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This paper mainly introduced the research progress of ethical sensitivity of nurses from four aspects: the definition and concept of ethical sensitivity, measurement tools, influencing factors and intervention strategies, in order to provide basis for domestic scholars′ research and practice, improve the level of ethical sensitivity of nurses and effectively improve the quality of clinicalnursing service.
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Objective To observe the effect of vinpocetine combined with butylphthalide in the treatment of large artery atherosclerotic infarction.Methods From October 2014 to October 2016,Ninety patients with large artery atherosclerotic cerebral infarction in Datong Coal Mine Group Three Hospital were selected and randomly divided into two groups,with 45 cases in each group.The treatment group was given vinpocetine injection ,and the observation group was given vinpocetine injection combined with butylphthalide soft capsules .The ability of daily life ( Barthel) score,neurological deficit score (NIHSS),hemodynamics indicators [ high blood viscosity (HSV),plasma viscosity index(PSV)] and adverse reactions were compared between the two groups.Results After treatment,the Barthel score,NIHSS score of the observation group were (79.84 ±18.57) points,(9.54 ±3.22) points,respectively,which of the control group were (62.67 ±16.48)points,(13.69 ±3.47)points,respectively,there were statistically significant differences between the two groups (t ＝4.64,5.88,all P ＜0.05).The HSV,PSV of the observation group were (3.96 ±2.14)mPa/s,(1.12 ±0.74)mPa/s,respectively,which of the control group were (5.77 ±2.69)mPa/s, (3.10 ±1.02)mPa/s,respectively,there were statistically significant differences between the two groups (t＝3.53, 10.54,all P＜0.05).The incidence rate of adverse reactions of the observation group was 4.44%,which was lower than 17.78%of the control group,the difference was statistically significant (χ2＝4.05,P＝0.04).Conclusion Vinpocetine injection combined with butylphthalide soft capsules in the treatment of large artery atherosclerotic infarction can improve neurological function and hemodynamics ,the effect is superior to single vinpocetine treatment.
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Objective To compare the effect of treating cricopharyngeal achalasia in stroke survivors using transnasal or transoral balloon dilatation.Methods Thirty stroke survivors with cricopharyngeal achalasia were randomly divided into a transnasal and a transoral balloon dilatation group (group N and group O),each of 15.Both groups were given routine swallowing rehabilitation training as well as the transnasal or transoral balloon dilatation.Their heart rate was monitored during the dilatation.Nasal bleeding,mucous membrane swelling and pain were also observed.Their swallowing function was evaluated using the Fujishima Ichiro swallowing efficacy score (FISE) and videofluoroscopy (VFSS) before and after the intervention.Results After the treatment,the average FISE and VFSS scores of both groups had improved significantly comnpared to before the treatment but there were no significant differences between the groups.During the treatment,the average heart rate of group O increased significantly less than that of group N.The treatment acceptance of group O was 98.2％,significantly higher than that of group N (80.1％).One case of mucosal bleeding was observed in group O,and laryngeal edema occurred significantly less often than in group N (9 cases vs.7).The average pain score was also significantly lower in group O.Conclusions Balloon dilatation facilitates swallowing among stroke survivors with cricopharyngeal achalasia.The transoral approach can help to reduce the occurrence of complications such as mucosal bleeding,laryngeal edema and pain,and has better patient acceptance.
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Objective To investigate the status quo and influencing factors of compassion fatigue among nurses in psychiatric hospitals. Methods The self-designed demographic questionnaire,compassion fatigue scale,occupation-al identity assessment scale and social support rating scale were employed to investigate 480 nurses in five psychi-atric hospitals from two provinces. Results The scores for each dimension in compassion fatigue scale were as fol-lows:compassion satisfaction(32.26±5.34),occupational burnout(27.67±4.34),and secondary traumatic stress(23.72± 4.41).Age,position,individual monthly income,health status,job satisfaction and occupational identity had significant influence on compassion satisfaction(F=19.351,P<0.001). Individual monthly income,health status,job satisfaction and occupational identity had significant influence on occupation burnout (F=35.705,P<0.001). Individual monthly income, personality and social support had significant influence on secondary traumatic stress(F=17.203,P<0.001). Conclusion Nurses in psychiatric hospitals had severe compassion fatigue and this status was influenced by multiple reasons. Nursing managers should pay great attention to nurses with low monthly income,poor health,low job satisfaction, weak social support and low occupational identity,and take effective measures to decrease compassion fatigue of nurses.
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Objective To explore the value of superb microvacular imaging ( SMI) technology in differentiating thyroid microcarcinomas from benign micronodules comparing with contrast‐enhanced ultrasound (CEUS) . Methods A total of 195 thyroid micronodules ( ≤1 .0 cm) from 172 patients were examined using CEUS and SMI ,and the findings were reviewed and evaluated in comparison to the pathological results . Results Of all the 195 thyroid nodules ,pathologic findings revealed that 140 (71 .8% ) were malignant and 55 (28 .2% ) were benign ,CEUS diagnosed that 127 (65 .1% ) were malignant and 68 (34 .9% ) were benign ,and SMI diagnosed that 129 (66 .2% ) were malignant and 66 (33 .8% ) were benign . There were no differences between the SMI and CEUS in terms of sensitivity ( 90 .0% vs 87 .9% ) , specificity ( 94 .5% vs 92 .7% ) ,accuracy ( 91 .3% vs 89 .2% ) ,positive predictive value ( 97 .7% vs 96 .9% ) and negative predictive value ( 92 .9% vs 87 .9% ) ( P > 0 .05 for all) . Conclusions SMI can effectively observe the perforating blood vessels of thyroid micronodules , which plays an important role in differentiating of benign and malignant thyroid micronodules .
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ObjectiveControl study on the clinical efficiency and costs of fast track surgery(FTS) and traditional method was carried out in colorectal cancer patients. Methodsone hundred colorectal cancer patients were randomLy selected, 50 cases treated with conventional therapy as control group and 50 cases treated with FTS programme. The postoperative initial venting time, the incidence of complications, the hospital stay and cost index were compared between the two groups. ResultsThe postoperative initial venting time was in advance and postoperative stay was obviously shortened in FTS group. Hospitalization expenditure in FTS group was lower than that in control group. Patients recovered quickly, the result was satisfactory. The complication was not significantly different between the two groups (P ＞ 0.05 ) . ConclusionsFTS treatment can accelerate postoperative rehabilitation and elevate clinical efficiency in colorectal cancer patients during operation period. FTS treatment is a safe and effective method.
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Obesity is an established risk factor for endometrial cancer. Leptin, a secreted protein of the ob gene by white adipose tissue, plays an important role in the regulation of food intake and energy consumption in the brain and acts as a potential growth stimulator in normal and neoplastic cancer cells. However, a direct role for leptin in endometrial cancer has not been demonstrated. In the present study, the effect of leptin on the proliferation of Ishikawa endometrial cancer cells was investigated as well as the possible mechanism(s) underlying this action in endometrial cancers which express both short and long isoforms of leptin receptors. The expression of leptin receptor (ObRb) in Ishikawa cells was detected by RT-PCR and Western blotting. The cells after serum starvation, were treated by leptin with various concentrations (0, 10, 50, 100, 150 ng/mL) for different durations (6, 12, 24 h). The effect of leptin treatment on cell proliferation was examined by MTT assay. Meanwhile, inhibitory effect of Janus tyrosine kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) inhibitor AG490 or extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 on the proliferation of Ishikawa cells induced by leptin was also studied. Ishikawa cells were treated with 100 ng/mL leptin for various periods (0, 20, 40, 60 min), and the levels of STAT3 phosphorylation and ERK1/2 phosphorylation were examined by Western blotting. The results showed that leptin induced the phosphorylation of STAT3 and the activation of ERK1/2 in a time- and dose-dependent manner in the Ishikawa endometrial cancer cells. Blocking STAT3 phosphorylation with the inhibitor AG490, or blocking ERK1/2 activation by the specific ERK1/2 kinase inhibitor, PD98059, abolished leptin-induced proliferation of Ishikawa cells. In addition, leptin was found to potently induce the invasion of endometrial cancer cells in a Matrigel invasion assay. Leptin-stimulated invasion was effectively blocked by pharmacological inhibitors of STAT3 (AG490) and ERK1/2 kinase (PD98059). These results suggested that leptin promotes endometrial cancer growth and invasiveness by activating STAT3 and ERK1/2 signaling pathways and therefore blocking its action at the receptor level can be a rational therapeutic strategy.
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To investigate the expression of mRNA of leptin long-form receptor (OB-Rb) in luteinized granulosa cells of obese women with polycystic ovary syndrome (PCOS), and to determine the role of leptin in the physiopathology of PCOS, luteinized granulosa cells were collected from the follicle fluid of 10 obese women who met the diagnostic criteria for PCOS and their BMI was equal to or greater than 25 kg/m2, and at the same time, granulosa cells were collected from 10 normal women undergoing IVF-ET who served as the control group. Some luteinized granulosa cells were taken from normal women for in-vitro culture, into which human leptin of different concentrations was added (0, 10, 100 and 1000 ng/mL). After stimulation with leptin for 48 h, RT-PCR was employed for the detection of the expression of OB-RLmRNA in the luteinized granulosa cells. Our results showed that the level of OB-RLmRNA in luteinized granulosa cells of obese PCOS women was higher than those in the control (P＜0.05). In luteinized granulosa cells cultured in vitro and stimulated by human leptin for 48 h, the level of OB-RLmRNA was higher than those without leptin stimulation (P＜0.01), and when leptin concentration was at 100 ng/mL, and the level of OB-RLmRNA reached a peak. It is concluded that in obese PCOS women, the level of serum leptin is increased, which promotes the expression of OB-RL in luteinized granulosa cells and increases the sensitivity of the granulosa cells to leptin. Leptin may contribute to anovulation in obese women with PCOS.