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Objective:To investigate the value of nomogram predictive model established by the risk factors of upper extremity venous thrombosis risk associated with peripherally venous inserted central catheter (PICC) in cancer patients.Methods:A total of 1 032 patients who underwent PICC insertion between January 2016 and March 2017 in Zhejiang Cancer Hospital were selected by using prospective cohort study and convenience sampling. Risk factors of upper extremity venous thrombosis risk associated with PICC in cancer patients were evaluated by using Cox regression model. The nomogram predictive model of upper extremity venous thrombosis risk associated with PICC insertion was constructed. Bootstrap method was used to complete the inside check, and figure calibration was used to verify the nomogram.Results:A multivariate Cox regression analysis showed that trombosis history ( HR = 27.82, 95% CI 8.17-94.88, P < 0.01) and hyperlipidemia ( HR = 3.01, 95% CI 1.31-6.93, P = 0.009) were independent risk factors for upper extremity venous thrombosis associated with PICC. The nomogram model C-index was 0.71 (95% CI 0.63-0.80) based on the above risk factors, which indicated that the nomogram had a good differentiation. The calibration curve for predicting the probability of upper extremity venous thrombosis risk associated with PICC within one week, two weeks and one month deviated slightly from the standard curve, suggesting that the model might overestimate the risk of upper extremity venous thrombosis associated with PICC in cancer patients. Conclusions:The nomogram model has a good predictive value and strong operability, which can be used to predict the probability of upper extremity venous thrombosis associated with PICC in cancer patients after PICC insertion. It can provide a reference for identifying the high-risk cancer patients and formulating proper therapeutic strategies.
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Objective To understand the application of Nursing Information Management Software to provide reference for Nursing Information Construction of our country. Methods A self-designed questionnaire was employed and according to stratified sampling principle, 334 nursing managers were enrolled in this study to investigate the awareness of nursing managers on the traditional nursing management model and the application of nursing management software. Results Nearly 96.41％(322/334) of nursing managers believed that the introduction of nursing management software is very necessary, 94.90％(317/334) of managers believed that the use of nursing management software could improve work efficiency in different degrees, and 98.09％(328/334) of nursing managers gave the management software good evaluation. But because of the software features, cost-effective and hospital attention and other reasons, only 52.99％(177/334) of the managers applied the software. Conclusions The use of nursing management software is the only way to develop the nursing work, but its function needs to be further improved, the software also needs to further promote the application.
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@#Objective To observe the effect of the expanding training orthosis on webbed-finger adhesion post burn. Methods From May, 2014 to April, 2016, 37 hands of 33 patients with webbed-finger adhesion post burn were divided into two groups. 21 hands from 18 patients were as experimental group, 16 hands from 15 patients were as control group. The control group accepted routine care, while the experimental group accepted the expanding training orthosis in addition. Their angles between the fingers were measured six months after treatment. Results The angles between the fingers increased in the experimental group after treatment (t>3.060, P<0.01), and were more than those of the control group (t>2.273, P<0.05). Conclusion Application of expanding training orthosis can improve the compliance of the patients with webbed-finger adhesion post burn, and promote hand function recovery.
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Objective To evaluate the effect of acupointhot compress with warming moxibustion bag on treating radiation proctitis caused by radiotherapy in cervical cancer. Methods 78 patients of cervical cancer with acute radioactive proctitis caused by radiotherapy were divided into two groups according to the length of hospital stays. The experiment group was given compress Tianshu acupoint with warm moxibustion bag every day, along with drug and retention enema, while the control group was treated with drug and retention enema only. Then observe and evaluate the effect of different treatment on each group. Results The total effective rate of treating radiation proctitis in experimental group was 94.44%(34/36) which was superior to 76.19% (32/42) of the control group (χ2=4.962, P<0.05). The influence of tumor radiotherapy in experimental group was also superior to the control group, nine patients were forced to suspend to radiotherapy by (6.11 ± 1.96) days in the control group, while five cases were suspended to radiotherapy by (2.20±1.09) days in the experiment group (t=4.066,P<0.05). Conclusions Acupoint hot compress with warming moxibustion bag combine with retention enema have an advantage over retention enema only on radiation proctitis caused by radiotherapy in cervical cancer.
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Objective To investigate Monilia infection and adverse pregnancy outcomes of pregnant women in labor.Methods Before informed consent,542 cases of pregnant women in labor were collected in Obstetrics Department of Maternity and Child Healthcare of Maoming City from January 2013 to April 2014,and all of these cases were examined by Monilia inspec-tion of vaginal secretions.All of these cases were 20 to 30 years old,without vaginal pathogenic infection symptoms,but in-cluded in a few of formulation of clinical features of vaginal Candida infection.With the two methods of 10% potassium hy-droxide solution wet sheet and Gram staining,if blastospore or pseudohypha of Candida mycoderma were found out in the two methods under microscope,this case was diagnosed as positive result,otherwise as negative result.Respectively choosing positive cases as observation group,and negative cases as control group,the indexes of premature rupture of membranes,per-ineum wound infection,neonatal thrush and neonatal diaper rash of the two groups were recorded.The statistical method:e-numeration data by chi-square test,measurement data using analysis of varianc.Results The positive rate of Monilia was 23.1% (125/542),higher than 19.3% reported in domestic.The incidence rates of neonatal diaper rash,premature rupture of membranes,neonatal thrush and perineum wound infection of the observation group were respectively 19.2%,8.0%, 16.8% and 12.8%,all much higher than the control group respectively was 8.4%,1.2%,3.8% and 1.7%,(χ2 =12.578~29.273,all P <0.01).Conclusion Monilia infection of pregnant women in labor could increase the chance of adverse preg-nancy outcomes.Healthy or clinical doctors should suggest that pregnant women early carry out routine examination and ear-ly treatment,in order to prevent adverse pregnancy outcomes.
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Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.
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Objective To investigate the development and prognosis of peroxisome proliferator-activated recepor-γ(PPAR-γ) and cyclooxygenase-2(COX-2) in endometrial carcinoma. Methods The electron microscopic immunohistochemical technique was used to observe the ultrastructure location of COX-2 protein labeled by colloidal gold in the endometrial carcinoma. Results 1.There were negative immunohistochemical staining signals of PPAR-γ in both the normal endometrium and hyperplasia endometrium, whereas, was positive staining in the endometrial carcinoma;2.The intensities of the COX-2 immunohistochemical staining were significantly statistical difference among the normal endometrium, the hyperplasia endometriu and the endometrial carcinoma(P<0.01);3. The COX-2 labelled by colloidal gold granules was observed in the endoplasmic reticulum, nuclear membrane and nuclei in the endometrial carcinoma. Conclusion Both PPAR-γ and the COX-2 might play an important role in the development of the endometrial carcinoma.
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Objective To study the effect of pine root liquid on the fermentation Poria mycelia yield and content of water-soluble polysaccharide, and difference between fermentation Poria mycelium and the natural Poria. Methods Poria mycelia was cultured with pine root solution and non-fermented liquid, the production of water-soluble polysaccharide content was compared. The content of water-soluble polysaccharide of fermentation mycelia and natural Poria was also compared. Results The production of fermentation Poria mycelia cultured with pine root liquid increased slightly, but water-soluble polysaccharide content decreased. Water-soluble polysaccharide content in Poria mycelia was significantly higher than that in natural Poria. Conclusion Pine root solution has different effect on fermentation Poria mycelia yield and polysaccharide content. Water-soluble polysaccharide content in Poria fermentation mycelia was higher than natural Poria.
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BACKGROUND: Femoral head necrosis can be induced in adult rabbits when a large dose of steroid has been used for a long time. However, the pathogenesis of steroid-induced femoral head necrosis needs further study.OBJECTIVE: To probe into the mechanism of the disease by light microscope and transmission microscope from morphological perspective based on the model of femoral head necrosis in rabbits.DESIGN: A randomized controlled observation.SETTING: Laboratory of Morphology; Teaching and Research Division of Pathology; Laboratory of Surgery, Weifang Medical College.MATERIALS: The experiment was carried out at the Experimental Center of Morphology, Weifang Medical College, between March 2002 and March 2003. Totally 40 adult New Zealand white rabbits were randomly divided into control group (n=10), dexamethasone group (n=10) and horse serum group (n=20).METHODS: Control group was given intravenous injection of normal saline of 10 mL/(kg·d) for 7 consecutive days. Dexamethasone group was given intramuscular injection of dexamethasone of 10 mL/(kg ·d)for 7consecutive days. Horse serum group was given intravenous administration of horse serum of 10 mL/kg; 3 weeks later the same volume of horse serum was injected once again, followed intramuscular injection of dexamethasone of 10 mL/(kg·d)for 7 consecutive days. Inferior sections of cartilage of the femoral head necrosis in the experimental animals were obtained 5 and 10weeks later, and then histological and ultrastructural changes were observed under the light microscope and transmission microscope.MAIN OUTCOME MEASURES: ① Histo-morphological observation of the animals in each group. ② Ultrastructural changes.RESULTS: All the experimental animals survived and entered the result analysis. ① Histo-morphological observation: The cells of inferior sections of cartilage of the femoral head necrosis of the experimental animals in control group were arranged regularly and had a small volume of elliptical bone cells. The cell body was located at bone lacuna, blood vessel arranged well in the medullary cavity of bone. Lesion haracteristics of femoral head in dexamethasone group and horse serum group were similar:Hematopoietic adipose in the medullary cavity of bone was significantly decreased while fat adipose obviously increased; bone trabecula of metaphysis and the inferior sections of cartilage of femoral head were found with ered, and so was the bone nucleus. The number of lacuna of bone was increased. ② Ultrastructural changes: Normal bone cells in control group were elliptical, located at bone lacuna. Nucleus was at one end of the cell with complete karyotheca and many mitochondria in the cytoplasm. In dexamethasone group and horse serum group there were lipid droplets in the osteocytes, narrowed blood capillary in the medullary cavity of bone and injured vascular endothelial cells.CONCLUSION: Corticotropin can induce necrosis of femoral head; the hormone causes accumulated fat adipose in the medullary cavity of bone.The increased internal pressure in the medullary cavity leads to ischemia of femoral head, thus inducing the necrosis of osteocytes.
