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Objective:To explore the methods and effect of applying specialized training and multimedia education in key infection-related departments of a hospital to intervene standard precautions for clinical practice interns.Methods:Based on the cases of nosocomial infection at home and abroad, the Science and Education Section and Infection Management Section designed and produced videos about standard precautions and occupational protection. The content of these videos covered two fields including knowledge training and skill training, with emphasis on enhancing awareness of profession risks and skills of hospital infection control and occupational protection of 196 medical students through specialized training in key infection-related departments. The training effect of standard precautions education for the two groups of students was evaluated from the theoretical test scores, questionnaire survey on their attitude and compliance to standard precautions, and the incidence of their occupational exposure to needle stab wound. SPSS 18.0 was performed for t test and chi-square test. Results:Apart from the knowledge of the unfavorable factors of implementing standard precautions, there were significant differences between the experimental group and the control group in six aspects: theoretical test scores, hospital infection risk cognition, significance cognition of standard precautions, favorable factors of implementing standard precautions, self-efficacy evaluation and self-evaluation of compliance to standard precautions ( P<0.05). And there was significant difference in the incidence of occupational exposure to needle stab wound between the experiment group and control group (1.02% vs. 7.14%; χ2=4.69, P<0.05). Conclusion:Various teaching interventions of standard precautions during the entire internship period have expanded and deepened the contents of school education, enabling the students to form good occupational risk awareness and coping skills to protect the patients and themselves.
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Objective:To explore the nursing effect of enhanced recovery after surgery in total knee arthroplasty under multidisciplinary cooperation.Methods:From January 2017 to May 2020, the clinical data of 102 patients with total knee arthroplasty in First Hospital of Zibo were selected for retrospective analysis. According to the different nursing methods, they were divided into observation group and control group with 51 cases in each group, observation group was given enhanced recovery after surgery under multidisciplinary collaboration, and the control group was given routine nursing care. The length of hospitalization, hospitalization costs, intraoperative blood loss, 24 h postoperative hemoglobin, Visual Analogue Scale (VAS), knee range of motion (ROM), New York Hospital for Special Surgery (HSS) Knee Joint Score and complications were compared between the two groups of patients.Results:In the observation group the length of hospitalization was (7.65 ± 1.21) d, the cost of hospitalization was (92 355.21 ± 352.52) yuan, intraoperative blood loss (224.12 ± 25.32) ml, and 24 h postoperative hemoglobin was (115.12 ± 12.05) g/L,while those were (9.68 ± 2.15) d, (105 423.45 ± 544.25) yuan, (362.12 ± 38.78) ml, (102.32 ± 7.52) g/L in the control group, the difference between the two groups was statistically significant ( t values were 5.88-143.92, all P<0.05). Repeated measures analysis of variance showed that time point, between groups, interactive comparisons of VAS scores, ROM, HSS scores were significantly different between the two groups ( P<0.05). And 12, 48, 72 h after the operation, the VAS scores of the observation group were 4.12 ± 0.35, 2.62 ± 0.21, 1.65 ± 0.12, and 5.62 ± 0.58, 3.85 ± 0.41, 2.85 ± 0.24 in the control group, the difference between the two groups was statistically significant ( t=15.81, 19.07, 31.94, all P<0.05). 1 and 3 months after the operation, the ROM of the observation group were (99.78 ± 12.14)° and (108.95 ± 15.25)°, and the ROM of the control group were (81.65 ± 10.02)° and (98.77 ± 11.08)°, respectively. The difference between the two groups was statistically significant ( t=9.00, 4.22, both P<0.05). Conclusions:To give fast track surgery under multidisciplinary cooperation is beneficial to reduce the amount of bleeding in patients undergoing total knee arthroplasty, shorten the length of hospital stay, and reduce the incidence of complications.
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BACKGROUND@#Peritendinous adhesion that simultaneous with tendon healing link the healing tendon to the surrounding tissue. It results in functional disability, and has a significant adverse impact on health as well as social and economic development. @*METHODS@#Based on a search in the PubMed and Web of Science database, the research articles were screened by their time, main idea, impact factor index, while the ones with no credibility were excluded. Afterwards, we go through the analysis of the reliability and characteristics of the results were further screened from selected articles. @*RESULTS@#A total of 17 biomaterials used to evaluate the adhesion mechanism and the properties of the material were found. All of these biomaterials contained randomized controlled studies and detailed descriptions of surgical treatment that support the reliability of their results which indicates that biomaterials act as barriers to prevent the formation of adhesion, and most of them exhibit satisfactory biocompatibility, biodegradability or selective permeability. Moreover, a few had certain mechanical strength, anti-inflammatory, or carrier capacities. However, there still existed some defects, such as time, technology, clinical trials, material targeting and different measurement standards which also lowered the reliability of their results. @*CONCLUSION@#In future, anti-adhesion biomaterials should focus on affordable raw materials with wide sources, and the production process should be simplified, in this way, the versatility and targeting of materials will be improved.
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BACKGROUND@#Peritendinous adhesion that simultaneous with tendon healing link the healing tendon to the surrounding tissue. It results in functional disability, and has a significant adverse impact on health as well as social and economic development. @*METHODS@#Based on a search in the PubMed and Web of Science database, the research articles were screened by their time, main idea, impact factor index, while the ones with no credibility were excluded. Afterwards, we go through the analysis of the reliability and characteristics of the results were further screened from selected articles. @*RESULTS@#A total of 17 biomaterials used to evaluate the adhesion mechanism and the properties of the material were found. All of these biomaterials contained randomized controlled studies and detailed descriptions of surgical treatment that support the reliability of their results which indicates that biomaterials act as barriers to prevent the formation of adhesion, and most of them exhibit satisfactory biocompatibility, biodegradability or selective permeability. Moreover, a few had certain mechanical strength, anti-inflammatory, or carrier capacities. However, there still existed some defects, such as time, technology, clinical trials, material targeting and different measurement standards which also lowered the reliability of their results. @*CONCLUSION@#In future, anti-adhesion biomaterials should focus on affordable raw materials with wide sources, and the production process should be simplified, in this way, the versatility and targeting of materials will be improved.
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OBJECTIVE：To study the effects of costunolide on the proliferation ，migration and apoptosis of breast cancer SK-BR-3 cells and its mechanism. METHODS ：SK-BR-3 cells in logarithmic growth period were collected and cultured with different concentrations （10，20，30，40，50 μmol/L）of costunolide for 24，48，72 h. Inhibitory rate of costunolide on cell proliferation was detected with CCK- 8. The cells were divided into blank control group and costunolide group （10，20，30 μmol/L）. Hoechst 33258 fluorescence was used to observe the morphology and apoptosis of cells ，and apoptotic rate of cells were calculated. Cell scratch test was used to detect the migration ability of cells and calculate the migration rate. Western blotting was used to detect the relative expression level of Bcl- 2，Bax，Caspase-3 and Cleaved Caspase- 3 in cells. RESULTS ：The proliferation of SK-BR-3 cells were significantly inhibited by costunolide （P＜0.05 or P＜0.01），and it shows a trend of concentration and time dependence. In the blank control group ，cells possessed clear contour ，regular shape and good adherence . Compared with blank control group，the number of cells were decreased significantly in 10，20，30 μmol/L costunolide groups，the cell structure was loose，the volume was reduced ，and the gap became larger ，and most of the cell contour disappeared and became round ，the cell adherence was poor ；cell migration rate and Bcl- 2 protein relative expression level were decreased significantly ，while apoptosis rate and the relative expression level of Bax ，Caspase-3 and Cleaved Caspase- 3 protein were significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS ： Costunolide can inhibit the proliferation and migration ，and induce apoptosis of human breast cancer SK-BR- 3 cells，mechanism of which may be through up-regulating the expression of Bax ，Caspase-3 and Cleaved Caspase- 3 while down-regulating the expression ofBcl-2.
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Objective:To study the correlation between fatigue symptoms and living condition of liver transplant recipients after discharge from hospital, so as to provide reference basis for preventing postoperative fatigue symptoms in recipients.Methods:From September 2018 to December 2018, 280 liver transplant recipients were selected from the liver transplantation clinic of a grade-three hospital in Shanghai by convenience sampling method, and clinical data of the patients were obtained by questionnaire survey to analyze factors of the symptom of postoperative fatigue.Results:A total of 280 patients were included, among which 130 patients showed fatigue symptoms, accounting for 46.4%. The results of single-factor analysis showed that the postoperative survival days, gender, total time of exercise, body mass index, working status, mode of payment of medical expenses, Sleep quality, negative emotions, and nutritional risk all exert an influence on fatigue symptoms ( P<0.05). The results of multi-factor analysis showed that the total time of exercise during a week ( OR=0.674, 95% CI:0.512-0.887), postoperative survival days ( OR=0.993, 95% CI:0.989-0.997) and the score of negative emotion scale ( OR=1.484, 95% CI:1.157-1.902) had significant influence on fatigue symptoms in patients ( P<0.01). Conclusions:Postoperative survival days, exercise time and negative emotions are the main factors affecting fatigue symptoms. Medical staff should evaluate and manage patients' psychological and activity exercise to improve fatigue symptoms.
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BACKGROUND@#Lung cancer is the cancer with the highest morbidity and mortality at home and abroad at present. Using computed tomography (CT) to screen lung cancer nodules is a huge workload. To test the effect of artificial intelligence in automatic identification of lung cancer by using artificial intelligence to find the lung cancer nodules automatically in the chest CT of 1 mm and 5 mm thick.@*METHODS@#5,000 cases of T1 stage lung cancer patients with 1 mm and 5 mm layer thickness were respectively labeled and learned by computer neural network, the algorithm of forming pulmonary nodules was carried out. 500 cases of chest CT in T1 stage lung cancer patients with 1 mm and 5 mm thickness were tested by artificial intelligence formation, and the sensitivity and specificity were compared with artificial reading.@*RESULTS@#Using artificial intelligence to read chest CT 500 in 5 mm, the sensitivity was 95.20%, the specificity was 93.20%, and the Kappa value of two times repeated read was 0.926,1. For 1 mm chest CT 500 cases, the sensitivity is 96.40%, the specificity is 95.60%, and the Kappa reads two times is 0.938,6. Compared with 5 doctors, the same CT sets with 1 mm thickness were read. The detection rates of artificial intelligence and artificial reading were similar to those of lung cancer nodules and negative control read films, and there was no significant difference between them. In the comparison of the same CT slices with 5 mm thickness, the number of detection of lung cancer nodules by artificial intelligence is better than that of artificial reading, and the sensitivity is higher, but the number of false messages is increased and the specificity is slightly worse.@*CONCLUSIONS@#The automatic learning of early lung cancer chest CT images by artificial intelligence can achieve high sensitivity and specificity of early lung cancer identification, and assist doctors in the diagnosis of lung cancer.
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Humans , Artificial Intelligence , Lung Neoplasms , Diagnosis , Pathology , Medical Informatics , Methods , Neoplasm StagingABSTRACT
Objective To study the relationship between macular pigment optical density (MPOD) and serum concentration of lutein and zeaxanthin in an adult population.Methods Twenty patients with mild cataract and 39 healthy subjects were enrolled in this study,including 15 males and 44 females.The average age was 43.75 years.Fifty-three subjects were non-smokers and 6 male subjects were smokers.Two subjects preferred meat diet,22 preferred meat-less diet,and 35 have balanced diet.MPOD was measured using heterochromatic flicker photometry at 0.25,0.5,1.0 and 1.75 degrees,and serum concentration of lutein and zeaxanthin was measured using high-performance liquid chromatography.The relationship between MPOD and serum concentration of lutein and zeaxanthin was analyzed.The differences of serum lutein and zeaxanthin between different gender,smokers and non-smokers and subjects with different dietary pattern were also analyzed.Results MPOD at 0.25,0.5,1.0 and 1.75 degrees were 0.59,0.48,0.34 and 0.18,and the average concentration of lutein and zeaxanthin were (0.45± 0.16) μmol/L and (0.11 ± 0.04) μmol/L respectively.Serum concentration of lutein and zeaxanthin in males were slightly higher than that in females,but it was not statistically significant (t=1.13,0.86;P=0.27,0.40).The differences of serum lutien and zeaxanthin between smokers and non-smokers (t=0.15,-0.11;P=0.87,0.91),among subjects of 3 dietary patterns groups were not statistically significant (Flutein=3.87,4.05,0.18;P=0.83,0.81,0.99.Fxeaxanbin=0.99,1.51,0.52;P=0.85,0.68,0.72).There was no correlation between MPOD and serum concentration of lutein (r=-0.06,-0.02,-0.07,0.03;P＞0.05) and zeaxanthin(r=0.02,0.12,0.09,0.11;P＞0.05).Conclusion MPOD was not statistically significantly correlated with serum concentration of lutein and zeaxanthin in the studied population.
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Objective To study the expression of forkhead box Q1(FOXQ1)in non‐small cell lung cancer(NSCLC) ,then investi‐gate clinical pathological characteristics of NSCLC and its prognosis in patients .Methods The expression of FOXQ1 in 84 cases of NSCLC(selected from June 2007 to December 2008 )was detected by immunohistochemistry(SP) .The correlations of the expres‐sion of FOXQ1 with clinic pathological features and survival time of the NSCLC patients were analyzed .Results The positive ex‐pression rate of FOXQ1 was 91 .7% (77/84) ,closely correlated with patients`histological type and TNM stage(P<0 .05) .The Cox multivariate analysis demonstrated that histological type ,TNM stage and FOXQ1expression were independent factors of NSCLC (P<0 .05) .Conclusion The expression of FOXQ1 may be highly expressed in NSCLC and negatively correlated with prognosis .
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Objective To investigate the correlation between the expression levels of semaphorin3A and MMP14,and their subsequent prognostic significance in nonsmall cell lung cancer(NSCLC).Methods The expression of semaphorin3A and MMP14 protein levels was analyzed in 94 cases of NSCLC tissues and in 80 cases of normal lung tissues,using immunohistochemistry(IHC).Correlation and survival analysis were used to further investigate their association and prognostic value.The correlation analysis using Pearson test,and log-rank test for survival analysis.Results The NSCLC tissues exhibited a lower expression of semaphorin3A and a higher expression of MMP14 than in the control lung tissues.The downregulation of semaphorin3A and upregulation of MMP14 may promote pleural invasion,lymph node metastasis,vascular invasion and proliferating cell nuclear antigen expression.The expression of semaphorin3A was correlated with the maximum diameter of tumor.There was a negative correlation between the protein expression levels of semaphorin3A and MMP14 in NSCLC tissues.Conclusion The data suggest that lower expression of semaphorin3A and a higher expression of MMP14 may promote occurrence and development in NSCLC and that the combined detection of semaphorin3A and MMP14 protein may be a helpful tool in predicting the prognosis of NSCLC.
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In order to reduce heavy burden of cancer on patients, families and social, it needs to raise special funds, apply regular screening for 45~65 years old group, achieve early detection and treatment of cancer, reduce medical expenses and economic loss of cancer greatly, reduce mental burden, establish the cancer prevention input-output model, calculates the economic benefits up to 1:9.89. It is proposed to establish the organization, improve the mechanism, expand the overall costs, secure the screening and popularize early detection and treatment.
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In order to understand the cost of cancer in rural area, to evaluate the cost burden, the project content and treatment status. Typical sampling and random sampling survey are combined to investigate and account major expenditure and economic loss of cancer treatment and related items, analyzes its rationality and scientific, provide references for improving the level of cancer prevention and treatment.
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Objective To observe the effect of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus.Methods Forty-nine patients with type 2 diabetes mellitus were randomly assigned to participate in the trial from 2002 to 2007,receiving either intensive (24 cases) or standard glucose control (25 cases).The patients were examined by the same ophthalmologists to identify any new diabetic retinopathy (DR).After 5 years of intensive glucose control,all of the patients were asked to attend our clinic every 6 months,but no attempts were made to maintain their previously assigned therapies.Hemoglobin A1c (HbA1 c) was measured regularly.In November of 2009,a retinal examination was carried out by the same ophthalmologist who worked in the trial.The visual acuity,lens,vitreous body and fundus were examined after pupil dilation to identify diabetic retinopathy (DR).Fundus fluorescein angiography and retinal laser photocoagulation were carried out when necessary.Results In the second year after enrollment in the trail,the median HbA1c level of the intensive-therapy group was significantly lower than that of the standard-therapy group [(6.3 ± 0.6) ％ vs.(7.2 ± 1.2) ％,t =2.09,P ＜ 0.05],and was maintained in a controlled level throughout the following 4 years.During the post-trial monitoring,no new case of of macula edema or diabetic associated blindness occurred in either intensive or standard-therapy group,the whole occurrence of micro-aneurysms,fundus hemorrhage,as well as those who needed retinal laser photocoagnlation and lowering in visual acuity in intensive-therapy group was lower than that in the standard-therapy group (3 vs.14,1 vs.7,2 vs.4,3 vs.11,respectively ;9 vs.36,totally,x2 =4.719,P ＜ 0.05).During the first post-trial monitoring,there was no difference in median HbAlc level between intensive-therapy group and standard-therapy group [(7.2 ± 1.1) ％ vs.(7.3 ± 1.3) ％,t =0.25,P =0.806],which was sustained in the following years.In the trail,no new case of fundus hemorrhage or diabetic associated blindness occurred in intensive-therapy group during the five-year period of therapy.Number of new episodes of micro-aneurysm,macula edema were less in intensive-therapy group than that in standard-therapy group,number of new episodes of lowering in visual acuity,and those who needed retinal laser photocoagnlation,were significantly less in intensive-therapy group than that in standardtherapy group(15 vs.25,4 vs.23,Z =-4.459,P ＜ 0.05) during five-year follow-up.Conclusions The benefit of reduced incidence of diabetic retinopathy in intensive glucose can be maintained because of the legacy effect.
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Objective To evaluate the clinical significance of the changes of microalbunminuria(MAU) levels in mechanical ventilated patients with severe pneumonia. Methods According to the ratio between the microalbunminuria and the urine creatinine (MAU/CR) (ACR), setting 25mg/mmol as the threshold, 78 mechanical ventilated patients with severe pneumonia were divided into two groups :ACR increasing group and ACR Non-increasing group,then the clinical significance of changes of MAU levels in 72 hours on prognosis of these patients was observed. Results MAU increased in 64 cases(82. 1%) ,of which 46 cases in ACR increasing group and 18 cases in ACR non-increasing group. There showed statistically significant differences on APACHE Ⅱ score, CPIS score,PCT、the success of getting out of mechanical ventilation and the mortality between two groups, (t = 3.50、2. 19 、x~2 = 3. 95、6. 70、5.38 ,P = 0.01,0.03,0.04,0.01,0.02, all P ＜ 0.05). Conclusion Changes of MAU levels have the clinical significance on prognosis of the mechanical ventilated patients with severe pneumonia.
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BACKGROUND: Treatment methods for defects of fingertip skin or soft tissue combined with partial deletion bed include the phalanx shortening or flap coverage of wounds, each with shortcomings.OBJECTIVE: To investigate the efficacy of repairing finger nail bed defects by different treatments in one stage, and to evaluate the functional recovery of nail beds comprehensively.METHODS: From December 2002 to February 2009, 51 fingers with nail bed defects in 40 patients (11 thumbs, 22 index fingers, 14 middle fingers, 4 ring fingers) were repaired. Under the situation that the periosteum exist, when the area of nail bed defect area was less than one third of the nail, the graft was taken from the same finger. If the area of nail bed defects were larger than one third of the nail or two nail bed defects, the grafts were taken from the nail beds of 1st or 2nd toes. Under the situation that the periosteum nonexist, when the area of nail bed defect area was less than one half and more than one third of the nail, the split tissue flap was transferred from the same finger. The finger appearance and functions were observed in the follow-up. RESULTS AND CONCLUSION: All patients were followed up from 1 month to 2 years with an average of 6 months, 86.3% grafts survived very well, no pain, no infection and obvious deformed growth of nail were found. It revealed that using different treatment to repair nail bed defect is available. The grafted nail can grow in good appearance, and finger can act in good function.
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Objective: To analyze the status quo of assanation and ethics courses and their social requirement, thus to explore a scientific mode for the course setting; Method: The course setting status quo of assanation and ethics is analyzed among 18 colleges in which the nursing speciality is set up. A questionnaire was also conducted to investigate students' inclination towards politics-sorted courses, and relevant data were analyzed. Results: The establishing rate of assanation courses in the higher professional colleges is higher than that in the comprehensive universities. The most favorable subjects among freshmen are the Chinese national political theories, and assanation & ethics, while the counterparts among seniors are assanation & ethics, law basis, and philosophy. Seniors have an obvious higher desire for the course of assanation & ethics compared with freshmen (P