本文拟探讨甲状腺不同缝合方式及不同引流对甲状腺手术效果的影响,比较得出甲状腺手术最佳治疗方式,分析得出其最好的缝合、引流方式、手术方式及预防瘢痕形成或减轻瘢痕的敷料,应用于临床.

Objective:To improve the quality of the breast cancer patients'life in the period of the postoperative rehabilitation .Meth-ods:choose 80 breast cancer patients who has got cured during January to April 2012 from the thyroid and breast surgery department of The First Affiliated Hospital of Harbin Medical University,then divide them into experimental group and control group averagely, with the&nbsp;consent of the patients .The control group was given regular treatment and nursing only, the experimental was given the series health edu-cation activities during the chemotherapy period in addition.The two groups fill out the breast disease related knowledge measurement scale and the cancer rehabilitation evaluation table ( CARES-SF ) ( before and after the health education) in the first period of the chemother-apy and in the sixth time of chemotherapy relatively, analysed the comparison of each table score in the end.Results:the awareness level of the experimental group to the breast cancer disease related knowledge is significantly higher than that in control group ( P <0.05 ) , the difference between the two groups is significant.Conclusion:it had important significance to carrying out the health education activi-ties to the breast cancer patients in the postoperative rehabilitation period for improving the survival quality of them.

Objective:To discuss the best application time of continuous renal replacement therapy for severe acute pancreatitis.Methods:30 cases of patients with severe acute pancreatitis (SAP) were selected in our hospital as the research object,according to the onset of CRRT after time,they were divided into group A and group B.Group A was treated within 72h after onset,while Group B was treated in the pathogenesis of 72 h.The clinical outcome and changes of invital signs,APACHE Ⅱ score,hospitalization costs and average hospitalization time were analyzed.Results:After the CRRT,the mortality rate (14.3％) of Group A was lower than that of group B (43.7％),the difference was statistically significant (P＜0.05); after the treatment,two groups of treatment,heart rate,respiratory rate and mean arterial pressure were stable,Group A was better than that of group B,and the difference was statistically significant (P＜0.05); The average hospitaliza-tion time (15.7± 8.9) days,hospitalization costs (107000± 65000)yuan of group A were significantly better than those in group B,with significant difference (P＜0.05); the APACHE Ⅱ score after the treatment of the two groups were significantly higher than those before treat-ment,group A APACHE Ⅱ score was significantly better than that in group B,the difference was significant (P＜0.05).Conclusion:Early continuous renal replacement therapy can significantly improve the curative effect and prognosis of acute pancreatitis,and the optimal timing of treatment may be within 72 hours after onset.

Objective To analyze the influence of positive thinking training in the psychology,sleep quality of life quality in patients after the breast surgery.Methods By convenience sampling,68 patients were se-lected and divided into observation group (positive thinking training)and control group (routine care)ac-cording to the admission time with 34 cases in each group.After 7 days of nursing,the psychology,sleep quality was evaluated and patients’s quality of life was compared following 3 months.Results After 7 days of intervention,the anxiety and depression scores in observation group were better than which in control group (all P<0.01).Scores of sleep quality,sleep time,time to fall asleep,sleep efficiency and hypnotic drug rating in observation group were lower than that in control group (all P<0.01).The scores of score of physiological function,health condition,social function and emotional function in observation group were higher than which in control group (all P<0.01).Conclusion Positive thinking training plays a positive role in the psychology,sleep quality and quality of life for patients with breast cancer after surgery,which is worth for clinical trial.

Objective: To investigate the job satisfaction and its influencing factors among nurses worked in ward.Methods: Nurses worked in the terriary hospital of Harbin were recruited and completed the job satisfaction assessment sacle and a demographic form.Results: The total average socre of nurses' job satisfaction was(76.85±10.97),the influencing factors of job satisfaction including age,marital status,and professional title.Conclusion: The level of ward nurses' job satisfaction was moderate,the factors of sociodemographic which influencing the job satisfaction were age,maritual status,and professional title.The manager should pay more attention to improve the working conditions,and formulate the personality regulatory framework to increase the nurses' job satisfaction,in order to enhance the quality of work.

Objective: To investigate the effect of the thyroid and breast preoperative anxiety level and personality characteristics on postoperative recovery.Methods: 1500 cases of thyroid breast surgery patients were chosen,SAS was used for self-rating anxiety scale assessed anxiety,Cattell's16 PersonalityFactorTest(16PF)wasused forpersonalitycharacteristicsofpatientsdetermination.Results: Thyroid and breast preoperative anxiety and postoperative complications,bed time,hospital stay,psychological adjustment,the number of analgesic use five indicators of association,P 0.05;Thyroid,breast,and postoperative recovery of O(anxiety),Q4(tension),I(sensitivity),C(stability) and A(Lok Kwan) showed correlation,P0.05,but they were not correlated with other factors.Conclusion: Preoperative anxiety and postoperative recovery of personality characteristics have an impact on the nursing staff to keep abreast of the patient's psychological adjustment and timely treatment of patients with a positive attitude to survive the perioperative period to ensure the safety of hospitalized patients and promote patient rehabilitation and prognosis.