肺癌是人类最常见的恶性肿瘤之一,其死亡率和发病率高居中国城市居民各类恶性肿瘤之首。在所有肺癌病例中,非小细胞肺癌(NSCLC)占80%以上,而且有70%~80%的NSCLC患者在确诊时已进展至晚期,错过了接受手术的机会,而针对新确诊的ⅢB期或Ⅳ期NSCLC患者的以铂类药物为基础的一线化疗方案并不能显著延长患者的生存期[1],针对晚期NSCLC患者的化疗疗效已达到一个平台,而且其毒副反应也愈发显
Objective To investigated job satisfaction and turnover intention of clinical nurses with different educational background in northeastern Sichuan Province and to study the cor-relation between the two factors.Methods A total of 860 clinical nurses were investigated by a questionnaire,including general data,turnover intention and job satisfaction.Results The opti-mistic degree on work in secondary education was better than those of undergraduate nurses and ju-nior education nurses,and the optimistic degree and severity on work of undergraduate nurses were highest.A significant difference was observed in management,work load,work or family balance, personal growth and development of job satisfaction among the 8 factors (P <0.05).Turnover in-tention score and job satisfaction score were significantly lower than the total theoretical score and the difference was statistically significant (P <0.05).Conclusion The higher the education is, the lower optimistic degree on the job and job satisfaction are,and the higher the turnover intention is.Thus,the hospital can improve the wages and welfare of nurses,and provide the support and platform for their development,and strive to improve their professional knowledge,positive nursing team construction,improve their job satisfaction so as to reduce turnover intention and the nursing resources loss.
Objective To explore effect of comprehensive nursing intervention on lymphedema after breast cancer operation. Methods A total of 100 patients with radical mastectomy were randomly divided into experimental group and control group,with 50 patients in each group. The control group used simple pressure treatment and the experimental group implemented comprehensive nursing intervention on the basis of pressure therapy. The lymphedema condition of two groups in one week,one month,3 months and 6 months after surgery were observed were recorded,and incidence of different degree was compared. Results After comprehensive nursing intervention,the degree of lymphedema in the experimental group was relieved,the difference was statistically significant( P < 0. 05). The incidence of lymphedema was also significantly reduced,and no severe lymphedema occurred. Conclusion Comprehensive nursing intervention can effectively improve the incidence of lymphedema and improve curative effect,so it is worthy of clinical practice.
由于受到治疗的影响,肝胆外科手术患者在围术期经常会出现紧张、焦虑等心理问题,这些心理问题会使患者对后期的治疗护理产生抗拒、反感等消极情绪,从而严重阻碍治疗护理工作的开展,降低了治疗和护理工作的有效性与安全性[1]。随着现代医学技术的进步,医护人员已经越来越认识到心理护理的重要性,因此近几年来关于肝胆外科的心理护理已经成为治疗和护理的研究热点之一,本研究中的心理护理方案主要是指护理人员在手术前、手术中以及手术后采用一
Objective To explore the application effect of nutrition support nursing with homogenized diet in improving the nutrition and immune state in ICU patients.Methods 250 ICU patients were randomly divided into observation group and control group.The control group was given parenteral nutrition within 72 hours in ICU while the observation group was given the homogenate diet nutrition within 72 hours in ICU.Nursing effect was compared between the two groups.Results Counts of total serum protein,albumin,hemoglobin and lymphocyte after 1 week in the observation group were higher than that in the control group,the difference was statis-tically significant(P <0.05).The difference was statistically significant since gastrointestinal dys-function rate,hospitalization time in ICU in the observation group were less than that in the con-trol group(P <0.05).The difference was not statistical significant in the complications and mortal-ity (P >0.05).Conclusion Homogenate nutritional support therapy can improve the nutritional and immune status of ICU patients and promote the patients’recovery.
Objective To explore the clinical effect of edaravone combined with ozagrel sodiumon on the treatment of patients with acute cerebral infarction(ACI). Methods 60 patients with ACI were randomly divided into treatment group and control group, 30 cases in each group.Both groups were treated with conventional therapy, and the control group was treated with additional ozagrel 80 mg in 250 mL normal saline(NS)by intravenous infusion, once per day. On the basis of the control group, the treatment group was treated with additional edaravone 10 mg in 100mL NS by intravenous infusion, twice per day. 14 days were counted as a course of treatment. Degree of neurological impairment and clinical efficacy were evaluated in both groups. Results There were no significant differencesof pretherapeutic National Institutesof Health Stroke Scale(NIHSS)score, nervous functional score(NDS)and activity of daily living(ADI)score between the two groups(P> 0.05). After treatment, the NIHSS, NDS and ADI were significantly improved in both groups(P< 0.01), and the post- therapeutic levels of indexes mentioned above in the treatment group were significantly better than those in the control group(P< 0.01). The total effective rate in the treatment group was 90.00%, which was significantly higher than 53.33% in the control group(P< 0.05). Conclusion Application of edaravone combined with ozagrel sodium in the treatment of patients with ACI can significantly improve the status of neurological impairment.
乳腺超声检查以其良好的图像质量、无辐射相对方便及价格低廉的优势,在乳腺肿块的诊断中具有重要的应用价值。然而,对于周围分布脂肪等回声肿块或者不均匀回声且位置较深的肿块,乳腺超声检查有其局限性。尤其针对一些乳腺癌的患者,灰阶超声并不能很好地显示肿块以
Objective To explore the epidemiologic features of respiratory syncytial virus(RSV)in children with acute respiratory tract infection(ARTI)in Changzhou area.Methods Nasopharyngeal secretionsof 3 843 children with ARTI from January 2011 to December 2012 were collected and detected by direct immonofluorescence assay. Results 627 samples were positive for RSV antigen detection in all the children, and the positive rate was 18.00%(627/3843), furthermore the positive rate was 22.96%(306/1333)in 2011 and 14.93%(321/2150)in 2012. There wassignificantdifferenceofpositive rateof RSVbetween2 0 1 1 and2 0 1 2(χ 2= 3 5.9 0 4, P=0.000). The positive rate in boys was significantly higher than that in girls. With the increasing of age, the positive rate declined gradually, and the highest positive rate was observed in neonates.Epidemiologic peak of RSV was in winter and spring, and RSV infection was mainly observed in children with bronchiolitis. Conclusion RSV is the important viral pathogen in children with ARTI in Changzhou area. RSV infection, mainly popularizing in winter and spring, easily occurs in children less than 3 years old. Meanwhile, detection rate of RSV is the highest in children with
Objective To explore the influence of ginsenoside Rg3 on the proliferation of Lewis lung cancer cells in vitro and immune function of tumor-bearing mice.Methods 48 C57BL/6tumor-bearing mice were randomly divided into high-dose Rg3 group, low-dose Rg3 group, DDP group and normal saline(NS)group, 12 mice in each group.Another 12 normal mice treated with0.4 mLNS once per day were designed as control group.CCK-8 method wasused to detect the proliferation rate of Lewis cells, and flow cytometry was used to detect the apoptosis of tumor cells.Activitiesof natural killers(NK), lymphokine activated killers(LAK), cytotoxic lymphocytes(CTL)and serum tumor necrosis factors were compared in all the groups. Results Effects of 15μg/mL and 20μg/mLginsenoside Rg3 on inhibition of proliferation were significantly stronger than effect of 10μg/mL, but there was no significant difference between 15μg/mL and 20μg/mL ginsenoside Rg3. Role of ginsenoside Rg3 in inducing the apoptosis of Lewis lung cancer cellsenhanced with concentration increasing, and this efficacy was saturated after reaching a certain concentration(15μg/mL). NK, LAK and CTL activities and serum TNF level in high-dose and low-dose ginsenoside Rg3 groups were significantly higher than those in NS and DDP groups, but were lower than that in control group. Conclusion Ginsenoside Rg3 can significantly inhibit proliferation of Lewis lung cancer cells,induce apoptosisof Lewis cells and enhance the immune function of tumor-bearing mice.
Objectives To explore the role of C reactive protein(CRP), prealbumin(PA)and white blood cell(WBC)count and classification in the differential diagnosisof children with infantile acute upper respiratory tract infection. Methods 125 children with upper respiratory tract infection were collected and divided into bacterial infection group(n= 61)and viral infection group(n= 64)according to the clinical symptoms and laboratory examination. 60 healthy children were selected and designed as control group. The serum CRP, PA levels and WBC count and classification were measured and analyzed among three groups. Results There were no significant differences of serum CRP level and PA level between the virus infection group and the control group(P> 0.05). The level of serum CRP in the bacterial infection group was significantly higher than that in the virusinfection group and the control group(P 0.05). WBC count in the bacterial infection group was significantly higher than that in the virus infection group and the control group(P< 0.05). Percentage of neutrophils in the bacterial infection group was significantly higher than that in the control group(P< 0.05), and the percentageof neutrophils in the control group was significantly higher than that in the virus infection group(P< 0.05). Percentage of lymphocytes in the viral infection group was significantly higher than that in the control group(P< 0.05),and the percentage of lymphocytesin the control group was significantly higher than that in the bacterial infection group(P< 0.05). Conclusion Increasing of serum CRP level,WBC count,neutrophils percentage and declining of PA level can be used as the references for the diagnosisof the bacterial infection of the upper respiratory tract. Increasing of lymphocyte percentage can be used as the reference for the diagnosisof the viral infection of the upper respiratory tract.For the differential diagnosis,all these indicators should be considered comprehensively in order to formulate the proper therapeutic measures.
Objective To explore the correlation between levels of serum homocysteine(HCY)and high-sensitivity C-reactive protein(hs-CRP)and the disease severity and coronary artery changes in patients with coronary heart disease(CHD). Methods 130 patients with suspected or diagnosed CHD were divided into acute myocardial infarction(AMI)group, unstable angina(UA)group, stable angina(SA)group and non-coronary heart disease(NCHD)group(control group).Levels of HCY and hs-CRP were detected and compared among all the groups. Results Levels of HCY and hs-CRP in the SA group, UA group and AMI group were significantly higher than the control group(P 0.05). HCY level in the UA group and AMI group were significantly higher than the SA group(P 0.05). Level of hs-CRP decreased gradually in the AMI group, UA group and SA group(P 0.05). With the development of CHD, levels of HCY and hs-CRP increased gradually in the single vessel pathological change, double vessels pathological change and three vessels pathological change(P 0.05), and both indexes were associated with coronary artery changes(r= 0.482, 0.664, P 0.05). There was a positive correlation between serum HCY and hs-CRP in patients with CHD(r= 0.85, P 0.05). Conclusion Levels of serum HCY and hs-CRP were associated with CHD severity and coronary artery changes. A combined detection of HCY and hsCRP levels is helpful for understanding of disease, guidance of treatment and evaluation of prognosis.
慢性心力衰竭(CHF)是多种心血管事件如急性冠状动脉综合征、心肌病、高血压病、心脏瓣膜疾病等发展至一定严重程度的终末转归。近年来,CHF患病率大为激增,致病机制又极其复杂,治疗手段进展缓慢,预后往往不良。血浆B型利钠肽(BNP)可反映CHF患者心脏收缩和舒张功
小儿重症肺炎为儿科常见危重症,主要由细菌、病毒、支原体等感染所引起。该病临床首先出现发热、咳嗽、气促等上呼吸道感染症状,发热类型亦不规则,如弛张热或稽留热等,其他还可表现为食欲缺乏、呕吐、腹泻等。若病情继续恶化,还可出现气道高反应性、气道梗阻、分泌物潴留等,从而导致机体处于潜在呼吸衰竭的状态,或临界呼吸衰竭的状态。此时,患儿若得不到及时治疗,则会立即出现呼吸衰竭,病情凶险,死亡率较高,因此,积极治疗病因,纠正低氧状态是缓解病情的关键所在[1]。近年来,鼻塞式持续气道正压通气(NCPAP)在小儿疾病的应用中较为广泛,临床报道较多[2-3],而对于重症肺炎合并呼吸衰竭的报
Objective To find a new cell culture method for cartilage defect repair with the acquisition of a sufficient number of chondrocytes.Methods After induced differentiation of human bone marrow mesenchymal stem cells in vitro expansion mixed,the cells were cocultured with rabbit mature articular chondrocytes(RCH).Result Mixed culture showed up-regulation of cell proliferation,and increase of cartilaginous extracellular matrix production,type Ⅱ collagen gene,SOX9 expression;and mesenchymal stem cells differentiated into chondrocytes after 4 weeks.Conclusion MSCs and/or autocrine role in may regulate the transfor mation of MSCs into mesenchymal stem cells by paracrine or autocrine.
多西他赛为紫杉醇类抗肿瘤药,它通过与游离的微管蛋白结合,使游离微管蛋白显著减少,从而抑制肿瘤细胞的有丝分裂和增殖[1-3]。作者选用江苏连云港产的艾素(即多西他赛)加用氟尿嘧啶(5-Fu)及顺铂联合应用治疗胃癌取得较好的疗效,现将相关的观察与护理体会报告如下。1资料与方法1.1一般资料本科2005年2007年5月采用艾素等联合化疗治疗胃癌30例,男19例,女11例,年龄3580岁;其中手术患者21例,未手术者9例,伴有转移4例。1.2方法及观察措施艾素40 mg加入生理盐水(NS)150 mL中静脉滴注,输液泵2 h,顺铂40 mg加入NS 500 mL中静脉滴注46 h,5-Fu 1.
Objective To investigate the expression of C-erbB-2 in peripheral blood mononuclear cell(PBMC) and their relationship with the expressions of C-erbB-2、hermone receptor(ER、PR)in tumor tissues and the stage of the disease in patients with breast cancer.Methods Flow cytometry(FCM) was used to examine the C-erbB-2 expression in PBMC of breast cancer patients,meanwhile,the expression was compared with the expressions of C-erbB-2、ER、PR in tumor tissues and the stage.Results 77 cases of breast cancer,C-erbB-2 expression in PBMC was(24.16±20.81)%.The expression of C-erbB-2 in PBMC was significantly higher in C-erbB-2 positive tissues(30.69±21.70)% than that in C-erbB-2 negative tissues(17.47±17.48)%(P0.01).There was no significant difference in the expression of hermone receptor in tumour tissues and the stage(P0.05).Conclusions C-erbB-2 expressions in PBMC of breast cancer are associated with the expressions of C-erbB-2 in tumor tissues,which has no relationship with the stage of the disease and the expression of hermone receptor in tumor tissues.Further study is needed to predict the prognosis and guide the therapy.
Objective To study anti-angiogenetic ability of cyclophosphamide combined with thermotherapy. Methods Human microvascular endothelial cells(HMVEC) were cultured. MTT and number-calculating methods were used to observe cyclophosphamide on HMVEC′s proliferation and sprouts. Results Cyclophosphamide has no influence on endothelial cells at the dose lower than 0.4 mg/mL, but can suppress significantly survival rate of endothelial cells at the dose 0.4～1.6 mg/mL in a dose-dependent manner. No influence on HepGⅡ cells can be observed at the doses from 0.1 mg/mL to 1.6 mg/mL. Conclution Cyclophosphamide can significantly suppress the HMVEC′s prolifetation and sprouts at the dose 0.4～1.6 mg/mL in a dose-dependent manner. The combined use of Cyclophosphamide and thermotherapy has synergistic antiangiogenetic action in vitro.
