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Objective To summarize the effect of the timing of lung transplantation and related treatment measures on clinical prognosis of patients with paraquat poisoning. Methods Clinical data of a patient with paraquat poisoning undergoing bilateral lung transplantation were retrospectively analyzed. Clinical manifestations, auxiliary examination, diagnosis and treatment of this patient were summarized and analyzed. Results A 17-year-old adolescent was admitted to hospital due to nausea, vomiting, cough and systemic fatigue after oral intake of 20-30 mL of 25% paraquat. After symptomatic support treatment, the oxygen saturation was not improved, and pulmonary fibrosis continued to progress. Therefore, sequential bilateral lung transplantation was performed under extracorporeal membrane oxygenation (ECMO). After postoperative rehabilitation and active prevention and treatment for postoperative complications, the patient was discharged at postoperative 50 d. Conclusions The timing of lung transplantation after paraquat poisoning may be selected when the liver and kidney function start to recover. Active and targeted prevention of potential pathogen infection in perioperative period and early rehabilitation training contribute to improving clinical prognosis of lung transplant recipients.
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Objective:To investigate the characteristics related to proliferation, migration and invasion of radiation-induced polyploid colon cancer SW1116 cells and their progeny.Methods:Colon cancer SW1116 cells were conventionally cultured in Leibovitz's L-15 medium containing 10% fetal bovine serum. SW1116 cells at logarithmic growth stage were irradiated with 7 Gy X-ray, and the morphological changes of the cells were observed by inverted microscope on days 3, 5, 10 and 19 after radiation induction. According to the morphological changes of the cells, the cells at day 3 after radiation induction were labeled as polyploid giant cancer cell (PGCC) group, and the cells at day 19 were recorded as PGCC progeny group. SW1116 cells without radiation induction were used as control group. Flow cytometry was used to detect cell ploidy in the control, PGCC and PGCC progeny groups, CCK-8 assay was used to detect the proliferation ability of the three groups, cell migration and invasion abilities of the three groups were detected by cell scratch assay and Transwell assay, and Western blotting was used to detect the expressions of cell cycle and proliferation-related proteins and epithelial-mesenchymal transition (EMT) marker N-cadherin (N-cad) in the three groups.Results:The volume of SW1116 cells gradually became larger on days 3, 5 and 10 after radiation induction, and returned to normal on day 19. The proportions of polyploid (DNA content >4N) cell subsets in the control group, PGCC group and PGCC progeny group were (2.3±1.1)%, (23.1±8.1)% and (3.2±0.5)%, the difference was statistically significant ( F = 18.52, P < 0.05), and the proportion of polyploid cell subpopulations in the PGCC group was higher than that in the control group ( t = 5.38, P < 0.01), but the differences between the PGCC progeny group and the control group were not statistically significant ( t = 0.22, P > 0.05). After 72 h of culture, the cell proliferation rates of the control, PGCC and PGCC progeny groups were (100.0±4.1)%, (73.5±0.7)% and (123.9±3.5)%, and the difference was statistically significant ( F = 190.27, P < 0.001). After 48 h of cell scratching, the scratch healing rates in the control, PGCC and PGCC progeny groups were (38.0±2.7)%, (41.5±4.0)% and (63.7±4.2)%, and the difference was statistically significant ( F = 43.05, P < 0.001). After 24 h of culture, the number of invasive cells in the control, PGCC and PGCC progeny groups was 12.9±1.2, 3.4±0.6 and 23.7±1.5, and the difference was statistically significant ( F = 63.64, P < 0.001). The expression levels of cell cycle-related proteins P-cdc25c, cdc25c and cdc2 in the PGCC group were lower than those in the control group (all P < 0.05), and the expression levels of transcription factor-related proteins E2F-2, E2F-3 and EMT marker N-cad were downregulated compared with the control group (all P < 0.05); the expression levels of P-cdc25c, cdc25c, cdc2, E2F-2, E2F-3 and N-cad proteins in the PGCC progeny group were higher than those in the control group (all P < 0.05). Conclusions:Radiation can induce colon cancer SW1116 cells to produce polyploid, which may then generate daughter cells through asymmetric mitosis and gain new life, and then promote the recurrence and metastasis of colon cancer.
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Objective:To build a set of evidence-based quality of care indicators for patients with knee osteoarthritis(KOA) through a comprehensive literature search to collect high quality evidence. And provide theoretical reference for KOA clinical nursing.Methods:Systematically and comprehensively searched the Chinese English databases and relevant guide websites to collect KOA related guidelines, standards of care, recommendations and quality indicators. The databases search time of Chinese was from construction to 2018, and English was from 2001 to 2018. According to JBI levels of evidence classification and recommend system to evaluate the quality of evidence. Then established the quality indicators draft guided by the theory of structure-process-outcome quality pattern. Finally,implemented 2 rounds of experts consultation using Delphi method to confirm the quality indicators set for KOA.Results:A total of 137 KOA quality indicators were included after the comprehensive retrieval. The final indicator system consisted of three factors: quality of structure, quality of process and outcome quality, including 11 first-level indicators, 31 second-level indicators and 64 third-level indicators.Conclusions:In this study, the quality indicators set of KOA could supply the theoretical basis for the evaluation of KOA nursing institutions and provide reference for the establishment of quality evaluation in other fields.
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Objective:To investigate the biological characteristics of proliferation, apoptosis, migration and invasion of radiation-induced polyploid cervical cancer HeLa cells, and to analyze the potential facilitation of polyploid HeLa cells in cervical cancer recurrence after radiotherapy.Methods:HeLa cells were irradiated by 6 MV-X ray with 7 Gy and 14 Gy, the cells were cultured until the third day, and then they were recorded as 7 Gy group and 14 Gy group respectively. The unirradiated HeLa cells were recognized as the control group. The cell morphology was checked under optical microscope. Flow cytometry was used to determine cell ploidy. MTT assay was applied to detect cell proliferation. Flow cytometry by AnnexinⅤ-FITC/PI double labeling was used to detect apoptosis. The ability of migration and invasion was detected by Transwell assay. The expression levels of STAT3 signal pathway-related proteins were analyzed by Western blotting.Results:Compared with the control group, the volume of HeLa cells in 7 Gy group and 14 Gy group increased significantly. The percentages of polyploid HeLa cell subsets in the control group, 7 Gy group and 14 Gy group were (6.33±1.26) %, (21.13±0.50) % and (46.07±1.68) % respectively, with a statistically significant difference ( F=780.47, P<0.001) . The absorbance values in the control group, 7 Gy group and 14 Gy group of polyploidy HeLa cells were 0.21±0.01, 0.23±0.02, 0.16±0.01 at 24 h, 0.37±0.03, 0.38±0.06, 0.21±0.00 at 48 h, 0.66±0.02, 0.55±0.01, 0.28±0.01 at 72 h, and there were statistically significant differences ( F=31.62, P=0.001; F=20.10, P=0.002; F=708.52, P<0.001) . Further pairwise comparison showed that the proliferation abilities of polyploidy HeLa cells of the 14 Gy group at 24, 48 and 72 h were significantly lower than those of the control group and the 7 Gy group (all P<0.05) . The proportions of apoptotic cell subset in the control group, 7 Gy group and 14 Gy group were (3.67±1.16) %, (3.07±0.81) %, (3.83±0.91) %, the proportions of early apoptotic subset were (2.33±0.35) %, (2.13±0.61) %, (2.23±0.32) %, and the proportions of late apoptotic subset were (1.33±0.81) %, (0.93±0.31) %, (1.60±0.60) % respectively. There were no statistically significant differences ( F=0.52, P=0.620; F=0.15, P=0.864; F=0.92, P=0.450) . The migrated numbers of cells in the control group, 7 Gy group and 14 Gy group were 297.40±26.53, 121.33±15.16, 18.40±4.79, and the invaded numbers were 195.67±20.26, 63.60±6.91, 9.47±3.23 respectively, with statistically significant differences ( F=647.28, P<0.001; F=213.94, P<0.001) . Compared with the control group, the migration and invasion abilities of polyploid HeLa cells in the 7 Gy and the 14 Gy groups were significantly decreased, and the migration and invasion abilities of polyploid HeLa cells in the 14 Gy group were significantly lower than those in the 7 Gy group (all P<0.001) . The expression levels of P-STAT3 (Tyr 705) and Bcl-2 in radiation-induced polyploidy HeLa cells were higher than those in the control group, and the expression levels were further increased with the increase of radiation dose. Compared with the control group, the expression levels of Survivin and Mcl-1 in polyploid HeLa cells in the 14 Gy group were up-regulated (both P<0.05) . There was no significant difference in Bcl-xL expression among the three groups ( F=0.52, P=0.618) . Conclusion:The proliferation, migration and invasion abilities of polyploid HeLa cells are reduced by radiation, and the proportion of apoptotic subset is not significantly changed, but the activation of STAT3 signaling pathway is accompanied by up-regulation of downstream anti-apoptotic related proteins, which is favorable for the polyploid tumor cells to be the potential risk factor of recurrent cervical cancer after radiotherapy.
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Objective:To investigate the clinical efficacy of 125I seed implantation combined with anlotinib hydrochloride in the treatment of non-small cell lung cancer (NSCLC). Methods:61 cases of NSCLC patients were enrolled, of which 30 cases (observation group) received 125I seed implantation combined with anlotinib treatment, and 31 cases (control group) received 125I seed implantation only. To evaluate the curative effect and adverse reactions of all patients, the carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), neuroendocrine enolase (NSE), squamous cell carcinoma antigen (SCC) in the peripheral blood of the two groups was measured before the treatment and at 1 and 3 months after the treatment. Results:The effective rates in the observation group were 90.00% and 93.33%, the effective rates in the control group were 67.74% and 74.19% at 1 and 3 months after the treatment, respectively, and the difference in efficacy between the two groups was statistically significant ( χ2=4.504, P=0.034 vs. χ2=4.075, P=0.044). There was no significant difference in the incidence of adverse reactions between the two groups of patients after treatment ( P=0.785). At 1 and 3 months after the treatment, the levels of CEA, CYFRA21-1, NSE and SCC in the peripheral blood of the two groups of patients were lower than those before the treatment (all P<0.05). Conclusions:125I seed implantation combined with anlotinib hydrochloride is safe for the treatment of advanced non-small cell lung cancer, and has promotion value.
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This paper mainly introduces the concept and theoretical basis of motivational interviewing, summarizes its application effect in chronic obstructive pulmonary disease patients, existing problems and prospects in the application process, and provides theoretical support and behavioral guidance for the further use of motivational interviewing health education for chronic obstructive pulmonary disease patients.
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This paper mainly introduces the concept and theoretical basis of motivational interviewing, summarizes its application effect in chronic obstructive pulmonary disease patients, existing problems and prospects in the application process, and provides theoretical support and behavioral guidance for the further use of motivational interviewing health education for chronic obstructive pulmonary disease patients.
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Objective To explore the clinical significance of non-invasive prenatal genetic testing to screen prenatal fetal chromosomal abnormalities. Methods Peripheral blood was collected from 6 283 pregnant women who underwent non-invasive prenatal genetic testing at our hospital, and fetal DNA was extracted and purified for analysis. The complementary base principle of semiconductor chip technology was used to analyze all sequenced signals with BioelectronSeq 4000. Invasive prenatal diagnosis was performed in high-risk pregnant women according to the results of the sex chromosome sequencing signal analysis. Results Of the 6 283 pregnant women screened, 14 were found to have chromosomal abnormalities, and the positive rate was 0. 22％. Karyotype analysis was performed on 11 of the women; the remaining 3 refused to be diagnosed. Of these 11 women, 2 of the 5 patients with a high risk of XO were diagnosed with fetal chromosomal abnormalities (diagnosed as XO/XXX chimera and XO, respectively), and 3 were diagnosed with a normal karyotype; 5 patients with a high risk of XXY were diagnosed as XXY; and 1 patient with a high risk of XXX was confirmed as XXX. NIPT accuracy was measured to be 73％ (8/11). The detection rate of fetal chromosomal abnormalities by non-invasive prenatal genetic testing was significantly higher in the years 2015-2016 than in 2011-2014 (P ＜ 0. 05). Conclusion Non-invasive prenatal genetic testing for screening chromosomal abnormalities has a high accuracy rate and could improve the detection rate of fetal chromosomal abnormalities.
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Objective To compare the Modified Early Warning Score(MEWS),blood glucose value score and the two scores combined with the ability to predict the prognosis of patients with acute complication of diabetes mellitus,and to explore the most suitable assessment tools. Methods 419 patients with acute complica-tions were collected in diabetic mellitus. To put the admission time as the inital observation point,MEWS score, blood glucose value score and MEWS combined with blood glucose value were assessed and compared between the time point of admission and discharge by ROC curve.Results Using death as a prediction index,MEWS score of subjects operating characteristic area under the curve of AUCROC was 0.875 and the optimal cut-off value of was over 4 in the sensitivity of 78.43%,specificity of 85.60%,the positive predictive valueof 43.01% and the negative predictive value of 96.63% independently. The average score of blood glucose area under ROC curve AUCROC was 0.681 and the optimal cut-off value was 2 in the sensitivity of 50.98%,the specificity of 85.33% the positive predictive value of 73.4% and negative predictive value of 67.5% respectively. Two scores combined with area under ROC curve AUCROCwas 0.982,and the optimal cut-off value was over 7 in the sensitivity of 94.12%,the specificity of 95.65%,the positive predictive value of 75% and the negative predictive value of 99.15% individually. Conclusion For predicting the prognosis of patients with acute complications of diabetes,the combined scores are better than the pure MEWS score and blood glucose value.It is worth of clinical application.
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Objective Bibliometric analysis on research status and developing trends of work engagement of nurse in China, so as to provide reference and theoretical guidance for further research. Methods All published papers on work engagement of nurses were retrieved from CNKI,Wanfang and VIP database before July 2017 with the keywords "nurse" "nursing" "medical staff" "health personal""work engagement" "occupational engagement". Results A total of 189 included articles were published in 65 kinds of Chinese journals,and the number of publication tends to rose every year.Among them,the number of papers published by core periodicals accounted for 70.67% and the proportion of fund literature was 17.99%. There were 170 of survey studies, accounting for 89.95% of the total amount of literature. The main content of the included studies were the research on the relationship between organizational support, psychological capital, turnover intention and the work engagement of nurses. Conclusion Study on nurses′ work engagement in China is still in the initial stage and with the development rapidly. However, the depth and scope of these research is not enough, and the types and contents are relatively simple. The follow- up study should focus on theoretical construction and intervention research.
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Objective To investigate the effect of triptolide (TP) on proliferation and apoptosis of cyst-lining epithelial cells with autosomal dominant polycystic kidney disease ( ADPKD). Methods Primary cultured cyst-lining epithelial cells were treated with TP at different concentrations for 12 h,24 h,48 h and 72 h, respectively.The proliferation activity of the cells was evaluated by Brdu assay. The cell cycle distribution was determined by flow cytometry. The apoptotic and apoptotic ratio were determined by FITC-AnnexinV binding/ PI. The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope. Results TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced apoptosis in a dose- (10-40 ng?mL-1 )and time-dependent(12-48 h) manner. Typical ultrastructural changes of apoptotic cells were observed under electron microscope. Conclusion TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced the apoptosis of cyst-lining epithelial cells, thus inhibited cyst forming and delayed cyst developing. The mechanism may involve several targets and pathways.
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Objective To investigate the level of professional commitment of student nurses,and explore the impact of student nurses' role conflict and role ambiguity on their professional commitment.Methods From May to June 2014,totally 320 student nurses from a third-level hospital in Tianjin were recruited in this study.And Role Stress Scale and Nursing Professional Commitment Scale were used in the investigation.Results The total score of role stress of student nurses was (44.29±5.53) scores,and the total score of professional commitment of student nurses was (86.12±14.14) scores.Pearson correlation analysis and multiple linear regression analysis showed that student nurses' role conflict was positively correlated with professional commitment,but their role ambiguity was negatively correlated with professional commitment.Conclusion School and hospital managers should adopt effective measures to relieve student nurses' role ambiguity and guide the correct understanding of role conflict to maintain a stable nursing team.
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Objective To investigate the relationships between occupational coping self-efficacy, job stress and core competence of nurses. Methods A total of 493 registered nurses were recruited in the survey with the Chinese nurse job stressors scale, occupational coping self-efficacy scale for nurses and competency inventory for registered nurse (CIRN). The correlations were analyzed using Pearson correlation analysis. Results The total scores on occupational coping self-efficacy, job stress of nurses and core competence of nurses were (31.94 ± 6.39), (90.29 ± 17.41) and (159.93 ± 34.31), respectively. Nurses′occupational coping self-efficacy negatively correlated with (r=-0.267, P<0.01) and positively correlated with the core competence of nurses (r=0.355, P<0.01). Conclusions The occupational coping self-efficacy of the nurses can be improved by successful experiencing, verbal persuasion and positive feedback. In this way, nurses core competence can be enhanced and their job stress can be relieved and consequently the quality of nursing can be enhanced.
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Objective The article is prepared to evaluate the efficacy of Chinese acupressure and ventral massage on prevention and treatment of constipation.Methods Electronic databases such as CNKI,VIP,CBM,Wanfang,EBSCO,PubMed and the Cochrane Library were searched from their establishment to December 2013 to meet the inclusion criteria of randomized and quasi-randomized controlled trials.Meta-analysis was conducted using RevMan 5.2 and Stata 12.0 software.Results A total of 29 RCTs involving 3 084 participants were included.The Meta analysis showed that compared with the control group,the new option for prevention and treatment tended to be more effective for constipation.Compared with the control group,first defecation time,defecation difficulty rate,defecation time,dry stool rate and defecating unfinished feeling rate of the experimental group were lower.Laxative provided for the experimental group was less than that of the control group.Conclusions On the basis of available evidence,the traditional Chinese acupressure and ventral massage treatment are effective and safe in prevention and treatment of constipation.
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Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P ＜ 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P ＜ 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P ＞ 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P ＜0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.
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Objective To investigate the level of professional commitment of nursing baccalaureate students,and explore the relationship between the professional commitment and communication ability.Methods Questionnaires were used to investigate 430 nursing baccalaureate students who were studying in the school.Results The professional commitment of nursing students was in the middle level.Correlation analysis revealed that the communication ability was correlated with the professional commitment.Conclusions We should take measures to improve the competency of professional commitment of nursing undergraduate students,strengthen their communication ability,promote the construction of nursing staff.
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Breast cancer related lymphedema is the accumulation of interstitial fluid due to the lymphatic fluid load exceeds its transport ability as a consequence of the lesion of lymphatic structure.It mainly presents as swelling of the affected limb,a feeling of heaviness or tightness in the limb,aching and restricted limb motion.Its incidence is related to surgery,chemical therapy,obesity,hypertention as well as the alteration of particular genes.To prevent the occurrence and exacerbation of lymphedema,patients should avoid the overuse of the affected limb.While limb exercise step by step can solve part of this problem,but not all,doctor should also take both the patterns of exercise and risk factors that patients expose into consideration,then make a individualized exercise plan,evaluate the condition precisely,in order to achieve the best treatment purposes.
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Objective To evaluate the effectiveness of an innovative pathway manual in clinical clerkship of fundamentals of nursing.Methods A total of 120 undergraduate nursing students were sampled at random and divided into the experimental group(57 students) and the control group(60 students).The control group undertook the clinical clerkship according to the traditional syllabus,meanwhile,the experimental group referred to the innovative pathway manual.At the end of clinical clerkship,questionnaires were used to investigate the opinion of these two groups about the effectiveness of clinical clerkship.Results The experimental group were better than those of the control group in general self-evaluation of clinical clerkship,consolidation and improvement of knowledge by clinical clerkship,improvement of learning interest,practice of technique and promotion of occupation of emotion.Conclusions It is feasible and effective to use the innovative pathway manual in clerkship of fundamentals of nursing.
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Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy (CTVE) for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like "V" in 8 "Y-shaped" in 6 of the healthy volunteers. Its diameter was (0.84±0.17)cm. In the patients with common bile duct stones, it was nodular and its diameter (1.72±0.32)cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter (2.30±0.85)cm.There was significant difference among the 3 groups in the overall mean values (P＜0.01). Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.