Enlightenment on the Ideological Connotation of Spirit of Great Physician to Contemporary Medical Ethics Construction / 中国医学伦理学

Spirit of Great Physician, puts forward relevant requirements on the moral standards and humanistic qualities that doctors should possess. By tracing the formation background of Spirit of Great Physician, analyzing its rich ideological connotation, reflecting on the needs of contemporary society for medical ethics on the basis of the medical ethics standard of Spirit of Great Physician, combining the background of social development and medical reform in the new era, as well as the moral dilemma in the medical environment, this paper proposed that contemporary society should take the combination of the internal requirements of "moral self-discipline" and the external constraints of "moral heteronomy" as the new path of medical ethics construction. The purpose of this study was to provide theoretical reference for improving the construction system of contemporary medical ethics, enhancing the moral character of medical staff and building a good medical environment.

Case management of a patient with gingival cancer who took the obturator prosthesis combined with orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function / 中国实用护理杂志

Objective:To summarize the case management of promoting the rehabilitation of oral and maxillofacial function of a patient with gingival cancer.Methods:The patient took the obturator prosthesis and orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function. The key points of nursing included: nursing of obturator prosthesis, orofacial myofunctional therapy, psychological nursing and evaluation of oral and maxillofacial function rehabilitation.Results:after one year of case management, the total score of the Chinese version of the obturator functioning scale was 18 points, the mouth opening was 4cm, and the speech distinctness was 98%. The quality of life of the patient was good.Conclusions:When the obturator prosthesis and orofacial myofunctional therapy are taken, all-round cooperation of the medical staff of different specialties from the perioperative period to the discharge follow-up should be strengthened in order to promote the rehabilitation of oral and maxillofacial function.

Nursing care of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base:a case report / 中国实用护理杂志

Objective:To sum up nursing experience of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base.Methods:One patient with multi-drug resistant was admitted to our hospital in October, 2019. To observe and prevent the postoperative complications of lateral skull base and to prevent the rupture bleeding of carotid artery. The early detection and treatment the symptoms of upper gastrointestinal bleeding is effective and necessary. Intervention for patient receiving nutrition therapy is promoted.Results:By giving psychological care to improve patient compliance. The patient had no postoperative complications of lateral skull base, and the bleeding symptoms of upper gastrointestinal hemorrhage was controlled in time.Conclusion:The patient was discharged from the hospital with a tracheal tube in a stable condition.

Effect of personalized nutritional support during perioperative period on postoperative recovery of patients with oral malignant tumor undergoing radical mastectomy and simultaneous reconstruction / 中国实用护理杂志

Objective:To observe the effect of personalized nutritional support on postoperative rehabilitation and nutritional status in patients undergoing radical mastectomy and reconstruction of oral malignant tumor.Methods:Eighty-eight patients with oral malignant tumor admitted from January 2018 to December 2018 in Hospital of Stomatology, Sun Yat-sen University were divided into two groups according to the time of admission. 40 patients were selected as the study group and 48 patients were selected as the routine group. The routine group was given traditional health education and dietary guidance. In addition to dietary guidance, the study group was given personalized nutritional support according to the patients' body mass index and nutritional status before and after operation, including oral nutritional supplement before operation, personalized nutritional prescription after operation, and increased protein intake according to the nutritional indicators of the patients. The nutritional status, enteral nutrition complications and postoperative rehabilitation were compared between the two groups two weeks after operation.Results:Two weeks after operation, the hemoglobin, total protein, prealbumin were (107.93±16.19) g/L, (68.40±4.87) g/L, (189.02±55.19) mg/L in the study group, and (101.23±14.62) g/L, (63.11±6.42) g/L, (165.75±40.60) mg/L in the routine group, there were significant differences ( t values were -2.037, -4.271, -2.276, all P<0.05). The incidence of malnutrition, wound infection and gastrointestinal complications were 42.50%(17/40), 0, 5.00%(2/40) in the study group and 64.58%(31/48), 16.67%(8/48), 20.83%(10/48) in the control group, there were significant differences( χ2 values were 4.292, 7.333, 4.644, P<0.05). Conclusions:Perioperative personalized nutritional support can effectively improve the nutritional status, reduce enteral nutrition-related complications, improve immunity and reduce the risk of incision infection in patients undergoing radical mastectomy and simultaneous reconstruction of oral malignant tumors, which is helpful to improve the quality of life of patients and is worthy of clinical reference.

Analysis of related factors of postoperative fever in patients with oral and maxillofacial tumor radical treatment and simultaneous repair and reconstruction / 中国实用护理杂志

Objective:To understand the fever rate, disease distribution, fever degree and fever related factors of the patients in the same period of oral and maxillofacial tumor repair and reconstruction.Method:A retrospective analysis was performed on 153 patients who underwent radical treatment of oral and maxillofacial tumors from January 2018 to December 2018 in the affiliated stomatological hospital of sun yat-sen university. The patients were divided into fever group and non fever group, and their fever influencing factors were analyzed.Result:Among the 153 patients, 97 (63.40%) had fever symptoms.It’s mainly moderate fever. The incidence of fever was the highest in gingival cancer and oropharyngeal cancer.The results of univariate analysis showed that there were statistically significant differences in serum albumin, tracheotomy and infection between the two groups ( χ2= 7.74, 7.48, 8.58, P<0.01 or 0.05).Logistic multivariate regression analysis showed that infection and tracheotomy were independent influencing factors for postoperative fever in patients with oral and maxillofacial tumor repair and reconstruction (or = 4.74, 2.47, P < 0.05). Conclusion:Patients with oral and maxillofacial tumors undergoing radical treatment and simultaneous repair and reconstruction are more likely to have fever after surgery. Tracheotomy patients and patients with infection need to be paid more attention. They need to be strengthened tracheotomy care and actively prevent infection, so as to reduce the postoperative fever rate, and make the patients with oral malignant tumors repaired and reconstructed at the same time go through the perioperative period smoothly.

Design and application of new patient clothing for patients with oral cancer resection and reconstruction / 中国实用护理杂志

Objective:To design and evaluate a new type of clothes for patients with reconstruction after oral cancer resection.Methods:According to the characteristics of patients after oral tumor resection and reconstruction, a new type of patient clothing was designed. From January 2018 to June 2018, 79 patients with oral malignant tumor radical resection combined with reconstruction were selected as the control group, using traditional patient clothing. 64 patients with the same operation were selected as the experimental group from July 2018 to December 2018, and the new patient clothing was used. The time of changing clothing, wearing comfort and privacy protection, the convenience for medical staff to observe and change wound dressing were to evaluate.Results:The clothing change time of the patients was (124.00±23.35) s in the experimental group, and (156.09±25.66) s in the control group,the difference was statistically significant( t value was 14.97, P<0.01). The scores of clothing comfort and privacy protection were 8.23±0.91, 7.17±0.94 in the experimental group, and 4.78±0.94, 5.50±0.89 in the control group, the difference were statistically significant( t values were -15.21, -9.95, P<0.01). The scores of medical staff observing wounds and changing wound dressings were 7.88±0.89, 7.87±0.83 in the experimental group, and 4.15±0.78, 4.15±0.78 in the control group, the difference was statistically significant( t values were -18.98, -17.75, P<0.01). Conclusions:The new clothes is effective for patients with reconstruction after oral cancer resection. It can be popularized in patients with oral cancer resection and reconstruction.

Evaluation of the effectiveness of nasal feeding registration form based on energy intake optimization design for patients with oral cancer / 中国实用护理杂志

Objective@#To evaluate the effect of a new kind of nasogastric feeding registration form based on energy intake in perioperative nutrition support for patients with oral cancer.@*Methods@#According to the specification of nasal feeding and summarizing the ingredients in common foods, the form was optimized and applied. By the cluster sampling method, the knowledge about energy intake of 12 nurses were investigated before and after the use of the form. The accuracy of energy intake assessment of 5 patients by 12 nurses respectively and the time required for single registration was compared before and after the use. Meanwhile, the knowledge about nasal feeding of 18 patients before the use and 17 patients after the use was compared.@*Results@#The mean score of knowledge about energy intake of nurses was 57.50±17.77 before the use, which was lower than that after the use (89.00 ±6.18), the accuracy rate before the use (61.67%, 37/60) was lower than that after the use (93.33%, 56/60), and the mean time was (18.16 ±6.26) s, which was longer than that after the use (12.65 ±5.67) s (t=17.317, χ2=17.252 and t=22.445 respectively, all P<0.01). The mean score of knowledge about nasal feeding before the use (69.44 ±15.89) was lower than that after the use (86.47±11.15)(t=-3.649, P=0.001). All difference showed statistical significance.@*Conclusion@#The nasal feeding registration form based on energy intake is clear and easy to fill out. It can not only help the medical staff calculate the energy intake of patients more accurately, but also help formulate nutritional intervention plan and promote the recovery of patients. Meanwhlie, It shortens the writing time and improves the effect of education. In conclusion, it is worth being popularized.

Research progress of PICC tip positioning method / 中国实用护理杂志

This review introduced the best position of the tip of PICC, and sorted out the methods of confirming tips′ position before/through/after catheters′ insertion, which including measuring through landmark of body, intracardiac electrocardiogram positioning technique, electromagnetic induction, B ultrasound, digital subtraction angiography, radiograph and coughing. Every method played their unique role in clinical. We gathered these methods to wish to give some suggestions for clinicals.

Use BAPN and AngⅡ to establish SD rat aortic dissection model / 中华胸心血管外科杂志

Objective To establish the SD rat aortic dissection(AD)model by using both BAPN and AngⅡ,in order to investigate AD's pathogenesis. Methods 90 three weeks old SD rats were equally divided into three groups randomly:control group,medicine gavage group and blank medicine gavage group. Rats in control group were fed on a regular diet;BAPN ( 1g/ kg per day)was forced into rats'stomach in the medicine gavage group;the same volume saline was forced into rats' stomach in the blank medicine gavage group. 4 weeks later,when the rats were 7 weeks old,we stopped giving them BAPN, but to implant an omicro-osmotic pump subcutaneously in the abdomen. The pumps in control group and blank medicine gavage group were filled with 0. 9％ saline,the medicine gavage group'pumps were filled with AngⅡsolution( 1 μg·kg- 1 ·min- 1 ). 1 week later,all the survivals were dissected after anesthesia and the aortic vessels were acquired. All the acquired aortic ves-sels were proceed pathological examination. All the rats dead during the process of the experiment were dissected immediately to get the aortic vessels and proceed pathological examination. Results All rats in control group and blank medicine gavage group were survival,there was no aortic dissection or death. In medicine gavage group, 15 rats developped aortic dissection, 12 a-mong them were died of aortic dissection rupture,the aortic dissection formation rate was 50％ . Conclusion Using BAPN and AngⅡ to establish the SD rat AD model is feasible,it is simple and practicable,meanwhile,it has high aortic dissection for-mation rate. The process is similar with human's aortic dissection process.

Triptolide ameliorates transplant arteriosclerosis in rat aorta allograft by inhibiting the expression of NO synthase / 中华器官移植杂志

Objective To understand the pathological role of nitric oxide synthase 2 (NOS2) in rat allograft vascular lesions and the effects of triptolide.Methods The abdominal aorta transplantation between Wistar and SD rats was used as an animal model.Three groups were set up..the same genome group (group A),the allogeneic control group (group B),and the isogene Triptolide group (group C).The grafts were removed at 7th,28th,and 56th day after surgery.The transplant artery intima thickness was measured.The irnmunohistochemical staining was applied to observe the NOS2 expression in the vascular tissue layers.The integral optical density value in each group was calculated.Results The arterial intima of transplants at 28th and 56th day postoperation was thickened,and that was thickest in group C among the three groups (P＜0.05).There was significant difference in intima thickness and integral optical density between group C with groups A and B (P＜ 0.05).The expression of NOS2 was strongest in group B,and that in group C was significantly weaker than that in group B (P ＜ 0.05).Conclusion Triptolide is capable of slowing down the progression of graft vascular disease by inhibiting the expression of NOS2.

Quantitative evaluation of psychological characteristics and quality of life of patients with oral cancer during perioperative period / 中国实用护理杂志

Objective To investigatethe quality of life of patients with oral cancer in different period in a hospital, and to explore the impact of patients' psychological status on their quality of life. Methods 50 cases of oral cancer patients in our hospital were investigated in this study by Convenience sampling method. The scale of the hospital anxiety and Depression Scale (HADS, the Japanese version), the quality of life of cancer patients were measured by the scale (FACT-G); the functional evaluation of tumor therapy- head and neck questionnaire (FACT-H&N). Results The comparison of HADS score between patients before and after surgery showed that the improvement of mental status was not obvious in the postoperative patients.The scores of HADS between patients before surgery and after hospital showed that the improvement of mental status was obvious (t=-2.809, P=0.01; t=-3.828, P=0.003). There were significant differences in HADS anxiety and depression-related factors between different periods (F=7.644,P=0.001;F=6.442,P=0.002);Before surgery,patients with low anxiety and depression had higher scores in both emotional and physical functional dimensions, and the difference between the two groups was statistically significant (t=7.882,5.847,6.870,7.262, P<0.05 or 0.01). The scores of the two groups were higher in the whole life quality dimension after surgery,and the difference between the two groups was statistically significant(t=3.640-7.931,P<0.01 or 0.01).There were significant differences in body function and psychological function scores between different periods(F=8.569, P=0.000; F=10.250, P=0.003). Conclusions Oral cancer patients have a higher level of anxiety and depression before and after surgery, and psychological status of patients with a certain impact on quality of life, it should be targeted for individual characteristics of patients with targeted care measures to improve the psychological status of patients,thereby improving the quality of life of patients.

Effect of two fixation methods of nasotracheal intubation on the occurrence of nasal pressure sores in patients with maxillofacial surgery / 现代临床护理

ObjectiveTo discuss two fixation methods of nasotracheal intubation on the occurrence of nasal pressure sores in patients with maxillofacial surgery.MethodsThree hundred cases of patients under general anesthesia more than 4 hours with the nasal endotracheal intubation were randomly assigned into control group and experiment group with 150 cases in each group.In control group,medical tape was used to fix the endotracheal tube to dorsum,wrapping around the joint of endotracheal tube and threaded pipe.In experiment group,Mepilex foam dressing was used to wrap over the bend of endotracheal tube,with gauze covering the joint of endotracheal tube and threaded pipe before fixing the endotracheal tube to dorsum.Finally,the occurrence of pressure sores from the end of surgery to postoperative 1day were compared between the two groups.ResultsThe incidence of patients with first stage pressure sores was 4.7% in control group while none in experiment group.The incidence of nasal pressure sores was much lower in experiment group than that in control group (P<0.05).ConclusionsThe use of Mepilex foam dressing can reduce the pressure and friction between the endotracheal tube and the dorsum,which effectively prevents nasal pressure sores caused by endotracheal intubation.Therefore when having surgery with nasal general anesthesia and nasotracheal intubation and lastsing over 4 hours,the use of application covering the bend of endotracheal tube can prevent nasal pressure sores.

Preliminary study on the induction and differentiation of γδ T cells-Ⅰ / 中国免疫学杂志

Objective: To investigate the variation of γδ T cells from healthy human peripheral blood(PB)and neonatus cord blood (CB)in proliferation and subtypes with isopentenyl pyrophosphate(IPP), and to acquire enough γδ T cells possessing distinct characteristics for experimental study.Methods: Mononuclear-cells from peripheral blood and cord blood induced by IPP were stained separately with monoclonal antibodies,which were fluorescein-labeled,and then used for assaying the expressing condition of surfaco molecules,as well as to evaluate the variation of γδ T cells on the percentage, subtypes and pbenotypes by FCM.Results:γδ T cells only account for a small proportion in both PB and CB.However,there was a significant difference in the heterogeneity between peripheral blood and cord blood γδ T cells.Vγ9Vδ2 T cells were dominant in peripheral blood γδ T cells.Most of Vγ9Vδ2 T cells in fresh isolated PBMC were central memory-type(CD27~+ CD45RA~-)and effector memory-type(CD27~-CD45RA~-)with IPP, PB γδ T cells proliferated strongly;The effector memory-typo(CD27~-CD45RA~-)turned into the main subtype in all Vγ9Vδ2 T cells,and HLA-DR and B7 molecules were highly expressed on the populations.But the cord blood γδ T cells showed rather complex subgroup heterogeneity,and Vγ9Vδ2 T cells were almost na(i)ve-type(CD27~+ CD45RA~+); Though γδ T cells were expanded(the percent of γδ T cells was increased),and Vγ9Vδ2 T cells were differentiated towards central memory-type and effector memory-type on day 14 with IPP,most of γδ T celLs still remained in the phase of na(i)ve-type(CD27~+ CD45RA~+).Conclusion:Tbere lies great differences of γδ T cells in quantity and subtypes between healthy person peripheral blood and neonatus cord blood.Peripheral blood γδ T cells can be activated and proliferated with IPP, while cord blood γδ T cells have the potential to deferentiate into director memory-type which can be used for experimental and clinical study with the synergy of corresponding cytokines.The immuno-regulation and effector function will be reported in other papers.