"Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation" evidence application and effect evaluation / 中国实用护理杂志

Objective:To promote the evidence application of the "Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation" and verify its effectiveness.Methods:This was a quasi-experimental study. A total of 31 ICU nurses from Tianjin Teda Hospital were trained by workshops, in order to help promote the evidence transformation. With the evidence application model of the JBI Evidence-Based Health Care Center, we reviewed the measures for mechanically ventilated patients before and after intervention (51 cases at baseline and 77 cases at second review).Results:No unplanned extubation occurred during the period of two rounds of evidence review, the implementation rate of 9 review indicators had improved, and 6 of them showed statistically significant differences. indicator 1 increased from 3.92% (2/51) to 100.00% (77/77),indicator 3 increased from 86.27% (44/51) to 100.00% (77/77), indicator 5 increased from 27.45% (14/51) to 100.00% (77/77), indicator 7 increased from 45.10% (23/51) to 70.13% (54/ 77), indicator 8 increased from 50.98% (26/51) to 100.00% (77/77), indicator 9 increased from 45.10% (23/51) to 77.92 % (60/77), the difference was all statistically significant ( χ2 values were 8.02-119.87, all P<0.05). Conclusions:The "Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation" can provide guidelines for clinical nursing practice. While preventing unplanned extubation, it can standardize nurses' behavior and promote medical-nursing cooperation.

Investigation and research on nursing process based on industrial engineering theory / 中国实用护理杂志

Objective@#To explore the current status of nursing work process in Tianjin Third Grade A General Hospital, to interpret the available space of nursing human resources, and to find new ideas for configuration and optimization.@*Methods@#According to the industrial engineering theory and program analysis method, combined with the characteristics of nursing professional, define the name of the activity, build the evaluation index and formula of the nursing process level, the workday practice method was used to investigate and analyze the nurses′ work processes in a total of 48 departments in four hospitals in Tianjin.@*Results@#The overall nursing process level of Tianjin Third Grade A General Hospital was: β = 0.756. Among them, the process utility coefficient was: β1=0.913, and the coherence coefficient is only: β2=0.627. There were differences in the level of nursing processes between different hospitals and departments. Among them, the process coherence level was different and the overall level was low.@*Conclusions@#The level of nursing procedures in Tianjin Third Grade A General Hospital needs to be improved. It is necessary to improve the continuity of nursing work, appropriately increase the reserve talents, strengthen the standardized training of nursing procedures, and explore more flexible scheduling methods. Conditional hospitals and departments can explore the application of information technology in nursing work or implement an unaccompanied mode to reduce the workload of nurses and improve the continuity of the nursing process, thereby improving the level of nursing processes and improving the quality and efficiency of nursing work.

Investigation and research on nursing process based on industrial engineering theory / 中国实用护理杂志

Objective To explore the current status of nursing work process in Tianjin Third Grade A General Hospital, to interpret the available space of nursing human resources, and to find new ideas for configuration and optimization. Methods According to the industrial engineering theory and program analysis method, combined with the characteristics of nursing professional, define the name of the activity, build the evaluation index and formula of the nursing process level, the workday practice method was used to investigate and analyze the nurses′ work processes in a total of 48 departments in four hospitals in Tianjin. Results The overall nursing process level of Tianjin Third Grade A General Hospital was: β = 0.756. Among them, the process utility coefficient was: β1=0.913, and the coherence coefficient is only: β2=0.627. There were differences in the level of nursing processes between different hospitals and departments. Among them, the process coherence level was different and the overall level was low. Conclusions The level of nursing procedures in Tianjin Third Grade A General Hospital needs to be improved. It is necessary to improve the continuity of nursing work, appropriately increase the reserve talents, strengthen the standardized training of nursing procedures, and explore more flexible scheduling methods. Conditional hospitals and departments can explore the application of information technology in nursing work or implement an unaccompanied mode to reduce the workload of nurses and improve the continuity of the nursing process, thereby improving the level of nursing processes and improving the quality and efficiency of nursing work.

Metastases to the breast from non-mammary malignancies: a clinicopathologic study of 28 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic characteristics and differential diagnosis of the metastases to the breast from non-mammary malignancies.</p><p><b>METHODS</b>Twenty-eight cases were collected from 2004 to 2012;microscopic pathologic examinations and immunohistochemistry (EnVision method) were performed.</p><p><b>RESULTS</b>(1) All except one patients were female, ranging from 16 to 77 years old (average 45.8 years). Twenty-six (92.9%) patients initially presented with the primary site lesions; while the other two (7.1%) patients initially presented with breast lesions. The mean interval from primary diagnosis to detection of metastatic breast lesions was 32 months (0-228 months). Fifteen patients (53.6%) had other metastases detected simultaneously or preceded the breast lesions. (2) Macroscopically, all the tumors were relatively circumscribed, with a mean diameter of 4.0 cm (0.6-12.0 cm). The histological types of the corresponding primary tumors were as follows: eight (28.6%) cases from lung adenocarcinoma, five (17.8%) from high-grade ovarian serous carcinoma, three (10.7%) from gastric adenocarcinoma, two (7.1%) from rectal adenocarcinoma, one (3.6%) from pancreatic neuroendocrine carcinoma, one (3.6%) from prostatic carcinoma, four (14.3%) from melanoma, and four (14.3%) from mesenchymal malignant tumors (three rhabdomyosarcomas and one epithelioid malignant peripheral nerve sheath tumor, MPNST). (3) Histologically, the metastatic tumors showed the morphologic characteristics of the primary tumors. Lymph-vascular invasion was observed in 19 cases. Immunohistochemical features of metastatic tumors were consistent with the primary tumors. Molecular markers for breast such as GCDFP15 and mammaglobin were negative. Metastatic tumors from lung adenocarcinoma expressed TTF-1 (8/8). Ovarian serous carcinoma metastases were positive for PAX8 (5/5) and WT1 (4/5). Gastric adenocarcinoma metastases were positive for CDX2 (3/3) and villin (1/3). Rectal adenocarcinoma metastases were positive for CDX2 (2/2). Pancreatic neuroendocrine tumor metastasis was positive for Syn and CgA (both 1/1). Prostate carcinoma metastasis was positive for AR, PSA and P504S (all 1/1). Melanoma metastases were positive for HMB45 (2/3) and S-100 protein (3/3). Rhabdomyosarcoma metastases were positive for vimentin, desmin and myoD1 (all 3/3). MPNST metastasis was positive for S-100 protein (1/1). (4) Follow-up data was available in 17 patients, with median follow-up time 54 months. The median survival from diagnosis to breast metastasis was 24 months.Seven of 17 patients died.</p><p><b>CONCLUSIONS</b>Metastases to the breast from non-mammary malignancies are rare and show pathologic features of primary tumors. It is usually presumed to be a primary breast carcinoma. Histopathologic features and clinical history in conjunction with the immunohistochemical results should be considered in differentiating a secondary mass from a primary breast carcinoma.</p>

Advance of clinicopathological and molecular research of triple negative breast cancer / 中国癌症杂志

Triple negative breast cancer (TNBC) is characterized by the lack of expression of hormone receptors, as well as human epidermal growth factor receptor 2 and displays special biological and clinicopathological characteristics. This subtype is aggressive in nature with high histological grade. Besides invasive ductal carcinoma,several special histological types have also been found. The features of the TNBC subgroup roughly parallel those of the basal-like subgroup. Due to the lack of molecular targets, this subgroup has no chance of endocrine treatment and target therapy. Currently, the treatment of TNBC is dominated by chemotherapy based on anthracycline with suboptimal efficacy. Overall, the prognosis has remained quite poor. Emerging evidence indicates that patients regimens with triple negative breast cancer usually displays high rate of early recurrence and distant metastasis. Both the diseasefree survival and overall survival rates are low. Although this subtype which shows same immunohistologic pattern, great heterogeneity still exists within the group causing distinctions in morphology, prognosis, and more importantly, drastically different reactions to same treatment protocol. In recent years, TNBC has been widely concerned by both clinician and pathologist. Several targeted drugs for corresponding signal pathway as well as the subtype of triple negative breast cancer have been widely studied. This article focused on the advances in clinicopathological characteristics, new subtypes and treatment of triple negative breast cancer.

CT Value in the Diagnosis of Non-intestinal Lesions on the Right Lower Abdomen (A Report of 70 Cases) / 实用放射学杂志

Objective To evaluate the value of CT scan in diagnosing non-intestinal lesions on the right lower abdomen.Methods CT scan was performed in 70 patients with clinically supected non-intestinal lesions in the right lower abdomen.The diagnosis was confirmed by surgery or biospy in all cases,except 1 case of nephroptosis.Results 41 cases were benign lesions,which appeared as cystic or solid masses with definite bound on plain CT scans and were slight or middle enhanced on contrast enhanced CT scans,but abscess and tuberculosis were showed peripheral or multilocular enhancement with indistinct bound.The remaining 29 cases were malignant masses which presented as large irregular soft tissue mass and inhomogenous enhancement.Conclusion CT scan of certain is value in diagnosis and differential diagnosis of non-intestinal lesions of right lower abdomen.

CT Diagnosis of Malignant Lymphoma of Ileocecum / 实用放射学杂志

Objective To discuss CT features of ileocecum lymphoma.Methods All 12 patients with Non-Hodgkin lymphoma(NHL)proved by surgery and pathology had CT scanning.Results CT findings of 12 cases with NHL were as follows:①Diffuse thickness of cecal wall(9 cases).Five cases among them appeared transverse"8"sign when the lesions involved the ileocecal valve and the terminal ileum.②Focal convex mass of ceacal wall(3 cases).③Medium enhancement of the lesions.④Enlarged lymph nodes(10 cases)around lesions or in mesentery and retroperitoneum.Conclusion CT could clearly display the morphological findings and extension of ileocecum lymphoma and show enlarged lymph nodes.