目的 探讨阶段式健康教育视频在经外周静脉置入中心静脉导管(PICC)化疗患者围置管期中的应用效果.方法 选择2016年6-12月行2周期及以上化疗的PICC置管患者152例为对照组,接受常规PICC健康教育;选择2017年1-7月行2周期及以上化疗的PICC置管患者158例为观察组,采用阶段式视频化健康教育,比较两组患者围置管期的自我管理能力、并发症的发生率、导管有效留置时间.结果 观察组的自我管理能力高于对照组(P<0.05),导管有效留置时间长于对照组(P<0.05),围置管期并发症的发生率低于对照组(P<0.05).结论 采用阶段式健康教育视频在PICC化疗患者围置管期中的干预效果明显,能满足患者的健康需求,提高患者的自我管理能力,保障PICC的正常使用,确保化疗药物的安全输注.

目的 探讨淋巴瘤患者化疗后症状困扰评分与生活质量的关系.方法 选择2019年1月1日-2019年5月31日重庆市某大学附属肿瘤医院血液肿瘤科淋巴瘤化疗患者100例,分析患者一般资料,采用中文版安德森症状量表分析患者疾病困扰状况、中文版简明健康状况调查表分析患者生活质量,Pearson相关性分析淋巴瘤患者化疗后症状困扰评分与生活质量的关系.结果 淋巴瘤患者化疗后疲乏、睡眠不安、胃口差、口干、悲伤等症状的严重程度处于较高水平,情绪、工作、生活乐趣的困扰程度较为显著.淋巴瘤患者化疗后生活质量处于中等水平,精神健康维度得分最高,生理职能维度得分最低.淋巴瘤患者化疗后症状严重程度评分为3.93±1.56,症状困扰程度评分为3.05±1.47,均与生活质量各维度评分呈负相关r＜0,P＜0.05.结论 淋巴瘤化疗后患者症状严重程度及困扰程度较高,生活质量一般,且症状困扰与生活质量密切相关.

目的 对运用自我管理体系护理模式提高肿瘤患者口服化疗药物依从性的临床效果进行分析研究.方法 选取该院收治的淋巴瘤患者280例,随机分为对照组和观察组,每组140例.采用临床护理路径模式对对照组实施护理干预,采用自我管理体系护理模式对观察组实施护理干预,比较2组用药依从性和自我管理效能感.结果 观察组干预后用药依从性、自我管理效能感与对照组比较,差异有统计学意义(P<0.05).结论 运用自我管理体系护理模式能够有效提高肿瘤患者口服化疗药物依从性.

目的 探讨自制视频宣教在PICC置管阶段式健康教育中的应用及效果评价.方法 2017年年初成立项目小组,3～4月制作视频.将视频宣教前(2016年10月—2017年4月)符合PICC置管适应证的67例PICC置管患者设为对照组,视频宣教后(2017年5月—2017年11月)符合PICC置管适应证的92例PICC置管患者设为观察组,观察两组相关观察指标的差异性.结果 患者对PICC健康教育掌握程度提高;PICC留置的时间延迟;PICC留置期间并发症发生率降低;护士完成PICC健康教育的时间缩短(P<0.05).结论 对符合PICC置管适应证的住院患者采用自制视频宣教的PICC置管宣教法,有利于提高患者对PICC健康教育掌握程度、置管依从性,降低PICC留置期间并发症发生率,延长PICC留置的时间,缩短护理人员的宣教时间.

目的 探讨开展品管圈活动在提高护理人员对肿瘤患者跌倒风险评估准确性方面的运用.方法 科室成立品管圈活动小组,选定提高护士对肿瘤患者跌倒风险评估准确性为活动主题,对本科住院患者有跌倒风险评估的病例进行分析,根据柏拉图的80/20原则找出评估不准确的项目及原因,应用头脑风暴法制定出整改措施并组织实施.结果 活动开展后与开展前相比,本科跌倒风险评估的准确率由63.44％上升至94.4％,差异具有统计学意义(P<0.05).结论 品管圈活动在提高护士对肿瘤患者跌倒风险评估准确性方面效果显著.

目的 通过对口服化疗药物管理不合理的流程进行改造,提高患者用药疗效,保障患者用药安全.方法 选择2016年3-6月在该院血液肿瘤科采用CHOPE方案化疗的恶性淋巴瘤患者52例为对照组,2016年8-11月行同种方案化疗的患者58例为观察组,比较流程优化前后医嘱不规范,口服化疗药漏服,服药时间不准确,患者对口服化疗药物相关知识掌握不全的发生例数.结果 口服化疗药物管理流程优化前医嘱不规范,口服化疗药物漏服,服药时间不准确,患者对口服化疗药物相关知识掌握不全等不良事件的发生例数明显减少,差异有统计学意义(Z= -3.956,P<0.05).结论 口服化疗药物管理流程优化,降低了口服化疗药的差错率,提高了口服化疗药的发放质量和效率,保证了患者的用药安全和疗效.

目的 检测肝细胞癌(hepatocellular carcinoma,HCC)的相关抗原,并予以验证.方法 分别提取15例HCC组织及其癌旁组织总蛋白.Western blot分别检测各总蛋白与其HCC患者自体血清的杂交情况.双向电泳(two-dimensional electrophoresis,2-DE)技术将15例混合总蛋白中的各蛋白进行分离与染色.图像分析法比对染色胶上HCC组织及其癌旁组织蛋白的表达差异,基质辅助激光解吸/电离飞行时间二级质谱(matrix-assisted laser desorption/ionization-time-of-flight with two mass analyzers for tandem mass spectrometry,MALDI-TOF MS/MS)技术及生物信息学网络数据库分别对表达差异蛋白予以分析鉴定与检索匹配,免疫组织化学与Western blot分别检测该差异蛋白在人HCC组织及其癌旁组织中的变化情况.结果 2-DE染色胶图像分析比对结果显示,HCC及其癌旁组织蛋白表达差异斑点共90个,MALDI-TOF MS/MS与数据库对其中19个蛋白斑点分析鉴定与检索匹配发现15个蛋白表达上调,4个蛋白表达下调.免疫组织化学与Western blot检测结果显示,与对照比较,上调蛋白中的DnaJ同源B亚家族成员11 (dnaJ homolog subfamily B member 11,DNAJB11)在HCC组织中的表达明显增强,下调蛋白中的蛋白酶体亚基α3 (proteasome subunit alpha type 3,PSMA3)在HCC组织中的表达则相反.结论 人原发性肝癌相关抗原DNAJB11在HCC组织中的表达上调,PSMA3在HCC组织中的表达下调.

Objective:To investigate the effects of DNAJ homolog subfamily B member 11 (DNAJB11)gene-silencing on proliferation,cell cycle and apoptosis of human hepatocellular carcinoma cell line SMMC7721.Methods:The recombinant lentiviral vector pCDH-Puro/DNAJB11-shRNA carrying the specific shRNA targeting DNAJB11 gene was established.The SMMC7721 cells were infected with high infective lentivirus pCDH-Puro/DNAJB11-shRNA.Then the proliferation of SMMC7721 cells was detected by CCK-8 method.The expression levels of DNAJB11,proliferating cell nuclear antigen (PCNA) and caspase-3 mRNAs and proteins in SMMC7721 cells were detected by real-time fluorescent quantitative PCR and Western blotting,respectively.The cell cycle distribution and the apoptosis rate of SMMC7721 cells were analyzed by FCM.Results:The pCDH-Puro/DNAJB11-shRNA was constructed successfully.The proliferation of SMMC7721 cells was significantly inhibited after infection with pCDH-Puro/DNAJB11-shRNA (P ＜ 0.05).In SMMC7721 cells infected with pCDH-Puro/DNAJB11-shRNA,the expressions of DNAJB11 mRNA and protein were silenced effectively (both P ＜ 0.05).After DNAJB11 gene-silencing,the expressions of caspase-3 mRNA and protein in SMMC7721 cells were up-regulated (both P ＜ 0.05),while the expressions of PCNA mRNA and protein were down-regulated (both P ＜ 0.05).Furthermore,the cell cycle was arrested in G1 phase (P ＜ 0.01),and the apoptosis rate was significantly increased (P ＜ 0.01).Conclusion:The DNAJB11 gene-silencing can effectively suppress the proliferation of SMMC7721 cells,and promote their apoptosis.These effects may be related to downregulation of PCNA expression and upregulation of caspase-3 expression in SMMC7721 cells.

Objective:To know about the influence of intravenous chemotherapy period and different chemothera-py days of plan on falls of cancer patients,in order to reduce the blindness of time assessment and intervention measures on falls,and to provide clinical basis for the safety management of cancer patients.Methods:The canc-er patients fall risk assessment scale was used to assess and analyze the risk factors of 343 cancer chemotherapy patients admitted to Department of internal medicine from December 15,2014 to January 30,2015 in our hospi-tal.Results:There were 58.0% of patients without the risk of falls before chemotherapy,while only 0.6% of pa-tients without the risk of falls in chemotherapy.Before chemotherapy,40 cases of patients were in middle risk, while 33 patients(82.5%)in the chemotherapy drop to high risk.There were 7.3% of the patients still in the high risk of fall when they discharged.The high risk fall population and high risk fall assessment score of pa-tients before chemotherapy,in chemotherapy and after chemotherapy have statistically significant difference(P<0.05).The falls high risk assessment score in patients treated with different period and different chemotherapy had no statistically significant difference(P>0.05).Conclusions:Intravenous chemotherapy could increase the risk of falls in patients,so patients in chemotherapy should be treated with the high risk management directly.

[目的]探讨培门冬酶联合Chop方案治疗NK/T细胞淋巴瘤病人不良反应的护理.[方法]选择使用Chop方案(环磷酰胺、长春新碱、吡柔比星)联合培门冬酶化疗的70例次NK/T细胞淋巴瘤病人,密切观察病人组使用药物过程中的不良反应,并给予有效的护理措施.[结果]出现胃肠道反应有19例,骨髓抑制有17例,凝血因子Ⅰ降低20例,高脂血症有12例,精神疲乏10例,皮肤出现皮疹瘙瘁9例,过敏反应无.[结论]培门冬酶联合Chop方案治疗NKT细胞淋巴瘤病人发生的不良反应发生率高,医护人员应在病人使用药物期间严密观察病情,给予及时有效的护理,提高用药的安全性及病人对治疗的满意度.

Objective: To explore the effect of intravenous chemotherapy on the fall risk of the cancer patients. Methods: Using fall risk assessment scale of cancer patients to assess the fall risk in 343 cancer patients before chemotherapy, undergoing chemotherapy and after chemotherapy and to analyze the difference on fall risk score in three stages. Results: The distribution proportion of cancer patients which had different grade of fall risk in three stages of chemotherapy were significant different (χ2=260.753,P<0.001). The fall risk score before chemotherapy, undergoing chemotherapy and after chemotherapy were 1.08±1.93, 3.07±1.96 and 1.76±1.90 respectively, and they were statistically signiifcant (F=92.283,P<0.001). According to the days receiving chemotherapy, we divided the patients into four different groups. And there were no signiifcant difference of fall risk score in different groups (F=0.511,P>0.05). Conclusion: Intravenous chemotherapy could increase the fall risk in cancer patients. We should take high risk management model for the patients with intravenous chemotherapy and take measures to prevent the risk of fall before chemotherapy for increasing the work efifciency. After the patients discharged, we should also pay attention to the fall risk of the patients to ensure the patients' safety.

目的:探讨细胞因子诱导的杀伤细胞(cytokine induced killer,CIK)对肝癌干细胞(liver cancer stem cells,LCSCs)生长、增殖的影响.方法:用含多种细胞因子(LIF、EGF、bFGF及B27)的无血清培养液(serum-free medium,SFM)诱导SMMC7721人肝癌细胞产生LCSCs,并行LCSCs表面标志CD133、CD90的流式仪(flow cytometry,FCM)检测鉴定与裸鼠致瘤能力观测.以IFN-γ、CD3单克隆抗体(human CD3 monoclonal antibody,hCD3mAb)与IL-2等诱导肝癌患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)的悬浮细胞生成CIK.用Transwell培养小室将LCSCs与不同密度的CIK在同一培养体系内以该小室膜分隔培养24、48、72 h,采用CCK-8试剂盒检测CIK对LCSCs生长、增殖的影响.以RT-PCR与Western blot分别检测与CIK共培养的LCSCs的增殖细胞核抗原(proliferating cell unclear antigen,PCNA)基因及其编码蛋白的表达变化.结果:FCM检测显示,LCSCs高表达干细胞表面标志分子CD133、CD90.CCK-8法检测表明,与对照比较,与相同密度的CIK共培养的LCSCs,其生长、增殖减慢,48 h开始变得更加明显(P＜0.01).RT-PCR、Western blot检测显示,CIK能明显下调LCSCs的PCNA基因及其编码蛋白的表达.结论:成功诱导培养并鉴定到LCSCs.肝癌患者的CIK可明显抑制LCSCs的生长、增殖与下调其PCNA基因及其编码蛋白的表达.

目的：探讨月固定循环排班模式在血液肿瘤科落实责任制整体护理，推进优质护理服务中的应用与效果。方法对血液肿瘤科实施传统的护士三班轮流值班排班模式和月固定循环排班模式进行对比研究。结果实施月固定循环排班模式后，科室的护理质量，患者及医护人员对护理工作的满意度明显高于传统排班模式，差异有统计学意义（P＜0．05）。结论月固定循环排班模式保证了护士工作的连续性、无缝性，使责任制整理护理得到真正落实，保障了患者安全，提高了护理质量和医、护、患三方满意度，深化了优质护理服务工作，是一种有效的排班模式。

Objective Todevelopcomprehensiveevaluationsystemsoftwareofdigestivetractsymptomsoftumor chemotherapy( DRSTC)to manage DRSTC patients effectively and to provide reference for patients participating in clinical deci-sion.Methods ThroughestablishingtheoreticalmodelofDRSTCcomprehensivescoringsystem,thetechniquesofcomputer and network were used to design database and construct architecture,system function and operation flow of software system. Re-sults Afterrunningfor6months,thesoftwarecollectedtheinformationof114DRSTCpatients.Theinformationwascomplete, data processing rapid. The system realized the DRSTC management in which patients and medical staff participated together. Conclusion ThesystemcanevaluateandmonitorDRSTCdynamically,collectpatients′informationscientificallyandsystemati-cally,to lay the foundation of management,research and network system reporting clinical outcomes of DRSTC.

随着医疗护理技术的发展,各类深浅静脉导管针在临床中得到广泛的应用,静脉药物外涌率逐渐下降,但仍有部分病人使用一次性头皮钢针输液,我科针对部分无条件使用静脉导管针且需输液注弱刺激性的化疗药物病人,特制作了一种简易的手部输液固定托,有效减少了钢针输液引起的静脉药物外渗.

心电监护仪因可动态监测生命体征、心电图与经皮血氧饱和度,成为重症患者重要的监护仪器,而加强该设备维护,可延长其使用寿命.鉴此,我科设计制作了心电监护仪机罩和导线固定带,经临床应用,效果满意,介绍如下.

对化疗性口腔黏膜炎的病因、发病机制,以及口腔黏膜炎的预防、治疗和护理的研究进展进行介绍,旨在为护士选择适宜的护理措施,防治化疗性口腔黏膜炎,以保障化疗的顺利进行,提高肿瘤患者的生存质量。