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Objective:To investigate the current situation and correlation between organizational climate perception, professional identity, self-disclosure and transformation impact of new nurses in oncology department, and explore the chain mediating effect between organizational climate perception and professional identity between self-disclosure and transformation shock, so as to provide basis for further formulating the intervention plan of transformation impact.Methods:This study was a cross-sectional survey. From August 2021 to April 2022, a total of 252 newly graduated nurses in oncology department from nine Class ⅢGrade A hospitals in Henan Province were selected as the research objects by the convenient sampling method. General Information Questionnaire, Transformation of New Nurses Impact Evaluation Questionnaire, Distress Disclosure Index, Nursing Organization Climate Perception Scale, Professional Identity Scale were used for survey. Pearson correlation analysis was performed, and AMOS26.0 software was used to build a chain intermediary model, and the model was tested by Bootstrap method.Results:The total score of the transformation impact of new nurses in the oncology department was (96.51 ± 13.04); the total score of the Distress Disclosure Index was (33.84 ± 7.18); the total score of Nursing Organizational Climate Perception Scale was (99.16 ± 12.97); the total score of the Professional Identity Scale was (91.23 ± 19.92). Self-disclosure, organizational climate perception and professional identity were negatively correlated with transformation impact ( r = - 0.743, - 0.684, -0.631, all P<0.05). The indirect effect of self-disclosure on transformation impact was true, and the total indirect effect was 0.435. The specific mediating effect of nursing organizational climate perception accounted for 51.5% (22.4/43.5) of the total indirect effect and that of professional identity 15.9%(6.9/43.5) of the total indirect effect. The organizational climate and professional identity accounted for 32.4%(14.1/43.5) of the total indirect effects. Conclusions:Self-disclosure, organizational climate perception and professional identity of new nurses in oncology department was negatively correlated with transformation impact. Self-disclosure is positively correlated with organizational climate perception and professional identity, organizational climate perception and professional identity play a chain mediating effect between self-disclosure and transformation impact. It is suggested that managers should adopt positive and effective self-disclosure intervention programs and develop relevant training programs to improve the organizational climate perception and professional identity level of new nurses in oncology department, so as to reduce their transformation impact.
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Objective:To explore the effect of Chin-down-plus-larynx-tightening maneuver on improving choking cough and swallowing function in patients after esophageal cancer surgery.Methods:A total of 121 patients with esophageal cancer surgery had been randomly divided into control group and observation group from November 2018 to September 2019. Starting from feeding after surgery, the head and neck were in normal habits when swallowing in the control group, and the observation group used Chin-down-plus-larynx-tightening maneuver to perform swallowing training. The feeding process of two groups was observed and recorded for one week. One week after eating, the water swallowing test and M. D. Anderson Symptom Inventory for Gastrointestinal cancer (MDASI-GI) were used to evaluate the difference of swallowing function and gastrointestinal symptoms between the two groups.Results:During one week period of feeding, the incidence of choking cough in observation group was 3.39%, (2/59), which was significantly lower than that in the control group (14.52%, 9/62)( χ2 value was 4.53, P=0.033). After one week of feeding, the swallowing function showed significant difference ( Z value was 6.07, P=0.014), the gastrointestinal symptoms and the degree of life interference caused by gastrointestinal symptoms of observation group scored 2.57 ± 0.81, 1.76 ± 0.84, lower than those of the control group (4.25 ± 1.54, 2.18 ± 1.24), and the difference was statistically significant( t values were -7.56, -2.17, P<0.05). Conclusions:The Chin-down-plus-larynx-tightening maneuver can promote recovery of postoperative swallowing function in patients with esophageal cancer, reduce the incidence of choking cough, and help reduce the symptoms of digestive tract, and then raise the level of patient′s clinical prognosis.
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Objective:To construct an early warning score model for the identification of hand-foot-mouth disease (HFMD) in children using the decision tree, and to provide scientific evidence for early recognition of critical HFMD in clinical practice.Methods:The medical records of 2 488 children with severe and critical HFMD hospi-talized in Qingdao Women and Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed.Multivariate Logistic regression analysis was made to screen the independent risk factors of critical HFMD.An early warning score model for identifying children with HFMD was established by using the chi- square automatic interactive detection method in the decision tree, and the effectiveness of the model was evaluated by the receiver operating characteristic curve (ROC). Results:The multivariate Logistic regression analysis identified 5 independent risk factors of critical HFMD, including age<3 years old, blood sugar≥8.0 mmol/L, body temperature≥39.0 ℃, limb shaking and trembling, and hand-foot herpes.Two risk factors, i.e., blood sugar and body temperature, were included in the tree chart through the decision tree, and scoring criteria were established according to the tree chart.Combining the early warning scoring system for children, the warning model were finally set up, which consisted of 5 dimensions and inclu-ded 9 evaluation indicators: consciousness, skin color, heart rate, capillary refill time, respiratory frequency, participation of respiratory muscles, oxygen therapy, blood sugar and body temperature.Each dimension ranged from 0 to 3 points, totaling 0-15 points.The area under the ROC, sensitivity, specificity, maximum Youden index, and cut-off value of the model were 0.911, 0.910, 0.774, 0.684, and 6.5, respectively. Conclusions:The early warning score model established in this paper can accurately identify critical HFMD, with high sensitivity and specificity.
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The paper introduces the overall architecture,technique construction,functional modules and application effects of the system.Using the B/S mode,it designs and develops the network platform for the management of Electronic Health Records (EHR) of veteran cadres.This platform fills the gap in the informatization development in sanatoriums for retired cadres,and facilitates the provision of individualized medical service and health guarantee for veteran cadres.
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Objective To evaluate the value of contrast-enhanced CT in diagnosis of mesenteric fibromatosis (MF).Methods CT images of 6 patients with pathologically proved mesenteric fibromatosis were retrospectively analyzed.The imaging characteristics analysis in-cluded the number,size,density of the lesion,the degree and quality of enhancement,as well as the relationship with the surrounding tissues.Results Singular lesion located in the mesentery was found in all the 6 patients (100%).The size of all cases ranges from 2.0 cm to 8.5 cm and the mean diameter was 6.5 cm.CT scan showed 5 tumors were homogeneous (83.3%),while one tumor had mixed den-sity (1 6.7%).On contrast-enhanced CT images,5 cases showed mild enhancement (83.3%),while 1 case showed moderate en-hancement (1 6.7%).And 4 cases appeared as heterogeneous enhancement (66.7%).4 cases of lesions infiltrated the surrounding tissue(66.7%)and the peripheral intestines were compressed in 2 cases(33.3%).5 masses were surrounded by mesenteric vessels (83.3%).Conclusion MF has certain CT manifestations,especially when mesenteric vascular surrounded the lesion.CT can provide important information for the diagnosis of this disease.
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Objective To explore the values of combined detection of serumhuman epididymis protein E4 , CA125 and CA199 in diagnosis of endometrial cancer. Methods 118 patients with endometrial cancer were chosen as group A, 82 patients with benign uterine disease were assigned to group B. Serum levels of HE4, CA125 and CA199 were detected and the positive rates were compared between the two groups. Results Serum levels of HE4, CA125, and CA199, the positive rate were significantly higher in group A than in group B (P <0.05). HE4 positive rate was highest in group A, and group B had no HE4-positive patients. The sensitivity and accuracy of HE4 + CA125 + CA199 were the highest, which was 94.9% and 92.5%. Levels of HE4, CA125 and CA199 and positive rate showed a rising trend as FIGO stage increased (P < 0.05), and HE4 positive rate was significantly higher than those of CA125 and CA199 (P < 0.05). Conclusions HE4 can be used to identify benign and malignant diseases in the uterus , and has a higher diagnostic value of endometrial cancer as compared with CA125 and CA199. Combined detection of HE4, CA125 and CA199 can improve the positive rate and diagnosis accuracy in endometrial cancer.
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Objective To explore the value of susceptibility weighted imaging (SWI) in the quantitative analysis of ischemia-reperfusion injury (IRI) of the rabbit kidneys . Methods Thirty New Zealand white rabbits were randomly assigned to IRI group (n=24, operation with clamping) and Sham group (n=6, operation without clamping). Left renal ischemia-reperfusion was performed by occlusion (calmping) of the left renal arterial for 60 minutes, followed by reperfusion. All the rabbits underwent MRI including T2WI and SWI before and 0.5 h, 12 h, 24 h and 48 h after the establishments of models . Three rabbits in IRI group were randomly sacrificed 0.5 h, 12 h, and 24 h after the establishment of model. The rest of the rabbits in IRI group and 6 rabbits in sham group were sacrificed for pathological examination 48 h after the establishment of model All specimen were cut into slices and stained with hematoxylin-eosin (HE). Region of interest ( ROI) was manually created by outlining the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex, then relative signal-to-noise ratio of the kidney (rSNR) to muscle in SWI sequence was recorded. and compared with histopathologic features. One-way ANOVA was performed to compare difference of rSNR to muscle in respective location at 5 time-points between Sham group and IRI group, and the differences between groups were tested using repetitive measure analysis of variance, repetitive measure analysis of variance was performed to compare difference of rSNR to muscle in respective location at respective time-points between Sham group and IRI group. Results rSNR value in the inner medulla 0.5 h, 12 h, 24 h and 48 h after the establishments of models were 0.28 ± 0.04, 0.98 ± 0.14, 0.69 ± 0.07, 0.57±0.06, 0.43±0.03, respectively (F=69.82,P<0.01), the inner stripe of outer medulla at the five time-points 0.08 ± 0.03, 0.57 ± 0.05, 0.32 ± 0.07, 0.16 ± 0.02, 0.04 ± 0.01, respectively(F=16.59,P<0.01), the outer stripe of outer medulla were 0.31 ± 0.04, 0.86 ± 0.09, 0.65 ± 0.07, 0.55 ± 0.06 0.43 ± 0.04(F=67.52,P<0.01), respectively,the cortex 0.05±0.01, 0.80±0.04, 0.68±0.07, 0.47±0.07, 0.36±0.08, respectively(F=118.96,P<0.01). The difference of the rSNR was statistically significant in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex at the five different time-points. The differences between two groups were significant (F=206.29, 14.25, 42.8, 39.12, P all<0.05). The pathological findings in Sham group included normalglomerular structure l, clear cavity of tubular, no interstitial hyperemia and edema. The pathological findings in IRI group demonstated, at 0.5 h after IRI, Bowman's capsule cavity expansion, glomerular shrinkage, swelling of renal tubular epithelial cells, vacuoles degeneration, the tube cavity expansion, interstitial edema and congestion ecta became slender, andat 12 h after IR, Bowman's capsule expansion became more obvious, foam degeneration of renal tubular epithelial cells, apoptosis, partial loss of the brush border of the proximal convoluted tubule, formation of protein cast, and a small amount of inflammatory cells appeared in the renal interstitium, swelling of endothelial cells of the vasa recta, congestion of small vessels, and at 24 and 48 h after IRI, more serious injury of renal tubular in the outer stripe of outer medulla , massive necrosis of renal tubular epithelial cells, apoptosis, parts of the renal tubular had the contour lines, and renal tubular outline, increment in inflammatory cells, red cell and protein cast. Conclusion rSNR of SWI in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex of the kidney varies with the degree of IRI over time, and is consistent with corresponding pathological feature, suggesting SWI is useful imaging tool to detect early damage of renal IRI quantitatively.
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The paper introduces the purpose for the research and development of the grading management information system in the 98th Hospital of PLA, describes the establishment process of the system's operation grading catalog , the operation application and appoint-ment process and operation approval process , and summarizes the functional design and application effects .The application of this system realizes dynamic management of doctors'operation authority and fully guarantees operation safety .
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Objective To investigate the feasibility,efficacy and key points of individually designed endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries. Methods The clinical,DSA imaging,interventional treatment and follow-up data of 21 patients with ruptured tiny aneurysms (21 aneurysms)of anterior communicating arteries from March 2009 to March 2014 were analyzed retrospectively. Thirteen of them were treated with coil embolization only,6 were embolized with microcatheter-assisted technique,and 2 were embolized with balloon-assisted technique. Results (1)One patient was failed to embolize because of technical reason. Immediate postoperative angiography found that in the other 20 patients:14 were packed densely,6 had residual aneurysm necks. (2)Intraoperative complications:One patient had acute occlusion of ipsilateral anterior cerebral artery,the blood vessel was patent after thrombolytic method;2 patients had intraoperative ruptured aneurysm. (3)The modified Rankin scale (mRS)scores of 20 patients with successful embolization at discharge:0-1 in 14 cases,2 in 4 cases, and 3-4 in 2 cases. (4)Follow-up study:20 patients were followed up for 12 months after discharge. The mRS scores:0-1 in 18 cases,2 in 1 case,and 3-4 in 1 case. Clinical follow-up for 6 to 60 months,no aneurysm ruptured. Fifteen patients were followed up for 6 to 60 months with DSA,one of them recurred,and he was treated with supplementary dense packing. Conclusion Endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries is difficult,but it is feasible and effective. The proficient surgical skill,individualized surgical design and appropriate embolism are the keys to improve the embolization effect.
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Objective To investigate the safety, efficacy and key points of technology of endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries. Methods The clinical, DSA imaging, interventional treatment and follow-up data of 35 patients with ruptured wide-neck aneurysms of anterior communicating arteries were analyzed retrospectively. Results Immediate postoperative angiography of the 35 patients found 100% occlusion were achieved in 29 (82.9%), 90% occlusion were achieved in 5 (14.3%), and 80%occlusion was achieved in 1 (2.8%). One patient had occlusion in ipsilateral anterior cerebral artery , whose blood vessel was patent after thrombosis. One patient had intraoperative aneurysm rupture. One patient had cerebral infaraction of anterior cerebral artery after the operation. Clinical follow-up was made from 6 to 60 months , and no aneurysms ruptured was found. 21 patients were followed up for 6 to 60 months with DSA. Two of them experienced recurrence, and they were not treated with supplementary packing. Conclusion Endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries is more difficult , but it is safe and effective. Flexible choosing of various kinds of embolism technique and designing the most optimal embolism treatment plan are the keys to the improvement of embolization effect.
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Objective To obtain the improved synthesis of imatinib mesylate .Methods 4-[(4-methyl-piperazin-1-yl) methyl〗benzoyl chloride dihydrochloride and 4-methyl-N3-[4-(3-pyridyl) pyrimidin-2-yl]-1,3-phenylenediamine were used as starting raw mate-rial to perform a condensation reaction in the aqueous phase to give imatinib free base , which was then neutralized with methanesulfonic acid to obtain the novel antineoplastic tyrosinase inhibitor imatinib mesylate by the use of a two -step reaction .Results The improved syn-thesis was considered to have the advantages of low cost , easy post-processing, high purity, high yield and environmental pollution with the HPLC purity≥99.7%and the single impurity<0.1%.Conclusion The total yield of the novel method was 81.5%, having an e-nough broad industrial production prospect .The targeted compound structure was confirmed by 1 H NMR and ESI-MS.
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Objective To compare the placement of peripherally inserted central catheters(PICC)by using vascular ultrasound guidance system and traditional method.Methods Totally 938 patients undergoing PICC were divided into the traditional method group and the vascular ultrasound system and microintroducer techniques group according to the puncture time.The differences in the one-attempt success rate and the overall success rate of the placement and the incidences of complications were compared between the two groups.Results The one-attempt success rate was 93.01％ in the traditional method group and 98.76％ in the vascular ultrasound system and microintroducer techniques group(P =0.005).The successful rate of PICC placement was 100％.The incidence of complication was 11.29％ in the traditional method group and 2.47％ in the vascular ultrasound system and microintroducer technique group(P =0.000).Conclusion The PICC placement using vascular ultrasound guidance system and microintroducer techniques can increase one-attempt success rate and decrease complications.
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Objective To study the nursing methods of gastrointestinal cancer patients undergoing continuous hyperthermic peritoneal peffusion chemotherapy (CHPPC) in the peri-operative period.Methods A total of 126 patients with gastrointestinal cancer underwent continuous hyperthermic peritoneal perfusion chemotherapy,and nursing care was implemented continuously,comprehensively and individually.Results All of the patients underwent continuous hyperthermic peritoneal perfusion chemotherapy successfully,without any complication occurred.Conclusions Intensive and effective nursing care is helpful to carry out continuous hyperthermic peritoneal perfusion chemotherapy safely,and avoid the complications.
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Objective:To investigate the effect of IL-7 on differentiation of thymic T lymphocytes and dendritic cells' differentiation in vitro.Methods:Thymic lobes were apspectically removed from 15-day-old or 16-day-old mouse fetueses and were cultured by the way of fetal thymus organ cultures (FTOC) in vitro.Lobes were cultured in the dishes with or without Interleukin-7(IL-7),then collected the cultured cells respectively.The expression of CD4,CD8,CD11c,B220,Ia,and CD11b was detected by flow cytometry,and the morphology was observed under the ligt microscope.The proliferation of these cells was determined by cell counting.The cultured cells were used as stimulators for allogeneic T cells,whose proliferation were detected later by MTT method.Results:The result of cell counting indicated that the total amount of the thymocytes was decresed obviously after being cultured with IL-7,while the proportion of CD4~+ CD8~+ thymocytes decreased,the proportion of CD4~- CD8~-,and CD4~- CD8~+ thymocytes increased,and no much difference in the amount of CD4~+ CD8~- thymocytes was found.In addition,the amount of B lymphocytes,natural killer cells,and dendritic cells increased in different degree.Conclusion:IL-7 participates in differentiation and development of thymic T lymphocytes and dendritic cells.
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Objective:To optimize the culture system for the mesenchymal stem cells from the Placenta Chorion (hCMSC) in vitro by adding the selected cytokines to amplify the hCMSC effectively,with furthermore some preliminary analysis of the hCMSC performed.Methods:Immunohistochemistry was applied to show the localization of the mesenchymal stem cells within the placenta chorion,then the corresponding part of chorion was digested by collagenase Ⅳ to get the cell suspension for primary culture and subculture;Flow Cytometry was used to detect the surface marker of hCMSC,whose proliferation was detected by direct cell counting and the MTT method;then Butylated Hydroxyanisole (BHA),and DMSO was used combinedly as the inducer in the differentiation of the hCMSC to the neuron like cells,which was then detected by Immunofluorescence staining for the expression of NSE;finally RT-PCR was used to detect the expression of flt3.Results:The result of immunohistochemistry showed CD105~-,CD90~- positive hCMSC was much easier to be found around the blood vessels within the villous of chorion,which then could be obtained by mechanical dissociation and collagenase digestion.bFGF was good at amplifying the hCMSC among all selected cytokines,but FL was showed even obviously effective on the proliferation of the hCMSC.The propagating cells were found to highly express CD73,CD90,CD105;and negative for CD14,CD34,CD45 and HLA-DR.We also found that the hCMSC happened to express PDL-1 the negative co-stimulatory molecules,while their potential to different into the neuron like cells was still well maintained.Conclusion::There is low immunogenicity mesenchymal stem cells within the placenta chorion,both bFGF,FL are shown good effects on the proliferation of the hCMSC,with maintaining their differentiation potential as well.
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Objective To detect the in vitro effect of the traditional Chinese medicine on the tachyzoites of Toxoplasma gondii. Methods Supernatant (1