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Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.
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Objective:The aim of this study was to explore the relationship between nurses ′ work environment and menopausal symptoms. Methods:A multicenter, cross-sectional study was performed in Beijing, China, distributed to 2 194 registered nurses at 37 hospitals. Using a self-designed questionnaire included individual personal details, and the hospital working environment. Menopausal symptoms were evaluated using a modified Kupperman index (KMI) scoring system.Results:The average natural age at menopause stag was 47.64 years with 63.91% (1 328/2 078) nurses without menopausal symptoms. Logistic analysis showed that menopausal symptoms were co-dependently influenced by the following: to frequently contact with patient bodily fluids during your work ( P=0.037); be intimidated in your work ( P<0.01); to often or occasionally face death at work ( P=0.013 and P=0.002). Nurses suffered more stressful environment with high prevalence of menopausal symptoms. Conclusions:The mid-age nurses with menopausal symptoms were related with work environment. Managers should pay more attention to this problem.
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Objective To observe and evaluate acute toxicities in a series of human immunodeficiency virus (HIV)-positive cancer patients receiving radiation therapy.Methods The study retrospectively reviewed the acute radiation reaction of radiation therapy of 14 HIV seropositive patients diagnosed with carcinoma between Feb 2008 and Dec 2013 at the Yunnan Tumor Hospital during the radiotherapy period and 1 month following treatment.Acute adverse effects were classified according to the site of radiation therapy and analyzed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.Results Seven patients experienced interruptions or delays in treatment,and 2 stopped treatment entirely.The most common acute adverse effects were skin reactions and mucous membrane reactions,including dermatitis,stomatitis or diarrhea.Eight patients had grade 3 acute adverse effects,including 6 patients with grade 3 skin reactions and 2 patients with grade 3 mucosa reactions.Conclusions Radiotherapy is an effective treatment for HIV positive patients with tumors,however it frequently induced severe acute radiation responses.
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Ku is a heterodimeric protein which is composed of Ku70 and Ku80.DNA dependent protein kinase is composed of Ku and DNA dependent protein kinase catalytic subunit (DNA-PKcs).DNA double strands break is the main method that radiation kill tumor cell,which will restraint DNA repair,and induce cell apoptosis.Ku protein is the key point in the repair of DNA.Blocking Ku protein will increase the radiosensitivity of tumor cell.
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Based on the statistical materials of SARS epidemic process in a general hospital in 2003 and with least square method, the epidemic laws are fitted through MATLABL, and the infection characteristics and relative conclusions of SARS are analyzed.