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1.
Chinese Journal of Digestive Endoscopy ; (12): 743-746, 2021.
Article in Chinese | WPRIM | ID: wpr-912170

ABSTRACT

To evaluate the efficacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for patients with metastases to the pancreas.Data on patients with pancreatic lesions who underwent EUS-FNA and confirmed as having metastases to the pancreas at the Endoscopy Center of Zhongshan Hospital, Fudan University from January 2015 to November 2020 were retrospectively analyzed.Characteristics of patients, EUS performance, pathological results, and follow-up were reviewed and analyzed. A total of 11 patients were diagnosed of metastasis to pancreas by EUS-FNA.The primary tumor mainly came from kidney (4/11) and lung (4/11), and the rest from colon (1/11), breast (1/11) and bladder (1/11), respectively. EUS performance of metastases to the pancreas mostly presented homogeneous hypoecho (10/11)with unclear margin (6/11). Enlarged lymphnodes were noticed in nearly half of the patients (5/11). The time span from detection of primary tumor to metastases ranged from 6 days to 27 years. EUS-FNA is effective in the diagnosis of metastases to the pancreas.

2.
Chinese Journal of Medical Science Research Management ; (4): 35-38, 2020.
Article in Chinese | WPRIM | ID: wpr-872018

ABSTRACT

Objective To discuss the management level positioning of scientific research secretary in university affiliated hospitals,also propose suggestions for the team building.Methods Discussed the characteristics and particularities of the university affiliated hospitals,analyzed management level of scientific research secretary.Based on the fact that doctors or professional technicians are commonly part-time scientific research secretaries in these hospitals,discussed the responsibilities and team building.Results The university affiliated hospitals should establish a scientific research secretary as a management level between administrative entities and researchers,to form a four-level management mode.To fulfill this,detailed suggestions on qualifications,occupational instructions,selection process,job task and position transition of scientific research secretary were discussed in this article.Conclusions The responsibility of scientific research secretaries should be positioned to assist the scientific research management departments,to extend better need-based services to all scientific researchers,with the aim of promoting scientific research management services to "implement to people" and implementing the "people-oriented" concept.

3.
Chinese Journal of Gastrointestinal Surgery ; (12): 183-187, 2020.
Article in Chinese | WPRIM | ID: wpr-799572

ABSTRACT

Objective@#To evaluate the feasibility and short-term efficacy of a novel and simplified closure method developed by our team for the defect closure after endoscopic full-thickness resection (EFTR) for gastric submucosal tumors (SMT) in the gastric wall.@*Methods@#A prospective single-arm clinical study was used. Inclusion criteria: (1) the lesion was located in the fundus or the greater curvature of the stomach, and was confirmed to originate from the muscularis propria layer; (2) the diameter of the tumor was ≤3.5 cm, and the tumor had no extensive adhesion to the peritoneal tissues and organs in extraperitoneal cavity; (3) the tumor had no malignant features under ultrasound endoscopy; (4) the patient agreed to participate in the study; (5) patients with severe complications were excluded. Based on the above criteria, 20 patients with gastric SMT at the Endoscopy Center of Zhongshan Hospital of Fudan University from January 2015 to March 2018 were enrolled in this study, including 5 males and 15 females with mean age of 61.1 (38 to 70) years. Grasping forceps-assisted endo-loop snare ligation device which is called "Shao-Mai" method was used to close the defect site. All the patients underwent EFTR and "Shao-Mai" method to perform defect closure. After successful tumor resection by EFTR, an endo-loop was anchored onto the edge of the gastric defect with grasping forceps assistance and closed tightly. The observation indicators included tumor size, en bloc resection, operation time, postoperative complications and hospital stay. The follow-up indicators included tumor residual, local recurrence, and metachronous lesions.@*Results@#All the 20 lesions were located in the muscularis propria with a size of 0.5-3.5 (mean 1.4) cm. Three of them were located in the greater curvature of the mid-upper gastric body, 17 were located in the fundus. The endoscopic "Shao-Mai" closure was successfully performed after EFTR in all the 20 cases. Endoscope was used uniquely through the entire process, without laparoscopic assistance. The operative time was 20-100 (mean 43.8) minutes, while the "Shao-Mai" closure procedure took a range of 3-30 (mean 10.1) minutes. The en bloc resection rate was 100%. The pathological diagnosis included 17 gastrointestinal stromal tumors and 3 leiomyomas. No major complications occurred during or after surgery. All the patients were discharged 1-11 (mean 3.1) days after operation. The wounds of all the cases were healed completely six months after operation and only scar was observed without ulcer. No residual lesion, tumor recurrence or metastasis, leakage or fistula of digestive tract were found during the follow-up period of 15-54 (median 41) months.@*Conclusion@#The endoscopic "Shao-Mai" closure method is a simplified novel way, which is feasible, effective, and safe for closing the gastric defect after EFTR.

4.
Chinese Journal of Radiological Medicine and Protection ; (12): 768-771, 2019.
Article in Chinese | WPRIM | ID: wpr-796644

ABSTRACT

Objective@#To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application.@*Methods@#A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5.0 mg/kg repeated every 14 d and 7.5 mg/kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded.@*Results@#Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5.0 mg/kg group were increased by 31.66 points on average compared with those before treatment. The KPS scores of 7.5 mg/kg group were increased by 27.50 points on average compared with those before treatment. The volume of CRN lesions were decreased(46.0±9.4)%(t=6.57, P<0.05) and the volume of edema lesions decreased(68.9±8.9)%(t=3.32, P<0.05) in 5.0 mg/kg group. In 7.5 mg/kg group, these two parameters were reduced by(53.9±10.7)%(t=7.89, P<0.05 and (77.1±14.3)%(t=4.22, P<0.05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0.05). In this study, the incidence of adverse events in the 5.0 mg/kg group was similar to that in the 7.5 mg/kg group, with no significant difference(P>0.05).@*Conclusions@#Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5.0 mg/kg treatment regimen repeated every 14 d is similar to that of 7.5 mg/kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.

5.
Chinese Journal of Radiological Medicine and Protection ; (12): 768-771, 2019.
Article in Chinese | WPRIM | ID: wpr-791395

ABSTRACT

Objective To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application. Methods A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5. 0 mg/ kg repeated every 14 d and 7. 5 mg/ kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded. Results Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5. 0 mg/ kg group were increased by 31. 66 points on average compared with those before treatment. The KPS scores of 7. 5 mg/ kg group were increased by 27. 50 points on average compared with those before treatment. The volume of CRN lesions were decreased (46. 0±9. 4)% (t = 6. 57, P<0. 05) and the volume of edema lesions decreased (68. 9±8. 9)% (t= 3. 32, P<0. 05) in 5. 0 mg/ kg group. In 7. 5 mg/ kg group, these two parameters were reduced by (53. 9±10. 7)% (t = 7. 89, P<0. 05 and (77. 1±14. 3)% (t = 4. 22, P<0. 05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0. 05). In this study, the incidence of adverse events in the 5. 0 mg/ kg group was similar to that in the 7. 5 mg/ kg group, with no significant difference (P> 0. 05). Conclusions Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5. 0 mg/ kg treatment regimen repeated every 14 d is similar to that of 7. 5 mg/ kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.

6.
Chinese Journal of Gastrointestinal Surgery ; (12): 634-638, 2019.
Article in Chinese | WPRIM | ID: wpr-810782

ABSTRACT

Objective@#To evaluate the clinical value of dual channel dual curved endoscope in the endoscopic submucosal dissection (ESD) for gastric angle mucosal lesions.@*Methods@#A descriptive cohort study was carried out. Clinicopathological data of 20 cases with gastric angle mucosal lesions undergoing ESD by dual channel dual curved endoscope in our center from October 2016 to August 2018 were collected and analyzed retrospectively. Inclusion criteria: (1) the lesion was located in the gastric angle confirmed by gastroscopy before ESD. (2) CT examination showed no distant metastasis. (3) pathological biopsy confirmed precancerous lesion or early cancerous lesion without submucosal invasion. (4) the whole operation was performed by the same endoscopist with ESD experience of about 2000 cases. Patients with previous ESD history of gastric angle and other serious diseases were excluded. The dual channel dual curved endoscopy (Olympus, GIF-2TQ260M) and other conventional endoscopic surgical instruments were used in all the cases. Complete tumor resection rate, pathological results, intraoperative and postoperative complications, operation time and hospitalization time were observed. Follow - up parameters included residual tumor, local recurrence and heterogeneous lesion.@*Results@#Of 20 patients, 14 were male and 6 were female with an average of 55.6 years (range, 37 to 75). All the tumors located in gastric angle. Specimen size ranged from 1.2 to 5.5 (average 2.9) cm. Operation time ranged from 50 to 120 (average 85.8) minutes. Hospital stay ranged from 3 to 7 (average 5.1) days. The en bloc excision was performed successfully in all 20 cases. There was no perforation or bleeding during or after operation. Pathological results showed curative or nearly curative resection stage in all the cases. No tumor residual or recurrence was found during follow-up for 8 to 30 (average 18.5) months.@*Conclusion@#Dual channel dual curved endoscope can provide good vision and easy control in removing the lesion completely and avoiding complications during the ESD procedure in gastric angle mucosal lesions with good long-term efficacy.

7.
Chinese Journal of Clinical Oncology ; (24): 1258-1262, 2018.
Article in Chinese | WPRIM | ID: wpr-754357

ABSTRACT

Objective: To investigate the application of 3D-printed minimally-invasiveguided template in the treatment of recurrent cer-vical cancer after surgery, assisting interstitial brachytherapy. Methods: From July 2017 to April 2018, a total of 10 patients admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei province with recurrent cervical cancer after radi-cal surgery underwent the 3D-printed customized template-assisted interstitial brachytherapy. According to the specific conditions of patients, different vaginal localization templates were selected for CT simulation localization. The main guidance needle space distribu-tion was designed, and 3D minimally-invasive guidance templates were printed. Then, needles were inserted according to the main guide channel of the template commissioned by medical photosensitive resin. The high-risk clinical target volume (HR-CTV) of 6 Gy/fraction was administered (4 to 6 fractions). Results: Overall, 10 patients were treated with implantation for a total of 52 times. Treat-ment with average scanning CT number for each brachytherapy was (1.58±0.70) times. The average elapsed time for each brachythera-py implant treatment, from plug implant to inserting planting needle satisfactorily with the location of the tumor, was (10.88±2.94) minutes. The mean number of metal needles used was (5.69±1.91) in each brachytherapy. The mean D90 value for high-risk clinical tar-get volume (HR-CTV) was (6.41±0.29) Gy. The cumulative D2cm3 values for the bladder, rectum, and sigmoid colon were (4.75±0.37) Gy, (3.93±0.26) Gy, and (4.33±0.24) Gy, respectively. After 3 months of treatment, the efficacy was evaluated in 8 cases with CR and 2 cas-es with PR. Conclusions: The technology of 3D-printed minimally-invasive guided template shows the advantage of accurate location and superior repeatability in the application of interstitial brachytherapy in treating recurrent cervical cancer after operation, which in-volves less time and insertion needles. The patients had minor aches and few complications. The tumor shrank significantly, which indi-cated a bright future of the technology's clinical application.

8.
Chinese Journal of Medical Science Research Management ; (4): 321-325,338, 2018.
Article in Chinese | WPRIM | ID: wpr-712302

ABSTRACT

Objective The purpose of this analysis is that it helps to set an example to adopting policies to nourish Government Funded Overseas Study for doctors and improving management by way of analyzing the benefits of going abroad for further study for these dentists.Methods To take 108 dentists who go through Government Funded Overseas Study for doctors from Peking University School of Stomatology for one by adopting the ways of questionnaire and in-depth interview,we undertake the analysis of benefits of overseas study from the perspectives of the time of their staying abroad and being back to the motherland.Results We find that doctors perform much better in aspect of cognition,attitude,research,medical skills and international communication and cooperation,especially their cognition and research ability.Conclusions We can draw the conclusion overseas study for doctors is an effective way of smoothing the future path of individual career,improving the medical quality and researching as well as internationalizing.Only by playing their leading role and carrying out overall planning plus some stimulating measures,hospitals can reach their maximum benefits in using the resources available.

9.
Chinese Journal of Digestive Endoscopy ; (12): 882-886, 2017.
Article in Chinese | WPRIM | ID: wpr-711476

ABSTRACT

Objective To investigate the value of endoscopic ultrasonography(EUS)in the diagnosis and treatment of undetermined etiology of common bile duct (CBD) dilatation. Methods Patients, who were referred for dilated CBD but unable to identify the cause by imaging, underwent EUS for the diagnosis of etiology in Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University from December 2015 to December 2016. The therapy was on the basis of diagnosis of EUS. Final diagnoses were determined by surgical pathology or follow-up for at least 3 months. Results A total of 76 patients were included in the study. The sensitivity, specificity and accuracy of EUS for patients with choledocholithiasis,patients with ampullary tumor, and patients with inflammatory stenosis were 100.0%(7/7), 100.0%(69/69), 100.0%(76/76), and 88.0%(22/25), 92.2%(47/51), 90.8%(69/76),and 90.9%(40/44), 93.8%(29/32), 90.8%(69/76), respectively. Accuracy of EUS for etiological diagnosis of CBD dilatation was 90.8%(69/76). The sensitivity,specificity and accuracy of EUS combined with tumor markers for patients with malignant CBD dilatation were 96.0%(24/25), 96.1%(49/51),and 96.1%(73/76), respectively. Conclusion EUS is an effective method for the etiological diagnosis of CBD dilatation and has guiding significance for the treatment. EUS combined with tumor markers may benefit differential diagnosis of benign and malignant CBD dilatation.

10.
Chinese Journal of Radiological Medicine and Protection ; (12): 919-923, 2017.
Article in Chinese | WPRIM | ID: wpr-666021

ABSTRACT

Objective To compare the dosimetric differences between intracavitary brachytherapy in combination with interstitial brachytherapy or not for locally advanced cervical cancer.Methods From May 2016 to March 2017,35 patients with locally advanced cervical cancer treated with combined external beams and intracavitary/interstitial brachytherapy were selected in this study.The prescription of intensity-modulated radiation therapy was:46.8-50.4 Gy/26-28 fractions,1.8 Gy/fraction.The prescription for combined intracavitary/interstitial brachytherapy was 7 Gy/fraction × 4,once per week.Each patient was first implanted with a three tube applicator for brachytherapy,and the CT images were acquired for treatment planning.The three tube applicator was removed before a uterine tube and needles were implanted,thereafter planning images were acquired again.Dose to the targets and organs at risk were evaluated respectively for the two groups.Results A total of 212 brachytherapy plans were developed,including 106 intracavitary and 106 endoluminal combined interstitial plans.The target dose in endoluminal combined interstitial brachytherapy was significantly higher than that of intracavitary treatment alone,where D90 of the high-risk clinical target volume (CTV) and moderate CTV were both significantly increased (t =-6.01,-2.73,P < 0.05).The D2 cm3 of the bladder,rectum and sigmoid colon were significantly reduced (t=3.07,4.52,2.91,P<0.05).Conclusions The application of the endoluminal combined interstitial brachytherapy for locally advanced cervical cancer can significantly increase the target dose,and reduce the dose to organs at risk such as the bladder,rectum and sigmoid colon.

11.
Chinese Journal of Hospital Administration ; (12): 656-658, 2016.
Article in Chinese | WPRIM | ID: wpr-498621

ABSTRACT

An introduction to the concept ofintegration of medical service and aging care,the strategic goals and policies in support of the new ecology of integration of medical service and aging care.The authors described specific practices in the development of laws and regulations,provision of various services and update means to build such an ecology in Wuxi,along with proposals to speed up the innovation and development.

12.
Chinese Journal of Medical Science Research Management ; (4): 169-172, 2016.
Article in Chinese | WPRIM | ID: wpr-497179

ABSTRACT

Based on domestic and international studies on Career-Life-Cycle theories,this paper analyzed the scientific research data of doctors to elucidate characters of varied steps in clinical and research practices,trying to construct Research Life-Cycle theory for doctors and provide theoretical references of talent cultivation in hospitals.

13.
Chinese Journal of Digestive Endoscopy ; (12): 40-44, 2016.
Article in Chinese | WPRIM | ID: wpr-491487

ABSTRACT

Objective To evaluate the efficacy of a new endoscopic suturing device(OverStitchTM, Apollo Endosurgery, USA)for gastrointestinal wall defect after endoscopic full?thickness resection (EFTR). Methods Clinical data of the patients with submucosal tumors who underwent endoscopic suturing closure of gastrointestinal wall defect at the Endoscopy Center of Zhongshan Hospital from April 2015 to June 2015 were retrospectively analyzed. Results Five patients were included in this research with 4 lesions located in stom?ach and 1 lesion located in descendent duodenum. The mean diameter of lesions was 3?? 2 cm (ranging 2?? 0?5?? 0 cm). All patients underwent complete closure and none of them was converted to laparoscopic surgery or laparotomy. The mean repairing time was 16?? 6 min (ranging 11?? 0?22?? 0 min). The mean postoperative hospi?talization time was 5 days ( ranging 4?6 d). Two patients complained about slight abdominal pain and elevated body temperature. CT showed minor pleural effusion in one case. These patients received antibiotics, were on gastrointestinal decompression and asked to maintain the semi?supine position and discharged after 3 to 4 days. Conclusion Endoscopic suturing closure of gastrointestinal wall defect with the OverStitchTM en?doscopic suturing device is technically fast, feasible and safe.

14.
Chinese Journal of Medical Science Research Management ; (4): 321-324,331, 2016.
Article in Chinese | WPRIM | ID: wpr-605360

ABSTRACT

Based on Career-Life-Cycle theory and practical experiences,this paper analyzed characters and varied requirements in scientific research during doctors' career development,and discussed the way and effects to construct talent cultivation mode of Research-Life-Cycle for doctors in hospitals.

15.
Chinese Journal of Gastrointestinal Surgery ; (12): 338-341, 2015.
Article in Chinese | WPRIM | ID: wpr-260357

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinicopathological features of small gastrointestinal stromal tumors(GISTs) and to evaluate the efficacy of endoscopic therapy for GISTs.</p><p><b>METHODS</b>Clinicopathological and follow-up data of 418 patients with GISTs undergoing endoscopic therapy in the Zhongshan Hospital between January 2009 and July 2014 were analyzed retrospectively. All the cases were evaluated by the NIH risk classification and AIFP classification, and were grouped according to the tumor size and location. Nuclear atypia and mitotic count were used to evaluate the biological behavior of small GIST. Efficacy of endoscopic therapy was analyzed with follow-up data.</p><p><b>RESULTS</b>Out of 418 patients, GISTs located in the esophagus was 14(3.3%), in the stomach 389(93.1%), in the duodenum 5(1.2%), in the rectum 10(2.4%). A total of 412(98.6%) patients were mainly spindle cells, and mitosis was not found in 320(76.5%) patients. In 389 small stomach GIST, 245(58.6%) were in fundic region. Cases were divided into four groups according to the size and the result revealed the bigger the size, the more the mitotic count. Nuclear atypia in the 1.5-1.9 cm group was significantly higher compared to other groups. Cases were divided into four groups according to the location and the result revealed the mitotic count was not associated to the location. While the nuclear atypia of stomach GIST was significantly higher than that of esophageal GIST and the nuclear atypia of rectum GIST was significantly higher than that of other positions. The median follow-up was 32(4-69) months. One case(gastric fundus GIST, >1.5 cm) presented local recurrence 23 months after operation and underwent endoscopic resection again. No recurrence or metastasis was found in other patients.</p><p><b>CONCLUSIONS</b>Endoscopic resection technique is effective for small GISTs patients. The small GISTs with 0.4 cm diameter or less are often benign and should be followed up for long time. The small GISTs with 0.5 cm diameter or more possess the risk of malignancy, then surgical resection should be performed. Rectum small GISTs (except for 0.4 cm diameter or less) have worse biological behavior and should be removed.</p>


Subject(s)
Humans , Gastrointestinal Neoplasms , Gastrointestinal Stromal Tumors , Neoplasm Recurrence, Local , Retrospective Studies
16.
Chinese Journal of Medical Science Research Management ; (4): 471-474, 2015.
Article in Chinese | WPRIM | ID: wpr-489522

ABSTRACT

It has proved to be difficult for administrators of scientific research to improve process management,especially to manage cooperative research projects accomplished by various institutions.In this paper,we took the process management of Scientific Research in Public Interest (SRI-PI) based on a Grade 3A hospital and other 19 institutions as an example,to analyze the application of PDCA cycle in projects management.It is concluded that the comprehensive quality management of research projects should follow the scientific procedure of PDCA cycle.

17.
Chinese Journal of Gastrointestinal Surgery ; (12): 71-73, 2014.
Article in Chinese | WPRIM | ID: wpr-256815

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of gastrointestinal cysts.</p><p><b>METHODS</b>Clinicopathological data of 40 patients with gastrointestinal cyst undergoing ESD in our center during January 2008 and February 2012 were analyzed retrospectively. Complications, en bloc resection rate, and local recurrence were assessed.</p><p><b>RESULTS</b>Eight lesions located in the esophagus, 11 in the stomach, 5 in the duodenum, and 16 in the colorectum. Thirty-seven lesions were successfully resected with ESD in an en bloc fashion (92.5%). During the operation, one perforation was encountered in the ascending colon and was clipped; one massive hemorrhage occurred in the esophagus and was treated with balloon compression. Postoperative pathological examination revealed cyst samples were intact without lesions in lateral and basal resection margins. Local recurrence was not found in 36 patients during a median postoperative follow-up of 9.7 months (range, 6-12 months).</p><p><b>CONCLUSION</b>ESD is a safe and effective procedure for the treatment of gastrointestinal cysts.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cysts , General Surgery , Digestive System Neoplasms , General Surgery , Endoscopy , Mucous Membrane , General Surgery , Retrospective Studies
18.
Chinese Journal of Medical Education Research ; (12): 618-621, 2013.
Article in Chinese | WPRIM | ID: wpr-435350

ABSTRACT

Objective To investigate and analyze the attitudes of higher vocational nursing students toward death and the related effect factors.Methods Totally 324 nursing students in a higher vocational school in Shaanxi province were investigated with death attitude profile-revised scale.Contents of investigation included physical and mental health status,family members' attitude towards death,family form and ranking,religion,presence of suicidal thoughts,exposure to mass media reports about death,reading books about death,death fear,death escape,natural acceptance,approach acceptance,avoidance acceptance,etc.SPSS 16.0 was used for data entry and statistic analysis,mean and standard deviation for statistical description,t test and variance analysis for statistical inference.Results ①Higher vocational nursing students got the highest average score (3.93 ± 0.55) in the dimension of natural acceptance.②In the dimension of avoidance acceptance,the scores of nursing students with excellent and good physical and mental health were significantly lower than those of students with general physical and mental health (F=4.80,P=0.009) ; the scores of nursing students in single parent family were significantly higher than those of students in other family forms (F=4.59,P=0.004) ; the scores of nursing students with suicidal thoughts were significantly higher than those of students without (t=-4.77,P=0.000).In the dimension of death avoidance,the scores of nursing students whose family discussed death openly were significantly lower than those of students whose family never done so (F=6.88,P=0.001).In the dimension of natural acceptance,the scores of nursing students with religious beliefs were significantly lower than those of students without (t=2.52,P=0.012) ; the scores of nursing students who gained information of death from mass media were significantly higher than those of nursing students who never done so.(t=-3.85,P=0.000),which was the same in the dimension of approach acceptance (t=-3.48,P=0.001).Conclusions The majority of higher vocational nursing students can naturally accept death reality.Attitude of higher vocational nursing students toward death are influenced by physical and mental health,discussing death in family,family form,religious belief,suicidal thought and news or report about death from the mass media.

19.
Chinese Journal of Digestive Endoscopy ; (12): 422-428, 2012.
Article in Chinese | WPRIM | ID: wpr-429199

ABSTRACT

Objective To investigate the clinicopathological features of specific subtypes of laterally spreading tumor (LST) and assess the outcomes of endoscopic submucosal dissection (ESD) based upon differentiation status.Methods A total of 174 cases of colorectal LST,treated with ESD between January 2007 and April 2011,were divided into granular type (LST-G) and non-granular type ( LST-NG),and further divided into 4 subtypes,including homogeneous granular,nodular mixed,flat elevated and pseudo-depressed types.Clinicopathological data and ESD parameters were compared between the four subtypes.Results Nodular mixed tumors were larger than homogeneous tumors,needed longer operation time and were more frequently seen in malignant transformation,high grade intraepithelial neoplasm ( HGIN ) as well as submucosal invasive cancer.So were peeudo-depressed tumors compared with flat elevated ones ( P <0.01 ).There was no significant difference between LST-G and LST-NG in the parameters of ESD including en bloc resection rate,complete resection rate and complete cure resection rate.The complications tended to be more frequent in nodular mixed tumors (bleeding rate:4.6%; peroration rate:3.5% ) and pseudo-depressed tumors ( bleeding rate:11.1% ; perforation rate 11.1% ),but there was no severe complication in either homogeneous tumors or fiat elevated tumors.One recurrent pseudo-depressed tumor was found 6 months after ESD treatment.Conclusion The degree of technical difficulty appears higher for nodular mixed and pseudo-depressed tumors than for homogeneous and flat elevated tumors,as is shown in procedure time and complication rate.ESD for these two subtypes should better be performed by experienced endoscopists.Accurate differentiation of the LST lesions is needed in basic and clinical research.

20.
Chinese Journal of Digestive Endoscopy ; (12): 259-262, 2012.
Article in Chinese | WPRIM | ID: wpr-428824

ABSTRACT

ObjectiveTo study the diagnostic and therapeutic value of endoscopy for gastrointestinal (GI) schwannoma.MethodsWe retrospectively studied data of 13 patients who underwent endoscopy and were confirmed as having GI schwannoma by pathology in our hospital during January 2006 and July 2011.ResultsSchwannoma of 8 patiets located in stomach,3 in esophagus and 2 in colon.Endoscopic ultrasonography showed schwannoma originated from muscularis propria,characterized by hypoecho.Twelve patients received endoscopic treatment,and 11 were successfully removed.The en bloc resection rate was 91.7%.Among them,6 were treated by endoscopic submucosal excavation,4 by endoscopic full-thickness resection and one by submucosal tunnel endoscopic resection.Another patient with schwannoma located in esophagus with a maximum diameter of 4.7 cm was transferred to thoracic surgery since the tumor had a wide base even after partial resection.No bleeding,inflammation or abscess occurred.The average follow-up time was 23.3 ± 10.8 months ( range,6-36 months).No metastasis or recurrence was found during follow-up.ConclusionEndoscopy and endoscopic ultrasonography,safe and efficacious,are valuable for the diagnosis and treatment of GI schwannoma.

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