护理管理者自我效能量表的汉化及信效度检验

目的旨在翻译护理管理者自我效能量表(Self-Efficacy Perception Scale of Administrator Nurses,SEPSAN),并对其进行信度和效度的检验。方法对英文版SEPSAN进行翻译,并通过横断面研究验证其信效度。采用Brislin翻译模型,包括直译、回译、整合、文化调适5个步骤,将英文版量表翻译为中文版。于2023年4—5月采用目的抽样法,选取中国5个城市20所综合性医院的382名护理管理者进行问卷调查。采用内容效度、结构效度和聚合效度评估量表的效度;采用Cronbach's α系数、重测信度评估量表的信度。结果中文版SEPSAN各条目内容效度指数(I-CVI)为0.86~1.00,平均内容效度指数(S-CVI/Ave)为0.98。探索性因子分析提取5个公因子,为计划、组织、指挥、协调、质量控制,共包括41个条目,累计方差贡献率为63.72%;验证性因子分析显示各项拟合指数表现较好。中文版量表的Cronbach's α系数为0.95,重测信度为0.87(P<0.05)。结论中文版SEPSAN具有良好的信效度,可作为评估我国护理管理者自我效能的评价工具。

Effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer

Objective:To investigate the effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer. Methods: From April 2016 to April 2017, 86 cases of elderly laparoscopic radical resection of colorectal cancer in our hospital were selected and randomly divided into the observation group and the control group. 2 groups of patients were open venous access, oxygen mask, monitoring heart rate (HR), blood pressure (BP), electrocardiogram (ECG), oxygen saturation (SpO2), bispectral index (BIS), after induction of anesthesia, the observation group was given dexmedetomidine 0.4 g/kg to 20 mL of normal saline control. Group of 20 mL saline, 15 min infusion is completed, and the observation group of dexmedetomidine in 0.4 g/kg - h continuous infusion of normal saline control group, continuous infusion, until the end of surgery. Before induction of anesthesia (T0), 2 h after operation beginning (T1), at the end of operation (T2), 24 h after operation (T3) in venous blood, using ELISA method for the determination of serum interleukin-2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (the level of TNF-alpha);on preoperative and postoperative 4 h, 12 h, 24 h after operation in venous blood serum epinephrine ELISA method (E), norepinephrine (NE), endothelin-1 (ET-1) level;on preoperative and postoperative 4 h, 12 h after surgery, 24 h venous blood flow cytometry determination of CD3+, CD4+, CD8+, CD4+/CD8+.Results:compared with before operation, the observation group after 4 h, 12 h, 24 h NE, and the lower control group E, NE and ET-1 increased, the observation group after 4 h, 12 h, 24 h E, NE, ET-1 lower than that of the control group;compared with T0, 2 patients in group T2, T3 sIL-2R, IL-6, TNF-alpha were increased, the observation group T2, T3 sIL-2R, IL-6, TNF- were lower than that of the control group;compared with the preoperative, 2 group after 4 h, 12 h, 24 h CD3+, CD4+, CD8+ and CD4+/CD8+ decreased, the observation group after 4 h, 12 h, 24 h CD3+, CD4+, CD8+, CD4+/CD8+ higher than those in the control group.Conclusion: Dexmedetomidine has a good analgesic effect on elderly patients undergoing laparoscopic radical resection of colorectal cancer. It can effectively relieve the stress reaction and inflammatory reaction during perioperative period, and effectively improve the immune function of the patients.

Effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery

Objective:To investigate the effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery. Methods: from June 2016 to June 2017 in our hospital for laparoscopic surgery of 120 cases of elderly patients, were randomly divided into A group, B group, C group, D group of 30 cases, all patients underwent intravenous inhalational anesthesia, A, B, C in three groups were given dexmedetomidine before induction of anesthesia. Fixed loading dose of 0.5 μg/kg, after intubation respectively with dexmedetomidine 0.2 μg/(kg.h), 0.5 μg/(kg.h), 0.8 μg/(kg.h) after continuous infusion to surgery, D group at the same time with the same volume of physiological saline. Before induction of anesthesia (T0), 24 h after operation (T1), 72 h after operation (T2) of venous blood interleukin-1 were measured beta (IL-1 beta), interleukin -2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and T lymphocyte subsets (CD3+, CD4+, D8+).Results: the T1 of the 4 groups of sIL-2R, IL-6, IL-1 beta, TNF-alpha and T0 levels were significantly higher than, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;group IL-1, sIL-2R, IL-6, TNF-beta and alpha level of T1 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference. T1 of the 4 groups of CD3+, CD4+, D8+, CD4+/CD8+ and T0 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;T2 D group CD3+, CD4+, D8+, CD4+/CD8+ lower than T1, and A group, B group, C group, CD3+, CD4+, D8+, CD4+/CD8+ higher than that of D group, B group, C group, CD3+ CD4+, D8+, CD4+/CD8+ higher than that of A group, B group, C group no significant difference.Conclusion: Dexmedetomidine can inhibit the inflammatory reaction and improve the immune function in elderly patients undergoing laparoscopic surgery, and the effect of middle and high dose is more significant.

Effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy

Objective:To investigate the effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy. Methods: A total of 70 cases of hypertensive patients undergoing painless gastroscopy from March 2016 to March 2017 were selected as the subjects. They were randomly divided into the observation group and the control group. The control group was injected with physiological saline before injection and injected with propofol 2 mg/kg. The observation group was injected with propofol 0.4 g/kg before injection, and 1 mg/kg by intravenous injection of propofol. 2 groups of patients before administration (T0), after administration (T1), gastroscopy (T2), gastroscope examination at the end of the 10 min (T3) collected venous blood, plasma epinephrine by radioimmunoassay (E), norepinephrine (NE), cortisol (COR) levels of T0 records;T1, T2, T3 at the time of breathing (HR), mean arterial pressure (MAP);after 5 min, 30 min, 3 h, 6 h was evaluated with mini mental state examination (MMSE) to evaluate the cognitive function in early stage.Results: 2 groups of patients with T1, NE, COR levels of plasma E and T0 no significant difference, T2, T3, NE, COR and plasma E levels higher than the T0 level, the observation group T2, T3, NE, plasma E COR levels lower than the control group, there was statistical significance the difference between the 2 groups;the control group T1 HR is slower than T0, MAP less than T0, T2, T3 HR faster than T0, MAP is higher than T0, and the observation group HR and MAP each time point did not change significantly between the 2 groups was statistically significant the difference;after 5 min and 30 min compared with the preoperative MMSE score decreased 1 D, 3 h after operation, the 6 h gradually increased, but the observation group after 3 h MMSE score higher than the control group, the difference was statistically significant.Conclusion: Dexmedetomidine combined with propofol can reduce the stress reaction of patients with hypertension during painless gastroscopy, and reduce the early understanding of the occurrence of dysfunction, which is worthy of clinical promotion.

Effect of endoscopic chemo-seed implantation combined with DC-CIK therapy on tumor malignancy in patients with obstructive esophageal cancer

Objective:To study the effect of endoscopic chemo-seed implantation combined with DC-CIK therapy on tumor malignancy in patients with obstructive esophageal cancer.Methods: Patients with advanced obstructive esophageal cancer who were treated in Wuhan Hankou Hospital between April 2014 and November 2017 were selected and randomly divided into two groups, the experimental group received endoscopic chemo-seed implantation combined with DC-CIK therapy and the control group received endoscopic chemo-seed implantation. The contents of serum tumor markers and peripheral blood immune cells were determined before treatment and 4 weeks after treatment;the expression levels of tumor suppressor genes in esophageal cancer lesions were measured 4 weeks after treatment.Results:CA199, SCCAg and CYFRA21-1 contents in serum of both groups after treatment were lower than those before treatment;Th1 content in peripheral blood of experimental group after treatment was higher than that before treatment whereas Th2, Treg and Th17 contents were lower than those before treatment;Th1, Th2, Treg and Th17 contents in peripheral blood of control group after treatment were not significantly different from those before treatment, and CA199, SCCAg and CYFRA21-1 contents in serum as well as Th2, Treg and Th17 contents in peripheral blood of experimental group after treatment were lower than those of control group whereas Th1 content in peripheral blood as well as ECRG4, Beclin1, PTEN and Spink8 mRNA expression was higher than those of control group.Conclusion: Endoscopic chemo-seed implantation combined with DC-CIK therapy can be more effective than seed implantation alone to reduce the tumor malignancy of obstructive esophageal cancer.

Effect of laparoscopic surgery combined with neoadjuvant chemotherapy on serum CEA, VEGF, CA724, CA242, LEP and T lymphocyte subsets in patients with low rectal cancer

Objective: To study the effect of laparoscopic surgery combined with neoadjuvant chemotherapy on serum CEA, VEGF, CA724, CA242, LEP and T lymphocyte subsets in patients with low rectal cancer. Methods A total of 80 patients with low rectal cancer in our hospital from June 2014 to June 2017 were enrolled in this study. The subjects were divided into the control group (n=40) and the treatment group (n=40) randomly. The control group were treated with laparoscopic surgery, the treatment group were treated with laparoscopic surgery combined with neoadjuvant chemotherapy, and both the two groups were treated for 6 periods with neoadjuvant chemotherapy after surgery. The serum CEA, VEGF, CA724, CA242, LEP levels and peripheral blood CD3+, CD4+, CD8+, NK cells of the two groups before and after treatment were compared. Results: There were no significantly differences of the serum CEA, VEGF, CA724, CA242, LEP levels and peripheral blood CD3+, CD4+, CD8+, NK cells of the two groups before treatment. The serum CEA, VEGF, CA724, CA242 and LEP levels of the two groups after treatment were significantly lower than before treatment, and that of the treatment group were significantly lower than the control group.The peripheral blood CD3+, CD4+, CD8+, NK cells of the two groups of the two groups after treatment were significantly lower than before treatment, and that of the treatment group were significantly higher than the control group. Conclusion: Laparoscopic surgery combined with neoadjuvant chemotherapy can significantly reduce the serum CEA, VEGF, CA724, CA242, LEP levels, improve the immunologic function, and it was worthy clinical application.

Effects of laparoscopic operation combined neoadjuvant chemotherapy on serum levels of CEA, CA242, CA19-9, CA724, ICAM-1 and VCAM-1 in patients with colorectal carcinoma

Objective: To observe the effects of neoadjuvant chemotherapy on the basis of laparoscopic operation on colorectal carcinoma patients, serum CEA, CA242, CA19-9, CA724, ICAM-1 and VCAM-1 levels. Methods: A total of 120 cases of colorectal carcinoma in our hospital from January 2012 to January 2015 were retrospectively analyzed and divided into control group and observation group, with each group of 60 patients. All patients were given laparoscopic operation, the patients in the observation group were given neoadjuvant chemotherapy (FOLFOX4 regimen) four cycles before laparoscopic surgery, fasting venous blood before and after treatment in the morning was taken and centrifuged, and the serum CA242, CA19-9, ICAM-1 and VCAM-1 levels were measured by ELISA, and the serum CEA levels were measured by MEIA, and the serum CA724 levels were measured by ECLI, and compared with those of the two groups. Results: (1) Before treatment, there was no statistically significant difference in the serum CEA, CA242, CA19-9 and CA724 levels between the two groups. After treatment, compared with the same group before treatment, the serum CEA, CA242, CA19-9 and CA724 levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, there was significant difference between the two groups;(2) Before treatment, there was no statistically significant difference in the serum ICAM-1, VCAM-1 levels between the two groups. After treatment, compared with the same group before treatment, the serum ICAM-1, VCAM-1 levels of the two groups were significantly lower, and those levels of observation group were significantly better than the control group, there was significant difference between the two groups. Conclusion: The treatment of colorectal cancer patients with neoadjuvant chemotherapy combined with laparoscopic operation can effectively reduce serum CEA, CA242, CA19-9, CA724, ICAM-1 and VCAM-1 levels, indicating that the program can regulate cancer-related tumor markers and the expression of relative factors, to promote the recovery of patients with autoimmune system, ease the patient's condition, safe and reliable, worthy of clinical application.

Electroacupuncture attenuates chronic salpingitis via transforming growth factor-β1/p38 mitogen-activated protein kinase signaling pathway

OBJECTIVE:To explore the effect of electroacupuncture(EA)on rats with chronic fallopian tube inflammation and its potential mechanisms.METHODS:Thirty-six female Sprague-Dawley rats were divided into Control,Model and EA groups.The pathological morphology of the fallopian tubes was observed by hematoxylin-eosin(HE)and Masson staining.The results of transforming growth factor-β1(TGF-β1),P38 mitogen-activated protein kinase(MAPK),phosphorylation(p)-p38MAPK in rat oviduct tissues were detected by immunohistochemistry.Results of P38MAPK,p-P38MAPK and TGF-β1 in rat oviduct tissues were detected by immunofluorescence.The expression level of p38MAPK,p-P38MAPK,TGF-β1 protein in rats was detected by Western blot.Quantitative real-time polymerase chain reaction(RT-q PCR)was used to detect m RNA expression levels of TGF-β1.RESULTS:It found that collagen fibers counts decreased significantly in EA group compared to Model group.The phosphorylation of P38MAPK in EA group was significantly reduced compared to Model group.The serum TGF-β1 expressions in EA group increased decreased significantly.CONCLUSION:Electroacupuncture was able to attenuate chronic salpingitis through down-regulating TGF-β1/MAPK signaling pathway.