teams should develop standardized procedures for nasogastric tube care, initiate swallow screening, oral care and training early, and develop a care plan for nasogastric tube removal. An evidence-based, practical example of nasogastric tube care implemented by an interdisciplinary team in a neurology unit is presented in this article. Interdisciplinary teams may assist patients to prepare to return to a normal tube-free life using individualized, safe, and dignified nasogastric tube care to improve quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the clinical efficacy of a simple negative pressure suction drainage device based on a disposable infusion set and a plastic bottle of normal saline in drainage after auricular reconstruction with expanded method. Methods From March 2020 to September 2021, 23 patients received auricular reconstruction with expanded method. A simple negative pressure suction drainage device based on a disposable infusion set and a plastic bottle of normal saline with air drawn was applied for drainage. The efficacy of negative pressure drainage was observed. The postoperative drainage volume, time to extubation, wound healing, infection and flap survival were observed and recorded. Results This simple negative pressure suction drainage device was always unobstructed for all patients. The flap closely fitted the framework. The substructure of auricle was clear. The average drainage volume of the wound was 11 ml daily, and the time to extubation was from 4 to 7 days, with an average of 5 days. All incisions healed by first intension. No necrosis, infection and hematoma of incisions occurred. The blood supply of flap was good. No flap necrosis or framework exposure occurred. Conclusion This device can maintain appropriate negative pressure, which not only ensures the close fit of flap and framework but also does not affect the blood supply of flap. The efficacy of drainage is good and the substructure of reconstructed auricle is clear. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Compare the efficacy and prognosis of PAHG removal during the same period and second stage breast reconstruction to provide some experience for clinical treatment. Methods: Taking the PAHG patients undergoing breast reconstruction in our hospital from April 2017 to April 2019 as the research object, they were divided into group I and group II using random methods combined with the needs of patients. Group I received breast reconstruction during the same period after taking PAHG, and Group II received second-stage breast reconstruction after taking PAHG. The operation indexes (operation time, bleeding volume, extubation time and hospitalization time), complications (pain, infection, swelling and poor morphology, etc.), postoperative quality of life and self-esteem score were used as indicators to evaluate the efficacy and prognosis of the two groups. Results: There was no significant difference in the first stage operation time, bleeding volume, extubation time and hospital stay between group I and group II(P>0.05). The indexes in the second phase of Group II were significantly lower than those in the first phase (P<0.05). There was no significant difference in the incidence of various complications between the two groups of patients (P>0.05). However, the incidence of pain and poor morphology in group I was slightly higher than that in group II, and the incidence of capsular contracture in group II was slightly higher than that in group I. The total incidence of complications between the two groups was not statistically different (P>0.05); The quality of life and self-esteem scores of group I at 1 month after operation were significantly higher than those of group II (P<0.05). There were no significant differences in the quality of life and self-esteem scores at 6 and 12 months after operation between the two groups (P>0.05). Compared with 1 month after operation, the quality of life and self-esteem scores of the two groups of patients at 6 and 12 months after operation were significantly improved (P<0.05). Conclusion: The results and prognosis of breast reconstruction after PAHG removal are good, and they can be selected according to the patient's condition and their own wishes, which is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this article is to explore the value of echocardiography (TTE), phrenic activity (DE) ultrasound and serum N-terminal brain natriuretic peptide precursor (NT-proBNP) in predicting the outcome of patients with invasive mechanical ventilation after extubation. In this study, 85 patients undergoing invasive mechanical ventilation due to respiratory failure were selected as the research group. TTE ultrasound examination, DE ultrasound examination and SBT test were performed respectively to observe the outcome of patients after extubation. The results showed that among the 85 patients, 30.59% were unsuccessful and 69. 41% were successful. After the SBT test, the E, E/e' and NT-proBNP values of the failed extubation group were higher than those of the successful extubation group (P<0.05), while DE value was lower than that of the successful extubation group (P<0.05). Binary logistic regression analysis showed that E/e', DE and Nt-proBNP were all influencing factors (P<0.05). In addition, the ROC curve showed that the the combined AUC of E/e', DE, NT-proBNP predicting the failure was 0.989, which was higher than any single test. It suggested that the predictive value of cardiac and DE ultrasound combined with serum NT-proBNP for successful extubation of patients with invasive mechanical ventilation was relatively high. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of extubation under deep anesthesia on agitation in children with cerebral palsy after selective posterior rhizotomy. Methods: From August 2017 to February 2019, 89 cases of children with cerebral palsy who were diagnosed and treated in our hospital were selected and were divided into observation group of 49 cases and control group of 40 cases accorded to different anesthesia methods. All children were treated with selective posterior rhizotomy and general anesthesia. The observation group were continuously pumped with propofol intravenously during deep anesthesia during anesthesia maintenance, and the control group were extubated under deep anesthesia with sevoflurane. Results: There were no significant difference in anesthesia time, eye opening time and extubation time compared between the two groups (P>0.05). The incidence of postoperative restlessness in the observation group were 2.0 %, which were significantly lower than 15.0 % in the control group (P<0.05). The postoperative 1 month of adaptation and speech behavior scores in the two groups were significantly higher than in the preoperative 1 d (P<0.05), and the observation group were significantly higher than the control group (P<0.05). The postoperative 1 month of Vs and Vd of the middle cerebral arteries in the two groups were significantly higher in the two groups than preoperative 1 d (P<0.05), and the observation group were significantly higher than the control group (P<0.05). Conclusion: The application of extubation under selective posterior rhizotomy in children with cerebral palsy undergoing selective spinal nerve root resection can reduce the occurrence of postoperative restlessness without affecting the effect of anesthesia, thereby improve the treatment effect and improving cerebral hemodynamics. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of lidocaine on sedation and analgesia, hemodynamics and cough response in patients with general anesthesia during the recovery period. Methods: From March 2018 to August 2019, 63 patients who had completed urology and abdominal surgery under endotracheal general anesthesia in our hospital and were expected to have tracheal catheters removed quickly after surgery were selected The above patients were divided into group A (n = 31) and group B (n = 32) according to the random number table. Group A patients were given lidocaine intravenously, and group B patients were given lidocaine intratracheal. The recovery time, extubation time, sedation and analgesia effect, hemodynamics and cough response of the two groups were compared. Results: There were no significant difference in recovery time and extubation time between the two groups (P>0.05). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) increased first and then decreased in the two groups during intubation, extubation and 10 minutes after extubation, and HR, SBP and DBP in group B at during intubation, extubation and 10 minutes after extubation were lower than those in group A (P<0.05). There was no significant difference in Sedation agitation score (SAS) between the two groups at the time of extubation and 10 minutes after extubation (P>0.05). Visual analogue scale (VAS) score of pain 10 min after extubation was higher than that of extubation in the two groups, but that in group B was lower than that in group A (P<0.05). The incidence of cough reaction during intubation and extubation in group B during intubation, extubation were lower than those in group A (P<0.05). Conclusion: Compared with intravenous administration, the administration of lidocaine in the wake period of general anesthesia has a definite sedative and analgesic effect, which can reduce the fluctuation of blood flow and reduce the incidence of choking reaction during intubation and extubation. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objective Lung cancer is currently the leading malignant tumor in both domestic and foreign morbidity and mortality. Surgical treatment is the main treatment option for lung cancer. The aim of this study is to explore the effects of enhanced recovery after surgery (ERAS) combined with respiratory function exercise combined with single-hole thoracoscopic surgery on lung cancer patients with postoperative pulmonary complications, postoperative pain, time to get out of bed, time to extubation and length of hospital stay. Methods A total of 240 patients who underwent endoscopic lung cancer surgery at the Affiliated Hospital of Yangzhou University and the Yancheng First People's Hospital from October 2017 to October 2019 were randomly divided into 4 groups, with 60 patients in each group. Patients in group A underwent single-hole thoracoscopic surgery, and preoperatively performed ERAS concept education and respiratory function training; group B used conventional 3-hole thoracoscopic surgery, and performed ERAS concept education and respiratory function training before operation; group C used conventional 3-hole thoracoscopic operation surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept education; group D used single-hole thoracoscopic surgery, routine hospitalization education and nursing guidance, routine respiratory function training, no preoperative ERAS concept mission. The number of postoperative pulmonary complications, postoperative pain, time to get out of bed, extubation time, and hospital stay were recorded in the four groups. Results Compared with the groups B, C, and D, the incidence of pulmonary complications was significantly reduced, and the time to get out of bed, extubation time, and hospital stay were significantly shortened in group A. Compared with groups B, C, the postoperative pain was significantly reduced in group A. Compared with group C, the pulmonary complications were significantly reduced, and the time to get out of bed, extubation time and hospital stay were significantly shortened in group B. The differences were statistically significant (P<0.05). There was no significant difference in postoperative pain between group A and group D, group B and group C (P>0.05). Conclusion For patients with single-hole thoracoscopic lung cancer surgery, the ERAS concept guidance can effectively reduce the incidence of pulmonary complications and postoperative pain, shorten the time to get out of bed, the time to extubate, and the length of hospital stay. [ABSTRACT FROM AUTHOR]

Background and objective Minimally invasive and rapid recovery are trends in surgical treatment of lung cancer, and Da Vinci Surgical Robotic System plays an important role in them. This study was planned to explore the effect of chest wall external nursing interventions on reducing postoperative thoracic drainage and promoting rapid recovery of patients. Methods The patients who underwent robotic radical lung cancer resection in our hospital from November 2017 to April 2018were randomly divided into two groups. The control group received robotic radical lung cancer resection with abdominal bands wrapped around the chest. The experimental group underwent Da Vinci robotic radical lung cancer surgery and assisted chest wall external nursing interventions after surgery. Results The total and average daily drainage of the experimental group were less than those of the control group. Both the extubation time and the hospitalization time were shorter than those of the control group, but there was no significant difference. The pain score in the second days after operation of the experimental group was slightly higher than that of the control group, with no significant statistical difference. For patients whose chest wall thickness is less than 4 cm, mirabilite external application can significantly reduce the average daily and total drainage volume, but there is no significant difference in extubation time and hospitalization time. Conclusion Chest wall external nursing interventions are beneficial to the recovery of patients undergoing Vinci robotic lung cancer surgery. Especially for patients with thinner chest wall. It can reduce postoperative drainage, shorten tube retention time and accelerate discharge. Further improvement is expected to achieve better clinical results. [ABSTRACT FROM AUTHOR]

Obective: To compare effectiveness and safety of general anesthesia endotracheal intubation between visual soft laryngoscope and light stick for patients with cervical spine injury. Methods: From January 2017 to February 2019, 60 patients with high cervical spine fracture who need general anesthesia through tracheal intubation were selected, which were randomly divided into visual soft laryngoscope group (U group) and light stick group (G group) with 30 patients in each group. Before operation, all patients were fixed with neck bracket. U group was intubated with UE visual soft laryngoscope, G group was intubated with light stick. After the intubation was confirmed to be successful, mechanical ventilation was performed with ventilator. The time of tracheal intubation, the success rate of single intubation, oropharyngeal complications after extubation, the changes of cortical somatosensory evoked potential (CSEP) and Myogenic Motor Evoked Potentials (MMEP) before and after intubation were compared between the two groups. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia, after anesthesia induction, immediately after tracheal intubation, 1 min after tracheal intubation and 3 min after tracheal intubation. Results: The intubation time of U group was longer than that of G group (P<0.05), the success rates of single intubation in U group and G group were 95% and 100% respectively. The MAP of G group was significantly higher than that of U group immediately after intubation (P<0.05), the HR of G group immediately after intubation, 1 min and 3 min after intubation was significantly higher than that of U group (P<0.05). The oropharyngeal complications of U group were less than that of G group. There were no positive changes in SSEP and MMEP after intubation compared with those before intubation in the two groups. Conclusion: The intubation time of visual soft laryngoscope is longer than that of light stick, and the success rate of intubation is higher in both cases. However, the circulation fluctuation during intubation of visual soft laryngoscope is less, and the postoperative oropharyngeal complications are less, which is worthy of clinical application [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effect of dexmedetomidine on cognitive function, hemodynamics and analgesia in patients after hip joint operation. Methods: 80 patients with hip joint operation in our hospital in recent 3 years were randomly divided into study group and control group according to different anesthesia methods, 40 patients in each group. Patients in the study group were microinjected with dexmedetomidine, while patients in the control group were injected with normal saline. The cognitive function, hemodynamics and analgesic effect of different anesthesia methods were compared. Results: Before anesthesia induction and 3 d after operation, there was no significant difference in MMSE score between the two groups (P>0.05). At 1 d, 2 d after surgery, the MMSE score in the study group was significantly higher than that in the control group (P<0.05). POCD incidence in the study group was significantly lower than that in the control group (P<0.05). There was no difference in hemodynamic indexes (HR, SBP, DBP) between the two groups before anesthesia induction (P>0.05). The HR, SBP and DBP in the study group were significantly lower than those in the control group at intubation, extubation and 15 min after extubation (P<0.05). The VAS pain scores in the study group were significantly lower than those in the control group at 1 h, 2 h, 6 h, 12 h and 24 h after operation(P<0.05). Conclusion: Dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction, maintain the hemodynamic stability of patients, and has good analgesic effect, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of general anesthesia combined with epidural anesthesia and general anesthesia on the elderly patients with abdominal tumors. Methods: Ninety-six elderly patients with abdominal tumors who underwent surgery from October 2015 to October 1818 were randomly divided into two groups, 48 patients in each group.Among them, patients in the control group were given general anesthesia, and patients in the study group were combined with epidural anesthesia. The anesthesia index, peri-operative index, stress hormone index, lung function index and serum NSE and S100β concentration at different time points were compared between the two groups. Results: The doses of remifentanil, propofol, wake-up time and extubation time in the study group were significantly less than (shorter than) control group (P<0.05). In the control group, the levels of postoperative adrenaline, norepinephrine and cortisol were significantly higher than those before surgery (P<0.05). With the treatment time, the serum NSE and S100β concentrations in the two groups were gradually increased at 1h after surgery, 2 h after surgery, and at the end of surgery, but the patients in the study group were lower than the control group(P<0.05). The levels of (MVV-VE)/FEVl and MVV/FEVl in the control group were significantly lower than those before surgery(P<0.05). The RV/TLC level was significantly higher than that before surgery(P<0 .05). However, there were no significant differences between the study group (MVV-VE)/FEVl, MVV/FEVl, RV/TLC and preoperative (P>0.0 5); Conclusion: Compared with general anesthesia, general anesthesia combined with epidural anesthesia can more effectively improve the surgical parameters of elderly patients with abdominal tumors, and control the body's stress response and reduce brain injury during anesthesia and have little effect on the lung function. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of different doses of sufentanil on stress response, inflammatory factors and myocardial injury in patients undergoing cardiac valve replacement. Methods: 100 patients undergoing cardiac valve replacement were divided into low dose group（n=33, sufentanil dose was 1.0 μg/kg）, middle dose group（n=33, sufentanil dose was 1.5 μg/kg） and high dose group（n=34, sufentanil dose was 2.0 μg/kg）. The changes of stress response, inflammatory factors, myocardial injury and perioperative indexes were compared in the three groups. Results: Heart rate（HR） and mean arterial pressure（MAP） were lower in middle-dose group and high-dose group than in low-dose group at the same time point after induction of anesthesia（T1）, 1 minute after intubation（T2）, 5 minutes after intubation（T3）, 10 minutes after intubation（T4）, and the high dose group was lower than that of the middle dose group（P < 0.05）. Compared with the low dose group, the levels of interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） in the middle dose group and the high dose group decreased at 30 minutes after blockade（T6）, 2 hours after aortic occlusion（T7） and 1 day after operation（T8）（P<0.05）. Compared with the low dose group, the cardiac troponin I（cTnI） and creatine phosphokinase isoenzyme（CK-MB） decreased in the middle dose group and the high dose group at cardiopulmonary bypass shutdown for 2 h（T9）, cardiopulmonary bypass shutdown for 8 h(T10), cardiopulmonary bypass shutdown for 24 h(T11) and cardiopulmonary bypass shutdown for 48 h(T12) time points（P<0.05）. The detention time of ICU and extubation time in low dose group and middle dose group were significantly shorter than those in high dose group（P<0.05）. There was no significant difference in the incidence of adverse cardiovascular events in the three groups（P>0.05）. Conclusion: Anesthesia with 1.0 μg/kg sufentanil has less stress reaction. 1.5 μg/kg and 2.0 μg/kg sufentanil can better control the inflammatory reaction in patients undergoing heart valve replacement and has a protective effect on myocardial injury, but 2.0μg/kg sufentanil can prolong ICU detention time and extubation time. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of epidural block combined with general anesthesia and total intravenous anesthesia inon the cervical cancer surgery. Methods: Selected 90 cases of patients with cervical cancer surgery who were treated in our hospital from January 2016 to December 2018, were selected and randomly divided into two groups randomly. The control group was given total intravenous anesthesia, while the observation group was given epidural anesthesia combined with general anesthesia. The postoperative infection rate, extubation time and recovery time, changes of the serum TNF-α and IL-6 levels, CD3+, CD4+/CD8+, CD8+ and CD4+ levels before surgery, at 12 h and 72 h after surgery, 72 h surgery were compared between the two groups. Results: The infection rate, extubation time and recovery time in the observation group were significantly lower than those in the control group (P < 0.05). The serum TNF-αand IL-6 levels of cervical cancer patients in the observation group were significantly lower at 12 h after surgery than those before surgery and in the control group (P < 0.05). The serum TNF-α and IL-6 levels in both groups recovered to the preoperative levels at 72 h after surgery. The levels of CD3+, CD4+/CD8+, CD4+in the two groups at 12 h after operation were significantly lower than those before operation (P< 0.05). The levels of CD3+, CD4+/CD8+, CD4+in the observation group at 12 h after operation were significantly higher than those in the control group (P < 0.05). The levels of CD3+, CD4+/CD8+CD4+in both groups recovered to the preoperative levels at 72 h after surgery. Conclusion: Compared with total intravenous anesthe sia, epidural anesthesia combined with general anesthesia is more conducive to the early extubation and revive of cervical cancer patients, it significantly alleviatinges the postoperative immunosuppression and effectively reducinges the incidence of postoperative infection. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of permissible hypercapnia in laparoscopic rectal cancer surgery, the optimal range of application and the effect on the patient's circulatory function. Methods: 90 cases with rectal cancer were researched to undergoing laparoscopic surgery according to the random number table they were divided into Test 1 group, 2 groups and control group, 30 cases in each group. The PaCO2 of the test group 1 was maintained at 56-65 mmHg, the PaCO2 of the test group 2 was maintained at 46-55 mmHg, and the PaCO2 of the control group was maintained at 35-45 mmHg. They were compared with Pneumoperitoneum time, mechanical ventilation time, operation time, extubation time, wake-up time, mean arterial pressure, heart rate, and airway pressure at 10 minutes before pneumoperitoneum (T1), 1 hour after pneumoperitoneum (T2), 2 h after pneumoperitoneum (T3), and 15 min after deflation (T4). dynamic lung compliance, oxygenation index, recording of complications such as subcutaneous emphysema, vomiting, irritability and postoperative cognitive impairment. Results: There was no significant difference in the operation time, pneumoperitoneum time, mechanical ventilation time, extubation time and recovery time between the three groups (P>0.05). Compared with the control group, HR, PaO2, and Cdyn in the test group significantly increased at T2 and T3, and Pmax decreased significantly; compared with T1, HR, Pmax, and PaO2 in the test group increased at T2 and T3, and Cdyn decreased; Compared with the experimental group 2, the HR and Pmax of the experimental group 1 were significantly lower, PaO2 and Cdyn were significantly higher, and the difference between the three groups was significant (P<0.05), but there was no significant difference in the OI between the three groups (P>0.05). Compared with the control group, the PaCO2, Qs/Qt of the test group increased at T2 and T3, and the pH and MAP decreased. Compared with T1, the PaCO2, Qs/Qt of the test group increased at T2 and T3, and the pH and MAP decreased. Compared with the experimental group 2, the Pa-CO2 and PaCO2 in the experimental group 1 were significantly lower and the pH was significantly higher (P<0.05), but there was no significant difference in the MAP between the three groups (P>0.05). There was no significant difference in preoperative CO, CVP, and CI between the three groups (P>0.05). At 30 min and 1 h after surgery, CO, CVP, and CI were lower in the experimental group than in the control group, while the experimental group 1 was significantly more lower than the experimental group 2 (P<0.05). There was no significant difference in the improvement of complications between the three groups (x2=0.1973, P=0.9954); the MMSE score after treatment was significantly lower than before treatment, and the test group was significantly higher than the control group, and the test group 1 was significantly higher than the test 2 group (P<0.05). Conclusion: Permissive hypercapnia protects lung compliance by reducing airway pressure during oxygen laparoscopic surgery for prolonged laparoscopic rectal cancer surgery, and can reduce the occurrence of postoperative cognitive impairment to a certain extent, it has a certain degree of brain protection. [ABSTRACT FROM AUTHOR]

Patients with head and neck cancers are often intubated with nasogastric tube after surgery for nutrition provision and infection prevention. The rate of deliberate self-extubation of nasogastric tube was 3.60% among patients after surgery in our hospital from January to February, 2012. By investigating cases of successful extubation, our team was able to identify the major factors behind the premature self-extubation: low rate of patient education delivered by nurses according to patients' needs (only 13.33%), and low percentage of consistency in patients' descriptions of their experience after nasogastric intubation (23.96%). This project was aimed to reduce the self-extubation rate of nasogastric tube among patients with head and neck cancers to 0.72%. The nursing interventions included: 1. develop and implement nasogastric tube care model: (i) set the care model as a key point in the patient education shift routine, (ii) set the care model as a focal point for each shift, and (iii) establish effective communication and feedback; 2. encourage case discussions using positive feedback and revise care model accordingly; 3. revise patient education pamphlets. After the project was implemented, from Sept. 2012 to August 2013, the rate of deliberate self-extubation of nasogastric tube was reduced to 0.57%. This result indicates that our nasogastric tube care model is effective in reducing the rate of deliberate self-extubation of nasogastric tube among patients with head and neck cancers after surgery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of dexmedetomidine on brain protection and its effect on stress response and inflammatory factors of patients in the operation of craniocerebral trauma. Methods: 136 patients with severe craniocerebral trauma who were treated in our hospital from January 2016 to December 2017 were selected as the research subjects, and the patients were divided into the control group(n=68) and the study group(n=68) according to the random digital table. The control group was given midazolam by intravenous drip during the operation, the study group was given dexmedetomidine by intravenous drip during the operation. The plasma S-100β protein, neuron specific enolase(NSE), cerebral extraction of oxygen(CERO2), arterio-jugular difference of oxygen(Da-jvO2)and jugular venous oxygen saturation(Sjv O2) levels of two groups before operation(T1), postoperative 24 h(T7) were compared, cortisol(COR), adrenaline(E) and blood glucose(GLU) levels at successful puncture of radial artery(T2), endotracheal intubation(T3), upper opening device(T4), end of operation(T5), extubation(T6) were compared, and the levels of interleukin-6(IL-6), interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α) at T2, T5, T7 were compared. Results: S-100β protein and NSE of patients in the two groups at T7 were significantly higher than those of T1, but the study group was lower than the control group(P<0.05). CERO2 and Da-jvO2 of patients in the two groups at T7 was lower than that of T1, and the study group was lower than the control group, Sjv O2 was higher than that of T1, and the study group was higher than that of the control group(P<0.05). At the time point of T4-T6, GLU of the study group was significantly lower than the control group, at the time point of T3-T6, the COR and E of the study group were significantly lower than the control group(P<0.05). The levels of IL-6, IL-10 and TNF-α in the two groups at T5 and T7 were higher than those of T2, the IL-6 and TNF-α in the study group at T5 and T7 were lower than those in the control group, and the IL-10 was higher than that of the control group(P<0.05). Conclusion: Compared with midazolam, dexmedetomidine can significantly reduce brain injury and reduce inflammatory factors in patients with craniocerebral trauma, and the stress response is relatively small. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Lung Cancer is the property of Chinese Journal of Lung Cancer and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The project aims to reduce the rate of unplanned endotracheal extubation in medical ICU. Our average rate of unplanned endotracheal extubation from January to April in 2014 was 0.358%, which had exceeded the threshold of 0.192%. The project was created in response to the compromised safety of intubated patient. According to the analysis, the possible factors for high rate of unplanned endotracheal extubation were as followed : analgesics standards were not implemented, insufficient communication tools for patients and medical personnels, incorrect endotracheal tube fixation, traditional bite block inapplicable, and inappropriate physical restraint. The project, lasted from May, 2014 to Feburary, 2015, implemented pain evaluation and treatment, communication cards, check list and care plans for high risk patients, improved bite blocks, and regular physical restraint evaluation. The implementation of the project had successfully attained its intended goal by reducing the unplanned endotracheal extubation rate to 0% and secured the safety of intubated patients. We would like to share our successful experience of patient safety management as a reference for clinical care. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing is the property of Taiwan Nurses Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effect of dexmedetomidine combined with propofol on analgesia and postoperative recovery in patients with lumbar surgery. Methods: Selected 92 patients underwent elective lumbar anesthesia surgery in our hospital from October 2015 to October 2016. The patients were randomly divided into observation group and control group with 46 cases in each group. The two groups used the same anesthesia induction program, the observation group was given intravenous infusion of dexmedetomidine before anesthesia induction, while the control group was received intravenous infusion of saline. And the patient- controlled intravenous analgesia was given in two groups. Recorded the systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse oxygen saturation (SPO2) and heart rate (HR)in two groups at below time points: before anesthesia induction (T0), 1 min after intubation (T1), 5 min after intubation (T2), 1 h after extubation (T3)and right after the surgery completed (T4). Compared the pain and sedation status between the two groups right after extubation. Recorded the recovery time of orientation, wake-up time, extubation time, dosage of morphine and adverse reactions of two groups. Results: SBP and DBP levels in two groups at T1 were significantly decreased than T0, and the SBP in control group at T3 was higher than T0, the differences were statistically significant(P<0.05); The SBP and DBP levels in observation group at T1 were higher than the control group, and the SBP at T3 was lower than the control group, the differences were statistically significant (P<0.05); The HR level in observation group at T1, T2, T3, T4 were significantly higher than the control group respectively, the differences were statistically significant (P<0.05); The visual analogue scale(VAS) score in the observation group was lower than control group, and Ramasy score higher than the control group right after extubation, the differences were statistically significant (P<0.05). The dosage of morphine in the observation group was significantly lower than that in the control group, the difference was statistically significant (P<0.05), while the recovery time of orientation, wake-up time, extubation time and adverse reactions of two groups had no statistical difference (P>0.05). Conclusion: Using dexmedetomidine combined with propofol has little effect on hemodynamics in patients with lumbar surgery, analgesic and sedative effect significantly, with small dosage of postoperative analgesic drugs, which is worthy of promotion. [ABSTRACT FROM AUTHOR]