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Objective:Through the analysis of intelligent nursing patents, to provide reference for clinical nurses to understand the development trend of intelligent nursing patents and carry out related inventions.Methods:The website of China Intellectual Property Office and CNKI were searched with the keywords of " intelligence" , " intellectualization" and " artificial intelligence" , " nursing" and " nurse" from the establishment of the database to December 31, 2020. Information of the patent application time, application area, patent type, main classification number and other patent information were analyzed.Results:Until 2020, China applied for 4 128 patents related to intelligent nursing, among which invention patents were the most, and appearance patents were the least; before 2006, intelligent nursing patents were in the early stage of development, from 2006 to 2014, it showed a slow increasing trend, since 2015, it entered the stage of rapid growth; the regions with the largest number of applications were Shandong, Jiangsu, Guangdong, Shanghai and Zhejiang; IPC of A61, G06, H04, G16 and A47 accounted for the largest proportion, and showing an upward trend as a whole, but different technical fields show different growth rates; intelligent nursing was the most popular. The number of applications for beds and related ancillary products was the largest, followed by intelligent nursing monitoring equipment.Conclusions:It is suggested that to improve the patent incentive mechanisms, encourage nurses to solve clinical problems from an intelligent perspective, and actively promote the transformation of intelligent nursing patents.
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Otbjective:To provide body-mind-spirit-society holistic services for patients,through medical social workers intervening in chronic pain patients and using the professional theory of social work.Methods:By serving the patients and the potential people with community work,group work and case work,this paper explored the tertiary prevention mode for chronic pain patients,and then to intervene in their social psychosocial problems caused by pain and improve their quality of life.Results:Medical social workers intervening in chronic pain patients'social psychosocial problems made a difference.Through combining the prevention model with the three methods of social work,the service scope was expanded and the effectiveness was improved significantly.Conclusion:Under the guidance of tertiary prevention theory,this paperhas explored a set of models to intervene in chronic pain patients' social psychological health,which is of great significance to mitigate chronic pain patients' social psychological problem.
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Objective To investigate the risk factors of spontaneous rupture of BCLC stage A and stage B hepatocellular carcinoma (HCC),and to review the surgical outcomes.Methods From April 2002 to November 2006,89 patients who suffered from spontaneous rupture of HCC of BCLC stage A and stage B were included into this study.A control group of 171 patients was selected by matching the sex,age and BCLC stage.Clinical data and survivals were collected and analysed.Results On multivariate analysis,hypertension (HR 7.38,95％CI:1.91 ～28.58,P＜0.05),cirrhosis (HR6.04,95％ CI:2.83 ～12.88,P ＜ 0.05) and tumor location in segments Ⅱ,Ⅲ,Ⅵ (HR 5.03,95％ CI:2.70 ～ 6.37,P ＜ 0.05) were predictive factors of spontaneous rupture of HCC.In the study group,the median survival and median disease-free survival were 12 months (range,1 ～ 78 months) and 4 months (range,0 ～ 78 months) respectively.The overall survival rates and disease-free survival rates at 1-,3-and 5-year were 66.3％,23.4％,10.1％ and 57.0％,16.8％,4.5％,respectively.Only radical resection remained predictive of overall survival (HR 0.32,95％ CI:0.08 ～ 0.61,P ＜ 0.05) and disease-free survival (HR 0.12,95％ CI:0.01 ～ 0.73,P ＜ 0.05).Conclusions Tumor location,as well as hypertension and cirrhosis were associated with spontaneous rupture of HCC.One-stage hepatic resection should be recommended to patients with ruptured HCC of BCLC stage A and stage B.
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Objective To investigate the natural history and growth pattern of hepatic hemangioma in adults.Methods From April 2010 to March 2013, adult patients with hepatic hemangioma who had no prior treatment were enrolled.A routine follow-up was performed to observe the natural history and complications of these lesions.Results 236 patients were enrolled in the study.The median size of the hemangiomas was 4.5 cm (range 0.6 ～ 19.2 cm).During a median follow-up of 48 months (range 3 ～ 266 months), the hemangiomas increased in size in 61.0％ of patients, remained stable in size in 23.7％, decreased in size in 8.5％.The peak growth period was in patients ＜ 30 years age (0.46 ± 0.41 cm/year) and the growth rate decreased significantly after 50 years of age (0.21 ±0.40 cm/year).Hemangiomas with a size ＜2.0 cm had the lowest growth rate (0.16 ± 0.42 cm/year).The peak growth rate was in hemangiomas 8.0 ～ 10.0 cm (0.80 ± 0.62 cm/year) , but for hemangiomas ＞ 10.0 cm, the growth rate was only (0.47 ±0.91)cm per year.Only 9 patients had severe symptoms caused by the hemangioma.No patients presented with hemangioma-related complications.Conclusions The majority of hepatic hemangiomas have the tendency to increase in size but they rarely caused complications.All the hemangiomas could be safely managed by observation, and surgery should only be considered in patients with complications.
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Objective To investigate the appropriate cutoff point of CA19-9 in prognosis and to determine other potential prognostic factors which may affect survival of patients with hilar cholangiocarcinoma (HC) after radical surgery.Methods 168 patients who had undergone radical surgery for hilar cholangiocarcinoma with R0 and R1 resection were selected for the study.Categorized versions were used in univariate model to determine the appropriate cutoff point of CA19-9.CA19-9 and other clinicopathologic factors were analyzed for their influence on survival using multivariate methods.Results The strongest univariate predictor among the categorized preoperative CA19-9 measures was CA19-9 of less than 150 IU/L (P ＜0.001).On univariate analysis,age,differentiation,tumor size,Bismuth-Corlette classification,portal vein invasion,lymph node metastasis,hepatic artery invasion,liver invasion,preoperative biliary drainage,resection margin and preoperative CA19-9 levels were identified as significant prognostic factors.On multivariable analysis,lymph node metastasis,resection margin and preoperative CA19-9 levels were independent prognostic factors of survival.Conclusions A raised preoperative CA19-9 level was an independent prognostic factor of survival for hilar cholangiocarcinoma.The most discriminative cutoff point of CA19-9 for prognosis was at 150 kU/L.
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BACKGROUND:Recently, periprosthetic femoral fractures have been a common complication after total hip replacement. Vancouver type B1 periprosthetic femoral fractures commonly received internal fixation due to stable femoral prosthesis and less bone defects. OBJECTIVE:To evaluate the effect of the application of Synthes cable system in the treatment of Vancouver type B1 periprosthetic femoral fractures after total hip replacement. METHODS:From May 2009 to October 2012, 18 patients with Vancouver type B1 periprosthetic femoral fractures were treated with Synthes cable system in the Department of Orthopedics, Nantong First People’s Hospital. There were 8 males and 10 females with an average age of (62.67±8.67) years ranging 45 to 80 years. They received a further consultation at 1, 3 and 6 months after treatment. The function of hip joint was evaluated by Harrris evaluation standard:ful marks, 100 points, ≥ 90 points, excellent;80-89 points, better;70-79 points, good; RESULTS AND CONCLUSION:Al 18 patients were fol owed up for 6 to 43 months. Mean healing period was (19.06±4.04) weeks. Harris score was (22.3±3.6) points before treatment in 18 cases. Harris score was higher significantly at 1, 3 and 6 months after treatment compared with that before treatment (P<0.01), and the recovery of hip function was good. Results indicated that Synthes cable system could help to restore the normal anatomic structure of femur in the greatest extent, showing simple operation, little injury, high stability and high safety. It is an ideal method for treating Vancouver type B1 periprosthetic femoral fractures.
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BACKGROUND:Serious patel ar comminuted fractures can be treated by a number of methods such as cerclage with tension band steel wire or steel wire, or fixation with the nickel titanium patel a concentrator and absorption lines, or cerclage with 10# double-loop wire plus fixation with split-type patel a claws or with the memory al oy patel a concentrator. But it is difficult to achieve strongly fixed effect on patel a fractures by these methods. OBJECTIVE:To investigate the clinical effects of suture with polyester braided wire and cerclage with belt lock cable on serious comminuted patel ar fractures. METHODS:A retrospective analysis was performed on the clinical data of 57 patients with serious comminuted patel ar fractures who received suture with polyester braided wire and cerclage with belt lock cable from January 2007 to October 2012. According to AO classification of fractures, there were nine cases of type B3, 22 cases of type C2 and 26 cases of type C3. After satisfactory reduction of comminuted patel ar fractures during the operation, firstly we sewed up both sides of the expansion region of quadriceps muscle and stitched on periosteum and prepatel ar tissue with thick polyester braided wire fol owed by patel ar cerclage with belt lock cable. According to the stability of fracture blocks, tension band fixation with polyester braided wire was partial y added. After the operation, the clinical effects were assessed based on the Bostman score system. RESULTS AND CONCLUSION:Total y 46 out of 57 cases were fol owed up with an average of 8 months (4-18 months). Al patients obtained bone union within 3-5 months. Wounds healed in the first stage without any infections, and fractures in al patients healed without complications such as implant loosening and skin irritation. According to the Bostman score system, 33 cases were scored excellent, 10 good and three fair. The excellent and good rate was 93.5%. It suggests that treatment of serious patel ar comminuted fracture by the combination of polyester braided wire and belt lock cable leads to closely contact fracture sites and reliably fix bone fragments. It can facilitate early postoperative range of motion exercises.
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Objective To identify clinicopathologic factors which predict survival following hepatectomy in HBV-related cirrhotic patients with early hepatocellular carcinoma (HCC).Methods A database was used to identify patients with histologically confirmed early HCC (≤5 cm,no nodal involvement,metastases,or major vascular invasion) who underwent surgical resection (excluding ablation or transplantation).Among 20 700 patients with HCC who were diagnosed at the Eastern Hepatobiliary Surgery Hospital from April 2005 to November 2010,537 (2.6％) patients with early HCC were studied retrospectively.Prognostic factors were evaluated using the Kaplan-Meier curves,Cox proportional hazards models and the receiver operating characteristic (ROC) curves.Results The study included 537 patients.The median tumor size was 2.9 cm,and 33％ of patients had tumors ≤2 cm.Most HCC lesions were solitary (63％) and had no evidence of vascular invasion (64％).Following surgery,the overall median and 5-year survival were 45 months and 33％ respectively.After adjusting for demographic factors and histological grade,tumor size ＞2 cm (hazard ratio [HR]:1.56),multifocal tumors (HR:1.34),and vascular invasion (HR:2.03) remained independent predictors of poor survival (all P ＜ 0.05).Based on these findings,a prognostic scoring system was developed that allotted 1 point each for these factors.Patients with early HCC could be stratified into 4 distinct prognostic groups (median and 5-year survival,respectively):0 points (97 months,96％),1 point (85 months,76％),2 points (76 months,54％),3 points (56 months,39％) (P ＜0.01).Conclusions The present study emphasized the importance of pathologic staging even in patients with small HCC.Anatomical resection of HCC should be the preferred surgical procedure in cirrhotic patients.
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BACKGROUND:The effects of artificial joint replacement, osteotomy and reconstruction in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult are not very satisfied. OBJECTIVE:To evaluate the effect of artificial total hip arthroplasty and hip-self procedure in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult patients. METHODS:Twenty-three adult patients with Crown Ⅳ-type congenital dislocation of hip were treated with artificial total hip arthroplasty and hip-self procedure. There were 2 males and 21 females with an average age of (24.26±3.56) years ranging 20 to 35 years. The effect was evaluated according to the Harrris evaluation standard, and the statistical analysis was performed. RESULTS AND CONCLUSION:Al of the patients were fol owed-up for 12-60 months, averaged of (26.60±13.16) months. Statistical comparison with the SPSS 19.0 system showed there was significant difference of the Harrris scores between preoperation and postoperation period (P<0.05). The artificial total hip arthroplasty and hip-self procedure can be used to reconstruct the normal function of hip joint, relieve pain and increase the joint stability, which is considered as the best method for the treatment of Crown Ⅳ-type congenital dislocation of hip in adult.
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Objective To determine the risk factors of ruptured hepatocellular carcinoma (HCC) and to study the prognostic factors of long-term survival.Methods Of the 4209 patients with HCC diagnosed and treated at the Eastern Hepatobiliary Surgery Hospital from Apr 2002 to Nov 2006,200 patients (4.8％) presented with ruptured HCC.These patients were studied retrospectively and the results of treatment were evaluated and compared with a randomly selected group of 202 patients who had no history of rupture and were treated during the study period.Results On multivariate logistic regression analysis,co-existing hypertension and cirrhosis,tumor size ＞5 cm,vascular thrombus and extrahepatic invasion were predictors of spontaneous rupture of HCC.For the 200 patients with spontaneous rupture of HCC,105 patients underwent elective one stage hepatic resection,33 received transcatheter arterial chemoembolization (TACE),and 62 were treated conservatively.The median survival time (MST) for patients with spontaneous rupture of HCC was 6 months (range,1-72 months),and the overall survival rates at 1-,3-and 5-year were 32.5％,10％ and 4％,respectively.The MST was 12 months (range,1-72 months) in the surgical group,4 months (range,1-30 months) in the TACE group and 1 month (range,0-19 months) in the conservative group.The 1-,3-and 5-year overall survival rates in patients with ruptured HCC who received partial hepatectomy were 57.1 ％,19.0％ and 7.6％,respectively,compared with 77.1％,59.8％ and 41.2％ in 98 patients who underwent partial hepatectomy for HCC without rupture (P＜0.001).Conclusions For patients with HCC who had underlying of hypertension and cirrhosis,extrahepatic invasion and tumor size ＞5 cm,there was a high propensity to rupture.Prolonged survival could be achieved in selected patients who received one-stage partial hepatectomy,although the survival results were inferior to the patients had no rupture.
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Objective To study the outcomes of partial hepatectomy in patients with liver metastases from breast cancer.Methods The data of 47 patients who underwent partial hepatectomy for liver metastases from breast cancer between 2000 and 2009 were studied.The relationship between the clinical features and outcomes were analyzed retrospectively.Results The mortality of surgery was 0％.The 1-,3-,and 5-year survival rates for these 47 patients were 74.5％,42.5％ and 17.0％ respectively.The median survival was 29 months.Patients with less than 3 metastatic nodules survived longer than those with more than 3 metastatic nodules.The 1-,3-,and 5-year survival rates were 86.7％,53.3％,23.3 ％ versus 52.8％,23.5％,5.9 ％,and the mean survival was 79.4 months versus 34.6 months (P=0.001),respectively.Patients without local lymph node metastases had longer survival than those with local lymph nodes metastases.The 1-,3-,and 5-year survival rates were 82.3％,50.0％,23.5％ versus 53.8％,23.1 ％,0％,and the mean survival was 71.9 mouths versus 28.6 months (P＝0.002),respectively.There was no relationship between survival and tumor differ entiation,expression of ER,PR and Her 2.Conclusion Surgical treatment was safe for patients with liver metastases from breast cancer.The long-term survival was better for patients with liver metastases with less than 3 nodules compared to those with more than 3 nodules.The survival was poorer in patients with local lymph node metastases than those without lymph node metastases.
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Objective To examine the association of arteriovenous fistula (AVF) blood flow (Qa) dynamics with inflammation state and its effect on cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients.Methods Thirty MHD patients with AVF and twelve healthy people were enrolled in the study.Qa and cardiac output (CO) were measured by Transonic Hemodialysis Monitor HD 02.In MHD patients,pre-dialysis blood samples were taken before Qa monitoring.High-sensitivity C-reactive protein (hsCRP) was measured by immunoturbidimetry (Kyoma,Japan).Inflammatory factors IL-2,IL-6,IL-10,TNF were measured by Cytometric Bead Array (BDTM).Cardiovascular diseases morbidity was monitored prospectively within nineteen months follow-up period.Results There were no significant differences in age and sex between MHD patients and healthy people.The serum IL-6,IL-10,TNF and hsCRP were significantly higher in MHD patients than those in healthy controls [2.38 (1.86-4.69) vs 1.14 (0.27-1.18) ng/L,P＜0.01; 1.47 (1.19-2.10) vs 1.04 (0.00-1.23) ng/L,P＜0.01; 1.33 (1.05-1.56) vs 0.54 (0.00-1.24) ng/L,P＜0.05; 4.90 (1.58-7.45) vs 1.50 (0.63-1.90) mg/L,P=0.01].During the follow-up period,6 patients (20.0％) developed at least one episode of cardiovascular event.Qa,serum IL-6 and hsCRP levels were significantly higher in patients with CVD as compared to those without CVD [(1120±192) vs (893±189) ml/min,P＜0.05; 4.86 (2.96-7.85) vs 2.20 (1.80-3.10) ng/L,P＜ 0.01;11.75 (3.83-31.53) vs 4.45 (1.05-6.68) mg/L,P＜0.05].Binary Logistic regression analysis demonstrated that serum IL-6 was an independent and stronger risk factor for CVD morbidity [HR=1.943,95％CI (1.110-3.402),P=0.02].Spearman rank correlation analysis and liner regression analysis showed that Qa was positively correlated with serum IL-6 (β=0.492,P＜0.01).Path analysis suggested that Qa contributed to CVD mortality via the increase of serum IL-6.Conclusions AVF blood flow monitoring is important for MHD patients.IL-6 is an independent risk factor of CVD in MHD patients.AVF blood flow increases cardiovascular diseases morbidity in MHD patients via its promotion of IL-6 production.
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By using recurrence quantification analysis (RQA) to analyze traditional Chinese medicine pulse signals of patients with coronary heart disease (CHD), this study aims to find nonlinear dynamic parameters of pulses to distinguish patients with CHD from normal subjects.
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Objective To evaluate the safety and feasibility of hepatectomy for huge focal nodu-lar hyperplasia of the liver. Methods The clinical data of 29 cases of huge FNH of the liver with an average diameter of 12.5 cm (10-26 cm) who were admitted to our hospital from 1996 to 2007 were retrospectively analyzed. Lesions protruded from the liver in 26 cases, compressed extrahepatic organs in 10 and adjoined or compressed hepatic hila in 19. Results All the lesions were successfully resected without operative death. The mean intraopreative blood loss was 747 ml (100-4000 ml). The first he-patic portal blocking was performed in 27 cases and the mean blocking time was 26 min (13-78 min).Among 19 cases of huge FNH involving hepatic hila, the mean intraopreative blood loss was 1011 ml,the mean blocking time 30 min and the liver cross-section was not completely sutured in 7 of these ca-ses. The intraoperative hemorrhea occurred in 7 and postoperative biliary fistula in 1. Twenty-seven cases were followed up for a median of 46 months (4-132 months) with no recurrence and the longest survival time had reached to 11 years. Conclusion Hepatectomy is a safe and feasible means for huge focal nodular hyperplasia of the liver. For those involving hepatic hila, distinguishing between the le-sion and intrahepatic vessels, performing resection closely around the lesion and dealing with the liver cross-section properly may be helpful to reduce the surgical complications.
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To provide more objective basis for traditional Chinese medicine (TCM) syndrome differentiation of deficiency and excess by collecting and analyzing voice signals and extracting characteristic parameters.
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Abstract: In this paper, factors contributing to the formation of pulse wave were analyzed based on hemodynamic principles. It is considered that formation of pulse wave was related to its propagation and reflection characteristics. Propagation of the pulse wave was characterized by pulse wave velocity, and reflection of the pulse wave was characterized by reflection coefficient. Pulse wave velocity and reflection coefficient were proposed as the eigenvectors of pulse wave in pulse diagnosis of traditional Chinese medicine, and support vector machine (SVM) was used to recognize slippery pulse, stringy pulse and plain pulse. Pulse wave velocity and reflection coefficient of the slippery, stringy and plain pulses in healthy people were calculated in this study, and SVM with Gaussian radial basis function was used for classifying. Results showed that pulse wave velocity and reflection coefficient with physiological and pathological significance had advantages in distinguishing slippery pulse, stringy pulse and plain pulse, which offered a new idea for recognizing pulse condition.
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Objective:To observe the co-antitumor effect and hepatic protection of melatonin on unresectable advanced primary liver cancer treated by transcatheter arterial chemoembolization (TACE). Methods:One hundred and forty patients with unresectable advanced primary liver cancer were divided into 2 groups at random, seventy patients received TACE alone while the other 70 patients were treated by TACE+Mel (20 mg/d at 8:00 P.M orally, 7 d before each TACE and lasted for 21 d). Results: The partly resolution rate of TACE and TACE+Mel were 12.86% and 22.86% respectively( P
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Objective To comparatively analyze the DNA extracted from sweat latent fingerprints on the adhesive side of tapes by three kinds of methods. Methods DNA was extracted from sweat latent fingerprint on the adhesive side of tapes using silicon bead test,QIA micro Kit and combined silicon bead-QIA micro Kit. STR loci were detected by multiplex PCR procedures. The PCR product was electrophoresed on an ABI 3100 Genetic Analyzer. Results 36%of the sweat latent fingerprints on the adhesive side of tapes was successfully genotyped using combined silicon bead-QIA micro Kit, and 21% using QIA micro Kit. Conclusion DNA genotyping of the sweat latent fingerprints on the adhesive side of tapes reveals higher possibility using combined silicon bead-QIA micro Kit than using QIA micro Kit and is less time-consuming.