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Objective@#To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department.@*Methods@#The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month.In March 2018, 17 900 cases were in the traditional group, and in April 2018, 18 590 cases were in the intelligent group.The traditional group conducted manual triage according to the five-level pre-screening and triage standard.The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system.Intelligent assistant decision-making included automatic identification of whether vital signs data was abnormal and automatic provision of basis for triage level to help nurses confirm two major functions.The patients′ information were collected according to the established content, and the system would automatically identify and present according to the corresponding triage basis to determine the triage level.The two groups of children were compared and analyzed in terms of disease distribution, triage level, triage accuracy.The clinical application effect of the emergency pediatric pre-check triage system was evaluated.@*Results@#There was no significant difference in disease distribution between the two groups.The top three were respiratory diseases, infectious diseases and digestive diseases.In the comparison of waiting time between the two groups, the waiting time of grade Ⅲ, Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group, the difference was statistically significant (P<0.05). The consistency of triage grade in the intelligent group was higher than that in the traditional group.The family satisfaction of children in the intelligent group of Ⅲ, Ⅳ, and Ⅴ grade was higher than that in the traditional group.@*Conclusion@#The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses, ensure the effectiveness of the triage and the safety of the children, and improve the satisfaction of family members.
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Objective To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department. Methods The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month. In March 2018,17 900 cases were in the traditional group,and in April 2018,18 590 cases were in the intelligent group. The traditional group conducted manual triage accord-ing to the five-level pre-screening and triage standard. The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system. Intelligent assistant decision-making included au-tomatic identification of whether vital signs data was abnormal and automatic provision of basis for triage lev-el to help nurses confirm two major functions. The patients′information were collected according to the estab-lished content,and the system would automatically identify and present according to the corresponding triage basis to determine the triage level. The two groups of children were compared and analyzed in terms of dis-ease distribution,triage level,triage accuracy. The clinical application effect of the emergency pediatric pre-check triage system was evaluated. Results There was no significant difference in disease distribution be-tween the two groups. The top three were respiratory diseases,infectious diseases and digestive diseases. In the comparison of waiting time between the two groups,the waiting time of grade Ⅲ,Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group,the difference was statistically significant (P<0. 05). The consistency of triage grade in the intelligent group was higher than that in the traditional group. The family satisfaction of children in the intelligent group ofⅢ,Ⅳ,andⅤgrade was higher than that in the traditional group. Conclusion The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses,ensure the effectiveness of the triage and the safety of the children,and improve the satisfaction of family members.
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Objective To investigate the tumor/ non-tumor (T/ NT) ratio during 99 Tcm-hydrazinon-icotinamide(HYNIC)-( poly-( ethylene glycol), PEG) 4-Glu( cyclo ( Arg-Gly-Asp-D-Phe-Lys ( PEG4 ))) 2 ( 99 Tcm-3PRGD2 ) SPECT/ CT imaging and clinical pathological features of breast cancer. Methods Forty-five female patients (age range: 39-76 (53.0±9.5) years) with suspected breast malignant nodules or mas-ses from October 2016 to June 2017 were prospectively enrolled. Patients underwent 99 Tcm-3PRGD2 SPECT/CT imaging before breast puncture and surgery. All subjects had pathological results, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER-2), Ki-67 and mi-crovessel density ( MVD) were obtained by immunohistochemistry and fluorescence in situ hybridization(FISH). Two-sample t test and Kruskal-Wallis H test were used to analyze the data. Results Invasive duc-tal carcinoma was pathologically confirmed in 35 of 45 patients. There were 7 patients in stage Ⅰ, 11 pa-tients in stage ⅡA and 17 patients in stage ⅡB. The Luminal A subtype, Luminal B subtype, ERBB2+subtype, Basal-like subtype were found in 6, 9, 9 and 11 patients, respectively. The T/ NT ratio was signifi-cantly higher in the stageⅡB patients than that in stageⅠ+ⅡA patients (4.54±1.46 vs 3.32±1.72, t= -2.24, P<0.05). Patients with ERBB2+ subtype had higher T/ NT ratio compared to patients with Basal-like sub-type: 5.80(3.90, 6.70) vs 2.80(2.20,3.50), H= 11.06, χ2 = 15.31, both P<0.05. Besides, the T/ NT ra-tios in the HER-2 positive group and lymphatic metastasis group were significantly higher than those in the HER-2 negative group and group without lymph node metastasis (t values: -3.99, -2.51, both P<0.05). MVD of HER-2 positive group was higher than that of HER-2 negative group (t= 7.13, P<0.01). Conclu-sion The T/ NT ratio during 99 Tcm-3PRGD2 SPECT/ CT imaging has relations with TNM staging, lymph node infiltration and HER-2 in breast cancer.
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Aim To investigate the effect of genistein on apoptosis in triple-negative breast cancer MDA-MB-231 cells and the underlying mechanisms.Methods MTT assay was used to detect the inhibition rate on breast cancer MDA-MB-231 cells of genistein.Hoechst 33258 staining was applied to determine the effect of genistein on morphology of MDA-MB-231 cells.qRT-PCR was employed to detect the mRNA expression of EGFR in MDA-MB-231 cells.Western blot was utilized to determine the expression of Bcl-2, Bax, caspase-3, EGFR, Akt, and p-Akt.The expressions of Akt and p-Akt proteins in breast cancer MDA-MB-231 cells were detected after treated with Akt activator insulin, genistein and in combination with insulin.Results Genistein inhibited the viability of breast cancer MDA-MB-231 cells in a time-dependent manner.The results of Hoechst 33258 staining showed a typical apoptotic morphological changes of MDA-MB-231 cells after treatment of genistein for 36 h.qRT-PCR showed that the mRNA expression of EGFR in MDA-MB-231 cells decreased after treated with genistein for 36 h.The expression levels of Bcl-2, EGFR, Akt, p-Akt, ERK, p-ERK were significantly down-regulated(P<0.01) compared with control.While, the expression of Bax, caspase-3 was significantly up-regulated (P<0.01).It was observed that p-Akt was significantly activated after the treatment of Akt activator insulin (P<0.01), however, significantly down-regulated (P<0.01) when treated with genistein.Conclusion Genistein could inhibit the growth of triple-negative breast cancer MDA-MB-231 cells and induce apoptosis, which probably involves regulating EGFR/PI3K/Akt signaling pathway.
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Objective To analyze the correlation between critical thinking ability and self- efficacy for nursing students in university of traditional Chinese medicine, so as to provide references and evidences for nursing quality teaching. Methods A total of 291 nursing students in university of traditional Chinese medicine were investigated with Critical Thinking Disposition Inventory- Chinese Version (CTDI- CV) and General Self- Efficacy Scale (GSES). Results The total scores of critical thinking ability and self- efficacy were (288.24±32.95) and (25.44±5.74). There were consistence between critical thinking ability and self- efficacy (r=0.348, P<0.01). Regression analysis revealed that self- efficacy and interpersonal relations were predictors of critical thinking ability. Conclusions There were consistence between critical thinking ability and self- efficacy. Self- efficacy and interpersonal relations were predictors of critical thinking ability. It is suggested to promote critical thinking ability by enhancing self- efficacy and interpersonal relations, which contributes to improvement of comprehensive quality.
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Objective To establish intellectual critique of nursing thesis course in postgraduate nurse,and to evaluate teaching effectiveness and the reasonableness of the course.Methods A total of 44 postgraduate nurses were involved in the study,which were carried out through action research of planning,acting and observing,and reflecting.After the course,researchers evaluated the reasonableness of the course and teaching effectiveness through the self-control.Results There was significant difference in the scientific research ability score of research object before and after the course:(60.09±16.26) scores vs.(71.27±13.22) scores,t=-3.264,P＜0.01.But there was no significant difference in the critical thinking ability scores of research object before and after the course:(295.55±29.71) scores vs.(292.71±26.67) scores,t=0.478,P＞0.05.Conclusions The course of intellectual critique of nursing thesis can improve the research ability of postgraduate nurse,but the role of the critical thinking ability remains to be discussed.And the course needs to be further improved.