For the sake of understanding the deterioration behavior of concrete in actual railway tunnel structures subjected to aggressive sulfate medium in practice,detailed field investigations and tested analysis on sprayed ...For the sake of understanding the deterioration behavior of concrete in actual railway tunnel structures subjected to aggressive sulfate medium in practice,detailed field investigations and tested analysis on sprayed concrete linings of approximately 40-year-old railway tunnels in environments containing sulfate ion were carried out,respectively.The results show that the deterioration of concretes in the investigated area is serious,which involves complicated physicochemical process between the sulfate salt and concrete.Among them,the secondary sulfateminerals such as gypsum formation under very high concentration sulfate ion condition by accumulating and evaporation process dominate,followed by the crystallization of sulfate salt and formation of thaumasite.展开更多
Objective This study aimed to adapt relevant clinical practice guidelines for distress management in cancer patients based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT),and develop Canc...Objective This study aimed to adapt relevant clinical practice guidelines for distress management in cancer patients based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT),and develop Cancer-related Distress Management Guidelines in the context of the research site.Methods According to CAN-IMPLEMENT,the symptoms of cancer patients in Shanghai were investigated,and a work plan was formulated to adapt cancer-related distress management guidelines.The relevant clinical practice guidelines for distress management in cancer patients were searched,screened and assessed,the contents of the included clinical practice guidelines were screened,extracted and integrated,and the Cancer-related Distress Management Guidelines was developed.After peer review,the Cancer-related Distress Management Guidelines was finally formed.Results The physical symptom distress score was higher than the psychological symptom distress score among cancer patients in Shanghai.Two clinical practice guidelines related to distress management in cancer patients were included after searching,screening,assessment and selection systematically.The domain scores of the draft Cancer-related Distress Management Guidelines on Appraisal of Guidelines for Research and Evaluation II(AGREE II)were 73.75%–87.50%,respectively.The scores of most recommendations on feasibility,appropriateness,meaningfulness and effectiveness were at least 90%.The final guidelines included 13 recommendations.Conclusions The quality of the draft Cancer-related Distress Management Guidelines based on two included guidelines was well-accepted.The final Cancer-related Distress Management Guidelines needs to be further verified in clinical practice for feasibility,suitability and effectiveness.展开更多
Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer pa...Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT).Methods:Based on the theoretical framework of CAN-IMPLEMENT,A multidisciplinary team was established,barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed,corresponding solutions were formulated,the guidelines implementation process was monitored,and implementation results were evaluated.Results:The multidisciplinary team developed review criteria,standardized work paths,assessment tools,training manuals for healthcare professionals,education manuals for patients and their caregivers.After guidelines implementation,the completion rate of the distress management record came up to 97.9%(189/193).From September 2017 to December 2018,the compliance of medical staff on most items in the audit checklist was improved,ranging from 57.1%(100/175)to 100.0%(193/193).The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7%(32/141)to 9.3%(18/193)(P<0.05),and the Median(range)of the distress score declined from 2(0e9)to 0(0e7)(P<0.001).Conclusions:The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units.The review standards,standardized work paths,and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness.Quality control in the practice of distress management was effective.The compliance of healthcare professionals with distress management was improved.The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.展开更多
We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor...We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor.Same side lung biopsy and histopathological study characterized tuberculosis but biopsy of the left lung lesion identified adenocarcinoma of the lung.The final diagnosis was right scapular metastatic lesion from left lung adenocarcinoma.Musculoskeletal symptoms are commonly encountered in lung malignancies due to paraneoplastic syndrome or hematogenous metastasis but scapular metastasis on the other side as the presentation of lung cancer is extremely rare.展开更多
基金Project(2008G025-C) supported by the Ministry of Railway of ChinaProject(50708114) supported by the National Natural Science Foundation of China
文摘For the sake of understanding the deterioration behavior of concrete in actual railway tunnel structures subjected to aggressive sulfate medium in practice,detailed field investigations and tested analysis on sprayed concrete linings of approximately 40-year-old railway tunnels in environments containing sulfate ion were carried out,respectively.The results show that the deterioration of concretes in the investigated area is serious,which involves complicated physicochemical process between the sulfate salt and concrete.Among them,the secondary sulfateminerals such as gypsum formation under very high concentration sulfate ion condition by accumulating and evaporation process dominate,followed by the crystallization of sulfate salt and formation of thaumasite.
文摘Objective This study aimed to adapt relevant clinical practice guidelines for distress management in cancer patients based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT),and develop Cancer-related Distress Management Guidelines in the context of the research site.Methods According to CAN-IMPLEMENT,the symptoms of cancer patients in Shanghai were investigated,and a work plan was formulated to adapt cancer-related distress management guidelines.The relevant clinical practice guidelines for distress management in cancer patients were searched,screened and assessed,the contents of the included clinical practice guidelines were screened,extracted and integrated,and the Cancer-related Distress Management Guidelines was developed.After peer review,the Cancer-related Distress Management Guidelines was finally formed.Results The physical symptom distress score was higher than the psychological symptom distress score among cancer patients in Shanghai.Two clinical practice guidelines related to distress management in cancer patients were included after searching,screening,assessment and selection systematically.The domain scores of the draft Cancer-related Distress Management Guidelines on Appraisal of Guidelines for Research and Evaluation II(AGREE II)were 73.75%–87.50%,respectively.The scores of most recommendations on feasibility,appropriateness,meaningfulness and effectiveness were at least 90%.The final guidelines included 13 recommendations.Conclusions The quality of the draft Cancer-related Distress Management Guidelines based on two included guidelines was well-accepted.The final Cancer-related Distress Management Guidelines needs to be further verified in clinical practice for feasibility,suitability and effectiveness.
基金funded by Fudan-Fuxing Nursing Research Funds(No.FNF201701)JBI Evidence Based Clinical Fellowship Pro-gram Funds(No.FNF201861)from Fudan University,China.
文摘Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT).Methods:Based on the theoretical framework of CAN-IMPLEMENT,A multidisciplinary team was established,barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed,corresponding solutions were formulated,the guidelines implementation process was monitored,and implementation results were evaluated.Results:The multidisciplinary team developed review criteria,standardized work paths,assessment tools,training manuals for healthcare professionals,education manuals for patients and their caregivers.After guidelines implementation,the completion rate of the distress management record came up to 97.9%(189/193).From September 2017 to December 2018,the compliance of medical staff on most items in the audit checklist was improved,ranging from 57.1%(100/175)to 100.0%(193/193).The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7%(32/141)to 9.3%(18/193)(P<0.05),and the Median(range)of the distress score declined from 2(0e9)to 0(0e7)(P<0.001).Conclusions:The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units.The review standards,standardized work paths,and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness.Quality control in the practice of distress management was effective.The compliance of healthcare professionals with distress management was improved.The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.
文摘We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor.Same side lung biopsy and histopathological study characterized tuberculosis but biopsy of the left lung lesion identified adenocarcinoma of the lung.The final diagnosis was right scapular metastatic lesion from left lung adenocarcinoma.Musculoskeletal symptoms are commonly encountered in lung malignancies due to paraneoplastic syndrome or hematogenous metastasis but scapular metastasis on the other side as the presentation of lung cancer is extremely rare.
