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Objective:To explore the current situation of evidence-based practice competence of masters of nursing specialist at Class Ⅲ hospitals and its influencing factors so as to provide decision-making basis for optimizing the construction and educational management of clinical teaching base for masters of nursing specialist.Methods:From July to October 2021, 141 masters of nursing specialist of Class Ⅲ hospitals in Tianjin were selected as subjects by purposive sampling. All students were investigated with the Chinese version of Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) and the Barriers to Research Utilization Scale. Multiple linear regression was used to analyze the influencing factors.Results:Among 141 masters of nursing specialist, the total scores of the EBP-COQ and the Barriers to Research Utilization Scale were 95.35 ± 11.90 and 72.52 ± 26.28 respectively. Multiple linear regression analysis showed that the influencing factors of evidence based practice competence of masters of nursing specialist included the results of availability and the awareness of evidence-based nursing ( r = -2.85, -2.41, both P<0.05). Conclusions:Masters of nursing specialist have the intermediate level of evidence-based practice competence and positive attitudes to evidence based practice, but their evidence-based knowledge and skills need to be improved. Clinical teaching base managers should pay attention to the training of evidence-based nursing practice ability of professional nursing master students, provide more supportive resources and environment, and promote the development of specialty nursing practice.
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Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.
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Objective:To investigate the association between indoleamine 2,3-dioxygenase(IDO)expression in tumor tissue,its periph-eral blood activity, and the efficacy of neoadjuvant chemotherapyin patients with breast cancer. Methods: Immunohistochemistry (IHC)and high-performance liquid chromatography(HPLC)were used to measure IDO protein expression in tumor tissue,and kynuren-ine(Kyn),tryptophan(Trp),and IDO activity(Kyn/Trp)in peripheral blood before neoadjuvant chemotherapy in 53 patients with breast cancer from Tianjin Medical University Cancer Institute and Hospital between September 2015 and December 2016.The correlations between the expression and activity of IDO and the efficacy of chemotherapy were analyzed.Results:In tumor tissue,IDO expression-before neoadjuvant chemotherapy was related to clinical tumor stages(P=0.006),node stages(P=0.020),clinical stages(P=0.045),and estrogen receptor(ER)status(P=0.014).High IDO activity before neoadjuvant chemotherapy in peripheral blood was associated with high IDO expression in tumor tissue(P=0.004),and was also correlated with clinical tumor stages(P=0.019)and node stages(P=0.047). Univariate analysis showed that the clinical efficacy of neoadjuvant chemotherapy was associated with pre-chemotherapeutic clinical tumor stages(P=0.049),ER status(P=0.025),and molecular subtype(P=0.014),while pathologic complete response(pCR)was related to pre-chemotherapeutic clinical tumor stages(P=0.014).Importantly,the clinical efficacy of neoadjuvant chemotherapy and pCR were both related to IDO expression and activity before chemotherapy(all P<0.05).Multivariate analysis showed that pre-chemotherapeu-tic IDO activity in peripheral blood was the only independent factor that affected pCR(P=0.032).Conclusions:Tumor tissue IDO expres-sion and peripheral blood IDO activity before chemotherapy were associated with chemotherapy efficacy,and could provide promising information for the clinical prediction of chemotherapy sensitivity.
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Objective To get further insight into the breakthrough pain experiences in advanced cancer patients in order to provide targeted nursing measures for breakthrough pain patients. Methods Semi structured interviews were performed in 12 advanced cancer patients. Colaizzi analysis program was used to analyze, induct and extract the themes. Results The breakthrough pain experiences of advanced cancer patients were as follows:overall perception of breakthrough pain;the experience when experiencing breakthrough pain; personal growth related to breakthrough pain. Conclusions Nurses should provide sufficient information to patients timely, consider patients′needs and combine with non-drug methods to better manage breakthrough pain to improve patients′experience about breakthrough pain.
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Objective To study the distribution ,specimen types and characteristics of antibiotic resistance of Escherichia coli producing extended‐spectrum βlactamases(ESBLs) of the hospital in 2013 and to guide clinical drug use .Methods Analyzed the distribution and antibiotic resistance for the 375 strains of ESBLs‐producing E .coli ,and ESBLs was detected by disk diffusion phe‐notypic confirmatory test .Results The major distribution department was gynecology department which accounted for 42 .67% , followed by uropoiesis surgical department which accounted for 14 .67% ;the major specimen type was urine(55 .2% ) ,followed by puncture fluid(15 .47% )and excretion(14 .67% ) .For the 375 isolates of ESBLs‐producing E .coli ,the resistance rates to cefazolin , cefuroxime ,cefoperazone and cefotaxime were 100 .00% ,to SMZco was 78 .10% ,while the resistance rate to imipenem was 0 .00% , and to amikacin and fosfomycin were 4 .30% and 10 .10% respectvely ,the resistance rates to piperacillin/tazobactam and aztreonam were 17 .10% and 66 .70% respectvely .Conclusion ESBLs producing Escherichia coli have severe multidrug resistance .Antibiotics should be chosen and used rationally in accordance with results of drug susceptibility testing ,meanwhile the monitoring of ESBLs′infection rate and drug resistance should be strengthened .
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Objective To evaluate quantitative examination of urinary sediment bacteria as a basic feasibility of screening indicators for urinary tract infection .Methods 191 outpatients and inpatient specimens were gathered firstly to implement a urine culture ,and then the rest of the urine were used for sediment bacteria quantitative testing .Meanwhile ,bacterial culture was conducted as the standard .According to the results of bacterial culture ,receiver operating characteristic(ROC) was drawn ,the threshold values of leukocyte and bacteria counts for diagnosis of urinary tract infection were found out and its sensitivity ,specificity ,positive / negative predictive value ,false positive/false negative rate and accuracy were calculated .Results The positive rate of urine culture was 39 .7% ,and the most common pathogen was Escherichia coli .The threshold value of bacteria and leukocyte counts for diagnosis of urinary tract infection was 1 024 .5/μL and 135 .8/μL respectively .When combined leukocyte and bacteria counts for urinary tract infection ,the optimum sensitivity was 62 .5% ,specificity was 98 .1% ,positive predictive value was 95 .7% ,negative predictive value was 79 .6% ,false positive rate was 1 .9% ,false negative rate was 37 .5% ,and accuracy was 83 .8% .Conclusion With UF‐1000i urinary sediment analyzer ,the combined determination of leukocyte and bacteria counts can remove the great mass of negative results ,Especially the results of bacterial culture positive predictability is higher ,but still can not replace of quantitative bacterial culture .
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(P < 0.05 ).Scanning electron microscopy showed that the three-dimensional structure of mix-biofilm in control group was more complex.As real-time PCR showed,after 6-hour culture,the expressions of icaA,fbe,aap,hwp1, als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group and after 24-hour culture the expressions of aap,hwp1,als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group.Conclusion With the intervention by fungal quorum sensing molecules Farnesol,the structure in control group became denser and more complex than that in Farnesol group.This change may have a closer correlation with the down-regulated expressions of als3,hwp1 and efg1 genes,which are related to the formation of Candida albicans biofilms.
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Objective To explore the clinical characteristics,treatment and prognosis of ductal carcinoma in situ of the breast.Methods We retrospectively analysed 430 patients with a diagnosis of DCIS in Cancer Hospital of Tianjin Medical University from January 1991 to December 2005,to evaluate the clinical characteristics,treatment and prognosis.Results Overall survival rate of 430 patients was 94.9％ (408/430).10 cases died of breast cancer recurrence,7 for local recurrence,3 for metastsis.Tumor size,TNM stages and structural pattern of pathlogy were prognosis impacting factors (P ＜ 0.05).The 5-year survival rate for combination radiotherapy and breast-conserving surgery group was 100％,and 10-year survival rate was 97.1％,comparing traditional modified radical mastectomy 5-year survival rate of 98.3％and 10-year survival of 96.7％ (P ＞ 0.05).The overall survival rate of surgery alone group (89.9％) was lower than the post-operative comprehensive treatment group (96.8％),(P ＜ 0.05).Conclusions Treatment of DCIS should be based on primary tumor's clinical stage and histologic characters.Breast-conserving surgery enjoys the same outcome as traditional modified radical mastectomy.
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carcinoma (SRCC) of the breast.Methods The clinical and pathologic data of 17 SRCC of the breast were analyzed retrospectively.Results Breast SRCC accounted for 2-4.5％ of all breast cancer patients.I0 (58.8％) patients suffered from lymph node metastasis at admission,the positive rates of estrogen receptor(ER) and progesterone receptor (PR) were 71.4％ (10/14) and 64.9％ (9/14) respectively.With a follow-up time varying from 8 months to 11 years recurrence or metastasis were found in 7 patients,another 3 patients were found having distant metastasis at admission.Bone metastasis (8 patients) was most common.Treatments of breast SRCC were analogous to breast cancer at the same stage,sixteen cases were treated with surgery and 14 cases with chemotherapy.The 3' and 5' year disease-free survival rates were 50.3％ (7/17) and 23.0％ (5/17) respectively.With a mean follow-up time of 57 months,the mortality was41.2％ (7/17).Conclusions SRCC of the breast is highly invasive,with high rate of positive receptors and recurrence,and poor patients' survival.
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ObjectiveTo analyze the clinical features and prognostic factors of occult breast cancer. MethodsThe clinical features and prognostic factors of 62 occult breast cancer patients,who were treated in Tianjin Cancer Hospital from October 1997 to October 2011,were retrospectively analyzed.ResultsThe 3-year,5-year and 10-year overall survival rates of 62 cases were 87.4％,76.4％,73.2％ respectively,a median of 53 months.The 3-,5-,and 10-year overall survival rates of the patients with ＞4 positive lymph nodes are lower than that of patients with ≤4 nodes (77.8％,64.8％,38.9％ vs.90.7％,86.7％,86.7％,P =0.015 ) ;The 3-year and 5-year overall survival rates of patients with primary cancer found in removed breast tissue are lower than that in those primary tumor was not found (60.0％,40.0％,40.0％ vs.92.0％,83.6％,79.2％,P =0.023).The 3-year,5-year and 10-year overall survival rates in patients with recurrence and metastasis are lower than that of patients without (63.5％,28.6％,19.0％ vs.97.1％,97.1 ％,97.1％,P =0.000). ConclusionsThe prognosis of occult breast cancer is related with the number of positive lymph node,pathology,recurrence and metastasis.
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BACKGROUND: It is confirmed that pathogenicity of biomaterials-centered infection is positive correlated to bacterial biofilm formation of Staphylococcus epidermidis on the surface of catheter-related materials. OBJECTIVE: To analyze the relations between expressions of central venous catheter-related Staphylococcus epidermidis icaA, icaD, transforming growth factor β1 (TGF-β1) and formation of bacterial biofilm. METHODS: The type of Staphylococcus epidermidis in lung cancer cases with catheter-related bloodstream infections (CRBSI) was indentified, followed by bacterial genomic DNA extraction. The expression of biofilm formation-related genes icaA, icaD mRNA and phenotype of biofilm were detected by PCR. The serum TGF-β1 levels in cases with or without CRBSI were measured by enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION: The expression of Staphylococcus epidermidis operon icaA and icaD gene was positive correlated to biofilm formation in lung cancer cases with CRBSI (P < 0.01); particularly, the TGF-β1 levels in CRBSI cases were greater than that of non-CRBSI cases (P < 0.05). The results demonstrated that, central venous catheter infection causes positive Staphylococcus epidermidis icaA and icaD gene expressions in lung cancer cases and is prone to form biofilm, high level of peripheral TGF-β1 may play a positive role in bacterial biofilm formation.
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BACKGROUND: Permanent or transient implantation of biomaterials can result in biomaterials-centered infections (BCI) in lung cancer patients.OBJECTIVE: To investigate the relationship between BCI and peripheral blood transforming growth factor β1 (TGF-β1) in patients with lung cancer.METHODS: A total of 248 lung cancer patients undergoing in vivo intravascular catheter indwelling > 7 days were included.Quantitative method was used for intubation, bacteriological culture and paired blood culture, and API Staph strips were adopted for positive patients. While enzyme-linked immunosorbent assay was used to detect TGF-β1 levels in the peripheral blood of patients with lung cancer and 75 healthy volunteers as normal controls.RESULTS AND CONCLUSION: Among the 248 patients, there were 82 BCI-positive cases, and 166 BCI-negative cases.Thirteen patients were confirmed to have catheter-related bloodstream infection. There were 48 Gram-positive bacteria, 24Gram-negative bacilli, and 10 fungal. The levels of TGF-β1 were higher in BCI-positive patients than BCI-negative patients (P < 0.05); the levels of TGF-β1 in the BCI-negative group were higher than those in the normal control group (P < 0.05). For lung cancer patients with nosocomial infection induced BCI, there are various species of pathogenic bacteria, and Gram-positive bacteria are more common. To detect TGF-β1 levels in patients with lung cancer is of significance for early prevention of BCI.