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Objective:To study the risk factors of venous thromboembolism(VTE)and the predictive value of the improved VTE score model to identify the risk of VTE in gynecological surgery patients.Methods:From Janu-ary 1,2020 to December 31,2022,41 patients with VTE after gynecological surgery were selected as the VTE group,and a total of 164 patients with adjacent gynecological surgeries during the same period were selected as the non-VTE group with a ratio of 1 :4.Univariate and multivariate Logistic regression analysis were used to ana-lyze the risk factors of VTE after gynecological surgery,and a modified VTE risk factor rapid assessment model(referred to as the improved VTE score model)was constructed.The receiver operating characteristic(ROC)curve was used to study the predictive value for VTE for in gynecological surgery,and compared with the Caprini score model(Caprini table for short).Results:①Multivatiate Logistic regression analysis showed that there were independent risk factors for postoperative VTE in gynecology surgery(OR＞1,P＜0.05),including age≥60 years,BMI≥28 kg/m2,malignant tumors,surgery time＞3 hours,history of thrombosis,and the increased D-di-mer difference before and after surgery.②The Area under Curve(AUC)of ROC was 0.963 in the improved VTE score model with a Youden index 81.10％,sensitivity 87.80％and specificity 93.29％.The AUC of the Caprini score model was 0.888 with Youden index 63.41％,sensitivity 73.17％and specificity 90.24％.The improved VTE score model the Caprini score model identified 92.68％and 85.37％of VTE patients as high-risk or ex-tremely high-risk,respectively,but the difference was not statistically significant(P＜0.05).Conclusions:More attention should be paid to the six independent risk factors for postoperative VTE in gynecology surgery.The two score models showed a similar identified level.However,the improved VTE score model is more simple and easier to operate,has better practicality,and has certain clinical promotion value.
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Objective:To explore the effect of comfort nursing intervention in hospice care for advanced cancer patients at home, and to provide reference for hospice care for advanced cancer patients at home.Methods:A randomized controlled trial was conducted. A total of 105 patients with advanced cancer who were treated in the Cancer Hospital Affiliated to Harbin Medical University from January to February 2023 were selected as the research objects. According to the random number table, they were divided into control group of 53 cases and intervention group of 52 cases. The control group received routine nursing methods, while the intervention group received comfort nursing interventions on this basis. The intervention lasted for 4 weeks. The changes in palliative care outcomes, quality of life and death anxiety were compared between the two groups before and after intervention.Results:Totally 105 cases were included, 53 cases in the control group and 52 cases in the intervention group. In the control group, there were 25 males, 28 females, aged (58.96 ± 10.71) years old; in the intervention group, there were 22 males, 30 females, aged (59.82 ± 10.53) years old. Before intervention, there was no statistically significant difference in palliative care outcomes, quality of life and cancer death anxiety scores between the two groups of patients (all P>0.05). After intervention, the total score of palliative care outcomes in the intervention group was (13.34 ± 5.88) points, significantly lower than (16.15 ± 5.72) points in the control group, with a statistically significant difference ( t = 2.48, P<0.05). The overall health status score of quality of life was (68.55 ± 9.34) points in the intervention group, higher than (63.01 ± 9.28) points in the control group ( t = 3.05, P<0.05). The total score of cancer death anxiety was (8.85 ± 2.72) points, significantly lower than (10.59 ± 3.14) points of the control group, with a statistically significant difference ( t = 3.04, P<0.05). Conclusions:The application of comfort nursing mode in home based hospice care can improve the quality of hospice care for advanced cancer patients, reduce their level of death anxiety, and is of great significance for improving the quality of life of advanced cancer patients.
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Objective To investigate the change of infusion particles and PH value of rifampicin for injection under dif-ferent configuration and application conditions,and to provide the best configuration method and the best infusion quality control strategy for rifampicin for injection.Methods The particle number and PH value of rifampin for injection were investigated and measured under different configuration and application conditions,and the factors affecting the formation of particles were ana-lyzed.Results The stable pH value of Rifampicin for injection was 7.2-8.1,and the number of particles was the least in the light filtering and 5%glucose 500 mL,and the number of particles was the least in 1～4 h after the configuration.Conclusion The optimal infusion quality control strategy is to filter rifampicin for injection by blocking light,500 mL of solute 5%glucose,1～4 h after configuration,and use of disposable precision filter infusion set.
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Objective:To explore the chain mediating effect of self-efficacy and positive coping styles between nurses′ adversity quotient on work engagement, so as to provide a theoretical reference for nursing managers to promote work engagement.Methods:A convenience sampling method was used to select 512 nurses from four tertiary hospitals in Shaanxi Province, and a cross-sectional study was conducted on them using the general information questionnaire, Adversity Response Profile, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Utrecht Work Engagement Scale-9.Results:The total scores of nurses' adversity response profile, self-efficacy, positive coping style and work engagement were 132.00(120.00, 139.00), 27.00(23.00, 29.00), 24.00(20.00, 25.00), 27.00(25.00, 35.00) points. Nurses' work engagement was significantly positively correlated with adversity quotient, self-efficacy and positive coping styles( r values were 0.523-0.614, all P<0.01). The independent mediation of self-efficacy or positive coping styles and the chain mediation of both accounted for 23.6%,40.9% and 15.9% of the total effect respectively. Conclusions:Nurses′ adversity quotient not only directly affected work engagemnet, but also indirectly affected work engagement through self-efficacy and positive coping style. The research suggested that managers should pay attention to the improvement of nurses′ self-efficacy and positive coping style, so as to promote nurses′ work engagement.
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Objective: To explore the therapeutic effects of sequential chemoradiotherapy with pemetrexed and cisplatin on locally advanced laryngeal cancer [LALC]
Methods:Fifty LALC patients who were treated in our hospital between January 2010 and January 2012 were selected and randomly divided into an observation group and a control group [n=25]. The two groups were given conventional radiotherapy in the same manner, before which two cycles of chemotherapy were performed. The observation group intravenously infused with 500 mg/m[2] pemetrexed on d1 and 25 mg/ m[2] cisplatin on d1-3, with 28 days as a cycle. The control group was intravenously infused with 25 mg/m[2] cisplatin on d1-3 and 400 mg/m[2] fluorouracil, with 28 days as a cycle. The short-term effects and adverse reactions of both groups were observed after treatment, and their survival was observed by follow-up for five years
Results:The response rate was 84% [21/25] in the observation group and 64% [16/25] in the control group, between which the difference was statistically significant [P<0.05]. The differences in the incidence rates of short-term adverse reactions such as grade III-IV gastrointestinal reactions and bone marrow suppression were not statistically significant between PC regimen [pemetrexed combined with cisplatin] and PF regimen [cisplatin combined with fluorouracil] [P>0.05]. The incidence of long-term adverse reactions such as grade III-IV laryngeal edemas, laryngeal cartilage inflammation and laryngeal cartilage necrosis showed no significant differences between the two groups [P>0.05]. The median survival was 3.3 years after PC chemotherapy and 2.8 years after PF chemotherapy, between which the difference was not statistically significant [P>0.05]. The levels of serum tumor markers significantly decreased after PC and PF treatments compared with those before [P<0.05]
Conclusion:Combining PC chemotherapy with radiotherapy has satisfactory short-term therapeutic effects on LALC, and the resulting adverse effects can be tolerated. Therefore, this strategy is worthy of promotion and application in clinical practice
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Objective To analyze effect of the exercise reducting and improving fistula complications and the quality of life for continuous hemodialysis patients.Methods 106 patients with end-stage renal failure and hemodi-alysis were randomly divided into all 53 patients in observation group (using yoga exercise intervention)and 53 pa-tients in the control group (no intervention measures).Incidence of venous thrombosis,arterial thrombosis,false aneu-rysm,vascular complications were observed in patients of two groups.The quality of patients′life after dialysis care sit-uation in two groups was evaluated by a simple scale of health survey Mos SF-36.Results The comparison result of complication occurs case showed that the incidence of venous thrombosis,arterial thrombosis end,false aneurysm,vas-cular complications in the observation group were respectively 13.21%,0,3.77% and 20.75%;The same indexes were 33.96%,9.43 %,15.09% and 58.49% in the control group,and the complications in the observation group were significantly fewer than the control group (χ2 =6.33,5.15,3.98,10.44,P<0.01,P=0.02,P=0.04).the improved situation of life quality in the two groups showed physiological function,physical function,bodily pain,g en-eral health,vitality,social function,emotional function were significant differences before and after the mental health care in the observation group (t=5.05,4.57,2.85,6.95,10.06,3.28,6.71,8.11,P<0.01);in addition to the physiological functions in the control group,social function,the other were also statistically significant (t =2.42, 1.27,2.06,4.54,4.76,2.19,1.46,3.83P<0.02,P<0.05,P<0.01).In addition to the social function,other improvements in the observation group were better than that in the control group after the mental health care (t=3.06,3.59,2.02,3.79,7.14,1.74,4.22,2.25,P<0.05,P<0.01).Conclusion Through Yoga intervention continued dialysis,the patients'own immune system and disease resistance are improved,the patient's ability to withstand continuous hemodialysis are also improved,thereby to increase the effect of continued hemodialysis.