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Objective:To investigate the clinical efficacy of combined spinal and epidural anesthesia with isobaric bupivacaine in older adult patients undergoing artificial femoral head replacement.Methods:The clinical data of 50 older adult patients who underwent artificial femoral head replacement in Zhuji Third People's Hospital between January 2016 and January 2020 were retrospectively analyzed. The patients were divided into a control group ( n = 22) and a combined anesthesia group ( n = 28) according to different anesthesia methods. The control group was subjected to epidural anesthesia with bupivacaine. The combined anesthesia group underwent combined spinal and epidural anesthesia with isobaric bupivacaine. The excellent and good rate of anesthesia as well as heart rate and mean arterial pressure measured before and 10 minutes after anesthesia, at 1 hour of surgery and at the end of surgery were compared between the two groups. Time to anesthesia onset and time to block completion were recorded in each group. Results:The excellent and good rate of clinical efficacy in the combined anesthesia group was significantly higher than that in the control group [85.71% (24/28) vs. 59.09% (13/22), χ2 = 4.54, P < 0.05]. There were no significant differences in heart rate and mean arterial pressure between the two groups before and 10 minutes after anesthesia, at 1 hour of surgery and at the end of surgery ( t = 0.83, 0.60, 1.13, 1.21; 0.98, 0.60, 0.85, 0.88, P > 0.05). The time to anesthesia onset and the time to block completion in the combined anesthesia group were shorter than those in the control group ( t = 4.99, 2.29, both P < 0.05). Conclusion:Combined spinal and epidural anesthesia with isobaric bupivacaine can increase the excellent and good rate of anesthesia effects and has no obvious effect on hemodynamics in patients undergoing artificial femoral head replacement. Combined spinal and epidural anesthesia takes a shorter time to anesthesia onset and a shorter time to block completion than spinal or epidural anesthesia.
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Objective@#To analyze the influence of sexuality education on primary school students’ attitude towards homosexuality, and provide practical teaching evidence of intervening campus bullying based on sexual orientation.@*Methods@#A primary school offering school-based sexuality education curriculums in Beijing was selected as an experimental school, another school with similar location, nature and scale, quality of teachers and teaching environment was selected as a control school. The graduates in experimental school received 6 years of sexuality education in grade 1 to grade 6 of primary school. A survey was conducted in Jun. 2018 among all the graduates in grade 6 of the two schools through an attitude scale on homosexuality adopting cluster sampling.@*Results@#The scores of attitude towards homosexuality in experimental school and control school were (42.85±15.46) and (60.17±12.54) respectively, with significantly statistical difference(t=-9.47, P<0.01). There were interaction effects on attitudes of primary school students towards homosexuality between gender and experience of sexuality education (P<0.05). There was no significant difference in attitude towards homosexuality between male and female students in control school(t=0.58, P>0.05), but in experimental school, the attitude scores of male and female students respectively were (47.64±14.31) and (38.13±15.19), with significantly statistical difference(t=3.47, P<0.01). There was no significant difference in attitude towards different sexual orientation between experimental school students and control school students(t=0.10，1.53，P>0.05).@*Conclusion@#Sexuality education curriculum can help improve attitude towards homosexuality of primary school students, which has better intervention effects on female students than male students, attitudinal difference in gay and lesbian has not formed in primary school students.