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Liver transplantation is a standard therapy for end-stage liver disease. The shortage of donor has greatly tethered the development of liver transplantation. With the use of living donors, we actually solved some problems. Nevertheless, cadaveric liver transplantation still accounts for the vast majority of liver donors. In recent years, technological innovations, including surgical methods and mechanical perfusion, have enabled the clinical realization of " multi-purpose liver" and increased graft survival rate. " Marginal donor" transplantation is a reliable way to expand the donor pool, which depends on the evaluation and maintenance of the donor liver.This review will describe the source of donors for liver transplantation and the way to expand donor pool.
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Objective:To construct a psychological support training program for palliative care specialist nurses based on positive psychology theory and make a preliminary application.Methods:From August to September, 2020, 142 palliative nursing specialist nurses in Hunan Provincial Palliative Nursing Specialist Training Base were selected as the research objects. Based on positive psychology therapy, using literature review and analysis, semi-structured interviews, expert group meetings and other methods to construct the program, and the work stress, psychological resilience and subjective well-being scores of nurses before and after 8 weeks of psychological support training were compared.Results:The program included three dimensions: cognition, emotion and behavior. After the psychological support training for 8 weeks, the nursing staff′s work stress score 80.76 ± 20.43 was lower than that before the psychological support training 84.70 ± 19.88, the difference was statistically significant( t=6.59, P<0.05), and the psychological resilience score 64.40 ±14.26 was higher than that before the psychological support training 60.19 ±15.85, the difference was statistically significant ( t=-7.39, P<0.05), and the subjective well-being score 75.70 ± 7.70 was higher than that before the psychological support training 74.13 ± 5.98, the difference was statistically significant ( t=-3.52, P<0.05). Conclusions:The psychological support training program based on positive psychology theory can reduce the the work stress, improve psychological resilience and increase subjective well-being of palliative care specialist nurses.
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Objective:To compare the efficacy of transcatheter arterial embolization (TAE) with laparotomy in the treatment of severe liver injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with severe liver injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from December 2013 to June 2020, including 28 males and 20 females; aged 16-75 years [(45.7±6.2)years]. There were 25 patients with grade III, 15 grade IV and 8 grade V according to the American Association for the Surgery of Trauma (AAST) classification. After general treatments such as infusion and hemostasis, TAE was performed in 26 patients (TAE group) and laparotomy in 22 patients (laparotomy group). The operation time and length of hospital stay were compared between the two groups. Erythrocyte, hemoglobin and serum creatinine were compared before operation and at postoperative 1 day. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before operation and at postoperative 1, 3, 7 days. Complications were observed.Results:All patients were followed up for 12-60 months [(17.1±9.1)months]. The operation time and length of hospital stay were (65.7±9.2)minutes and (21.6±6.6)days in TAE group, significantly shorter than (162.5±28.1)minutes and (31.5±7.4)days in laparotomy group ( P<0.05 or 0.01). There was no significant difference between the two groups referring to erythrocyte, hemoglobin and serum creatinine before operation and at postoperative 1 day (all P>0.05). There was no significant difference in ALT and AST between the two groups before operation (all P>0.05). TAE group showed ALT level of 1 154(884, 1 698)U/L, (975.3±400.9)U/L and (403.4±232.9)U/L at postoperative 1, 3, 7 days, significantly lower than 2 053(1 965, 2 132)U/L, (1 604.1±188.2)U/L and (915.3±160.5)U/L in laparotomy group (all P<0.05). TAE group showed AST level of (1 313.2±542.0)U/L, 525(302, 971)U/L and 174(84, 324)U/L at postoperative 1, 3, 7 days, significantly lower than (1 962.9±245.4)U/L, 1 478(1 089, 1 677)U/L and 837(674, 1 006)U/L in laparotomy group ( P<0.05 or 0.01). The complication rate was 26.9% (7/26) in TAE group, significantly lower than 59.1% (13/22) in laparotomy group ( P<0.05). Conclusion:For severe liver injury, TAE can significantly shorten operation time and length of hospital stay, accelerate the recovery of liver function and reduce the complication rate in comparison with laparotomy.
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Objective In critically ill elderly patients with "heat fecaloma with watery discharge", deficiency syndrome occupies its eighty to ninety percent, while "heat accumulation" occupies its ten to twenty percent; in fact, it is "dry feces accumulation stagnation and manure water side stream". Factors of Qi deficiency, blood deficiency, Yin deficiency, Yang deficiency, etc. are the main causes of dry stool accumulating in the intestine and manure water flows to side stream. The therapeutic principles of this disease should be removing stasis by purgation, in the mean time supplementing Qi and moistening intestine, or moisturizing dryness by nourishing blood, or supplementing Yin and increasing fluids, or warming yang for relaxing bowels in order to solve the root causes of the disease. The mechanism of heat fecaloma with watery discharge in critically ill elderly patients is different from that of general patients; clinically it is necessary to interrogate the disease history in detail, synthesize the four diagnostic methods, and differentiate manifestations from root cause, deficiency from sthenia, mildness from severity and amelioration from urgency. Casually using attack should be avoided, and aiming to treat its root cause is the proper therapeutic method.
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Objective To explorethe efficacy of anticoagulation therapy with peripherally inserted central venous catheter (PICC) for prevention of venous thrombosis in patients with lung cancer with hypercoagulability. Methods During the period from August 2015 to December 2016,30 patients in our hospital were enrolled as the observation group, and 30 patients from May 2014 to July 2015, with lung cancer treated with PICC catheter in our hospital were selected as the control group.In the control group, PICC during intubation by conventional methods to prevent the occurrence of venous thrombosis;while in the observation group with the additional treatment before and after anticoagulant therapy catheter based on routine prevention. Venous thrombosis incidence and the indwelling time of PICC were compared between two groups. Results The incidence of thrombosis in observation and control groups was 0 and 20% respectively,with significant difference between the two groups(P=0.024).The PICC retention time in observation group and control group was 95.5 (21.00, 117.25) days and 108 (97.00,130.25) days, the difference between the two groups was statistically significant (Z =-2.249, P = 0.025). Conclusions Anticoagulation treatment with PICC catheter before and after in hypercoagulability lung cancer patients can significantly improve the hypercoagulable state of patients,effectively prevent venous thrombosis,and prolong the PICC retention time.
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Objective To evaluate the effects of"PICC fixed standard operation flow chart"in PICC fixed quality management. Methods Patients with PICC were admitted to the control group from January to June in 2014, given the routine PICC fixed method. PICC patients in the observation group who were enrolled from July to December 2014 were given new PICC fixed method that obey the"PICC fixed standard operation flow chart", which was established from relevant norms and guidelines and related literature. The incidence rate of medical adhesive related skin injury and unplanned extubation of PICC were compared with those of the two groups. Results The incidence rate of medical adhesive related skin injury was decreased from 35.20％(70034/198962) to 18.03％(37862/209955) (Z=-3.363, P<0.01) and PICC unplanned extubation decreased from 1.31‰(20/15384) to 0.37‰(7/18919) , the difference was statistically significant (χ2=6.940, P<0.05). Conclusions The PICC fixed standard operating flow chart can be used as a guide to implement the PICC fixation. Based on this, the quantitative management index is applied to the PICC fixed quality management, which can standardize the fixation of the PICC , reduce the related complications caused by the fixation of the catheter, prevent the occurrence of unplanned extubation of PICC , provide effective protection to ensure safe PICC long-term use and improve the patient's comfort.
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Objective To evaluate the changes in expression of cold-inducible RNA-binding protein (CIRP) in hippocampus during brain injury in a rat model of cardiac arrest-cardiopulmonary resuscitation.Methods Seventv-two clean-grade healthy male Sprague-Dawley rats,weighing 280-350 g,aged 8-10 weeks,were divided into 2 groups using a random number table:sham operation group (S group,n=18) and ischemia-reperfusion group (I/R group,n=54).Tracheal intubation was performed and artery and veins were punctured in group S.Ventricular fibrillation was induced by transoesophageal cardiac pacing to establish the model of cardiac arrest in group I/R.Rats were sacrificed at 12,24 and 48 h after resuscitation and the hippocampus was harvested for determination of CIRP,tumor necrosis factor-alpha (TNF-α) and interleukin-lbeta (IL-1β) protein and mRNA expression (by quantitative polymerase chain reaction or Western blot) and for determination of pathological changes of hippocampi (with a light microscope).Results Compared with group S,the expression of CIRP mRNA in hippocampus was up-regulated at 24 and 48 h after resuscitation,the expression of TNF-α mRNA was up-regulated at 12,24 and 48 h after resuscitation,the expression of IL-1β mRNA was up-regulated at 12 and 24 h after resuscitation,and the expression of CIRP,TNF-α and IL-1β was up-regulated at 12,24 and 48 h after resuscitation in group I/R (P＜0.05).Pathological changes in hippocampal CA1 region were found in group I/R.Conclusion The expression of CIRP in hippocampus is up-regulated,which promotes central inflammatory responses during brain injury in a rat model of cardiac arrest-cardiopulmonary resuscitation.
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Objective To analyze data of fails among oncology inpatients from 2014 to 2015,and to explore the effects of the continuous quality improvement on management of falls among oncology inpatients.Methods According to data of falls among oncology inpatients in 2014,continuous quality improvement was carried out in prevention of falls,including health education,risk assessment process of falls and inter-department cooperation.Results One year after applying the continuous quality improvement for management of falls,the number and the rate of falls among oncology inpatients in the year of 2015 (Number=25,Rate=0.027‰) were significantly lower than those in 2014(Number=55,Rate=0.065‰,x2=15.195,P＜0.001).Conclusion Improvement of management protocol for falls can effectively reduce the rate of falls among oncology inpatients and ensure patient safety.
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Case management is a flexible, systematic, holistic new care model which can integrate the episodic therapy of cancer patients. Case management applied the process of assess, plan, implementation, evaluation and feedback to the process of case management, conduct the path management from diagnosis to follow-up. This paper introduces the job descriptions and competence of case managers, the development of cancer case management domestic and overseas; so as to offer reference for the domestic implementation of cancer case management. Consequently realize the comprehensive rehabilitation of physical, psychological, social and spiritual function for cancer patients.
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Objective To evaluate the effect of hydrogen sulfide on hippocampal endoplasmic reticulum stress during global cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two pathogen-free healthy male Sprague-Dawley rats,weighing 280-320 g,aged 8-10 weeks,were divided into 3 groups (n=24 each) using a random number table:sham operation group (group Sham),global cerebral I/R group (group I/R) and global cerebral I/R plus sodium hydrosulfide group (group I/R+NaHS).Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the global cerebral I/R model.Immediately after recovery of spontaneous circulation,sodium hydrosulfide 2.5 mg/kg was intraperitoneally injected in group I/R+NaHS,and normal saline 5 ml/kg was given in group I/R.The hippocampi were immediately removed at 24 h of reperfusion for determination of the expression of glucose-regulated protein 78 (GRP78),C/EBP-homologous protein (CHOP) and caspase-12 in hippocampal tissues (by Western blot).At 1,3 and 7 days of reperfusion,the hippocampal tissues were obtained and stained with haematoxylin and eosin for examination of the pathological changes in hippocampal CA1 region (under a light microscope) and for determination of apoptosis in hippocampal cells (using TUNEL staining),and the apoptosis rate was calculated.Results Compared with group Sham,the apoptosis rate of hippocampal tissues at 1,3 and 7 days of reperfusion in group I/R and at 3 and 7 days of reperfusion in group I/R+NaHS were significantly increased,and the expression of GRP78,CHOP and caspase-12 in hippocampal tissues was significantly up-regulated in I/R and I/R+NaHS groups (P＜0.05).Compared with group I/R,the apoptosis rate of hippocampal tissues was significantly decreased,and the expression of GRP78,CHOP and caspase-12 was down-regulated at 1,3 and 7 days of reperfusion (P＜0.05),and the pathological changes were significantly attenuated in group I/R+NaHS.Conclusion The mechanism by which hydrogen sulfide reduces apoptosis in hippocampal cells is related to inhibition of endoplasmic reticulum stress during global cerebral I/R in rats.
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Objective To explore the effects of the bio-psycho-social-spiritual health model intervention on the bio-psycho-social-spiritual health model of the patients with cervical cancer.Methods 118 patients with cervical cancer were randomly assigned to the control group (60 cases) and the intervention group (58 cases).All patients received the routing nursing of cervical cancer.In addition the intervention group received the bio-psycho-social-spiritual health model intervention.Functional Assessment of Cancer Therapy-General (FACT-G) was used to investigate their quality of life before being intervened,being intervened for 3 and 6 months.Results The range of FACT-G total score was 44-96 (68.29±11.60).The total scores of FACT-G before the intervention,3 and 6 months after the intervention were 66.82 ±12.21,79.31±5.15 and 89.67±5.21,compared with those of the control group,which were 69.81 ±10.84,74.48±7.97,79.74±7.17,the time effect,Inter group effect and interaction effect were 137.723,10.944 and 14.639,P＜0.01.Conclusions The bio-psycho-social-spiritual health model intervention can improve the quality of life of patients with cervical cancer.
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Objective To perfect the prescription knowledge discovery methods; To discover the key factors affecting the robustness of prescription therapeutic model as well as improve its recognition capability.Methods Expanded knowledge base and improved design of Chinese Medicine Prescriptions Intelligence Analytic System (CPIAS) were proposed, such as the establishment of the heuristic filtering rules of efficacy-syndrome relationship, knowledge table of efficacy-syndrome element relationship, identification of efficacy-syndrome element relationship, and syndrome element-syndrome relationship. In addition, quantitative data were calculated by CPIAS. Prescription therapeutic modeling experiments on the Chinese medicine prescriptions system were conducted based on support vector machine (CPSVM), which was also used to analyze the learning outcomes.Results Using expanded knowledge base and improved calculation results can significantly promote learning abilities of CPSVM.Conclusion Screening of efficacies, sorting of symptoms, and collection of syndrome elements are the key factors affecting the quality of prescription therapeutic model.
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Objective To explore the prevalence of the personality and mindfulness level of the nursing college students and investigate their correlation.Methods 180 nursing college students were investigated by the scale of NEO and FFMQ.Results The scores of personality trait were in the moderate level.The correlation between the score of the adaptability items and the mindfulness was negatively correlated,the moral sense items,sociability items and agreeableness items and the mindfulness was positively correlated.Conclusions The personality of nursing college students is closely related with their mindfulness level.To perfect the personality of the nursing college students can improve their mindfulness level.
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Objective To investigate the relationship between the level of mindfulness and the A-type behavior characteristics of the nursing college students.Methods 172 nursing college students were investigated by the scale of TABP and FFMQ.The results were analyzed.Results In the 172 nursing college students,there were 112 nursing college students belonging to type B behavior pattern,accounted for 65.1％,and 60 nursing college students belonging to type A behavior pattern,accounted for 34.9％.The correlation between the score of TABP and the observation items and describing items were positive statistically significant,and was negatively correlated with awareness items and non-judge items statistically.Conclusions The students with different behavior characteristics were different in their mindfulness level.In order to improve nursing college students' mindfulness level and their mental health,the educators should take intervention based on their behavior characteristics timely.
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Objective To explore the effects of the mindfulness mode intervention on the adverse reaction of the patients with breast cancer during the period of chemotherapy.Methods 75 patients with breast cancer during the period of chemotherapy were randomly assigned to the control group(38 cases) and the intervention group(37 cases).All patients received the routing nursing of chemotherapy.In addition the intervention group received the mindfulness intervention.The adverse reaction of chemotherapy questionnaire was used to investigate the level of their adverse reaction before the intervention and two months after the intervention.Results After the intervention,the scores of the adverse reaction in the intervention group was (32.19± 7.70)points,less than that of the control group,which was (36.97±10.03)points.There was statistically significant difference between two groups.Conclusions The mindfulness model intervention could reduce the adverse reaction of the patients with breast cancer.
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Objective To evaluate the effectiveness of aspirin in preventing peripherally inserted central venous catheter (PICC) -related thrombosis. Methods Totally 360 cancer patients who had undergone routine PICC placement were equally randomized into aspirin group (receiving conventional PICC maintenance plus oral administration of aspirin; 100 mg/d, for consecutively 21 days) and control group (conventional PICC catheter maintenance). The incidences of phlebitis and thrombosis were observed in both two groups. Results The incidences of phlebitis and thrombosis were 3.3% and 0 in aspirin group, which were significantly lower than those in control group (8.9% , P = 0. 025; 1.7% , P = 0. 025). Conclusion The oral administration of aspirin after the PICC placement can reduce PICC-related thrombosis and phlebitis.
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<p><b>OBJECTIVE</b>To study the characteristics of local cytokines profile in human gastric cancer lesions and offer guides for immunotherapy of gastric cancer.</p><p><b>METHODS</b>The cytokines profile in isolated CD4+, CD8+ T subsets and epithelial cells from cancer tissue, contrasted with benign gastric mucosa of 15 gastric cancer patients were analyzed by a highly sensitive radioactivity labeled semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) technique.</p><p><b>RESULTS</b>The predominance of increased Th2 and reduced Th1 immune response in both CD4+ and CD8+ T subsets from cancer tissue, compared with benign gastric mucosa, were observed. IL-6, IL-8 and TNF-alpha in CD8+ T cells from cancer tissue showed statistical higher levels than those from benign gastric mucosa (P = 0.029, P = 0.022, P = 0.002), so did IL-10, TGF-beta, TNF-alpha in T cells and epithelial cells.</p><p><b>CONCLUSION</b>A shift of Th1/Th2 cytokines to Th2 is found in T cells from local tumor lesion of gastric cancer, which suggests an immune suppressive status in local tumor lesion. The obvious change of cytokine profile in CD8+ T cell suggests they play a main role in immune suppression. To study the cytokine expression of different cell subsets, we are able to offer guides for immunotherapy for patients with gastric cancer.</p>