消化内镜诊疗患者回房交接中SBAR沟通模式的应用效果

分析消化内镜诊疗病人回房交接中SBAR沟通模式的运用效果。方法:选取2020年1月至2020年12月在我院接受消化内镜治疗的120例病人,随机将病人分为两组,参照组和研究组各60例,前者给予传统的交接模式,后者实施SBAR沟通模式,分析两组的护理满意度和交接完整率,观察比较结果。结果:研究组的交接完整率高于参照组,P<0.05,差异有统计学意义,研究组的护理满意度高于参照组,P<0.05,差异有统计学意义。结论:在接受消化内镜治疗后,在病人回房交接中运用SBAR沟通模式,效果更为明显,能够提升交接的完整率,值得推广。

细水雾灭火剂在商用厨房中的应用研究

商用厨房火灾的最主要原因是油锅的持续高温引发食用油自燃起火,食用油极易复燃的火灾行为大大增加了其扑救难度,通过实验表明,细水雾灭火剂极强的冷却作用能够有效扑救食用油火灾。

生活因房子而幸福

我憧憬着自己的房子里生活的幸福,因为有着对过去容纳过自己的那些房子的记忆和感念,我相信自己会过得很好。 在深圳生活,如果没有自己的房子,就没有真正安定的感觉。住在每月要付钱给人家的房子里。

我的房东

萧克瑾先生是我国教育界知名人士周世钊先生的高足,亦是张志新烈士的同学。基于以上原因和一个“出身”问题,文革中受到的冲击程度人们可以设想。萧先生已年过七十,现在为本刊读者回忆非常时期的亲身经历。一个系列,本刊将陆续推出。

珮格妈妈和她的孩子们(续)

十四、爱的艺术——大卫生病 星期一早饭后,珮格妈妈的外孙大卫突然皱起眉头、捂着肚子说不舒服。他用恳求的表情和语调问妈妈朱迪,是否可以让他留在家中不去上学。朱迪同意了。 午饭前,我和朱迪回到家中,看见大卫正在和珮格妈妈下棋。朱迪走过去想摸摸大卫的头,被大卫用手挡开了。骊格妈妈的眼睛没有离开棋盘,她用一种平静的声调说:“大卫说他已经好了,下午可以去上学了。”

教孩子接受"不公平"

女儿放学回来,一脸的委屈,问 她,什么也不说。吃过晚饭后,早 早就回房间去了。我洗涮好碗筷,就 走到电脑前,打开邮箱。我知道女 儿会给我写信,这是我们长期的习 惯,谁不开心了,就写封信给对方, 隔着屏幕,心比较容易敞开。

神奇的笔

"天啊!世界上怎么会有如此神奇的笔呢?"我刚进屋,瑞克就一惊一乍地对我说。前两秒钟我真被瑞克这句有趣的话吸引了,但剩下的时间我便不再相信什么威力无比的神奇的笔,我决定不再听瑞克的胡言乱语,打算回房休息。回到房间关上门不到1分钟,门竟然自己开了。我以为是风把门吹开了,便去关门。刚一用力推门,却传来一声尖叫"为什么夹我的手",这突如其来的叫声把我吓得魂飞魄散,一下子坐到了地板上。晚上,瑞克回来睡觉了,只见他左手搭在右手上,好像被什么东西夹到了似的。瑞克没说话,我也就没理他。第二天早晨,我做了一桌瑞克最爱吃的菜。

Influential Factors of House-purchasing Intention in Work construction Sites among Migrant Workers with a Case of Investigations on 203 Migrant Workers from Jiangxi Province

The research selected 13 factors from individual and family characters, construction site characters and work characters and analyzed the influences on the willingness of purchasing houses on construction sites with Logistic regression mod- el. The results showed that gender, age differences, personality, willingness on fami- ly land conversion, management of enterprises on construction sites, relatives and friends on construction lands, and Job satisfaction were approved by significant testing, but marital status, annual household income, the rate of migrant worker in a household, transportation in work city, and corporate reputation were not approved by significant testing.

Enterolactone modulates the ERK/NF-κB/Snail signaling pathway in triple-negative breast cancer cell line MDA-MB-231 to revert the TGF-β-induced epithelial–mesenchymal transition

Objective:Triple-negative breast cancer(TNBC)is highly metastatic,and there is an urgent unmet need to develop novel therapeutic strategies leading to the new drug discoveries against metastasis.The transforming growth factor-β(TGF-β)is known to promote the invasive and migratory potential of breast cancer cells through induction of epithelial–mesenchymal transition(EMT)via the ERK/NF-κB/Snail signaling pathway,leading to breast cancer metastasis.Targeting this pathway to revert the EMT would be an attractive,novel therapeutic strategy to halt breast cancer metastasis.Methods:Effects of enterolactone(EL)on the cell cycle and apoptosis were investigated using flow cytometry and a cleaved caspase-3 enzyme-linked immunosorbent assay(ELISA),respectively.Effects of TGF-βinduction and EL treatment on the functional malignancy of MDA-MB-231 breast cancer cells were investigated using migration and chemo-invasion assays.The effects of EL on EMT markers and the ERK/NF-κB/Snail signaling pathway after TGF-βinduction were studied using confocal microscopy,quantitative reverse transcription polymerase chain reaction(q RT-PCR),Western blot,and flow cytometry.Results:Herein,we report that EL exhibits a significant antimetastatic effect on MDA-MB-231 cells by almost reverting the TGF-β-induced EMT in vitro.EL downregulates the mesenchymal markers N-cadherin and vimentin,and upregulates the epithelial markers E-cadherin and occludin.It represses actin stress fiber formation via inhibition of mitogen-activated protein kinase p-38(MAPK-p38)and cluster of differentiation 44(CD44).EL also suppresses ERK-1/2,NF-κB,and Snail at the m RNA and protein levels.Conclusions:Briefly,EL was found to inhibit TGF-β-induced EMT by blocking the ERK/NF-κB/Snail signaling pathway,which is a promising target for breast cancer metastasis therapy.

Return on Investment after Implementation of a Centralized Automated Storage System in a Hospital Pharmacy

An ADS （automated dispensing system） was implemented in our hospital pharmacy in 2008 to optimize and secure the medication process. The main objective of this study was to compare the projected and the real ROI （return on investment）, after seven years of use. ROI was calculated annually （from 2008 to 2015）, by deducting the cost of investment （ADS buying and implementation, maintenance, repairs and ADS upgrade） from the cost saving （drugs stock reduction and decrease of pharmacy staff dedicated to global dispensing）. In 2015, total costs saving （＋$1,141,987） were divided between decreasing drug stock value and reduction of pharmacy staff. Total costs of investment （-$978,656） were acquisition, maintenance, repairs and an unplanned upgrade costs. Finally, the real ROI was ＋$163,331 after seven years of use. In 2008, projected ROI was ＋$410,786. The real payback period has been increased by approximately two years （six years of use, instead of four years as expected）. Despite their cost, ADSs are a worthwhile investment, leading to a ROI within a few years. These economic considerations should be put into perspective with optimization of drugs stock management, greater efficiency of the global dispensing process, securitization of medication process and redeployment of pharmacy staff.

Composite with Recyclable Loads for the Manufacture of Blocks to Build Popular Houses

The science space in a state school in Natal city was built using a composite consisting of gypsum, EPS （expanded polystyrene）, shredded tire, cement and water. Mechanical and thermal resistances were evaluated. Inside the blocks, three types of fillings （EPS plates, aluminum cans and 500 mL bottles of mineral water） were placed in order to obtain a walls with higher thermal resistance, but also to give it an ecologically correct order, considering that both the tire and the EPS occupy a large space in landfills and require years to be degraded when released into the environment. Compression tests were conducted according to the rules. The experiments demonstrated that the temperature difference between the internal and external surfaces on the walls reached levels above 12.0 ℃. It was also demonstrated that the proposed composite has adequate mechanical strength to be used for sealing walls. The proposed use of the composite can contribute to reduce the significant housing deficit of Brazil, producing popular houses at low cost and with little time to work.

Roadway layout for recycling residual coal pillar in room-and-pillar mining of thick coal seam

In the context of a room-and-pillar mining gob in Shanxi province in China,this paper numerically investigates the stress distribution and deformation rules of roadway surrounding rocks at various locations of residual coal pillars in room-and-pillar mining gobs using software FLAC3 D.It is found that the concentrated stress beneath coal pillars distributes in a shape of ellipse.A reasonable roadway layout is then proposed.In this design,it is indicated that roadways should be designed to avoid the supporting zones of pillars with increasing compression and take into account the roof falling and crushing in the upper gob.According to the surrounding rock deformation characteristics and mining roadway locations as well as the supporting principles of timely support,rock reinforcing,piecewise management and suiting local conditions,a new asymmetric shield supporting plan is proposed.The field surveying results show that this supporting plan can effectively control the roadway rock deformation,thus guarantee the safe and smooth construction of roadways.

Interest Rate, Unemployment Rate, and Housing Market in U.S.

The purpose of this paper is to investigate the relationships among the variables, and how interest rate, unemployment, stock market, and consumer confidence affect housing market index （HM1） in the U.S.. We construct vector autoregression （VAR） model with variables such as unemployment rate （UMR）, consumer confidence index （CCI）, the Dow Jones industrial index （DJI）, and interest rate, etc., to forecast the HMI. Our model and analysis show that U.S. HMI very sensitive to unemployment and interest rates. Every 1% moves in unemployment and interest rates will result in HMI to move in the opposite direction by 11.7% and 11.4% respectively. However, changes in CCI and stock mark index have only minor impacts on HMI--0.49% and 0.3%, changes for 1% fluctuation in CCI and DJI. Our research also shows that relationships among these variables associated with housing market are very stable in the long run.

Study of the relationship between average prices of residential properties and selected economic factors in the years 2000-2002 in Szczecin

The article presents the development unemployment and interest rates against the average of important economic variables such as GDP dynamics, transaction prices in one of the local property markets in Poland in the years 2000-2002. The strength, direction and time delay of the relationships between these variables and transaction prices have been considered during the only period of decline in property prices in the years 2000-2002. The specified relationships have been described using linear regression equations.

Recycling Plastics for Economical Housing

Abstract： The search for ＂new materials＂ to manufacture building elements for economical housing is the aim of this work. These materials are the following recycled plastics： Low-density polyethylene （LDPE）, recycled out of discarded soft drink packs： Polyethylene-terephthalate （PET）, recycled out of discarded soft drink bottles; and several plastics, from the printed films used like packages of candies （remainder of production plant by faults in the thickness of the films or in the inked process of themt. These conveniently grounded plastics were taken as ＂arids＂ to be mixed with Normal Portland cement, replacing heavy sand and gravel habitually used in these mixtures. These materials are used in constructive elements such as bricks, blocks and plates for economical houses closures or traditional construction. The developed constructive elements offer high thermal insulation, so they can be used in closures with a smaller thickness than conventional bricks and blocks. Besides, they have a lower specific weight than these traditiunal constructive elements. Recycling means lowering costs, making part of the environment contaminating waste useful and providing the unemployed and/or unqualified work force with jobs through uncomplicated technologies. Therefore, this recycling technology has an economic as well as an ecological purpose.

Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy

AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME.

家庭风波

令人窒息的寂静笼罩着这个家庭。堂罗克·兰达卢塞一面吃饭,一面不时地偷眼望望孩子们和他的妻子。气氛是严峻的,令人不能忍受。妻子终于难过地用手掩住了脸。儿子拉蒙见此情景,用询问的目光望了望两个妹妹。突然,母亲扯下餐巾站起身,神色严厉而激愤地回房去了。两个女儿也跟了去。 剩下父子二人面对面坐在那里。