RESUMO
Background: Ground glass nodules (GGN) of the lung may be a precursor of lung cancer and have received increasing attention in recent years with the popularity of low-dose high-resolution computed tomography (CT). Many studies have discussed imaging features that suggest the benignity or malignancy of GGN, but the extent of its postoperative pathological infiltration is poorly understood. In this study, we identified CT imaging features that indicate the extent of GGN pathological infiltration. Methods: A retrospective analysis of 189 patients with pulmonary GGN from January 2020 to December 2021 at Shanxi Cancer Hospital was performed. Patients were classified according to their pathological type into non-invasive adenocarcinoma [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS) in a total of 34 cases], micro-invasive adenocarcinoma (MIA) in 80 cases, and invasive adenocarcinoma (IAC) in a total of 75 cases. The general demographic data, nodule size, nodule area, solid component, CT indications and pathological findings of the three groups of patients were analyzed to predict the correlation between GGN and the degree of lung adenocarcinoma infiltration. Results: No statistically significant differences were found among the three groups in general information, vascular signs, and vacuolar signs (P > 0.05). Statistically significant differences among the three groups were found in nodule size, nodule area, lobar signs, pleural traction, burr signs, bronchial signs, and solid components (P < 0.05). Logistic regression equation tests based on the statistically significant indicators showed that nodal area, lobar sign, pleural pull, burr sign, bronchial sign, and solid component were independent predictors of lung adenocarcinoma infiltration. The subject operating characteristic (ROC) curve analysis showed that nodal area is valuable in predicting GGN infiltration. Conclusion: CT-based imaging indications are useful predictors of infiltrative adenocarcinoma manifested as pulmonary ground glass nodules.
RESUMO
Multiple injury refers to the injury of two or more anatomical parts of the body caused by mechanical injury factors. Even if only one injury exists alone, it can endanger limbs or lives. Therefore, nursing plays an important role in its treatment. Here, we investigated the application and clinical effect of nursing based on the Kano model in emergency multiple injuries. A case-control study was designed, where 48 patients with multiple injuries in the emergency department were divided into the control group to perform routine care and 48 patients were divided into the study group to carry on nursing based on the Kano model. The first-aid indexes, success rate of rescue, inflammatory response indicators, satisfaction rate of nursing, incidence of adverse events, and prognosis were compared between the two groups. A monofactor analysis showed that the emergency response time, admission time, and emergency department rescue time were shorter in the study group than those in the control group, indicating a higher success rate of rescue with nursing based on the Kano model. For the immunity of patients, the scores of mental states and the serum levels of inflammatory factors were lower in the study group than those in the control group. In addition, the rate of nursing satisfaction and good prognosis in the study group was significantly higher than those in the control group, and the incidence of adverse events was significantly lower than that in the control group. These results indicated that nursing based on the Kano model in patients with emergency multiple injuries can reduce the body inflammatory reaction, reduce the risk of adverse events, improve the prognosis of patients, and obtain high patient satisfaction.