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Objective:To explore the effect of Manchester pain management model (MPMM) combined with empowerment education nursing intervention on pain and recovery after cesarean section, and to provide reference for promoting recovery after cesarean section.Methods:A quasi-experimental study was conducted. A total of 120 pregnant women who underwent cesarean section in Shanxi Maternal and Child Health Hospital from September 2021 to June 2022 were selected by convenient sampling method and divided into observation group and control group according to the random number table method, with 60 cases in each group. The observation group received nursing intervention based on MPMM combined with empowerment education, while the control group received routine nursing. The degree of pain, postoperative recovery and nursing satisfaction were compared between the two groups.Results:After the intervention, the pain scores of the observation group were (5.13 ± 1.14), (4.17 ± 0.97), (3.56 ± 0.75) and (3.04 ± 0.79) points in the resting state 8, 12, 24 and 48 h after the operation, respectively, which were lower than (6.02 ± 0.81), (5.05 ± 1.08), (4.48 ± 0.82), (3.50 ± 0.95) points of the control group, the differences were statistically significant ( t values were 2.88 to 6.41, all P < 0.05). The pain scores of the observation group at 8, 12, 24 and 48 hours after operation were (6.98 ± 0.72), (6.44 ± 0.76), (5.48 ± 0.91) and (4.50 ± 0.89) points, respectively, which were lower than (7.62 ± 0.69), (7.47 ± 0.94), (6.95 ± 1.23), (6.18 ± 0.93) points of the control group, the differences were statistically significant ( t values were 4.84 to 10.12, all P<0.05). The time of getting out of bed for the first time in the observation group was (24.70 ± 2.53) h, which was lower than (26.32 ± 3.37) h in the control group, and the difference was statistically significant ( t=2.97, P<0.05). The success rate of first breastfeeding in the observation group was 76.7% (46/60), which was higher than 58.3% (35/60) in the control group, and the difference was statistically significant ( χ2=4.60, P<0.05). The overall nursing satisfaction score of the observation group was (8.25 ± 1.39) points, which was higher than (7.73 ± 1.04) points of the control group, and the difference was statistically significant ( t=-2.31, P<0.05). Conclusions:The nursing intervention based on Manchester pain management model combined with empowerment education can effectively reduce the pain after cesarean section, promote postpartum recovery and improve nursing satisfaction, which is worthy of clinical promotion.
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Acute respiratory distress syndrome (ARDS), a common respiratory critical illness with multiple causes, is associated with high mortality. The high degree of heterogeneity may be the reason why it is lack of highly specific and sensitive biological biomarkers. Therefore, it is an urgent need to explore biomarkers, perform phenotypic analysis and establish risk stratification model for diagnosis, prognosis, and treatment of ARDS. Endothelial cells specificity molecular-1 (ESM-1, endocan), is a soluble dermatan sulfate proteoglycan, and be involved in regulating biological behaviors such as cell proliferation, differentiation and migration. Numerous studies have confirmed that ESM-1 is closely related to inflammation, endothelial activation and dysfunction. However, the role of ESM-1 in the initiating and developing process of ARDS is still unclear. To provide a scientific basis for its clinical applications in ARDS, such as early prognosis assessment and timely prevent strategies, this paper focuses on the biological properties and the clinical value of ESM-1 as a potential biomarker for ARDS.
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Objective To determine whether relative abundance of epidermal growth factor receptor (EGFR) mutations in plasma predicts clinical response to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced lung adenocarcinoma. Methods In this prospective study, adult patients with advanced lung adenocarcinoma were enrolled in our hospital from 1 April 2016 to 1 January 2017. EGFR mutations in tumor tissues were detected by ADx-amplification refractory mutation system (ADx-ARMS). EGFR mutations of plasma free tumor DNA were detected by ADx-ARMS and ADx-super amplification refractory mutation system (ADx-SuperARMS) at the same time. Patients with EGFR-mutant in tumor tissues and receiving EGFR-TKIs were finally enrolled. Plasma mutation-positive patients with both methods were high abundance group.Patients with positive mutations by ADx-SuperARMS but negative by ADx-ARMS were medium abundance group. Mutation-negative patients with both methods were recognized as low abundance group. The correlation between EGFR mutation abundance and clinical response to EGFR-TKIs were analyzed. Results Among 71 patients enrolled, 42 harbored EGFR mutations in plasma were detected by ADx-ARMS, while 53 were found by ADx-SuperARMS.There were 42 patients in high abundance group, 11 in medium group while the other 18 in low group. The objective response rates (ORRs) were 69.0%,7/11 and 10/18 in high, medium and low groups, respectively. The difference was significant between high and low abundances groups (P=0.006). Median progression-free survival (PFS) in high,medium and low groups were 11.0, 8.5 and 9.0 monthes, respectively (P<0.001). In patients with tumor 19-Del, the ORRs were 70.4%,5/7 and 6/11 in high,medium and low abundance groups, respectively. The median PFS of high abundance group was significantly longer than the other two groups (12.0 monthes vs 9.0, 9.0 monthes). As to subjects with L858R mutation, the ORRs were 10/15,2/4 and 3/6,respectively, with median PFS 9.6, 5.5 and 9.5 monthes. Conclusions The relative abundance of EGFR mutations in plasma predicts clinical response to EGFR-TKIs in patients with advanced lung adenocarcinoma. The higher the mutation abundance is, the better the efficacy of EGFR-TKIs is.
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Objective To establish the ranges of normal reference values of fetal brainstem-vermis angle (BVA)and brainstem-tentorium angle (BTA)in normal fetuses at different gestational weeks,and to evaluate their clinical values in the diagnosis of mega cisterna magna.Methods Totally 320 normal singleton fetuses between 1 8 and 40 weeks of gestation were enrolled in this study.Three-dimensional ultrasound (3DUS)with volume contrast imaging (VCI)was used to measure their BVA and BTA,the correlations of BVA and BTA with gestational age were analyzed.The BVA and BTA of 24 fetuses with mega cisterna magna were also measured and were compared with those of the normal fetuses.Results In these normal fetuses,the BVA and BTA showed no correlations with gestational age (r=-0.05,0.04,both P >0.05);the ranges of normal reference values of BVA and BTA were 2.23°-19.30°and 18.53°-48.13°, respectively.The BVA and BTA of 24 fetuses with mega cisterna magna were 4.23°-17.42°and 20.41°-40.89°,respectively,which were not significantly different from those of normal fetuses (t =-0.55,0.92, both P >0.05).Conclusions 3DUS with VCI is feasible for measuring the BVA and BTA of fetuses,and the measured values can be used as the reference standards for BVA and BTA measurement in China.
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ObjectiveTo evaluate the clinical value of the rate of fetal urine production rate (UPR) in fetus with twin-to-twin transfusion syndrome(TTTS).Methods 22 continuative normal monochorionic diamniotic(MCDA) twin fetuses were selected as controll group.Eight fetuses with TTTS were selected as disease group,and UPR was measured by three-dimensional ultrasound virtual organ computer-aided analysis (VOCAL) and the rate of UPR in twin was calculated.Results1)The rate of UPR of twin fetuses in MCDA did not vary significantly throughout pregnancy (0.97 ± 0.28).The correlation coefficient between the rate of UPR and gestational age was 0.13,without obvious correlation.2)The rate of UPR-recipient/UPR-donor in TTTS fetuses increased significantly compared with MCDA twin fetus (7.83 ± 2.61,t =6.19,P ＜0.05).ConclusionsThe rate of UPR may be an important index in the assessment of TTTS.