1Department of Nuclear Medicine, Tenth People’s Hospital of Tongji University, Shanghai, People’s Republic of China; 2Department of Orthopaedic, Beijing Jishuitan Hospital, Beijing, People’s Republic of China; 3Department of Nuclear Medicine, Shanghai No. 4 People’s Hospital, Shanghai, People’s Republic of China; 4Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China

目的:调查老年腹腔镜手术患者术前焦虑情况,分析引起老年患者术前焦虑的主要影响因素.方法:采用横断面调查法,使用阿姆斯特丹术前焦虑量表(APAIS)调查老年腹腔镜手术患者术前焦虑情况;采用单因素分析与多元线性回归分析处理调查数据,分析老年腹腔镜手术患者术前焦虑的影响因素.结果:本次研究共发放调查问卷150份,回收有效问卷136份,有效回收率为90.67％.单因素分析结果提示,性别、主要照顾者、术前睡眠情况、既往手术体验是导致老年腹腔镜手术患者术前焦虑的主要影响因素(P<0.01,P<0.05);进一步通过多元线性回归分析可知,性别、术前睡眠状况、既往手术体验是影响老年腹腔镜手术患者术前焦虑的主要因素(R2=0.554,F=3.487,P<0.05).结论:老年腹腔镜手术患者术前焦虑水平较高,护士需要关注患者心理状态并给予针对性护理干预,尤其需要注意女性、术前睡眠状况差、有痛苦手术体验的患者.

Objective:To investigate the effects of 99Tc-methylene diphosphonate (99Tc-MDP) on osteoporosis (OS) in postmenopausal patients with differentiated thyroid cancer (DTC) under thyroid stimulating hormone (TSH) suppression.Patients and Methods:Patients (n = 142) were divided into two groups: (1) 99Tc-MDP (n = 70) and (2) alendronate (n = 72) treatments (NCT02304757). Bone mineral density (BMD) in the lumbar spine and hip was evaluated by DXA, along with bone turnover markers, safety, and quality of life (QOL) using SF-36 at three time points: before treatment and at 6 and/or 12 months after treatment.Results:The percentage change of BMD in total lumbar spine or hip showed no significant difference throughout the study (P > 0.025). 99Tc-MDP and alendronate treatment alone significantly increased BMD in the lumbar spine, but alendronate treatment also significantly increased BMD in total hip at 6 and 12 months, as compared with the baseline. There were no significant differences in the results of the SF-36 scores between the two treatment groups at any time during the whole study period. 99Tc-MDP significantly increased bone formation markers of osteocalcin at 6 and 12 months (P all < 0.05), PINP at 12 months (P = 0.001), and bone resorption markers of β-CTX at 6 and 12 months (p < 0.05) as compared with the alendronate treated group. No adverse event was observed in the 99Tc-MDP treatment group compared with alendronate (P = 0.014).Conclusion:99Tc-MDP was as efficacious as alendronate in the improvement of lumbar BMD for DTC patients with OS under TSH stimulation. 99Tc-MDP was shown to be safe and improved patients' QOL.

目的 探讨帕金森病(PD)患者在脑深部电刺激(DBS)手术清醒期间的术中体验,为今后行DBS手术的患者制订个性化的护理措施提供参考依据.方法 采用目的性抽样方法,选取2019年8月至2020年11月复旦大学附属上海市第五人民医院收治的8例成功完成DBS手术的患者,对其采用一对一半结构式访谈,并应用Colaiz-zi七步分析法进行资料分析.结果 DBS术中体验归纳为4个主题,包括主题1(面对手术未知的焦虑、恐惧和疼痛)、主题2(面临决策的选择)、主题3(社会和家庭支持的需求)和主题4(期待较好的治疗效果).结论 行DBS手术的患者在围手术期存在较多心理问题并希望得到相应的帮助,医护人员应予以重视并对其实施针对性的护理干预和心理指导.

总结经尿道1470nm半导体激光前列腺汽化剜除术(DiLEP)治疗高龄高危复杂性良性前列腺增生症(BPH)患者的手术护理配合.术前充分了解患者的身心情况,术中完善的物品准备、熟练的手术配合和紧密的相互协作,术后严密观察患者生命体征及膀胱冲洗液的颜色等.80例手术均获成功.无电切综合征(TURS)、无术后输血、无永久性尿失禁、无尿道狭窄等并发症.结论:良好的围手术期护理可保证手术成功、促进患者早日康复.

目的 通过对3种不同精密器械包装的绩效管理分析,探讨不同的包装对精密器械损耗的影响.方法 将棉布、无纺布及硬质容器分别作为精密器械的最终灭菌包装,并分为A、B、C3组,每组20个器械包,各跟踪30台手术.观察3组手术支持效率(REH)评分,记录3组器械的损耗情况.结果 C组REH评分合格率高于A、B组,C组的月均损耗数量、月均损耗费用以及年总损耗费用均低于A、B组,C组损耗率低于A、B组.结论 硬质容器作为精密器械的最终灭菌包装,能提高手术支持效率,降低器械损耗,节约手术室成本,提高手术室综合效益.

Glioblastoma multiforme (GBM), the most aggressive and lethal primary brain tumor, is characterized by very low life expectancy. Understanding the genomic and proteogenomic characteristics of GBM is essential for devising better therapeutic approaches.Here, we performed proteomic profiling of 8 GBM and paired normal brain tissues. In parallel, comprehensive integrative genomic analysis of GBM was performed in silico using mRNA microarray and sequencing data. Two whole transcript expression profiling cohorts were used - a set of 3 normal brain tissues and 22 glioma tissue samples and a cohort of 5 normal brain tissues and 49 glioma tissue samples. A validation cohort included 529 GBM patients from The Cancer Genome Atlas datasets. We identified 36 molecules commonly changed at the level of the gene and protein, including up-regulated TGFBI and NES and down-regulated SNCA and HSPA12A. Single amino acid variant analysis identified 200 proteins with high mutation rates in GBM samples. We further identified 14 differentially expressed genes with high-level protein modification, among which NES and TNC showed differential expression at the protein level. Moreover, higher expression of NES and TNC mRNAs correlated with shorter overall survival, suggesting that these genes constitute potential biomarkers for GBM.

Objective To investigate and analyze the risk factors of checking surgical goods.Aimming at risk factors, establish nursing measurement to diminish the checking er ors. Methods Facture a questionnaire of risk factors of checking surgical goods, depending on the nursing papers searched on database. Send these questionnaires to the operation room nurses in several general hospitals. Recover the questionnaire, extract the data and analyze. Results The most important factor the operation room fel ows point out is the operation type. There is the closest relationship between the operation type and operation er ors, the relevance are 72.5%. The second is quality of surgical good checking, the relevance is 57.5%. Besides, the quality of operation room fel ows and operation management are also very important. The relevance is 55%, 45%, respectively. Conclusion According to the grouping of checking surgical goods impact factors, the dif erence was statistical y significant( <0.05), operation factors including emergency operation and transit operation may make the max impact to the surgical good checking.

Objective To investigate the inactivation effect of disinfection and cleaning method on NCI‐N87 carried by surgical instruments ,and to provide experimental evidence for tumor destruction treatment on surgical instruments during surgeries .Methods NCI‐N87 was identified as the typical gastric cancer in our experiments . Hemostats that carried NCI‐N87 were scrubbed and cleaned with absolute alcohol ,WFI ,15% and 25% Lioner skin and mucous membrane disinfectant respectively for 5 ,10 ,and 15 seconds .Hemostats were then cultivated for 48 hours .After 72 hours ,NCI‐N87's cells were observed and calculated .Results Antiseptic liquids have grea‐ter inactivation effect on gastric cancer than saline .The differences between experimental groups were statistically significant ( P<0 .01) .The figures also indicated that 25% Lioner skin and mucous membrane disinfectant was of the most notable inactivation effect on gastric cancer cells .The longer surgical instruments were cleaned with the Lioner disinfectant ,the better the inactivation effect was .Conclusion During the operation of gastric cancer , cleaning surgical instruments with antiseptic liquid ,especially with 25% Lioner skin and mucous membrane disin‐fectant ,demonstrates positive inactivation effect on gastric cancer cells .

截石位相关并发症包括下肢静脉血栓形成、循环系统变化、周围神经损伤、小腿筋膜室高压综合征。其预防性护理方法包括辅助器具的使用、体位摆放方法的改进等。护理人员应针对患者病情采取有效护理干预措施,以预防截石位导致的相关并发症。

目的探讨标本处理方法对血液葡萄糖测定结果的影响。方法将同一份患者标本分别置于草酸钾-氟化钠真空采血管、肝素锂真空采血管、普通干燥真空采血管3种不同的采血管内,分别在2、4、6、8、24、48、72、96 h测定葡萄糖浓度,观察血液葡萄糖在3种不同采血管中及不同时间内的稳定性;将同一份标本置于3支相同的普通干燥真空采血管内,置37℃水浴箱30、60、90 min后,观察37℃水浴时间对葡萄糖测定结果的影响。结果肝素锂抗凝血浆、草酸钾-氟化钠抗凝血浆葡萄糖测定结果明显高于血清葡萄糖测定结果(P<0.001),肝素锂抗凝血浆、草酸钾-氟化钠血浆葡萄糖测定结果之间差异无统计学意义(P>0.05);血清、肝素锂抗凝血浆放置4 h后,葡萄糖明显降低;氟化钠抗凝血浆放置96 h内葡萄糖浓度没有明显变化(P>0.05);血清葡萄糖浓度随标本放置37℃水浴箱时间延长,葡萄糖浓度降低得越多。结论血清葡萄糖的浓度明显低于血浆,并且随标本放置的时间及置37℃水浴箱时间的延长而降低得越多,血液标本处理方法对血清葡萄糖测定结果有明显的影响。

为了满足手术的需要,患者在手术中被放置成各种手术体位以配合手术的进行,由于压力、剪切力、摩擦力和潮湿等原因[1],手术患者是急性压疮的高危人群.据统计,手术中压疮患者的发生率在3%～5%,其中外科手术的患者压疮的发生率更高[2].现就术中压疮的发生机制、影响因素、预防术中压疮研究中的各种方法和护理措施综述如下.

目的探讨肝素锂抗凝血用于门急诊临床生化检验的可行性。方法采集40例门急诊患者静脉血液标本,每一患者标本分别置普通干燥真空管、肝素锂真空管和肝素钠真空管3种不同的标本收集管内,用Roche Modu larPE全自动生化分析仪,测定26项常规生化项目。结果26项项目中除钾(K+)、钠(Na+)、乳酸脱氢酶(LDH)血清、肝素锂、肝素钠抗凝血浆测定值差异有统计学意义(P<0.05~0.001)外,其余指标差异均无统计学意义。结论除K+、Na+、LDH外,肝素锂抗凝血浆可用于其他门急诊临床生化项目的检测。