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To explore the effects of the humanoid figure teaching method on the improvement of humanistic care and job competence of newly recruited nurses. A total of 72 newly recruited nurses in our hospital were selected as the research objects. The research objects were divided into control group and observation group, with 36 in each group. The control group was taught by traditional nursing methods, and the observation group was taught by the humanoid figure teaching method. The clinical teaching effect, core competence and humanistic care ability were compared between the two groups of newly recruited nurses. The results showed that the newly recruited nurses in the observation group had higher academic performance, nursing ward round scores, teaching satisfaction and patient family satisfaction than the control group (P<0.05). The newly recruited nurses in the observation group were better than the newly recruited nurses in the control group in terms of core competence and humanistic care ability (P<0.05). Therefore, the humanoid figure teaching method can effectively improve the clinical teaching effect of nursing work, enhance the clinical competence and humanistic care ability of newly recruited nurses, which is conducive to the development of clinical teaching and work. The humanoid figure teaching method guides newly recruited nurses from the perspective of "whole person", infiltrate the medical humanistic spirit into clinical nursing work, and provide patients with personalized services with in-depth and humanistic care.
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【Objective】 To investigate the effects of preoperative ureteroscopy (URS) on the intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). 【Methods】 The clinical data of 241 UTUC patients treated during May 2012 and Jan.2020 in the Second Hospital of Laozhou University were retrospectively analyzed. The patients were divided into URS before RNU group (URS group) and non-URS before RNU group (non-URS group). The cumulative IVR rate, progression-free survival (PFS) and overall survival (OS) after RNU were compared, and the survival curve was drawn. Cox proportional hazards models were used to assess risk factors affecting IVR. 【Results】 Of the 241 patients, 64 (26.6%) were included in the URS group and 177 (73.4%) in the non-URS group. In the URS group, 49 underwent biopsy and 15 did not. All patients were followed up for a median of 44 (3 to 122) months, with a median time to recurrence of 12 (3 to 56) months. IVR occurred in 18 patients (28.1%) in the URS group and 25 (14.1%) in the non-URS group. Kaplan-Meier survival analysis showed that the cumulative IVR rate was higher in the URS group than in the non-URS group (all P<0.05), regardless of whether patients had a history of bladder cancer (BC) or not, while PFS was lower in the URS group than in the non-URS group (P=0.007). Cox multivariate regression analysis showed that URS (P=0.031) and complicated renal pelvis tumor and ureteral tumor (P=0.004) were independent risk factors for IVR. 【Conclusion】 Preoperative URS increases the incidence of IVR in patients with UTUC, and routine preoperative use of URS is not recommended.
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OBJECTIVES@#To explore a new method for electroencephalography (EEG) background analysis in neonates with hypoxic-ischemic encephalopathy (HIE) and its relationship with clinical grading and head magnetic resonance imaging (MRI) grading.@*METHODS@#A retrospective analysis was performed for the video electroencephalography (vEEG) and amplitude-integrated electroencephalography (aEEG) monitoring data within 24 hours after birth of neonates diagnosed with HIE from January 2016 to August 2022. All items of EEG background analysis were enrolled into an assessment system and were scored according to severity to obtain the total EEG score. The correlations of total EEG score with total MRI score and total Sarnat score (TSS, used to evaluate clinical gradings) were analyzed by Spearman correlation analysis. The total EEG score was compared among the neonates with different clinical gradings and among the neonates with different head MRI gradings. The receiver operating characteristic (ROC) curve and the area under thecurve (AUC) were used to evaluate the value of total EEG score in diagnosing moderate/severe head MRI abnormalities and clinical moderate/severe HIE, which was then compared with the aEEG grading method.@*RESULTS@#A total of 50 neonates with HIE were included. The total EEG score was positively correlated with the total head MRI score and TSS (rs=0.840 and 0.611 respectively, P<0.001). There were significant differences in the total EEG score between different clinical grading groups and different head MRI grading groups (P<0.05). The total EEG score and the aEEG grading method had an AUC of 0.936 and 0.617 respectively in judging moderate/severe head MRI abnormalities (P<0.01) and an AUC of 0.887 and 0.796 respectively in judging clinical moderate/severe HIE (P>0.05). The total EEG scores of ≤6 points, 7-13 points, and ≥14 points were defined as mild, moderate, and severe EEG abnormalities respectively, which had the best consistency with clinical grading and head MRI grading (P<0.05).@*CONCLUSIONS@#The new EEG background scoring method can quantitatively reflect the severity of brain injury and can be used for the judgment of brain function in neonates with HIE.
Subject(s)
Infant, Newborn , Humans , Hypoxia-Ischemia, Brain/diagnostic imaging , Retrospective Studies , Brain Injuries , Electroencephalography , ROC CurveABSTRACT
To explore the effects of the humanoid figure teaching method on the improvement of humanistic care and job competence of newly recruited nurses. A total of 72 newly recruited nurses in our hospital were selected as the research objects. The research objects were divided into control group and observation group, with 36 in each group. The control group was taught by traditional nursing methods, and the observation group was taught by the humanoid figure teaching method. The clinical teaching effect, core competence and humanistic care ability were compared between the two groups of newly recruited nurses. The results showed that the newly recruited nurses in the observation group had higher academic performance, nursing ward round scores, teaching satisfaction and patient family satisfaction than the control group (P<0.05). The newly recruited nurses in the observation group were better than the newly recruited nurses in the control group in terms of core competence and humanistic care ability (P<0.05). Therefore, the humanoid figure teaching method can effectively improve the clinical teaching effect of nursing work, enhance the clinical competence and humanistic care ability of newly recruited nurses, which is conducive to the development of clinical teaching and work. The humanoid figure teaching method guides newly recruited nurses from the perspective of "whole person", infiltrate the medical humanistic spirit into clinical nursing work, and provide patients with personalized services with in-depth and humanistic care.
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We reviewed the data of an 18-year-old male patient complained of weakness of limbs and hypokalemia for 6 months. CT scan revealed left adrenal adenoma. He was diagnosed as primary aldosteronism(PA). Laboratory tests showed hypokalemia and hyperaldosteronemia. After potassium supplement and blood pressure lowering treatment, laparoscopic resection of the left adrenal adenoma was performed, and severe hyperkalemia occured 2 hours after surgery(maximum serum potassium 7.02 mmol/L). After hyperrisotonic glucose+ insulin(10% glucose 200 ml+ 50% glucose 40 ml+ insulin 8U)+ cation exchange resin(Sodium Polystyrene Sulfonate 20 g) treatment, serum potassium returned to normal range within 12 hours. The plasma aldosterone, blood potassium and blood pressure returned to normal during the 5-month follow-up. According to the experience of this case report, after resection of aldosteronoma, the changes of serum electrolyte should be closely monitored, the occurrence of hyperkalemia should be vigilant.
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Solitary fibroma often occurs in the pleura, but rarely outside the pleura. Extrapleural solitary fibroma has atypical clinical symptoms and difficult imaging diagnosis. Here, we report a case of solitary fibroma recurred and metastasized to the bladder after pelvic surgery. He was treated with palliative resection in our hospital. The patient died of systemic metastasis 3 years after operation.
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Radical nephroureterectomy with bladder cuff resection is the gold standard for the treatment of high-grade upper tract urothelial carcinoma. Due to the multicenter characteristics of urothelial carcinoma, 22% to 47% of patients still have bladder tumor recurrence after operation. A series of randomized controlled trials have shown that postoperative intravesical chemotherapy can effectively reduce the intravesical recurrence rate after operation. At present, postoperative intravesical instillation treatment and drugs still refer to bladder urothelial carcinoma, and the standard treatment has not been established yet. This article reviews the relevant literature in recent years, and systematically discusses the research development of postoperative intravesical chemotherapy in terms of the choice of chemotherapy protocol and drugs.
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Objective To evaluate the function of auditory nerve and brainstem in children with Bell's palsy by using brainstem auditory evoked potential ( BAEP) . Methods A retrospective study was car-ried in total of 69 patients with Bell's palsy admitted in the pediatric department of Shengjing Hospital of China Medical University from January 2017 to January 2018. There were 33 males and 36 females,aged 1 to 12 years old. Sixty healthy children served as control group. BAEP were determined in 69 patients and 60 healthy subjects. EEG and CT or MRI of brain were performed to exclud tumor,intracranial infection and so on. The patients in the case group were divided into 2 groups:1-3 years old group (38 cases) and 4-12 years old group (31 cases). Sixty healthy children were also divided into 2 groups:1-3 years old group (30 cases) and 4-12 years old group (30 cases). Results The hearing threshold was normal in the children of the control group. There was no significant difference not only in potential latency but also internal potential latency of BAEP between right and left ear. The abnormal rate of BAEP was 39. 1％ ( 27/69 ) in case groups,19 cases of them recovered(70. 4％,19/27) after 2 weeks of clinical treatment. Another 8 patients re-covered after 2 months. The abnormality rate of EEG was 5. 8％ (4/69),and the abnormality rate of CT or MRI in head was 14. 5％ (10/69). Both were nonspecific changes. In the two groups,Ⅰ-Ⅲinternal potential latency was significantly shortened ( P <0. 05 ) , and Ⅲ-Ⅴinternal potential latency was significantly pro-longed (P<0. 05)respectively,between the normal side and abnormal side. There were significant differences in the Ⅲ potential latency(P<0. 05),Ⅰ-Ⅲinternal potential latency (P<0. 01),and Ⅲ-Ⅴ internal poten-tial latency ( P <0. 01 ) respectively, between pretherapy and post-treatment. Conclusion Bell's palsy of children could cause abnormal of auditory nerve conduction,and BAEP could find the electro physiologic ab-normality in nervous system,and guide clinical intervention.
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The common therapy of colorectal cancer is FOLFOX scheme,which contains flurouracil,leucovorin and oxaliplatin.Numerous clinical trials have demonstrated that bevacizumab combined with FOLFOX scheme in cancer's therapy is safe and effective.But the adverse reactions including hypertension,neurovirulence,gastrointestinal bleeding and perforation are raised up.Scholars have carried out a series of studies for the overall survival times,tumor response rates and survival qualities for the patients with metastatic colorectal cancer which using the joint scheme,but they draw different conclusions the usefulness and safety of the joint scheme still need more RCT and meta-ananlysis to be proved.
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OBJECTIVE@#To investigate the expression profile and the clinical significance of CDK3 in the tissues of nasopharyngeal carcinoma.@*METHOD@#Immunohistochemistry was utilized to detect the expression of CDK3 in 94 cases of NPC and 40 cases of nasopharyngeal inflammation.@*RESULT@#CDK3 was highly expressed in NPC cell lines. Immunohistochemistry showed that CDK3 was mostly expressed in the cytoplasm. The positive expression rate of NPC was 67% and that of nasopharyngeal inflammation was only 12. 5%. The difference between these two groups was highly statistically significant. The CDK3 expression in NPC was related to the TNM clinical staging of NPC (P < 0.01).@*CONCLUSION@#The expression levels of CDK3 were obviously higher in NPC tissues. The CDK3 expression in NPC was related to the TNM clinical staging of NPC. It suggests that CDK3 expression may play an important role in the occurrence and development of nasopharyngeal carcinoma.
Subject(s)
Adult , Female , Humans , Male , Carcinoma , Cyclin-Dependent Kinase 3 , Metabolism , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , Metabolism , Pathology , Neoplasm StagingABSTRACT
<p><b>OBJECTIVE</b>Hereditary nonpolyposis colorectal cancer (HNPCC) is one of the most common hereditary colon cancer syndromes accounting for 1%-5% of all colorectal cancer cases. Germline mutations in at least five genes coding for DNA mismatch repair (MMR) proteins are associated with the clinical phenotype of HNPCC. More than 400 MMR mutations have been identified in HNPCC patients, and about 40% of mutations affect MSH2 gene including nucleotide substitutions, deletions, and insertions. Only a few mutations have been reported in Chinese families.</p><p><b>METHODS</b>A Chinese family with HNPCC was collected and peripheral blood of individuals from the family was obtained. Mutation analysis was performed on genomic DNA.</p><p><b>RESULTS</b>The family fulfilled Amsterdam criteria I, and 17 people out of 31 were diagnosed as malignant tumor for 21 times. Twelve people (70.6%) had rectal cancer, and the onset age was young with an average of 42.9 years old. Right side colon cancer was common in the family. A novel duplication mutation of four nucleotides in exon 7 MSH2 (MSH2: c.1215_1218dupCCGA) was found, which result in a premature stop 10 codons downstream in MSH2 (p.L407fsX417) in the family. Site-specific PCR was applied to the pre-symptomatic diagnosis.</p><p><b>CONCLUSION</b>This novel genomic mutation MSH2 was confirmed to be pathogenic, and polymerase chain reaction with modified primer was successfully applied to the pre-symptomatic diagnosis. These data expand the spectrum MSH2 mutations causing HNPCC.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Asian People , Genetics , Base Sequence , China , Colorectal Neoplasms, Hereditary Nonpolyposis , Ethnology , Genetics , DNA Mismatch Repair , Genetics , Family Health , Germ-Line Mutation , Genetics , MutS Homolog 2 Protein , Genetics , Pedigree , Polymerase Chain ReactionABSTRACT
OBJECTIVE@#To establish a genetic diagnosis method for a novel MSH2 mutation.@*METHODS@#A specific primer on the mutated site of MSH2 was synthesized and PCR was conducted using the specific primer and another downstream primer. PCR products were electrophoresed and then the carriers with the novel gene mutation of the carriers or non-carriers were identified.@*RESULTS@#MSH2 in a hereditary nonpolyposis colorectal cancer family were successfully found.@*CONCLUSION@#The method is effective and simple for genetic diagnosis of the novel mutation in MSH2.
Subject(s)
Female , Humans , Male , Base Sequence , Colorectal Neoplasms, Hereditary Nonpolyposis , Genetics , DNA Mutational Analysis , Methods , Molecular Sequence Data , MutS Homolog 2 Protein , Genetics , Pedigree , Point Mutation , Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To identify the gene causing hereditary multiple exostoses in a Chinese pedigree.</p><p><b>METHODS</b>Linkage analysis was carried out in the family using microsatellite markers on chromosome 8, 11 and 19 respectively. To detect the mutation, the whole coding sequence and the intron-exon boundaries of the candidate gene were amplified and sequenced. The reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to amplify the mutated mRNA.</p><p><b>RESULTS</b>The disease-causing gene of the family was linked to the EXT2 locus on chromosome 11. A mutation IVS2+1G>A was detected in EXT2 and resulting in 221 bp deletion from 316 to 536 of coding sequence(CDS), which was co-segregated with the disease phenotype. This change led to deletion from codon 106 to codon 178 and subsequent 2 nucleotides, producing a frameshift and truncated protein of 125 aa.</p><p><b>CONCLUSION</b>The mutation IVS2+1G>A is the disease-causing mutation in the Chinese pedigree with hereditary multiple exostoses.</p>
Subject(s)
Female , Humans , Male , Exostoses, Multiple Hereditary , Genetics , Genes, Tumor Suppressor , Genetic Linkage , Mutation , N-Acetylglucosaminyltransferases , Genetics , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To construct a phosphatidylinositol 4-kinase beta (PI4K-beta) mutant with the 325th to 373rd amino acid codons deleted, and try to develop a simple method for constructing middle fragment deletion mutant.</p><p><b>METHODS</b>In line with the mechanism of gene splicing by overlap extension(SOE), an additional PCR was used to get the PI4K-beta mutant in which the 325th to 373rd amino acid codons were deleted. Then the mutated gene was cloned into pCMV-Tag4A mammalian expression vector.</p><p><b>RESULTS</b>A mutant with the 325th to 373rd amino acid codons deleted was constructed successfully.</p><p><b>CONCLUSION</b>The improved SOE is a very effective and reliable method to construct middle fragment deletion mutant. It is worthy to be popularized.</p>
Subject(s)
1-Phosphatidylinositol 4-Kinase , Genetics , Base Sequence , Genetic Vectors , Genetics , Molecular Sequence Data , Mutagenesis, Site-Directed , Mutation , Genetics , Polymerase Chain Reaction , Methods , Protein Engineering , Methods , Recombinant Proteins , Genetics , Sequence DeletionABSTRACT
<p><b>OBJECTIVE</b>To introduce a new technique for rapid construction of gene site-directed mutagenesis.</p><p><b>METHODS</b>Three primers are synthesized. One is a primer with the needed mutation; the other two containing appropriate enzyme sites for construction of the PCR fragment into a suitable plasmid are located at the flanks of the mutation primer. After the amplification of the PCR fragment using the mutation primer and the reverse flanking primer, another PCR is performed using the previous PCR mutation segment as primer and the other flanking primer. The final PCR segment can be cloned into an appropriate plasmid by using the enzyme sites in the primers.</p><p><b>RESULTS</b>Two site-directed mutagenesis have been successfully constructed in the Parkin gene by this method.</p><p><b>CONCLUSION</b>The method is effective and simple for construction of gene site-directed mutagenesis.</p>