Clinical application of new type individualized fixation device for radiotherapy of rectal cancer / 中国基层医药

Objective To explore the clinical effect of new type rectal cancer radiotherapy individualized fixation device in the radiotherapy of rectal cancer. Methods From June 2015 to December 2016,60 patients with rectal cancer who accepted the external irradiation in Zhejiang Tumor Hospital were divided into two groups by random number table method. A group(31 cases) received new type rectal cancer radiotherapy position fixation devices with thermoplastic film. B group(29 cases) received simple foam pad with thermoplastic film. Before each treatment,Cone beam CT(CBCT) scan was conducted. The applied CBCT image and the planned reconstruction image were compared in the direction of X(left and right),Y(upper and lower)and Z(front and rear) axis. The setup error was recorded, and the correlation between the two groups was analyzed. Results The average setup error of patients in A group in X (left and right),Y(upper and lower),Z(front and rear) axis were (1. 61 ± 0. 18)mm,(1. 82 ± 0. 13)mm,(1. 91 ± 0. 11)mm,respectively. The average setup error of patients in B group in X(left and right),Y(upper and lower),Z (front and rear) axis were (2. 22 ± 0. 13)mm,(2. 43 ± 0. 14)mm,(2. 36 ± 0. 13)mm,respectively. There were statistically significant differences between the two groups(t=14. 958,17. 501,11. 283,all P＜0. 001). Conclusion The new type of rectal cancer radiotherapy position fixing device is more comfortable than the simple foam pad,and the setting error is smaller than the simple foam pad.

Exploration and implementation on the mode of undergraduate community nursing practice, according to "National Standard of Undergraduate Teaching Quality" / 中国实用护理杂志

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science', the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Exploration and implementation on the mode of undergraduate community nursing practice, according to "National Standard of Undergraduate Teaching Quality" / 中国实用护理杂志

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science',the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Analysis of the influence factors of central venlus catheters-related infections in postoperative patients with gastric carcinoma treated with parenteral nutrition / 中国实用护理杂志

Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with central venous catheter related infections were set as infection group,patients without infection as the control group,and the group logistic regression analysis was used to analyze the collected data.Results 21 patients in infection group had CVC-RI,and the incidence was 14.00％ (21/150),while 129 patients in control group had CVC-RI.Univariate analysis showed there was significant difference between infection group and control group in age,anamnesis,catheter indwelling time and infusion rate of nutrient solution (x2=17.126,5.447,12.795,7.973,P＜0.05),however there was no significant difference in sex,health insurance,the success rate of catheterization and whether glutamine was in nutrient solution (P＞0.05);the group logistic regression analysis showed that age (OR=15.927,95％CI 3.305-76.756,P＜0.05)and catheter indwelling time (OR=3.511,95％CI 1.028-11.992,P＜0.05) were independent risk factors for CVC-RI,however infusion rate of nutrient solution (OR=0.140,95％CI 0.033-0.597,P＜0.05) was a protective factor.Conclusions For the postoperative patients with gastric carcinoma treated with parenteral nutrition,CVC-RI is closely related to age,catheter indwelling time and infusion rate of nutrient solution.So reducing catheter indwelling time,restoring the enteral nutrition under condition permission as so on as possible can reduce infection of elderly patients.

Analysis on set-up errors of position fixation with simple perforated foam pad in colorectal cancer radio-therapy / 中国基层医药

Objective To explore the set-up errors of position fixation with simple perforated foam pad in colorectal cancer radiotherapy and their causes as well as the improvement measures.Methods Sixty cases of color-ectal cancer patients undergoing radiotherapy were collected.Prone position was adopted with the position fixed by perforated foam pad and membrane.CBCT imaging was taken weekly before treatment,setup errors were corrected if necessary.Errors throughout the course of treatment for each patient were recorded and compared between patients, followed by analyzing the reasons of errors.Results Before calibration,the maximum errors on the direction of left and right (X-axis),front and back (Z),upside and downside (Y)in these 60 patients were 0.5cm,0.9cm and 0.7cm respectively with the average errors of (0.22 ±0.03)cm,(0.38 ±0.03)cm and (0.27 ±0.04)cm respec-tively.Conclusion The method of applying perforated foam pad and thermoplastic mask in colorectal cancer radio-therapy is currently the most commonly used in the clinical position fixation techniques,by which the small intestine, bladder and other pelvic tissues can be well protected.Due to poor comfort prone position,it is necessary to further improve perforated foam pad through improving the quality of the foam pad,thus improving patients comfort and posi-tioning repeatability and reducing position fixation errors.

Analysis on growth status of children under 3 years of age in Nankai district of Tianjin city / 中国实用护理杂志

Objective The study aimed to explore the growth status of children under 3 years of age in Nankai district of Tianjin city,provide reference evidence for children's health care work of the local area.Methods Convenience sampling was used to collect physical examination records of children under 3 years old from Wangdingdi hospital in Nankai district of Tianjin city.The records of 2 880 children' physical examination data were collected.Results The median scores of weight for height (WHZ) of children of 6,9,12,18 months old were 0.74 (0.01,1.49),0.73 (0.08,1.38),0.58 (0.11,1.27),0.54 (0.14,1.22),while children of 3,24,36 months old were 0.29 (0.45,1.03),0.17 (0.61,0.95),0.22 (0.36,0.80),the difference between them had statistical significance,x2=21.71,P＜0.05.The median scores of height for age (HAZ) of children of 3,6,9,12,16 months old were 1.05 (0.33,1.76),1.09 (0.32,1.85),1.22 (0.41,2.02),1.00 (0.20,1.79),1.09 (0.19,1.99),while children of 18,24 months old were 0.79 (0.06,1.51),0.86 (0.15,1.56),the difference between them had statistical significance,x2=27.83,P＜0.05.The median scores of weight for age (WAZ) of children of 3,12,18,24,36 months old were 0.88 (0.29,1.46),0.96 (0.31,1.61),0.85(0.19,1.51),0.64 (0.04,1.23),0.91 (0.28,1.54),while children of 6,9 months old were 1.10 (0.43,1.76),1.09 (0.43,1.74),the difference between them had statistical significance,x2=36.95,P＜0.05.The prevalence of stunting,wasting and overweight were 0.3％ (10/2 880),0.8％ (22/2 880) and 9.3％ (267/2 880).The physical condition between premature and full term infants and post-mature infants had statistical significance,t=140.23,100.64,P＜0.05.Conclusions The growth and development status of children in Tianjin Nankai district under 3 years old was generally good,and there was no significant difference between boys and girls,however,overweight has been the most serious problem at present.Compared with full-term and post-mature infants,the physical condition of premature newborn was lower.