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With the increasing number of cancer patients, the aging population, the shortage of medical resources and other problems in China, the demand for palliative care is gradually increasing. However, nursing staff are the main implementors of palliative care, and their cognitive level of palliative care is closely related to the quality of palliative care service and the outcome of patients. By summarizing assessment tools of palliative care knowledge, attitudes and skills, this review aims to provide a reference for developing appropriate palliative care assessment tools for nursing staff in China.
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BACKGROUND@#With the aging of the population and the increased importance of lung cancer screening, the number of early-stage lung cancer patients has been on the rise in recent years, which can be classified into operable early-stage lung cancer and inoperable early-stage lung cancer. The most common pathological type is non-small cell lung cancer (NSCLC). Stereotactic body radiation therapy (SBRT) is the optimal treatment for inoperable early-stage NSCLC. The aim of this study was to investigate the prognosis of early-stage NSCLC patients treated with SBRT and its influencing factors in order to reduce the side effects of radiotherapy and improve the survival and quality of life.@*METHODS@#Clinical data and follow-up outcomes of early-stage NSCLC patients treated with SBRT in our hospital from August 2010 to August 2020 were collected. Kaplan-Meier method was used to assess the prognosis, and the Cox proportional risk model was used for multivariate prognostic analysis.@*RESULTS@#A total of 165 patients were included with a median follow-up time of 43.2 (range: 4.8-132.1) mon. The local control (LC) rates at 1-yr, 2-yr and 5-yr were 98.1%, 94.8% and 86.5% respectively. Karnofsky performance status (KPS) score greater than 80 was an independent prognostic factor for LC (P=0.02). The overall survival (OS) rates at 1-yr, 2-yr and 5-yr were 97.6%, 93.0% and 68.9% respectively. A biological equivalent dose when α/β=10 (BED10) greater than 132 Gy was an independent prognostic factor for OS (P=0.04). Progression-free survival (PFS) rates at 1-yr, 2-yr and 5-yr were 93.3%, 79.5% and 55.3% respectively. The distance metastasis free survival (DMFS) rates at 1-yr, 2-yr and 5-yr were 94.5%, 83.2% and 58.4% respectively. BED10 greater than 150 Gy was an independent prognostic factor for DMFS (P=0.02). The regional control (RC) rates at 1-yr, 2-yr and 5-yr were 98.8%, 95.4% and 87.9% respectively.@*CONCLUSIONS@#SBRT is effective in treating early-stage NSCLC. KPS greater than 80 is an independent prognostic factor for LC; BED10 greater than 132 Gy is an independent prognostic factor for OS; BED10 greater than 150 Gy is an independent prognostic factor for DMFS.
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Humans , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Radiosurgery/methods , Early Detection of Cancer , Quality of Life , Prognosis , Small Cell Lung Carcinoma , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To investigate the clinical efficacy of modified parks incision in the surgery for correction of strabismus in children.Methods:Sixty children patients with strabismus who received treatment in Shanxi Hospital of Integrated Traditional and Western Medicine, China between January 2015 and January 2020 were included in this study. They were randomly assigned to receive surgery with either a trapezoidal flap incision (control group, n = 30) or modified Parks incision (modified Parks group, n = 30). Time to tear film break-up, amount of tears secreted, and the angles of deviation in strabismus were compared before and after surgery. The efficacy was evaluated by corneal fluorescein staining score. Postoperative complications were compared between the two groups. Results:Before surgery, there were no significant differences in the time to tear film break-up and the amount of tears secreted between the two groups (both P > 0.05). After surgery, the time to tear film break-up and the amount of tears secreted were (9.16 ± 1.74) seconds, (7.51 ± 1.36) mm/5 minutes in the modified Parks group and they were (7.57 ± 1.45) seconds and (6.05 ± 1.14) mm/5 minutes, respectively in the control group. After surgery, the time to tear film break-up and the amount of tears secreted in each group were shortened or decreased compared with before treatment, and these two indices in the modified Parks group were significantly shorter or less than those in the control group ( t = 3.845, 4.506, both P < 0.05). Before surgery, there were no significant differences in corneal fluorescein staining score and the angles of deviation in strabismus between the two groups (both P > 0.05). After surgery, corneal fluorescein staining score and the angles of deviation in strabismus in the modified Parks group were (5.14 ± 1.51) points and (10.68 ± 1.75) PD, respectively and they were (6.25 ± 1.73) points and (15.95 ± 2.14) PD, respectively in the control group. After surgery, corneal fluorescein staining score or the angle of deviation in strabismus was increased or decreased in each group. The corneal fluorescein staining score and the angle of deviation in strabismus in the modified Parks group were significantly lower than those in the control group ( t = 2.648, 10442, both P < 0.05). Total effective rate in the modified Parks group was significantly higher than that in the control group [96.7% (29/30) vs. 80.0% (24/30), χ2= 4.043, P < 0.05]. The incidence of postoperative complications and discomfort rate in the modified Parks group were 0.0% (0/30) and 53.3% (16/30), respectively, which were significantly lower than those in the control group 13.3% (4/30) and 80.0% (24/30), χ2 = 4.286, 4.800, both P < 0.05]. Conclusion:Modified Parks incision for corrective strabismus surgery can better correct the angle of strabismus, protect the stability of tear film function, reduce postoperative complications and decrease postoperative discomfort rate compared with trapezoidal flap incision.
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Objective:To explore early predictive factors for outcomes of congenital hypothyroidism (CH) in neonates.Methods:A total of 242 neonates diagnosed as CH in Shanxi Provincial Newborn Disease Screening Center from October 2009 to October 2014 were enrolled in the study. All CH children were treated with levothyroxine sodium (L-T 4) for 2-3 years and continued to follow up for more than 1 year after drug withdrawal. Seventy two cases dropped out during the follow-up; among 170 patients entering the final analysis, there were 61 cases of permanent congenital hypothyroidism (PCH group) and 109 cases of transient congenital hypothyroidism (TCH group). The clinical data and the L-T 4 dose during follow-up period were compared between two groups; and the predicting factors of clinical outcomes were analyzed. Results:There were significant differences in baseline thyroid stimulating hormone(TSH)level [127.0 (83.7,175.4) μIU/ml vs. 55.8(22.1,102.5)μIU/ml], initial treatment timing [26.0(20.5,34.5)d vs. 31.0(24.0,37.5)d], time required for TSH to return to normal [52.0(33.0,71.5)d vs.36.0(32.0,41.5)d], and thyroid ultrasound results [18.3%(11/60) vs. 94.0%(78/83)] between PCH group and TCH group. The initial screening TSH levels in children (optimal cut-off: 71.29 μIU/ml) and L-T 4 dose at 7 months after diagnosis (optimal cut-off: 24.4 μg/d) can be used for early differentiation between children with PCH and TCH. Conclusion:The initial TSH screening levels and the dose of L-T 4 during the follow-up period have predictive value for early differentiation of PCH and TCH in children.
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Objective To compare the stereotactic hematoma drainage and conservative therapy in the treatment of a small amount of bleeding in patients with hypertensive cerebral,and analyze its effects on serum matrix metalloproteinase 9(MMP-9),tumor necrosis factor alpha (TNF-alpha) effect.Methods 60 cases of patients with hypertensive cerebral small as the research object from January 2014 to 2016 10 in our hospital were bleeding,according to treatment methods are divided into operation group and non operation group,30 cases in each group,operation group by stereotactic hematoma drainage treatment,non operative group by con-servative therapy,changes of comparative analysis of the efficacy of the two groups and serum MMP-9,TNF-alpha.Results the operation of hematoma clearance time was (3.4 ± 0.9)d,which was significantly lower than the surgery group hematoma time (12.2 ± 2.5)d(P<0.05);surgery hospitalization time was (16.7 ± 4.5)d,which was significantly lower than the surgery group hospitalization time (23.6 ± 5.1)d(P<0.05). Before treatment,there was no significant difference in NIHSS score between the two groups (P>0.05).Af-ter 2 weeks and 1 months treatment,the NIHSS score of the operation group was significantly lower than that of the non operation group (P<0.05).Before treatment,the serum MMP-9 and TNF-alpha levels were not significantly different between the two groups (P>0.05).1 month after treatment,the serum levels of MMP-9 and TNF-in the operation group were significantly lower than those in the non operation group (P<0.05). The complication rate of the operation group was 13.3%,which was lower than that of the non operation group,and the complication rate was 26.7% (P<0.05).Conclusion stereotactic hematoma drainage is supe-rior to conservative therapy in the treatment of hypertensive intracerebral hemorrhage.It can shorten the time of hospitalization,reduce complications,and reduce the levels of serum MMP-9 and TNF-alpha.
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Objective To investigate the differential expressions of serum proteins by proteomics approach in rat model of sleep deprivation. Methods A rat model of 24-h rapid eye movement sleep deprivation was induced by MMPM. Twenty-four rats were randomly and averagely divided into three groups, namely, model group (M), model control group (MC) and blank control group (BC). Changes of body mass in rats were observed. Morris water maze test was used to evaluate the effect of sleep deprivation on learning and memory ability. Serum proteins were separated by two-dimensional electrophoresis and identified by LC-MS/MS. Results There was no significant difference in rat body weight between BC group and MC group. After sleep deprivation, mental irritable, pelage dull and weight loss were found in M group, but no significant changes were found in learning and memory ability. There were no significant differences in the number of protein spots between three groups. Four proteins were down regulated:Serotransferrin, Glutathione peroxidase 3, Ig kappa chain C region, B allele and Collagen alpha-2(I) chain. Conclusion The short term sleep deprivation may be related to iron metabolism, oxidative stress and immune function in rats.