Effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy

BACKGROUND Patients with colorectal cancer may need postoperative nursing to improve prognosis,and conventional nursing is not effective.Clinical research is needed to explore nursing methods that can more effectively improve postoperative conditions on colorectal cancer patients undergoing colostomy.AIM To explore the effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy.METHODS Data from 187 patients with colostomy treated in our hospital from May 2019 to March 2022 were collected and divided into three groups,A(n=62),B(n=62)and C(n=63),according to different intervention methods.Group A received internet multiple linkage mode-based extended care combined with in-hospital comfort care.Group B received internet multiple linkage mode-based extended care.Group C received usual care intervention.Complications were compared among the three groups.The stoma self-efficacy scale,Hamilton Anxiety Scale,RESULTS The complication rate of group A,B and C(16.13%,20.97%and 60.32%,respectively)was significantly different(all P<0.05).The incidence of complications in groups A and B was lower than that in group C,and there was no significant difference between groups A and B(P>0.05).After intervention,the scores of ostomy care,social contact,diet choice,confidence in maintaining vitality,confidence in self-care of ostomy,confidence in sexual life,confidence in sexual satisfaction and confidence in physical labor in the three groups were all higher than before intervention,and the scores of groups A and B were higher than those of group C,with statistical significance(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Scale scores of the three groups after intervention were lower than those before intervention.The scores of groups A and B were lower than those of group C,and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).There was a statist-ically significant difference in cancer-induced fatigue among the three groups(P<0.05).After intervention,the scores of physical health,psychological health,social health and mental health of the three groups were lower than before the intervention.The scores of group A and B were lower than that of group C;and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).CONCLUSION Internet multiple linkage mode-based extended care combined with in-hospital comfort care can effectively improve self-efficacy,bad mood,cancer-related fatigue and life quality of colorectal cancer patients undergoing colostomy.

Psychological preparation practices for children undergoing medical procedures in Japan and Germany

The present study aimed to clarify the current status and awareness of psychological preparation for children undergoing medical procedures in pediatric nursing in Japan as compared with that in Germany. An original questionnaire about the current status and awareness of psychological preparation for children in hospitals was distributed by mail to nurses’ working on Japanese pediatric wards in 2010. The same questionnaire, translated into German, was distributed to nurses working on German pediatric wards via the internet in 2010. A large majority of respondents strongly agreed that children have a right to informed consent. German nurses expressed a longer-term viewpoint on the effects of preparation than Japanese nurses. Japanese nurses recognized a greater need for improvement in their duties than German nurses. The results suggest that we should consider our own country’s nursing practices and need for improvement, but also learn from studies of other countries to address each culture and medical situation appropriately.

Tumor cells undergoing direct lineage conversion to neurons: unnatural but useful?

Dear Editor, In 2011, Son et al. （2011） reported that the forced expression of selected transcription factors is sufficient to convert mouse and human fibroblasts into induced motor neurons （iMNs）. The authors used three factors （Ascll, Brn2, and Mytll） to convert fibroblasts into neuronal-like ceils. After confirming that the cells had neuronal morphology, but with absence of motor neuron markers, eight candidate transcription factors were added, which participate in various stages of motor neuron specification. As expected, a significant number of motor cells emerged with known characteristics of cultured embryonic motor neurons.

Impact of early intensive rehabilitation care in patients undergoing cardiac surgery in a single center:a quasi-experimental study

Objective To evaluate the impact of early intensive rehabilitation care in adults undergoing cardiac surgery.Methods This was a quasi-experimental study using assessor blinding in 252 cardiac surgery patients recruited from Fuwai Hospital.Participants awaiting cardiac surgery were divided into the experiment group and the control group.The control group received routine rehabilitation care postoperatively,including the exercise training,deep breathing exercises,nutrition direction,medication instruction,psychological education,pain management and sleep conditioning.

The psychological trajectory from diagnosis to approaching end of life in patients undergoing hemodialysis in China: A qualitative study

Background: In China,the number of patients diagnosed with end-stage renal disease has increased rapidly in recent years.Patients undergoing dialysis treatment often experience psychosocial challenges,such as death anxiety,which may potentially cause patients to withdraw from treatment.Nephrology nurses and other practitioners who provide direct care to patients undergoing hemodialysis must understand how these challenges are perceived by patients and affect their daily lives.Aim: This article investigated the psychological trajectory and life experiences of hemodialysis patients to provide complementary guidance for nurses and healthcare practitioners.Method: This study utilized a qualitative descriptive phenomenological design.Data were collected by conducting semistructured interviews and analyzed by content analysis.Data were collected through indepth interviews from May to December 2014.The questions were designed to reveal the life experiences and perspectives of hemodialysis patients.Participants were selected by convenience sampling approach and recruited from outpatients receiving treatment in a blood-purification center in Jiangsu Province,China.Results: Twenty-three participants were recruited.Three stages were extracted from the interview data:(1) afraid stage,(2) adapted stage,and (3) depression stage.Accordingly,three corresponding stages of physiological status were identified: (1) induced stage,(2) stable stage,and (3) severe complications or approaching-end-of-life stage.Conclusions: Patients undergoing dialysis exhibited differing psychological statuses at different physical stages.Thus,nurses must assess the psychophysiological symptoms of patients and design individual care plans for each stage.Future studies should focus on developing stage-specific nursing-care protocols.

Safety and efficacy of trimodality therapy in patients undergoing extrapleural pneumonectomy

Malignant pleural mesothelioma （MPM） is a rare but rapidly deadly disease （1）. Macroscopic complete resection （MCR） is the goal of surgery （2）. MCR seems to have the most significant impact on survival in patients undergoing multimodality treatment for MPM. The role of surgical resection in the management of MPM remains controversial. The selection criterion to perform either extrapleural pneumonectomy （EPP） or extended/radical pleurectomy/ decortication （PD） rely not only on the cardio-pulmonary status of the patient, tumor stage and intraoperative findings but is strongly dependent also on surgeons＇ decision and philosophy. This is reflected by a recent survey of opinions and beliefs among 802 thoracic surgeons, in which EPP was believed to be more effective than PD （3）. Nonetheless, either surgery might achieve MCR.

BEIJING, TIANJIN AND HEBEI UNDERGO COMPREHENSIVE INTEGRATION

Three years have elapsed since the synergetic development of the Beijing-Tianjin-Hebei(Jing-Jin-Ji)region was first put forward as a major national strategy by Chinese President Xi Jinping in February 2014.Xi called for the coordination and integration of the economic zone surrounding Beijing.Now,a fledging Capital Economic Circle is taking shape.

Effect of lavender aromatherapy on pruritus, anxiety, and sleep quality of patients undergoing hemodialysis: a randomized controlled trial

Background:Patie nts un dergo ing hemodialysis experie nces some symptoms.Pruritus,an xiety,and sleep quality are three of the most com mon symptoms.Eve n though some pharmacological treatme nts use to cope with these symptoms,they are still experie need by the patie nts at a high level.Aim:This study aimed to determine the effect of lavender oil aromatherapy on pruritus,anxiety,and sleep quality of patients undergoing hemodialysis.Method:This randomized con trolled study was carried out betwee n December 2019 and March 2020.Eighty of 895 eligible patients were included in the study.Aromatherapy inhalation and massage together applied to the patients for six weeks.5D-Itch Scale,State Anxiety Inventory(SAI),and Richard Campbell Sleep Questio nn aire(RCSQ)were used for data collecti on.IBM SPSS 25.0 were used for statistical an alysis.Mann-Whit ney U,Wilcox on sig ned-ra nks test,and repeated measures-ANOVA tests were used to compare the difference between the groups and simple regression analysis to investigate the relationship between the dependent and independent variables.Results:Most of the patients were male(57.5%)and aged between 41 and 55 years(52.5%).There was significant difference in the mean scores of SAI(Pretest:44.02±5.33,Post-test:35.40±4.52,P=0.003),5D-Itch scale(Pretest:9.80±2.04,Post-test:7.00±2.31,P=0.001),and RCSQ(Pretest:17.11±40.30,Post-test:58.55±33.74,P=0.002)with in time in the in terve ntio n group.There was a statistically significant differenee between the groups regarding the mean scores of SAI(Intervention:35.40±4.52,Control:46.84±4.62,P=0.003),5D-Itch scale(Intervention:7.00±2.31,Control:8.96±2.05,P=0.004),and RCSQ(Intervention:58.55±33.74,Control:19.93±28.36,P=0.001)after the intervention.Conclusion:After six-weeks intervention,lavender aromatherapy was found an effective way to reduce pruritus,anxiety and to improve the sleep quality of patients undergoing hemodialysis.

Predictive risk factors for prolonged stay in intensive care unit in patients undergoing coronary artery bypass grafting surgery

Objective To describe the preoperative factors of prolonged intensive care unit length of stay after coronary artery bypass grafting. Methods From 1997 to 2009, 1318 patients underwent isolated CABG in our hospital. Retrospective analysis was performed on these cases. Univariate and multivariate analyses

Chang'e 5 Undergoing Thermal Test

Chang’e 5 probe has entered its critical phase of AIT.Units,except the lander,are undergoing thermal test.The flight model of Chang’e 5 is composed of an orbiter,a return capsule,a lander and an ascent unit.The thermal tests on the ascent unit,the lander-as-

The Second Pit of Qinshihnang's Terra-cotta Army Undergoes Excavation

ＴｈｅＳｅｃｏｎｄＰｉｔｏｆＱｉｎｓｈｉｈｎａｎｇ＇ｓＴｅｒｒａ－ｃｏｔｔａＡｒｍｙＵｎｄｅｒｇｏｅｓＥｘｃａｖａｔｉｏｎＢｙｓｔａｆｆｒｅｐｏｒｔｅｒＣＨＥＮＪＩＡＮＩｎｗｈａｔｓｅｅｍｓｔｏｈａｖｅｂｅｅｎａｒａｔｈｅｒｍｅｇａｌｏｍａｎｉａｃａ...

Predictive risk factors associated with prolonged stay in the intensive care unit for patients undergoing coronary artery bypass grafting surgery

Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit (ICU) after coronary artery bypass graft surgery (CABG) . Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital

The clinical study of preoperative external lumbar drainage in patients with aneurysmal subarachnoid hemorrhage in Hunt and Hess grades Ⅰ～Ⅲ undergoing early surgery

Objective To explore the therapeutic effect of preoperative external lumbar drainage in Hunt and Hess grade Ⅰ～Ⅲ patients with subarachnoid hemorrhage (SAH) undergoing early surgery for intracranial aneurysms. Methods 101 cases of gradeⅠ～Ⅲ patients according to the classification of Hunt and Hess

预后营养指数与尿素/肌酐比值在食管癌放化疗患者营养状态评估中的应用

目的探讨预后营养指数与尿素/肌酐比值在食管癌放化疗患者营养状态评估中的应用价值研究。方法筛选接受放化疗的食管癌患者138例,采用NRS 2002营养筛查为标准,应用患者客观指标的预后营养指数(PNI)及尿素/肌酐比值(UCR)对食管癌放化疗患者营养不良进行评价,分析两种客观性营养筛查工具与各营养指标的相关性,采用ROC曲线评估比较不同营养筛查工具的诊断效能。结果食管癌放化疗患者的生化指标和血液学指标呈现一定特征,其中尿素、肌酐、UCR、白蛋白(ALB)、前白蛋白(PALB)、总蛋白(TP)、TC、TG、HDL和LDL水平均在正常范围内波动。在营养风险筛查方面,NRS 2002评分识别出57.97%的患者存在营养风险,而PNI和UCR预测存在营养风险的患者比例分别为31.16%和40.58%。一致性检验显示,PNI与NRS 2002评分的Kappa值为0.460(P<0.05),UCR与NRS 2002评分的Kappa值为0.522(P<0.05),表明两者与NRS 2002评分在营养风险筛查上具有一定的相关性。相关性分析表明,NRS 2002评分与UCR、ALB、PALB、PBL、Cr、HDL、TP存在显著相关性(P<0.05),PNI与ALB、PALB、PBL、肌酐(Cr)、HDL、TP、尿素(UREA)存在显著相关性(P<0.05),UCR与PALB、UREA、Cr存在显著相关性(P<0.05)。Logistic单因素回归分析进一步证实了这些相关性,并揭示了营养不良与ALB、PALB、TP、淋巴细胞、Cr、BMI指标成负相关,与UREA呈正相关。然而,多因素回归分析未发现这些相关因素与两种客观评价指标之间存在统计学差异。诊断效能评价结果显示,PNI和UCR评估预测放化疗食管癌营养不良的ROC曲线下面积分别为0.779和0.736,差异有统计学意义(P<0.001)。其中,UCR显示出较高的灵敏度,而PNI表现出较高的特异度,但两者在诊断价值上无显著差异。结论PNI和UCR作为营养评估工具在食管癌放化疗患者的营养风险筛查中具有一定的应用价值,但两者与NRS 2002评分在一致性方面有待提高。在评估患者营养状况时,应结合多种指标和方法,以获得更准确的诊断结果。

优化护理理念在肾癌根治术患者围术期治疗中的应用及满意度分析

目的探究肾癌根治术患者围术期治疗中,采用优化护理理念的效果。方法随机选取2021年1月—2022年12月吉林省肿瘤医院接诊的100例肾癌根治术患者为研究对象,以随机数表法分为对照组(常规护理干预)和研究组(优化护理理念干预),每组50例,分析两组患者生活质量评分、疼痛评分、遵医行为、情绪评分和满意度。结果研究组患者生活质量评分高于对照组,差异有统计学意义(P<0.05)。研究组患者疼痛评分低于对照组,差异有统计学意义(P<0.05)。研究组患者遵医行为优于对照组,差异有统计学意义(P<0.05)。研究组患者情绪评分比对照组低,差异有统计学意义(P<0.05)。研究组的护理服务满意度(98.00%)高于对照组(86.00%),差异有统计学意义(χ^(2)=4.891,P<0.05)。结论以优化护理理念干预肾癌根治术患者的效果优异,能提高围术期治疗效果,减少不良并发症发生,提高患者生活质量,满意度等和缓解患者肢体疼痛。

布比卡因脂质体与盐酸布比卡因局部麻醉对老年胸骨正中切口心脏手术患者术后镇痛效果的比较

目的比较布比卡因脂质体(LB)与盐酸布比卡因(BH)局部麻醉在老年胸骨正中切口心脏手术患者中的术后镇痛效果。方法选取2023年9—12月周口市中心医院收治106例老年胸骨正中切口心脏手术患者,随机分为BH组和LB组,各53例。BH组术后切口局部注射BH并使用自控静脉镇痛(PCIA),LB组切口局部注射LB并使用PCIA。术后6、12、24、48、72 h,比较两组患者视觉模拟疼痛评分(VAS)、Ramsay镇静评分、血清疼痛介质[5-羟色胺、P物质、前列腺素E_(2)(PGE_(2))、β内啡肽(β-EP)]、应激激素水平[皮质醇、去甲肾上腺素(NE)]。比较两组术后镇痛药物使用情况、住院时间及不良反应。结果LB组术后24、48、72 h静息及活动状态下VAS评分低于BH组(P<0.05)。LB组术后6、12、24、48、72 h血清5-羟色胺、P物质、PGE_(2)、皮质醇、NE水平低于BH组,β-EP水平高于BH组(P<0.05)。LB组术后首次使用镇痛药物时间长于BH组,术后72 h内阿片类药总用量少于BH组(P<0.05)。LB组与BH组住院时间差异无统计学意义(P>0.05)。LB组不良反应发生率与BH组差异无统计学意义(P>0.05)。结论切口局部注射LB应用于老年开胸手术患者术后镇痛效果显著,能减轻机体应激反应与疼痛介质水平,且对镇静程度无影响,安全性较好。

剖宫产术后6h产妇下床活动对产后康复的影响

目的探讨剖宫产术后6 h产妇下床活动对产后康复的影响。方法选择厦门大学附属第一医院2022年1—12月收治的100例剖宫产产妇,以剖宫产术后首次下床活动时间的不同将其分为50例观察组和50例对照组。对照组产妇于产后24 h后协助下床活动,观察组患者则在术后6 h开始分阶段协助下床活动。比较2组产妇胃肠恢复时间、排气时间、拔尿管时间、泌乳始动时间等恢复时间指标,产妇产后24 h的视觉模拟评分(visual analogue scale,VAS),子宫复旧情况、产妇乳汁分泌量以及产后5 d母乳喂养率,产妇发生产后出血和深静脉血栓的并发症以及对术后恢复效果的满意度。结果观察组产妇胃肠恢复时间、排气时间、拔尿管时间和泌乳始动时间均短于对照组产妇(P<0.05)。其产后24 h VAS评分为(1.49±0.58)分,低于对照组的(2.45±0.83)分(P<0.05)。观察组产妇24 h宫底高度低于对照组,乳汁分泌量优于对照组(P<0.05)。观察组5 d母乳喂养率达到92.00%,高于对照组的50.00%(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。观察组产妇对产后恢复的满意度高达100%,高于对照组的78.00%(P<0.05)。结论剖宫产术后6 h产妇下床活动对其产后康复有积极意义,可缩短恢复时间,减轻疼痛感,促进子宫复旧和乳汁的分泌,降低并发症发生率,提高产妇满意度。

教育“双减”政策下义务教育阶段学生公共数字文化服务可及性测度

探究“双减”政策颁布后公共文化服务机构能否适应义务教育阶段学生需求转变,公共数字文化服务供给与义务教育阶段学生需求是否达到“适配”标准。结合公共数字文化服务可及性的相关研究,文章基于义务教育阶段学生视角提出可及性五维测度体系。以问卷调研的数据为基础,采用优序图法和CRITIC法组合赋权各级指标,计算出公共数字文化服务可及性的最终得分为3.661。通过对公共数字文化服务可及性各级得分与权重进一步分析解读,发现可知晓性与可适应性评分总体偏低、服务人员数量和素质不足的问题贯穿始终,提出宣传进校园、丰富志愿团队、减少技术性障碍、建立对话平台、加强人员培训的建议,为提升义务教育阶段学生公共数字文化服务可及性提供参考。

基于4C模式的延续性护理在食管癌根治术后患者中的应用效果

目的:观察基于4C模式的延续性护理在食管癌根治术后患者中的应用效果。方法:选取2020年1月至2022年8月该院收治的80例食管癌根治术患者进行前瞻性研究,根据随机数字表法将其分为对照组和观察组各40例。对照组予以常规护理,观察组在对照组基础上予以基于4C模式的延续性护理。比较两组护理前后自我效能感[癌症自我管理效能感量表(SUPPH)]评分、生命质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]评分和术后并发症发生率。结果:护理后,两组正性态度、自我减压、自我决策等SUPPH评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组躯体功能、角色功能、情绪功能、认知功能、社会功能、整体生命质量等EORTC QLQ-C30评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(P<0.05)。结论:在常规护理基础上予以基于4C模式的延续性护理可提高食管癌根治术后患者自我效能感、生命质量评分,降低术后并发症发生率,其效果优于单纯常规护理。

骨密度测量仪评估老年人骨密度与参数的关系

目的:探讨骨密度测量仪评估老年人群骨密度与相关参数的关系。方法:选取2019年3月~2021年3月收治的老年髋部骨折患者100例作为骨折组,老年体检者100例作为对照组。探讨骨密度测量仪评估老年人群骨密度与相关参数的关系。结果:骨折组患者在颈骨颈、股骨转子间、腰椎、Ward’s区及腰椎部位的骨密度、FNCT及FNCT/FNW均低于对照组,FMCW值高于对照组,骨质疏松组腰椎BMD与25-(OH)D3呈正相关,与Total-P1NP、β-CTX、N-MID等骨代谢志物呈负相关。结论:通过监测骨代谢指标水平有利于辅助临床早期诊断骨质疏松症。