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Purpose@#To evaluate the incidence and identify the risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma. @*Methods@#A meta-analysis was conducted. Eight electronic databases (Medline, Embase, Cochrane Library, CINAHL Plus with Full Text, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journals Database) were systematically searched from inception to 4 March 2023 for relevant studies. Study selection and data extraction were conducted by two independent authors. The Newcastle‒Ottawa scale was used for quality assessment among the included studies. Data synthesis and analyses were performed in R software package version 4.1.3 and Review Manager Software 5.4. The pooled incidence was calculated using proportions with 95% confidence intervals (CIs), and the risk factors were evaluated using the odds ratio (OR) with 95% CIs. Sensitivity analysis and predesigned subgroup analyses were also conducted. @*Results@#A total of 22 studies published from 2005 to 2023 were included. The results of the meta-analysis showed that the incidence of radiotherapy-induced oral mucositis was 99.0% among nasopharyngeal carcinoma patients, and the incidence of severe radiotherapy-induced oral mucositis was 52.0%. Poor oral hygiene, overweight before radiotherapy, oral pH < 7.0, the use of oral mucosal protective agents, smoking, drinking, combined chemotherapy, and the use of antibiotics at early treatment stage are risk factors for severe radiotherapy-induced oral mucositis. Sensitivity analysis and subgroup analyses also revealed that our results are stable and reliable. @*Conclusions@#Almost all patients with nasopharyngeal carcinoma have suffered from radiotherapy-induced oral mucositis, and more than half of patients have experienced severe oral mucositis. Facilitating oral health might be the key focus of reducing the incidence and severity of radiotherapy-induced oral mucositis among nasopharyngeal carcinoma patients.Registration numberCRD42022322035.
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Objective:To study the effect of visceral fat area (VFA) on postoperative complications and pancreatic fistula in patients undergoing laparoscopic assisted radical gastrectomy for gastric careinoma.Methods:Clnical data of 214 primary gastric cancer patients undergoing laparoscopic assisted radical gastrectomy between Jan 2017 and Jan 2022 at the Department of General Surgery, Shouguang People's Hospital were retrospectively reviewed.Results:There were 85 patients in high VFA group and 129 patients in the low VFA group. The body mass index (25.1±3.4) kg/m 2 and visceral fat area (143.4±41.1) cm 2 in the high VFA group were higher than those in the low VFA group (21.2±2.9) kg/m 2 and visceral fat area (58.7±31.9) cm 2. The operative time was (228.3±53.1) min vs. (206.3±62.9) min ( t=5.538, P=0.017). The intraoperative blood loss was (264.6±173.6) ml vs. (213.9±156.2) ml ( t=3.373, P=0.035). The postoperative hospital stay was (12.5±4.0) d vs. (10.3±3.7) d ( t=7.781, P=0.013). Twenty-three cases developed postoperative complications in the high VFA group vs. 20 cases in the low VFA group ( χ2=4.261, P=0.039). Patients in the high VFA group had an incidence of clinically relevant pancreatic fistula of 10.6% vs. 3.1% in patients in the low VFA group ( χ2=5.034, P=0.038). Univariate and multivariate analysis of clinically relevant pancreatic fistulas in patients with different VFA groups showed that men ≥134.6 cm 2 and women ≥91.1 cm 2 with VFA and operative time ≥250 min were independent risk factors for the occurence of clinically relevant pancreatic fistulas after laparoscopic assisted radical gastrectomy. Conclusions:VFA increases the difficulty of laparoscopic-assisted radical gastrectomy, resulting in increased postoperative complications. VFA and operation time are independent risk factors for clinically relevant pancreatic fistula after radical gastrectomy for gastric cancer.
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Objective:To investigate the related factors that affect the occurrence of severe pancreatic fistula after radical gastrectomy.Methods:The clinical data of 460 patients undergoing radical gastrectomy in The People's Hospital of Shouguang from January 2015 to January 2021 were retrospectively analyzed. These patients were divided into severe pancreatic fistula group ( n = 24) and non-severe pancreatic fistula group ( n = 436) according to whether they developed severe pancreatic fistula after surgery. Preoperative clinical data, surgical data, and abdominal drainage fluid amylase level in the first postoperative days were compared. The receiver operating characteristics (ROC) curve was used to calculate the cutoff value of abdominal drainage fluid amylase level on the 1 st and 3 rd days of developing severe pancreatic fistula after radical gastrectomy. The incidence of pancreatic fistula was compared between different amylase level groups. Multivariate logistic regression was performed to analyze the independent risk factors of severe pancreatic fistula after surgery. Results:There were significant differences in body mass index, operative time, intraoperative blood loss, peritoneal drainage fluid amylase level on the 1 st and 3 rd days after surgery, and the number of cases undergoing splenectomy between the two groups (all P < 0.05). The cutoff values of amylase level in peritoneal drainage fluid (D-AMY) on the 1 st and 3 rd days after surgery were 2 156 IU/L and 596 IU/L respectively, which had high sensitivity and specificity. On the 1 st and 3 rd days after surgery, the incidence of pancreatic fistula in the high-level amylase group was significantly higher than that in the low-level amylase group [26.2% (16/61) vs. 0.8% (3/334), χ2 = 62.82, P < 0.05). Multivariate logistic analysis showed that obesity, splenectomy, and abdominal drainage fluid amylase level higher than the cut-off value on the 1 st and 3 rd days after surgery were independent risk factors for severe pancreatic fistula, and the differences were statistically significant (all P < 0.05). Conclusion:Obesity, splenectomy, and abdominal drainage fluid amylase level higher than the cut-off value on the 1 st and 3 rd days after surgery are independent risk factors affecting the occurrence of severe pancreatic fistula. D-AMY (> 2 156 IU/L) on the 1 st day and D-AMY (> 596 IU/L) on the 3 rd day in the early postoperative days can be used as cutoff values to predict the occurrence of severe pancreatic fistula after radical gastrectomy.
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Objective:To evaluate the relationship between abdominal amylase, C-reactive protein (CRP), procalcitonin (PCT) and clinically relevant pancreatic fistula in the early stage after radical gastrectomy for gastric cancer, and to explore whether they can be used as early predictors of pancreatic fistula and their accuracy, in order to help identify pancreatic fistula in the early stage after gastrectomy.Methods:The clinical data of 372 patients diagnosed as gastric cancer and underwent gastrectomy in Shouguang People′s Hospital from January 2017 to December 2021 were retrospectively analyzed, including 190 males and 182 femals, aged from 28 to 32 years old, with the average years of 63.5±10.6. The receiver operating characteristic (ROC) curves of abdominal amylase on the first day and serum CRP and procalcitonin on the third day after surgery for gastric cancer were analyzed. The ROC curve was used to determine the optimal cutoff value and the sensitivity, specificity, positive and negative predictions, and accuracy of the optimal cutoff value were calculated. Single factor and multivariate analysis were used to analyze the risk factors of pancreatic fistula after gastric cancer surgery. SPSS 25.0 software was used for statistical analysis.Results:The incidence of clinically relevant pancreatic fistula after surgery for gastric cancer was 5.37%(20/372), including 18 cases of grade B pancreatic fistula and 2 cases of grade C pancreatic fistula. The critical values of amylase on the first postoperative day of clinically relevant pancreatic fistula after surgery for gastric cancer are predicted to be 2036 U/L, serum CRP 18 mg/dL, and procalcitonin 0.85 μg/L. In univariate analysis, body mass index, abdominal amylase concentration on the 1st postoperative day, serum CRP and procalcitonin on the 3rd postoperative day were the influencing factors for the occurance of pancreatic fistula after gastric cancer surgery. Multivariate Logistic regression analysis showed that body mass index>25 kg/m 2, abdominal amylase >2036 U/L on the first postoperative day and serum CRP>18 mg/dL on the third postoperative day were the independent predictors for pancreatic fistula. The sensitivity and specificity of the combination of intraperitoneal amylase on the first day and serum CRP on the third day after surgery for gastric cancer in predicting the occurrence of clinically relevant pancreatic fistula were 87.6% and 90.4%, respectively. Conclusions:The combination of amylase in abdominal cavity on the 1st day and CRP on the 3rd day after radical gastrectomy has high sensitivity and specificity in predicting clinically related pancreatic fistula. PCT on the 3rd day after gastric cancer surgery has limited accuracy in predicting clinically related pancreatic fistula, so it is not recommended as an early prediction index of pancreatic fistula after gastric cancer surgery.
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Objective To understand the status quo and demanding of resident pension service in Chongqing urban communities to provide the reference for constructing the community pension service system.Methods The questionnaire survey was conducted on 1 080 residents aged 50 years old or older in the nine districts of Chongqing City.Results 89.1％ of the respondents didn't have any pension service,but the currently facing maximal difficulty Was the low proportion of medicare reimbursement,the main service that the elderly wanted to get was life care,security safeguards services and ordinary medical help;73.4％ of the respondents were willing to try the integrated pension service model.Conclusion The government or related departments should optimize new pension resources,increase the funding sources,make reasonable overall planning and construct the pension service model.
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Objective To observe the clinical effect of Xiaoaiping Injection combined with gemcitabine and carboplatin in the treatment ofⅢB and Ⅳ non-small cell lung cancer (NSCLC).Methods Totally 106 NSCLC patients from Huangshi Central Hospital of Edong Medical Group were sellected in this study.The patients were divided into gemcitabine and carboplatin control group (n =53)and Xiaoaiping Injection combined with gemcitabine and carboplatin observation group (n =53).The clinical efficacy and adverse reactions were compared between two groups.Results After four cycles of treatment,the effective rate and control rate in observation group were 39.6％ and 77.4％,and those in control group were 35.8％ and 75.5％.There was no significant difference between the two groups.The decline rates of white blood cells,hemoglobin,and platelet in observation group were 41.5％,37.7％,and 45.3％,which were significantly lower than those of 64.2％,62.3％,and 69.8％ in control group (P ＜ 0.05).There was no significant difference of renal function injury,liver function damage,nausea,vomiting,dizziness,headache,diarrhea,and constipation between two groups.In observation group,the median survival time was 8.4 months,time to tumor progression was 5.3 months,and 1 year survival rate was 26.4％.In control group,the median survival time was 7.7 months,time to tumor progression was 4.2 months,and 1 year survival rate was 11.3％.There was significant difference between two groups (P ＜ 0.05).Conclusion Xiaoaiping Injection combined with gemcitabine and carboplatin can reduce the hematologic toxicity of chemotherapy drug in the treatment of ⅢB and Ⅳ NSCLC,and improve long-term clinical outcomes.combined with gemcitabine and carboplatin can reduce the hematologic toxicity of chemotherapy drug in the treatment ofⅢB and Ⅳ NSCLC,and improve long-term clinical outcomes.
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Objective To investigate the knowledge degree of the risk of intrauterine adhesions in patients with induced abortion.Methods A total of 360 patients,who accepted induced abortion in gynecological clinic from June to November 2015,were evaluated using self-edited Assessment on Doctor-patient Communication in Gynecological Outpatient Clinic.Results 83.9％ patients could provide previous pregnancy and fertility history,24.2％patients could repeat clearly therapeutic advice and attentions after induced abortion,13.1 ％ patients understood the risk of uterine adhesion,9.7 ％ patients understood the influnce of uterine adhesion on fertility and 31.9 ％ patients wished to prevent uterine adhesion with drugs,patients with spontaneous abortion and multiple abortion history understood the risk with 67.6％ and 31.5％ respectively,overall 61.9％ patients felt the pressure and wished to get more attetions.Conclusion We need to strengthen the risk informing of intrauterine adhesions after induced abortion.
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Objective To explore the clinical efficacy of Baihu decoction combined with insulin on type 2 diabetes with acute hyperglycemia patients.Methods A total of 86 cases of type 2 diabetes with acute hyperglycemia patients were randomly divided into experimental group (n=43) and control group (n=43).Two groups of patients underwent conventional exercise and diet adjustment intervention, control group was treated with insulin, continuous injection of 14d, experimental group was treated with Baihu decoction based on control group, 7d was taken for one courses, two course in all.The clinical symptoms of the two groups were compared, and the FPG, 2hPBG, HbAlc levels was detected in two groups pre-and post-reatment, the serum IL-6, hs-CRP, TNF-α, LP, APN, Cor were detected by enzyme linked immunosorbent assay method.Results The total effective rate was 91.7%in experimental group, higher than 76.7% in control group(P<0.05).After treatment, FPG, 2hPBG, HbAlc, IL-6, hs-CRP, TNF-αlevels in two groups were all significantly decreased (P<0.05), and those indexes in experimental group were significantly lower than those in control group (P<0.05).After treatment, APN and LP were significantly decreased, Cor was significantly increased in two groups(P<0.05), and the LP and APN in experimental group were significantly lower and Cor was significantly higher than that in control group (P<0.05).Conclusion Baihu decoction combine with insulin can significantly improve the clinical symptoms in type 2 diabetes with acute hyperglycemia patients, reduce the level of blood glucose and cytokines, and its mechanism may be relate to the increase APN level, reduce the LP and Cor levels.
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Objective:To probe the implement of inquiry -based teaching in nursing ethics. Method:105 nursing students attended the innovation of inquiry-based teaching for Nursing Ethics. Results:88. 5% nursing students satisfied with innovation of teaching;82 . 9% nursing studentsethics awareness was enhanced largely in understanding for nursing ethics;68 . 6% nursing students considered that their ability for ethical thinking has been enhanced largely;93 . 3% nurs-ing students thought that nursing ethics was important. Different inquiry methods for nursing students led to different level of analysis ability for ethic cases(P﹤0. 001). Conclusions:It's necessary to perform the innovation of inquiry-based teaching, promoting the student's activity, focus on learning process and enhancing the students comprehensive ability.
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Objective To understand college students on-site first aid training demand situation in Chongqing ,in order to provide the basis for college students to carry out on-site first aid training .Methods Using stratified random sampling method ,a question-naire survey was conducted on 1 232 students of 6 university in Chongqing .Results 90 .9% of the students hoped that they could master the on-site first-aid knowledge and skills ,students of different genders had significant differences on learning attitude of field first aid knowledge(P<0 .05) .The on-site first-aid knowledge among college students in Chongqing city most wanted to know was thetrauma emergency stop(74 .8% ) ,the most loving way of learning was to the hospital or emergency center study tour(47 .7% ) ,The love of on-site first aid training and learning style were theory teaching+watch video teaching or teacher demon-stration+classroom practice (63 .6% ) ,The operation way of learning the most love was teacher ,all the students into groups of two ,mutual operation practice(65 .9% ) ,and in both gender and specialty had significant differences(P<0 .05) .The survey of col-lege students in Chongqing city training status display results ,43 .5% of the students never received on-site first aid training .In ad-dition ,college students receive on-site first aid training frequencies were low ,48 .6% students in more than 2 years received 1 ses-sions of training .while the rescue confidence survey of college students after the on-site first aid training ,only 13 .1% of the students“completely had the confidence to do” .Conclusion College students in Chongqing have strong desire to learn on-site first aid training ,and there are differences in gender and major on demand ,past state of first aid training is poor ,in urgent need of the relevant departments give attention ,and formulate the on-site first aid training programs to improve college students′competence .
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Objective: To evaluate the status of loneliness, the influential factors and the relationship between loneliness and family function among bereaved parents in disaster area of 5.12 Earthquake and to provide basis for mental and family reconstruction for those people suffering from the Earthquake. Methods: A total 190 bereaved parents in disaster area of 5.12 Earthquake were enrolled for an across-sectional study. A face-to-face survey was conducted by following scales: General Data Scale, University of California at Los Angels Loneliness Scale, Emotional and Social Loneliness Scale and Family APGAR Index. Results: hTe score of loneliness ranged from 24 to 69 (mean=43.58, SD=9.61), the score of emotional loneliness ranged from 5 to 24 (mean=11.95, SD=3.60) while the social loneliness ranged from 6 to 24 (mean=13.99, SD=3.69). hTe scores of loneliness, social loneliness and emotional loneliness were all increased among bereaved parents compared to people without loss of their child. The results of multivariate analysis showed that family function and status of fertility significantly impacted the loneliness (P<0.05). Furthermore, there was negative correlation between family function and the loneliness, social loneliness and emotional loneliness (P<0.05). Conclusion: The bereaved parents in disaster area of 5.12 Earthquake showed higher level of loneliness. The better of family function indicated the less of loneliness in bereaved parents. Measures should be taken to promote mental and family reconstruction for such people, including providing effective skills to improve emotional communication and family function and offering technical support for having another baby.
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OBJECTIVE@#To investigate the family function among the bereaved in hard-hit areas 1 year after Wenchuan earthquake and to provide basic information for family reconstruction.@*METHODS@#A cross-sectional study was used to survey 264 bereaved who were selected according to the criteria in hard-hit areas after Wenchuan earthquake.@*RESULTS@#The scores of family care function of the bereaved in hard-hit areas after Wenchuan earthquake were 6.52±2.65. Fifty percent of the participants' family kept in good state. The scores of the bereaved family cohesion ranged from 28 to 83 (64.22±9.18), and the scores of family adaptability ranged from 21 to 62 (41.84±6.62). There was no significant difference in the score of family cohesion between the bereaved family and the non-bereaved family (P>0.05). But the score of the family adaptability of the bereaved family was significantly lower than that of the non-bereaved family (P<0.05). The bereaved family types were as follows: 22.0% balanced type, 53.8% middle type and 24.2% extreme type. In the 16 family types, the "intimate-rigid" (24.6%), "intimate-regular" (19.7%) and "disengaged-rigid" (19.3%) type ranked the top three.@*CONCLUSION@#The family care function of the bereaved in hard-hit areas after Wenchuan earthquake is damaged to different degrees. The main type of family is the middle type. The loss of relatives reduces the participant family adaptability. In the late intervention, we should help the bereaved improve and enhance family function, and promote family reconstruction of the bereaved.
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Female , Humans , Male , Adaptation, Psychological , Bereavement , China , Cross-Sectional Studies , Earthquakes , Family , Psychology , Family Health , Life Change Events , Loneliness , Surveys and Questionnaires , Survivors , PsychologyABSTRACT
Objective To understand the basic situation and the current work status of health education staff in Beibei district of Chongqing city and to explore the community health education pattern in Beibei district to provide reference for rational talent strat -egy and personnel policy adjustment .Methods By using the Investigation Questionnaires of Health Education Personal in Beibei District ,35 health education staffs in Beibei district were performed the investigation .Results Most health education staffs in Bei-bei district are young and middle-aged .The average age was 36 .7 years ;71 .4% of them had undergraduate or college degree .Only 3 individuals were full-time staff and the others were part-time;the health education forms were plentiful with various contents . The health education staffs were insufficient in the professional knowledge and the health education skill .The external factors had influence on the health education work .Conclusion The health education staffs rejuvenation ,lack of the professional staffs and in-adequate depth of the theory and practice of the health education work restrict the deep development of the health education work to some extent .It is suggested that the relevant departments introduce the professional health education talents ,conduct the systematic training for enhancing the professional knowledge and working skills ,and give support in terms of policy and funding .
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Objective The study aimed at establishing an evaluation index system of clinical competence of nursing undergraduate interns,which is more scientific,clearly guidable,comparative and convenient in order to provide the theoretical foundations to enhance the standardization,objectivity and fairness of the evaluation of clinical competence of nursing undergraduate interns.Methods Based on the Delphi method,the items of evaluation system was selected,the standards with 4 different levels for each item were set.Results The evaluation index system of clinical competence of nursing undergraduate interns was constructed,which was composed of 23 items from 5 domains including professional value,clinical nursing competence,communication and collaboration competence,teaching and management competence and professional development competence.Four different levels of evaluation standards were set for each item to differentiate different levels of clinical competence.The enthusiasm coefficient of experts was 96.2％(＞60％),the average authority coefficient of experts was 0.9128 (＞0.70).The harmonization coefficient of the 5 domains in the first grade index was 0.9262 and those of 23 items in the second grade index was 0.9127.Conclusions The index system of clinical competence of nursing undergraduate interns established evaluation standard of each level.The enthusiasm coefficient,authority coefficient and harmonization coefficient of expert consultation showed that it has high representativeness and reliability.
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Objective To promote health service information system for air force air-station. Methods According to service characters and demands of air force air-station, a general database was designed to integrate health information of pilots, health service of air-station, and physiology & psychology detection of pilots. Results It provided automatic and intelligent means for health service information and health information of pilots for all level health division of air force. Conclusion The successful running of the system enhances the service support efficiency of air force air-station, thus positively promoting the battle effectiveness.
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This paper discusses the present situation of the air-station medical equipment digital construction,and analyzes the common problems at present.According to the integration spirit of superior department,this paper designs air-station medical database and presents the solutions to realize resource integration and information sharing.
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Objective To evaluate the applicable and clinical value of CT and radiography in the dignosis of acetabular fractures.Methods The data of CT,X-ray and clinical treatment in 18 cases with acetabular fractures were analyzed and comparatively.Results There were 4 cases of the anterior wall fracture,4 cases of the anterior column fracture,2 cases of the posterior wall fracture,2 cases of the posterior column fracture and ,6 cases of complex fracture,11 cases were in company with swelling of the soft tissue in pelvic cavity.Of them,4 cases misdiagnosed by radiography.27 pieces of bone fragment were detected by CT,including 17 pieces of them in joint cavity.12 pieces of bone fragment were detected by X-ray,only 4 pieces of them were in joint.3 cases with femoral head fracture were included in 7 cases of the hip joint dislocation,1 case of them was misdiagnosed by X-ray.Conclusion In detecting the bone fragments in articular space,the type of acetabular fractures and soft-tissue swelling,CT is super to radiography.
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Objective To develop data analytic system of physiological parameters detecting device for pilots.Methods By analyzing the demands,the functions of the system were established;adopting module structure and Objective Oriented method,the system structure was designed;and applying modern digital signal processing technique,algorithms were de-veloped.Results The system has following functions: detection of QRS complex wave and breath rate,arrhythmia analyzing,HRV analyzing and synchro-analyzing of multi-parameter.Conclusion The application in many units demonstrates that the system is feasible,stable and reliable.It is useful for flight surgeon to know the physiological state of pilots.
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The fasting blood chromium and its area of 83 noninsulindependent diabetics and 24 normal subjects were determined. The results showed that both the fastng blood chromium concentrations (39.9?17.4ppb) and its area (128.8?48.5 ppb/h) of diabetics were significantly lower than that of normal subjects (80.9?28.5 ppb, 270.6?88.4 ppb/h) (P
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In order to find out an index for the assessment of chromium deficiency in diabetic patients, the contents of chromium in the hair of twenty-seven diabetic patients and sixty-three healthy subjects were determined. The contents of chromium in hair was determined with a flameless atomic absorption technique. The mean recovery rate was 103% and the CV was 4.3%.The results showed that the mean value of diabetic patients (104.22?61.99ng/g) was significantly lower than that of healthy subjects (173.19?79.96ng/g) (p