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OBJECTIVE@#To establish a method for directional screening of the cytotoxic components from the medicinal herb of Achnatherum inebrians by a combination of surface plasmon resonance (SPR) biosensor and chromatographic isolation technology.@*METHODS@#Under the guidance of bioactive assessment based on binding abilities between objects and the α-Mannosidase (α-Man) target, the active components from different solvents extracts, different polar extraction parts and fractions were screened orderly and directionally using SPR. Components with a high binding ability to α-Man can be precisely oriented in a narrower fractions range and are easy to isolate. Three human cancer cells were used to evaluate the cytotoxic activity of component with the highest affinity to α-Man.@*RESULTS@#Eight compounds were isolated and identificated from A. inebrians for the first time. Deoxyvasicinone possessed the highest affinity to α-Man among them. Moreover, deoxyvasicinone showed good effects on inhibited proliferation of human hepatoma cells HepG2 (IC50 = 5.7 μmol/L), human breast cancer cells MCF7 (IC50 = 7.21 μmol/L) and human lung cancer cells HCC827 (IC50 = 0.75 μmol/L), respectively. In particular, its inhibitory effect on HCC827 was stronger than the positive drug gefitinib (IC50 = 1.65 μmol/L).@*CONCLUSION@#A comprehensive strategy of directional screening potential cytotoxic components from herb based on biomolecular interaction and chromatography was established. Deoxyvasicinone as an effective anti-cancer component was initially isolated from A. inebrians. It is expected that this screening strategy could provide new perspectives for rapid screening and identification of active components from natural plants with the complex matrix.
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Objective:To construct a perioperative activity program for patients with minimally invasive esophageal cancer under enhanced recovery after surgery (ERAS) concept through literature review and Delphi method.Methods:This was a single-center and interview study. Databases and websites including PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Medive and other databases and websites were searched systematically for articles related to esophageal cancer and upper digestive tract cancer patients′ activities from January 1, 2002 to January 31, 2022. In this single-center and interview study, literature review and group discussion were conducted to form a preliminary activity program, and then Delphi method was used to further demonstrate the practicability and feasibility of the activity program.Results:The overall program and specific intervention methods of perioperative activity program for minimally invasive esophageal cancer patients under ERAS concept were constructed, including 3 first-level indicators, 9 second-level indicators and 35 third-level indicators.Conclusions:Perioperative activity program of patients with minimally invasive esophageal cancer is scientific and reasonable, which can provide reference for medical staff and patients.
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Thirst is one of the common complaints of critically ill patients, persistent and intense thirst is closely related to a variety of negative emotions, such as anxiety, depression, etc., which can cause restlessness, sleep disorders, and reduce the quality of life; at the same time, it can cause bacterial growth in the patient′s oral cavity, increasing the risk of secondary infection, thereby delaying the recovery of the disease and prolonging the length of ICU hospitalization. Therefore, this article reviews the current status, risk factors, and intervention strategies of thirst in critically ill patients in order to provide a reference and basis for medical staff to carry out thirst intervention measures in critically ill patients.
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Objective:To summarize and evaluate the domestic and foreign evidence on the intervention and management of neuropathic pain in patients with spinal cord injury, so as to provide evidence-based basis for clinical nursing staff.Methods:According to "6S" evidence model of evidence pyramid, computer evidence retrieval was carried out. Expert consensus and evidence summary quality assessment used the corresponding evaluation criteria of JBI evidence-based Health Care Centers (2016), while evidence-based guidelines quality used AGREE Ⅱinstrument, and high quality evidence was extracted.Results:A total of 6 articles, including 5 guidelines and 1 expert consensus, were included in this study. A total of 22 pieces of evidence were extracted, including the assessment, intervention measures, feedback, education and nursing model of neuropathic pain in patients with spinal cord injury.Conclusion:This study summarizes the evidence for the intervention and management of pathologic pain in spinal cord injury, which can provide scientific basis for clinical nursing staff. As the evidence summarized in this study comes from many countries, sufficient evaluation of clinical environment and other related factors should be conducted before application to promote the quality of nursing.
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Objective:To systematically review the qualitative researches on patients′ lived experiences of being mechanically ventilated in intensive care unit.Methods:The Cochrane Library, PubMed, Web of Science, Ovid, CNKI, VIP and Wanfang database were searched to collect qualitative studies on patients′ lived experiences of being mechanically ventilated in intensive care unit, from October 2009 to October 2019. Two reviewers independently screened the literature against the pre-determined inclusion and exclusion criteria, extracting the data, and evaluated the included studies according to JBI Critical Appraisal Tool for qualitative studies in Australia.Results:A total of fourteen studies were included. Thirty-eight complete results were grouped according to their similarities to form seven categories. These categories led to three synthesized findings: results 1: patients suffered from both physical and mental distress; results 2: they were eager for supports; results 3: patients achieved personal growth through self-adjustment and reflection.Conclusion:Discomfort experience during mechanical ventilation reduces patients′ comfort, and to a certain extent, has negative impacts on their physical or mental health and clinical outcome. As the main caregiver of patients with mechanical ventilation, not only should nurses alleviate patients′ physical distress by strengthening communication but also give them adequate psychological support. Eventually, promote the physical and mental recovery of patients.
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@#Objective To systematically evaluate the risk factors for perioperative blood transfusion in patients undergoing coronary artery bypass grafting (CABG). Methods PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang and VIP Database were electronically searched to collect case-control and cohort studies about the risk factors for perioperative blood transfusion in patients undergoing CABG from inception to February 2020. Two reviewers screened and evaluated the literatures according to the inclusion and exclusion criteria, and meta-analysis was performed by using RevMan 5.3 software. Results A total of 26 articles were collected, involving 84 661 patients. The results of meta-analysis showed that age (OR=1.06, 95%CI 1.03 to 1.08, P<0.001), age≥70 years (OR=2.14, 95%CI 1.77 to 2.59, P<0.001), female (OR=1.85, 95%CI 1.55 to 2.22, P<0.001), body mass index (OR=0.94, 95%CI 0.90 to 0.98, P=0.003), weight (OR=0.95, 95%CI 0.93 to 0.96, P<0.001), body surface area (OR=0.19, 95%CI 0.10 to 0.39, P<0.001), smoking (OR=0.80, 95%CI 0.69 to 0.93, P=0.003), diabetes (OR=1.15, 95%CI 1.09 to 1.20, P<0.000 01), chronic heart failure (OR=1.59, 95%CI 1.26 to 1.99, P<0.001), number of diseased coronary arteries (OR=1.17, 95%CI 1.01 to 1.35, P=0.030), reoperation (OR=2.12, 95%CI 1.79 to 2.51, P<0.001), preoperative hemoglobin level (OR=0.60, 95%CI 0.43 to 0.84, P=0.003), preoperative ejection fraction <35% (OR=2.57, 95%CI 1.24 to 5.34, P=0.010), emergency surgery (OR=4.09, 95%CI 2.52 to 6.63, P<0.001), urgent operation (OR=2.28, 95%CI 1.25 to 4.17, P=0.007), intra-aortic balloon pump (OR=3.86, 95%CI 3.35 to 4.44, P<0.001), cardiopulmonary bypass (OR=4.24, 95%CI 2.95 to 6.10, P<0.001), cardiopulmonary bypass time (OR=1.01, 95%CI 1.01 to 1.01, P<0.000 01) and minimum hemoglobin during cardiopulmonary bypass (OR=0.42, 95%CI 0.23 to 0.77, P=0.005) were the risk factors for perioperative blood transfusion in patients undergoing CABG. Conclusion Current evidence shows that age, age≥70 years, female, body mass index, weight, body surface area, smoking, diabetes, chronic heart failure, number of diseased coronary arteries, reoperation, preoperative hemoglobin level, preoperative ejection fraction<35%, emergency surgery, urgent operation, intra-aortic balloon pump, cardiopulmonary bypass, cardiopulmonary bypass time and minimum hemoglobin during cardiopulmonary bypass are risk factors for perioperative blood transfusion in patients who undergo CABG. Medical staff should formulate and improve the relevant perioperative blood management measures according to the above risk factors, in order to reduce the perioperative blood utilization rate and improve the clinical prognosis of patients.
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Objective Cancer-related fatigue (CRF) is a key in the management of cancer patients' clinic syptoms.This article investigated the status quo of nurses' knowledge and attitude towards CFR.Methods THe method of cross-sectional survey and questionnaire was used to investigate the knowledge and attitude towards CRF among nurses from related departments of three Grade III hospitals in Nanjing.Results 142 nurses answered the questionnaire.The average correct rate was 76.25%, among which nurses from the oncology department had better congition rate than nurses from other medical and surgical departments (84.3%, 75.98%, 79.57%) , representing significant difference (P<0.05).64.79% of the nurses found the relatives of cancer patients and nurses often fail to understand cancer patients;complaint of fatigue, 76.76% of nurses assumed there is lack of communication in fatigue between patients and medical staff.94.36% of nurses agreed medical institutions should strengthen the management of CRF.Conclusion At present, the clinical nurses have inadequate knowledge about CRF, which should be enhanced in future work.
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Objective It is a tough job to rescue batches of patients with severe blast injury .The article aimed to construct specific technique system management in the rescue of batches of patients with severe blast injury and evaluate its effects . Methods Retrospective analysis was made on 9 patients with severe blast injury who hospitalized simultaneously .According to the difficulties in the nursing process of treating severe blast injury such as management of respiratory tract , continuous renal replacement therapy , vascular access, nutritional supply, skin nursing, etc, specific technique system management was constructed to evaluate technical support key points at different phases , including personalized nursing scheme with disease progression , professional nursing instruction on key points of different phases from specialists as well as corresponding nursing decision and professional caring . Results Specific technique system management was applied in these 9 patients with severe blast injury .Only 1 patients developed ventilator related pneumonia when receiving mechanical ventilation and no procedure related complications occurred in the aspects of blood purification , skin management , vascular access and nutrition support .6 patients discharged from hospital after recovery . Conclusion Specific techniques and systemic management in batch treatment of severe bast injury patients could help collaborative nursing , improve the management of specific management and prevent complication .
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Objective To solve the difficulty of intubation of nasojejunal feeding tube under digital subtraction angiography (DSA) system when conventional methods were failed.Methods Seventy-one patients who failed to place the nasojejunal feeding tube by single guide wire under DSA conventional methods.With the methods of decreasing the stomach volume,changing the body posi-tion,and using a catheter or gastrointestinal motility,the nasojejunal feeding tube was placed into the proper position (more than 30cm far away from Treitz or gastrointestinal anastomosis).Results All the procedures were successfully accomplished.No compli-cations,such as throat damage,abdominal pain,perforation and hemorrhage of digestive tract were found.The mean duration under DSA was four minutes (2-7min).Conclusion With the help of various methods above,we can improve the success rate of intuba-tion and reduce the duration of the nasojejunal feeding tube placement,when conventional methods were failed.
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Objective:To investigate the status of humanistic quality in nursing undergraduates interns , to pro-vide a reference for optimization settings humanities courses and improving humanistic quality in nursing students . Methods:A self -designed questionnaire with convenience sampling method was used to investigate 90 nursing students in M hospital .The questionnaires included requirements for clinical teachers , needs for humanities cour-ses, cognitive knowledge on humanities curriculum .Results:The nursing intern students agreed with teachers're-spect for students , profession ability , attention to communication .They wanted to increase the humanities course of interpersonal and communication , nursing aesthetics and rituals , traditional Chinese culture courses .They had a humanistic understanding of the concept of learning is to help develop good mental state and healthy personality , enhance the sense of community , strengthen exchanges and cooperation with the person's ability .Conclusion:The nursing intern students have recognized the importance of humanities courses .Increasing humanities curriculum and using a combination of diverse teaching and assessment methods were proposed to promote their humanities quality of ability.
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Objective To observe and compare the antiemetic effectiveness and adverse effects of magnetotherapy plus the 5 -hydroxytryptamine (5-HT3 ) receptor inhibitor granisetron hydrochloride with that of granisetron hydrochloride alone with chemotherapy patients. Methods Sixty-four patients were randomized to receive either granisetron hydrochloride alone ( control group: granisetron hydrochloride 3 mg intravenous infusion before chemotherapy, from the 1st day of chemotherapy until the day after the chemotherapy course was completed) or magnetotherapy plus granisetron hydrochloride ( treatment group: the same granisetron hydrochloride regimen plus rotatory magnetotherapy of 1 h/time every day after chemotherapy). The baseline characteristics of the two groups were similar. The patients' emesia was evaluated according to the WHO's criteria. The density of 5-HT, in serum was detected by enzyme-linked immunosorbent assay ( ELISA). Results In terms of acute vomiting, there was no significant difference between the two groups, but in terms of tardive vomiting, the effectiveness in the treatment group was significantly better than in the control group. The densities of S-HT, in serum in the treatment and the control group were (225.32±57.29 ) ng/ml vs (213.00±53.29 ) ng/ml before chemotherapy and (273.88±5.42) ng/ml vs ( 313.17±76.36 ) ng/ml after chemotherapy, a significant difference. The rates of adverse events were 36.36% and 48.39% respectively in the treatment group and control group, a difference which was not significant. Conclusions Magnetotherapy plus granisetron hydrochloride is more effective than granisetron hydrochloride alone, and the two therapies have a synergistic effect. Adverse events didn't rise in the treatment group.
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Objective To observe the effect of phlebitis prevention by thermotherapy with electric heating pad after peripherally inserted central catheter(PICC). Methods 100 patients underwent PICC were randomly divided into two groups, 50 patients receiving thermotherapy with electric heating pad were named the experimental group, other 50 patients only given routine observation was selected as the control group.The incidence rate of phlebitis was compared between the two groups and the results went through χ2 teat. Results The phlebitis rate of the experimental group was significantly lower than that of the control group. Conclusions Thermotherapy with electric heating pad can prevent phlebitis caused by peripheral-ly inserted central catheter (PICC) .
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Objective To observe the efficacy of a rotating magnetic field and granisetron hydrochloride in preventing nausea and vomiting caused by a eisplatin regimen, and any side effects. Methods Sixty-eight patients receiving cisplatin regimen chemotherapy were randomly assigned to two groups: a magnetic treatment group and a drug treatment group. The patients in the two groups were exposed to a rotating magnetic field or received granisetron hydrochloride, respectively. The effects of the treatments were observed. Results Both treatments could effectively prevent and treat the vomiting caused by chemotherapy. The rate of response to the rotating magnetic field was 88.2% and to the drug 91.2%. However, tardive vomiting was significantly better controlled in the rotating magnetic field group. The incidence of side effects in the magnetic field group was 20.6% , and in the drug treatment group it was 45.6%. Conclusion The efficacy of a rotating magnetic field and granisetron in treating acute vomiting were simi- lar. The rotating magnetic field was more effective in preventing tardive vomiting and had fewer side effects. Magnetic therapy should be more generally applied in clinical practice.
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PurposeTo investigate the relationship between the TCD higher blood flow velocity and the pathology of internal cranial arteries,so as to improve the veracity of diagnosing cerebrovasculer diseases by TCD. MethodsComparing the blood flow velocity of 84 patients,whose cerebral blood flow are abnormal higher in one or above vessels detected by TCD,with the results of magnetic resonance angiography (MRA). ResultsCerebrovascular stricture,closeness and other diseases are discovered at different parts and to some extent in 80 of above 84 cases according to their detecting results of MRA. ConclusionIt is reliable to diagnose stricture,closeness and other diseases of internal cranial large arteries by TCD higher blood folw velocity.
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OBJECTIVE:To discuss the way,approach and the effects of continuing education of pharmacists in hospital.METHODS:Multimedia and lectures were adopted as the mode of teaching medical courses and exam system was established as well.RESULTS:Continuing education made up for pharmacists'lack of medical knowledge to some degree,which laid a specialty foundation for pharmacists in the clinical service.CONCLUSIONS:The mode of launching continuing medical education for pharmacists is practicable,which can make up for the current lack of clinical pharmacy graduates from medicine academy.
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Background and purpose:Paclitaxel and cisplatin were demonstrated to be effective and well-tolerated for advanced gastric cancer.The clinical efficacy of hyperthermic intraperitoneal perfusion(CHPP) has been established in numerous studies in recent years.The purpose of the study was to evaluate the efficacy and toxicities of paclitaxel combined with CHPP with cisplatin in the treatment of patients with advanced gastric cancer.Methods:51 patients with advanced gastric cancer were randomized into systemic chemotherapy group(25 patients) who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 25 mg/m2,iv,d1-3,reapeated every 3 weeks for 4 cycles and systematic plus CHPP group(26 patients)who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 60 mg/m2,CHPP,d1,8,22,29,and abdomen hyperthermia treatment twice a week in the whole chemotherapy period.Results:The response rate(CR+PR),the clinical benefitial response(CBR) in systematic plus CHPP group were 65.4% and 92.3%,and those in systemic chemotherapy group were 36.0% and 68.0%.There was obviously a statistical difference between two groups(P0.05).The major toxicities were myelo-suppression and nausea/vomiting.There was no significant difference in side-effect between the two groups.Conclusions:Paclitaxel administered by weekly infusion combined with hyperthermic intraperitoneal perfusion chemotheraphy with cisplatin in the treatment of advanced gastric cancer is effective and tolerable.It is worth studying in the future.
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Objective To explore the measure to diminish the misdiagnosis of Budd-Chiari syndrome.Methods 46 cases of Budd-Chiari syndrome were analyzed.Results 33 cases had ever been misdiagnosed with average time of 5.3 years.One of the main clinical symptoms was the pathological process of lower limb(84.8%).Doppler color flow imaging examination showed positive rate of 100% in liver veins and inferior vena cava,,but none of the misdiagnosed cases received this examination.The viral marker test had a positive rate of only 4.3% that was not higher than that of general population.Conclusion Budd-Chiari syndrome has a variety of symptoms,so Doppler color flow imaging is considered an important means to diagnose this disease.
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Purpose:To observe the therapeutic effects of gemcitabine plus cisplatin (DDP) for the treatment of non small cell lung cancer (NSCLC).Methods:20 cases were treated with gemcitabine and cisplatin.Results:The complete response rate was zero, and partial response rate was 45%. Conclusions:GP regimen is effective for treating non small cell lung cancer. [
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Combing with the ideology of humanism to expound the intention of the ideology of humanism in the employment work of graduate. Advancing the thinking and practice to carry out the ideology of humanism in the employment work of graduate.
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Combining with the disharmonious ethical phenomena in employment of medical students at present,this paper analyses its subjective and objective reasons,and puts forward some practical approaches to the cultivation of harmonious employment ethics of medical students.