BACKGROUND:Although the prognosis of ovarian cancer can be significantly improved through standardized surgery and chemotherapy, 70% of epithelial ovarian cancer (EOC) patients would suffer from drug resistance and recurrence during the long chemotherapy cycle.OBJECTIVE:To explore the impact of a training mode based on the integration of virtual reality technology and mindfulness on anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy.METHOD:Through virtual reality technology, a mindfulness training software was designed and developed, and a mindfulness training mode based on virtual reality technology was constructed. Using a self-controlled design, 48 ovarian cancer patients undergoing chemotherapy who were hospitalized in a tertiary hospital in Beijing from August 2022 to May 2023 were conveniently selected as the research subjects. The patients were subjected to four weeks of mindfulness training based on virtual reality technology, and the acceptance of the mindfulness training mode using virtual reality technology was evaluated. The Hospital Anxiety and Depression Scale (HADS) and Cancer Related Fatigue Scale (CRF) were used to evaluate the anxiety, depression, and fatigue of patients before and after intervention.RESULTS:The virtual reality based mindfulness training mode includes four functional modules: personalized curriculum, intelligent monitoring, emotion tracking, and Funny Games. 48 patients had a high acceptance score (139.21 ± 10.47), and after using mindfulness training mode based on virtual reality technology, anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy were significantly reduced, with a statistically significant difference (p< 0.001).CONCLUSION:Ovarian cancer patients during chemotherapy have a high acceptance of virtual reality based mindfulness training mode. The application of this mode can reduce the psychological problems of anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy, and is worth promoting and using.

BACKGROUND:Stress urinary incontinence is prevalent among women and the incidence increases with age. OBJECTIVE:To explore the effect of intelligent pelvic floor muscle rehabilitation on elderly female patients with incontinence. METHODS:A total of 209 patients with urinary incontinence who were treated with pelvic floor muscle rehabilitation at Peking University International Hospital from September 2020 to January 2022 were selected by convenient sampling. All subjects were divided into the 50-60 year old patient group (n= 51) and over 60 years old patient group according to age (n= 158). The subjects of different age group were divided into an experimental group and a control group. The patients in the control group received routine nursing and health education, and the patients in the observation group received a combination of mobile application use and smart dumbbells. Based on this, we constructed an intervention model for intelligent, continuous pelvic floor rehabilitation. After 7 and 12 weeks, pelvic floor muscle function knowledge and exercise compliance in the two groups were evaluated. The improvement of urinary incontinence symptoms, pelvic floor muscle strength grades and quality-of-life scales were evaluated. RESULTS:The results showed that pelvic floor knowledge and exercise compliance in the experimental group were better than in the control group at 7 and 12 weeks after intervention (P< 0.05). There was no significant difference in pelvic floor muscle strength and quality of life between the two groups at 7 weeks after intervention (P> 0.05). However, there was a significant difference in pelvic floor muscle strength and quality of life between the two groups at 12 weeks after intervention (P< 0.05). There was no significant difference between different age groups. CONCLUSION:The intelligent pelvic floor rehabilitation model that combines a mobile application with smart dumbbells can maintain and strengthen the clinical treatment effect for elderly patients with urinary incontinence.

近年来人们的健康意识不断提高,再加上宫颈癌的年轻化趋势,使得人们对宫颈癌的关注度越来越高.很多宫颈癌患者都能够及时发现和被有效治疗,手术是治疗宫颈癌的有效方法.

目的 探讨智能手机移动应用程序(Application,APP)联合阴道哑铃的盆底肌训练(pelvic floor muscle treatment,PFMT)居家康复模式在老年女性压力性尿失禁(stress urinary incontinence,SUI)患者中的应用效果,以期为SUI患者提供一种安全、有效的PFMT.方法 选择北京市某三级甲等综合医院2021年3月至12月就诊于妇科门诊的124例SUI老年女性患者,按计算机产生的随机数字表将患者分为试验组和对照组,每组各62例.对照组实施常规居家PFMT,试验组实施APP联合阴道哑铃的PFMT居家康复模式.比较干预前,干预7 w、12 w两组患者1h尿垫试验漏尿量、盆底康复知识得分情况、PFMT依从性、尿失禁生活质量量表(incontinence quality of life instrument,I-QOL)得分情况.结果 干预12 w试验组患者尿垫试验漏尿量均小于对照组干预前和干预7 w的漏尿量,两组比较,差异有统计学意义(均P<0.01);干预12 w试验组患者康复知识得分均高于对照组干预前和干预7w的得分,两组比较,差异有统计学意义(均P<0.001);干预7w、12w试验组患者康复锻炼依从性均高于对照组,两组比较,差异有统计学意义(均P<0.05);干预7w、12w试验组患者I-QOL得分均高于对照组,两组比较,差异有统计学意义(均P<0.001).结论 对SUI老年患者实施APP联合阴道哑铃的PFMT居家康复模式,能提高患者盆底康复知识知晓情况与PFMT的依从性,减少1h尿垫试验漏尿量,从而提高患者的生活质量.

目的:为满足尿失禁患者盆底康复锻炼的需求,提高患者盆底肌训练的依从性,改善尿失禁的症状,设计并开发智能盆底康复APP并评价其应用效果.方法:通过查阅文献,广泛征求临床医护人员、患者、高校护理教师的建议,设计开发APP.于2020年9月至2021年12月,采用方便抽样法选取北京市某三级医院81名老年女性压力性尿失禁患者进行调查,对患者进行智能盆底康复APP的接受度评价,并评价智能盆底康复APP使用前后患者盆底肌训练的依从性、尿失禁情况.结果:该APP含有知识讲堂、锻炼提醒、个性化课程、震动模式、趣味锻炼、可视化锻炼反馈、锻炼数据统计、互动平台8个模块.81例使用智能盆底康复APP的患者总体接受度得分为(141.27±11.37)分.使用智能盆底康复APP 7周后,患者盆底肌训练的依从性比使用APP前有提高,尿失禁情况得到改善,差异有统计学意义(P<0.05).结论:患者对智能盆底康复APP的接受度较高,应用该APP可提高患者盆底肌训练的积极性和依从性,并可改善尿失禁情况,值得推广使用.

目的:对比脂多糖(lipopolysaccharide,LPS)腹腔注射及盲肠结扎穿刺(cecum ligation and puncture,CLP)诱导脓毒血症肾损伤建模方法的肾脏损伤情况及炎症过程特点.方法:将48只8～10周龄C57BL/6雄性小鼠分为LPS组(n = 16),磷酸盐缓冲溶液(phosphate buffer saline,PBS)组(n=8),CLP组(n= 16)和假手术组(sham组,n=8).LPS组根据小鼠体质量注射LPS溶液20 mg/kg(浓度1 mg/ml),PBS组注射等量PBS,CLP组在距结肠末端1 cm行结扎术,并用21号针对穿两孔后关闭腹腔,sham组仅开腹暴露盲肠闭合腹腔.分别在建模后0 h、6 h、12 h、24 h、48 h处死小鼠,比较观察期内各组小鼠肾功能指标、病理损伤及炎症指标变化.用免疫荧光染色观察肾小管上皮细胞的凋亡.结果:PBS组及sham组小鼠建模前后血清肌酐、尿素氮水平比较,差异无统计学意义(P＞0.05);而LPS组和CLP组小鼠肌酐、尿素氮迅速升高,均在24 h达峰值,分别与建模前比较,差异有统计学意义(均P＜0.05),且48 h后均逐渐恢复.肾脏病理检查提示,LPS组及CLP组均显示肾小管上皮细胞空泡形成明显增多,小管坏死及凋亡不明显,但炎症反应过程有显著差别,其中LPS组白介素6、肿瘤坏死因子等炎症因子水平较CLP组迅速升高,6 h达到峰值后逐渐降低,且CLP组下降较LPS组缓慢.细胞凋亡染色显示LPS组和CLP组均存在局部凋亡,而PBS组和sham组均未见明显凋亡.结论:LPS腹腔注射及CLP均能成功建立脓毒血症肾损伤模型,其中LPS模型的全身性炎症反应剧烈,重复性好,而CLP模型更贴近临床败血症的炎症特点,在科研实践中可根据需要选择合适的模型.

目的 研究探讨加速康复外科理念对腹腔镜下子宫广泛切除术宫颈癌患者术后的临床疗效评价.方法 研究时间从2016年7月开始,至2018年8月结束,将医院收治的96例腹腔镜下子宫广泛切除术宫颈癌患者进行研究,随机分为实验组(48例,加速康复外科理念)和参照组(48例,常规护理方法),比较患者的相关临床参数与并发症发生率.结果 实验组患者的相关临床参数改善优于参照组,并发症发生率低于参照组,P<0.05.结论 采用加速康复外科理念可以改善相关临床参数,减少并发症发生,具有推广价值.

目的 对比妇产科术后感染患者血病原体培养阳性和阴性的实验室指标,为术后血流感染的诊断提供研究依据.方法 选取2015年1月-2017年12月于北京大学国际医院就诊的妇产科手术患者4 841例为研究对象,对术后感染情况和感染患者血病原体培养结果进行分析,对血培养阴性和血培养阳性患者的外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、中性粒细胞/淋巴细胞比率(NLR)、血小板计数(PLT)及血清C-反应蛋白(C RP)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-17、IL-23、IL-4、IL-10、IL-13、细胞间黏附分子-1(intercellular adhesion moleclar-1,ICAM-1)、血管细胞黏附分子-1(vascular cell adhesion molecule-1,VCAM-1)、嗜酸性粒细胞活化趋化因子-3 (eosinophil activation chemokine-3,Eotaxin-3)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,I MCP-1)水平进行比较.结果 妇产科手术患者术后感染率为3.86％(187/4 841),感染部位以呼吸道、泌尿道、手术部位为主;血培养阳性率为11.23％ (21/187),血培养阳性患者的外周血WBC、NEU、NLR与血清CRP、PCT、IL-6、IL-17、IL-23、IL-4、IL-10、IL-13、ICAM-1、VCAM-1、Eotaxin-3、MCP-1分别为(10.95±9.16)×109/L、(9.25±8.07)×109/L、(14.23±10.13)和(96.65±45.88)mg/L、(4.06±2.35)ng/ml、(293.88±40.96)ng/ml、(58.82±8.81)ng/ml、(86.08±11.53)pg/ml、(29.62±3.94)ng/ml、(55.06±7.82)ng/ml、(253.35±38.12)pg/ml、(126.08±17.15)ng/ml、(158.04±18.75)ng/ml、(227.41±39.56)ng/ml、(381.16±50.45)ng/ml均高于血培养阴性患者(P＜0.05),外周血PLT为(172.28±82.05)×109/L低于血培养阴性患者(P=0.945).结论 相对于血培养阴性的患者,血培养阳性的妇产科术后感染患者表现为外周血感染标志物、炎症因子、黏附趋化因子的过表达和凝血功能恶化,机体的炎症反应、免疫失衡和凝血障碍更加严重,对这些实验室指标进行综合性评价,可弥补血培养的局限性,提高针对术后血流感染的诊断效率.

目的 探讨加速康复外科(enhanced recovery after surgery,ERAS)用于妇科腹腔镜手术患者的可行性和安全性.方法 将2017年7月至2017年12月于本院妇科行腹腔镜手术的患者104例,按照随机数字表分为ERAS组(采用ERAS处理)和对照组(采用传统方法处理),每组各52例,比较两组患者术前血糖、术前乏力腹泻、手术时间、术中出血量、术后排气时间、平均住院日、再入院率及术后并发症等指标.结果 ERAS组患者术前饥饿感发生率(28.85％,15/52)、术前睡眠不良发生率(30.77％,16/52)、术前乏力、腹泻等不适发生率(5.77％,3/52)均明显低于对照组(P＜0.05).ERAS组患者术后24 h内肛门排气(71.15％,37/52)、术后6h内下床(48.08％,25/52)、术后6h疼痛评分≤3分(69.23％,36/52)、术后饥饿感(15.38％,8/52)、术后恶心呕吐发生率(28.85％,15/52)和平均住院日[(6.52±3.18)d]均明显低于对照组(P＜0.05).两组患者手术时间、术中出血量、术后尿潴留、术后感染、肠梗阻等发生率比较,差异均无统计学意义(P＞0D5).两组术后均无血栓及再入院患者.结论 采用ERAS理念对妇科腹腔镜手术患者进行围手术期处理,能够减轻患者术前不适,促进患者术后恢复,且并不增加术后并发症的发生.