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Objective:To explore the construction of evaluation index system of core competence of imaging specialized nurses and analysis of reliability and validity test.Methods:Firstly, a research group was established to consult the relevant literature. After repeated discussion among the members of the research group, imaging specialized nurses were invited to discuss, modify and improve the framework of the evaluation index system, and an expert consultation questionnaire for the evaluation index system of the core competence of imaging specialized nurses was formulated. Through two rounds of expert consultation, the core competence evaluation index system of imaging specialized nurses was constructed, and a questionnaire was compiled based on the constructed index system. Questionnaire survey method was used to verify the rationality and scientificity of the core competence evaluation index system of imaging specialized nurses constructed in this study.Results:The evaluation index system of core competence of imaging specialized nurses included 3 first-level indexes, 20 second-level indexes and 48 third-level indexes. The overall Cronbach's α coefficient of the evaluation index system was 0.972. The Cronbach's α coefficients of the theoretical knowledge of imaging specialized nursing, nursing practice skills of imaging specialized nurses and related abilities were 0.915, 0.934 and 0.924 respectively. The overall content validity index (S-CVI) of the index system was 0.977, and the CVI of each item (I-CVI) was 0.812-1.000. The overall correlation coefficient of the first-level indexes and index system was 0.800-0.936 ( P < 0.05), the correlation coefficient of the secondary indexes and the corresponding primary indexes was 0.562-0.972 ( P<0.05), and the correlation coefficient of the third-level indexes and the corresponding first-level index was 0.362-0.914 ( P<0.05). Conclusion:The constructed questionnaire for evaluation index of core competence of imaging specializied nurses has good reliability and consistent internal structure, and has good feasibility, reliability, rationality and scientificity, which provides a theoretical basis and practical guide for the cultivation, assessment and evaluation of core competence of imaging specialized nurses.
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Objective To explore the dosimetric characteristics of single photon emission computed tomography(SPECT)combined with bone marrow sparing intensity modulated radiotherapy in patients with cervical cancer.Methods Twenty patients with cervical cancer after hysterectomy were performed on 99Tc thiocolloid SPECT bone marrow imaging to determine the active bone marrow in the pelvis.SPECT image combined with the simulation CT was used as the primary planning data set.Two plans for bone marrow sparing modulated radiotherapy were generated according to the bone marrow volume defined by SPECT and outline of the pelvis(SPECT-IMRT planning and BMS-IMRT planning).Furthermore,the target section and the dosimetric distribution in organs at risk(bone marrow,small intestine,rectum and bladder)in the two plannings were compared.The prescribed dose to the PTV was 45 Gy.Results The volume of the bone marrow in SPECT-IMRT planning and BMS-IMRT planning was(238.15 ±36.82)and(1 100.61 ±109.92)cm3,respectively(t＝33.273,P＜0.05).The average bone marrow volume of SPECT-IMRT planning in high-dose radiation region(V30,V40and V45)was decreased by 6.9％,5.7％and 2.6％respectively compared with BMS-IMRT planning(t ＝3.540,3.4261,3.448,P＜0.05),but there was no statistical significant difference between the two plannings in the dose volume of low-dose radiation(V10and V20,P＞0.05).The PTV coverage rate and exposure dose of other organs at risk(small intestine,rectum and bladder)in the two plannings were not significantly different(P＞0.05).Conclusions SPECT bone marrow imaging could clearly show the range of active bone marrow on CT scan images.Compared with BMS-IMRT,SPECT-IMRT could further reduce the dose volume of high-dose radiation(V30,V40and V45).Yet the clinical significance of this advantage also needs to be confirmed by large-scale clinical studies.
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Objective To explore CT manifestion of multiple primary lung cancer (MPLC)and to improve the recognization of MPLC.Methods The CT manifestions of 12 cases with MPLC proved by pathology were retrospectively reviewed.Results All the 12 cases were double primary lung cancer.There were 24 lesions with 21 peripheral and 3 central,the average diameter was (2.2 ± 0.6)cm.Lesions located in contralateral lobes were in 2 patients,and located in ipsilateral lobes were in 10 patients,with 3 located in the same lobe and 7 in the different lobes.There were 7 cases of adenocarcinoma-adenocarcinoma,3 cases of squamous cell carci-noma-adenocarcinoma,1 case of squamous cell carcinoma-squamous cell carcinoma and 1 case of squamous cell carcinoma-carcinoid. 1 1 cases were metachronous and 1 case was synchronous.3 lesions were lump located at hilus of the lung,21 lesions were intrapul-monary nodules,showing masses with lobulated shape,spicules of margin,vascular convergence,vacuole and pleural indentation sign.Most foci displayed moderate intensity enhancement and homogeneous density in triphase enhanced scans,the CT value of le-sions on enhanced images ranged from 20-60 HU.Conclusion MPLC are synchronous and peripheral adenocarcinoma type,all of the lesions have typical CT features of primary lung cancer.
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OBJECTIVE@#To explore the severity index of Meniere's disease during acute phase by a statistical method of principal component analysis (PCA).@*METHOD@#Ninety-five patients with Meniere's disease in the acute phase who saw the doctor with 24 hours after onset were included in this study and their clinical data were analyzed retrospectively. The subjective symptoms of hearing loss (X1) and ear stuffy plug (X4) were evaluated by VAS scoring system, and the impact of vertigo (X2) and tinnitus (X3) on the patients were evaluated by DHI and THI score. The principal component analysis (PCA) method was used to analyze the quantified data and construct a synthetic evaluate function of subjective symptoms.@*RESULT@#(1) The quantitative results of subjective symptoms in patients with Meniere's disease were as follow: VAS score (X1) of hearing loss was 0-91 points, with an average of 46.23 ± 18.80, DHI score (X2) of vertigo was 8-98 points, with an average of 49.66 ± 15.67, THI score (X3) of tinnitus was 10-100 points, with an average of 47.53 ± 17.44, and ear VAS score (X4) of stuffy plug feeling was 0-82 points, with an average of 21.55 ± 27.54. (2) The eigenvalue of principal components Z1, Z2 and Z3 were 1.876, 0.984 and 0.703 respectively, and the variance contribution were 46.898%, 24.592% and 17.574% respectively. (3) The constructed synthetic evaluate function of the disease was as follow: The Meniere's disease severity index ƒ = 0.213ZX1 + 0.398ZX2 + 0.370ZX3 + 0.455ZX4.@*CONCLUSION@#The method of PCA for the subjective evaluation of symptoms in Meniere's disease can be constructed as a model of comprehensive evaluation system, which may provide relatively comprehensive information of clinical original variables included in the four main symptoms, reflecting the severity of the disease.
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Humans , Hearing Loss , Meniere Disease , Diagnosis , Principal Component Analysis , Retrospective Studies , Severity of Illness Index , Tinnitus , VertigoABSTRACT
Objective To investigate mutation spectrums of α- and β-haemoglobin genes in thalassemia patients and carriers in Yunnan province,and to establish procedures on prenatal gene diagnosis.MethodsTotally 10 033 counseling couples and pregnant women,and 22 cases of children with moderate or severe thalassemia were recruited from 5 parts of Yunnan Province,middle,western,eastern,southern and northern areas, during July 2009 to July 2011.Medical records, including results of haemoglobin electrophoresis,blood routine examination,and gene diagnosis of subjects were collected and saved in an database in Excel software by the Key Laboratory for Birth Defects and Genetic Diseases.Using multiple gap-PCR and PCR-reversed dot blotting kits, DNA samples collected from 1077 cases of haematological positive thalassemia patients and carriers were tested to determine common mutations of the α-or β-haemoglobin genes.The codon regions of haemoglobin genes were sequenced by the Sanger sequencing in cases that the mutation tests were negative.Mutation spectrums of α- and β-haemoglobin genes were concluded.Prenatal gene diagnosis was offered to fetuses who had risk of thalassemia major.Results( 1 ) In 1077 cases of haemological screen positive subjects,deletions and mutations of α-haemoglobin gene were tested in 119 subjects among 347 cases suspected as α-thalassemia patients and carriers.Five kinds of deletions and mutations on α-haemoglobin gene were found.In 104 subjects,four kinds of common deletions and mutations onα-haemoglobin gene were determined:--SEA, -α3.7, αCS α,-α4.2.Other 14 subjects were double heterozygotes with haemoglobin H disease and severe α-thalassemia phenotypes.A rare mutation of insertion and deletion in α2 haemoglobin gene intron,α301-24-301-23 indel,was found in one carrier subject.(2)In 1077 cases of haemological screen positive subjects,deletions and mutations of β-haemoglobin gene were tested in 297 subjects among 730 cases suspected as β-thalassemia patients and carriers.Sixteen kinds of β-haemoglobin gene mutations were found,including 7 cases of rare abnormal haemoglobinopathy patients with β-haemoglobin gene mutations.In one case with β + phenotype patient,the Codon 5 (-CT)mutation at β-haemoglobin gene was found (firstly reported in China ). (3) Three fetuses with high riskS of α-thalassemia were accepted for prenatal diagnosis.One case of Hb Bart's hydrops syndrome fetus with the genotype --SEA/--SEA,and one case of mild α-thalassemia fetus with the genotype αCS α/αα were found.Another one fetus was found with normal α-haemoglobin.In 6 fetuses accepted for prenatal diagnosis due to high risks of β-thalassemia,one case of β-thalassemia major with the genotype CD17( A→T)/-28 (A→G) was found,3 fetuses were heterozygote carriers,and 2 fetuses had normal genotypes without mutations found in their parents.Medical terminations for 2 fetuses with severe thalassemia were made according to the choice of pregnant women.Other 7 pregnancies continued to term.Anemia or growth retardation was not found in the 7 infants when following up after given-birth 6 to 12 months.Conclusions The mutation spectrums of α- and β-haemoglobin genes of thalassemia patients and αarriers.in Yunnan province are special,in which β-haemoglobin gene exits more polymorphism in the mutation spectrum.Carrier screening in pregnant women,and offering prenatal gene diagnosis to the high risk pregnancies should be an efficient strategy to prevent thalassemia major.
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Objective To investigate the effects of different chromatogram fingerprints analysis methods on the quality evaluation of Chinese herbal medicine. Methods With the chromatogram fingerprints of a Chinese patent medicine in different batches as the analytic object, the quality evaluation of three methods such as peak area ratio,peak area quantification and similarity coefficient were investigated. Results The method of peak area ratio has the highest accuracy rate and the precise rate for quality evaluation, and similarity coefficient and peak area quantification came next. The result of peak area quantification was similar to that by current evaluation method. Conclusion Different chromatogram fingerprints analysis methods would result in a great difference in the quality evaluation of Chinese herbal medicine.
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AIM: To construct suitable quality standard of evaluating antipyretic effect of 4 herbs,Bupleurum,Flos Lonicerae Japonicae,Radix Isatidis and Fructus Forsythiae. METHODS: Extracts,essential oils and its mixtures of extract and oil of above herbs,plus Ibuprofen Suspension,were used for antipyretic experiment on rats.Principal Component Analysis and Canonical Correlation Analysis were adopted as evaluation tools to examine the correlation between pharmacological effect and UV spectra of herb's chemicals,from which spectral marker of potential reliability for evaluating antipyretic effects of samples could be constructed. RESULTS: Antipyretic effect sequencing of UV spectral canonical variables was consistent with that of the four herbs. CONCLUSION: The first canonical variable U1 expressed by principal component scores of UV spectra of herbs could be used as spectral marker for evaluating antipyretic effects of the four herbs.