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Objective:To investigate the correlation between enhanced CT features and clinicopathological features of renal clear cell carcinoma.Methods:The clinicopathological data of 33 patients with renal clear cell carcinoma after radical operation in the Third People′s Hospital of Huzhou from January 2015 to January 2019 were analyzed retrospectively.The relationship between enhanced CT signs and pathological features was analyzed by speraman correlation analysis.Results:The pathological findings showed that there were 17 cases of capsule invasion and 16 cases of no capsule invasion, and there were statistically significant differences in lesion diameter, CT enhancement difference and enhancement rate between the two groups[(7.74±1.85)cm vs.(4.15±1.41)cm, (30.19±10.00)HU vs.(48.25±24.12)HU, (70.7±22.6)% vs.(137.0±86.6)%, t=-6.239, 2.841, 3.050, P=0.000, 0.008, 0.005]. There were statistically significant differences in lesion diameter and enhancement rate between patients with vascular tumor thrombus (12 cases) and without vascular tumor thrombus(21 cases)[(7.86±2.35)cm vs.(4.93±1.79)cm, (70.0±19.9)% vs.(121.0±81.7)%, t=-4.025, 2.074, P=0.000, 0.046], but there was no statistically significant difference in CT enhancement difference[(30.78±11.71)HU vs.(43.62±22.63)HU, t=1.823, P=0.078]. Spearman correlation analysis showed that there was a moderate negative correlation between CT enhancement difference and capsule invasion and vascular carcinoma thrombus( r=-0.593, -0.540, P=0.000, 0.001). The diameter of the lesion was positively correlated with capsule invasion( r=0.781, P=0.000). Conclusion:The diameter, CT enhancement difference and enhancement rate of renal clear cell carcinoma are different.The larger the diameter of the lesion and the smaller the enhancement difference indicate the capsule invasion and vascular carcinoma thrombus.
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Objective To explore nurses' bonus assessment and distribution methods based on the information technology platform and to improve the efficiency of nursing management. Methods We build a hospital informa-tion platform in order to collect nursing work efficiency data by using existing computer information network. We distributed the bonus through the information platform according to evaluate nursing quality and performance effi-ciency. Results After the information flatform used for 2 years,the satisfaction of nurses with different professional titles and different experience showed no significant difference (P>0.05). The time of department management person-nel collecting and distributing data change from [103.75 (180.00,215.00)] min per month to [42.50 (60.00,90.00)] min per month.The difference showed statistical significance(P<0.05). Conclusion The technology platform can im-prove the satisfaction and the nursing management efficiency.
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Objective To investigate the value of combined therapy for hand post-burn scars.Methods We retrospectively analyzed 78 hands post-burn scars in 46 cases from 2007 to 2011.A mong them,scar contracture releasing,scar excision,free skin grafting and fixation with Kirschner's pins were performed in 38 hands,scar excision and regional flat transfer were performed in 18 hands,scar excision and skin grafting were performed in 18 hands,abdominal expanded flap transplantation and scar excision were performed in 4 hands.All patients received elastic sleeve pressure therapy,sili cone gel for external application and function training.Within six months after the operation,52 hands received drug delivery by wax therapy,16 hands incision with scar proliferation received drug injection into scar.We followed up all patients from half a year to three years after the treatment to observe the recovery of the appearance and function of the hands.Results We mainly chose surgery,elastic sleeve pressure therapy,silicone gel for external application,drug injection into scar,wax therapy,function training and so on treating the hand post-burn scars and found that the joins deformities caused by scar contracture were largely or totally corrected.The function and appearance were satisfying.Conclusions It is a good method to treat hand scars by surgery and post-surgery combined physical rehabilitation therapy,which deserves to popularization.
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Objective To understand and analyze the situation of orthopedic nursing manpower resources in grade- Ⅲ general hospital in Shanghai and provide empirical evidence for appropriate allocation and exploitation of nursing manpower resources. Methods Data were collected by questionnaire and then underwent analysis. Results In 2009,the number of authorized beds was 1866,the actual number of open beds was 2007.The number of nurses was 595 (2 male).The ratio of ward bed and nurse were 1:0.319 and 1:0.296, calculated by the authorized beds and authorized beds, respectively.The average age of head nurses was (37.53±6.11 ) years old, average working life span was (17.87 ± 6.16) years; college degree or above accounted for 95.56%; middle professional titles accounted for 62.22%. College degree or above accounted for 75.13% in nurses, junior professional titles accounted for 92.1%; age group is mostly concentrated in the 20 to 29 years of age, accounted for 67.06%; working life span concentrated within 10 years, accounted foi 73.11%. The education level mainly is primary school in the care workers (carer), accounted for 45.83%; concentrated in the 40 to 49 years of age, accounted for 60.42%; working life span concentrated in more than 6 years, accounted for 55.21%. Conclusions There are shortage of orthopedic nursing manpower resources, unreasonable allocated structure, lack of male nurses in grade- Ⅲ general hospital in Shanghai. The management of the care workers should be standardized.
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BACKGROUND: Acute respiratory insufficiency is common complication of surgical treatment of adolescent scoliosis patients. The preventive effects of breathing exercise before surgery is still uncertain.OBJECTIVE: To explore the feasibility and efficacy of breathing exercises for scoliosis patients before operation.DESIGN: Nonrandomized cross sectional study.SETTING, PARTICIPANTS and METHODS: Totally 35 hospitalized kids with scoliosis and pulmonary dysfunction aged from 9 to 15 years old were selected from Shanghai Changhai Hospital. A set of breathing exercise including which included pursed lip breathing, abdominal breathing, diaphragmatic breathing and blowing balloon was performed to these patients one week before surgery. The changes of pulmonary function were recorded and compared before and after exercises.MAIN OUTCOME MEASURES: The change of vital capacity, lung capacity, forced ventilation capacity(FVC), maximal ventilation volume(MVV) before and after breath exercises.RESULTS: All sorts of indes are improved comparing with those before exercises. The vital capacity, lung capacity, FVC and MVV were greatly improved from(1.77 ±0. 36), (2.67 ±0. 84), (2.07 ±0.46), (52.5 ± 14.0) L before exercises to(2.65 ±0. 29), (3.56 ±0.79), (2.41 ±0.41), (70. 1 ± 17.0) L respectively( t = 3.63 - 11.28, P < 0.01).CONCLUSION: Preoperative breathing exercises can improve the pulmonary functions of kids with scoliosis and improve their tolerance to surgery and prevent the postoperative respiratory insufficiency.