Objective To describe the quality of life and symptom distress in esophageal cancer patients undergoing postoperative adjuvant chemotherapy,and explore the influence of symptom distress on quality of life.Methods The Functional Assessment of Cancer Therapy-General (FACT-G),M.D.Anderson Symptom Inventory (MDASI) and demographic questionnaire were used to measure eighty-four patients undergoing postoperative adjuvant chemotherapy.Results The total average score of quality of life in patients undergoing chemotherapy after radical esophagectomy was (65.95±13.76) points.There was a significanfly negative relationship between the symptom distress and the severity of symptom and quality of life.Analysis of multiple factors showed that education level and symptom distress were the included variables in the multiple regression equation of quality of life,and the R2 was 0.253.Conclusions Quality of life in esophageal cancer patients undergoing postoperative adjuvant chemotherapy is influenced by many factors.The nurses should take measures to manage the symptom of patients and improve the quality of life of the patients.

Objective To observe the lipid regulation role of electroacupuncture intervention in the rats with non-alcoholic fatty liver disease(NAFLD)induced with high fat and cholesteol forage,and to clarify the regulation mechanism of serum retinol binding protein 4 (RBP4 )level and liver X receptor a (LXR-α)and sterol regulatory element binding protein-1c(SREBP-1c)expressions.Methods 44 female SD rats were fed for 7 d to adapt the environment and were randomly divided into normal group, model group, Dongbaogantai group, electroacupuncture group;11 rats in each group.The rats in normal group got routine feeding,and the others were fed with high fat and high cholesterol forage. After 8 weeks, the models were established, the rats in electroacupuncture group were treated with electroacupuncture method (1.5-2.0 Hz, D.-D.wave, 9V, 1-3 mA)in“Ganshu”,“Pishu”,“Geshu”for 15 min,once a day,lasted for 28 d.The changes of fasting blood-glucose(FBG),serum free fatty acids(FFA)and liver tissue homogenate triglyceride(TG)and total cholesterol (TC)levels of the rats in various groups were tested, and enzyme-linked immunosorbent (ELISA)was used to determine the serum RBP4 levels, and Western blotting method was used to detect the LXR-αand SREBP-1 c protein expression levels in rat liver tissue.Results Compared with normal group,the FBG,serum FFA,TG and TC levels in liver tissue homogenate and serum RBP4 level of the rats in model group were increased (P<0.01);the LXR-αand SREBP-1c protein expression levels were also increased (P<0.01).Compared with model group, the FBG,serum FFA,the TG and TC levels in liver tissue homogenate and serum RBP4 levels of the rats in electroacupuncture group and Dongbaogantai group were decreased (P<0.01);the LXR-αand SREBP-1c protein expression levels were also decreased (P< 0.05 or P< 0.01 ). Conclusion Electroacupuncture method in“Fenglong”,“Zusanli”,“Sanyinjiao”can reduce the serum RBP4 level, regulate the lipid metabolism, and improve the lipid deposition of the NAFLD rats;they have obvious therapeutic effect on NAFLD, and its mechanism may be related to inhibiting the increasing of LXR-αand SREBP-1 c protein expressions in liver tissue.

Objective To get the information about the geriatric syndromes in the elderly with different age and gender so as to provide the basis for management of the geriatric syndromes.Methods A questionnaire survey was used to investigate and analyze the geriatric syndromes in 2 778 older subjects aged 60 years and above from Zhejiang and Jiangsu province.Results Among all 2 778 old adults,(3.4 ± 1.8)geriatric syndromes in average were found.The difference in geriatric syndromes number between different age groups showed a statistical significance(F =145.135,P＜ 0.001),but a significant difference in geriatric syndromes number between male and female group was not found(t=0.817,P=0.414).On the top incidence rate of geriatric syndromes were daily life ability defects 2 199 cases(79.2％),falls 1 828 cases(65.8％),urinary incontinence 1 356 cases(48.8％),sleeping disorder 1 023 cases(36.8 ％),cognitive impairment 908 cases (32.7 ％) and visual impairment 896 cases (32.3 ％).Among above six geriatric syndromes,the incidence of daily life ability defects,falls,urinary incontinence,sleeping disorder and cognitive impairment seemed to increase with ageing (P＜0.001).The incidence of daily life ability defects,falls and urinary incontinence was higher in males than in females (P＜ 0.05).The incidence of sleeping disorder and cognitive impairment was higher in females than in males(P＜0.05).The elderly patients with 3 or more geriatric syndromes exceeded about 66.4 ％.The most common clusters of geriatric syndromes were daily life ability defects combined with falls and urinary incontinence,which seemed to significantly increase along with ageing (x2=202.523,P＜0.001).Conclusions Geriatric syndromes are common in the elderly,medical care workers should pay attention to the management of the geriatric syndromes,and promote the development of the elderly healthcare.

Objective To describe the characteristics of nursing competence and self efficacy of new nurses in a tumor hospital and to explore the correlative relationship between them. Methods By convenience sampling method, a total of 303 new nurses who were employed in 2013 to 2015 from a tumor hospital were recruited in the study. A self-designed demographic questionnaire, the nursing competence scale (NCS) and the general self-efficacy scale (GSES) were used. Results The average score of nursing competence of new nurses was (83.80 ± 10.35) points. Among the six dimensions of nursing competence, the interpersonal relation competence had the highest score of (86.74 ± 10.55) points, while the nursing process applying competence had the lowest score of (81.41 ± 11.02) points. The level of nursing competence and each dimensions were positively related with self-efficacy (r=0.443-0.557, P<0.01). Conclusions The level of nursing competence of new nurses in a tumor hospital is good, but the nursing process applying competence, critical patient care competence and the health education competence were still insufficient, so it is necessary to take corresponding measures to improve the overall quality of new nurses. Self efficacy can effectively predict the nursing competence of new nurses. The hospital can improve the nursing competence by intervene the self efficacy of new nurses, in order to improve the clinical nursing quality and promote the development of nursing.

This article introduced the background, significance, working mode, talent training, qualification certification and clinical practice of oncology genetic nurses, providing the analysis of oncology genetic nurse development opportunities and challenges in our country. Proposals were put forward that China should draw lessons from successful experience of the development of oncology genetic nurses, strengthen the genetic nursing ability of nurses, establish oncology genetic nurse training mode, improve the post-setting and operation mechanism to meet the needs of hereditary oncology nursing management.

OBJECTIVETo investigate the correlation of serum osteoprotegerin (OPG) with the progression of nonalcoholic fatty liver disease (NAFLD) and the noninvasive prediction and diagnosis of nonalcoholic steatohepatitis (NASH).

METHODSA total of 136 patients with NAFLD were enrolled, and their tissue samples for liver biopsy and serum samples obtained at 1 week after liver biopsy were collected; 83 healthy subjects without the symptoms of fatty liver disease proved by ultrasound examination were enrolled as controls. The physiological indicators including height, body weight, and waist circumference were measured, and body mass index was calculated. The biochemical parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT, alkaline phosphatase, gamma-glutamyl transferase, total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. Double-antibody sandwich enzyme-linked immunosorbent assay was used to determine the serum level of OPG. The rank sum test, chi-square test, t-test, one-way analysis of variance, Spearman correlation analysis, least significant difference test, and receiver operating characteristic (ROC) curve were applied for statistical analysis of various data.

RESULTSSerum OPG level was correlated with AST and TG (P < 0.05), and was highly correlated with hepatocyte fatty degeneration, ballooning degeneration, intralobular inflammation, portal inflammation, and fibrosis degree (P < 0.01). With the increasing NAFLD activity score (NAS), serum OPG level decreased, and there was a highly negative correlation between them (r = -0.928, P < 0.01). Serum OPG level was significantly lower in NASH patients than non-NASH patients. The area under the ROC curve of serum OPG level was 0.963, and according to the Youden index, its optimal sensitivity and specificity were 96.1% and 97.4%, respectively, at an optimal cut-off value of 242.96 ng/L, which suggested a high diagnostic power.

CONCLUSIONIn NASH patients, serum OPG level decreases significantly. Serum OPG level can be used as an independent predictive factor to evaluate NASH and its severity, as well as a noninvasive diagnostic index for NASH.

Alanine Transaminase ; blood ; Alkaline Phosphatase ; blood ; Aspartate Aminotransferases ; blood ; Biopsy ; Body Mass Index ; Case-Control Studies ; Cholesterol ; blood ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Humans ; Inflammation ; pathology ; Liver ; pathology ; Non-alcoholic Fatty Liver Disease ; blood ; diagnosis ; Osteoprotegerin ; blood ; ROC Curve ; Triglycerides ; blood ; gamma-Glutamyltransferase ; blood

Objective:Based on the needs of advanced nursing practice development, to establish an indicator system of role function of position of oncology genetic nurses suitable for our national condition, and to provide a basis for position establishing of nocology genetic nurses.Methods:Initial indexes were generated through the literature review and semi-structured interviews. From September to December 2022, two rounds of expert consultations and analytic hierarchy process were conducted to establish the evaluation index for role function of position of oncology genetic nurses.Results:A total of 43 experts were included in the study, the response rates of 2 rounds were 93.62%(44/47) and 97.73%(43/44), and the authority coefficients of the experts were 0.821 and 0.853. The Kendall′s coefficients of concordance for the 2 rounds of consultations were 0.100-0.150 (all P<0.01) and 0.101-0.237 (all P<0.01). Finally, the role function system of position for oncology genetic nurses was formed, which consisted of 5 first-level indexes, 17 second-level indexes and 86 third-level indexes. Conclusions:The system of role function of position for oncology genetic nurses is reasonable, scientific and reliable, professional and specific, which can provide a theoretical reference for the development of advanced nursing practice on hereditary oncology in China.

OBJECTIVE To systematically evaluate the efficacy and safety of Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure. METHODS Retrieved from CNKI， CBM， VIP， Wanfang， PubMed， Embase and the Cochrane Library， randomized controlled trials （RCTs） about Shenfu injection combined with chemical medicine （trial group） versus chemical medicine （control group） in the treatment of heart failure with coronary heart disease were collected during the inception to August 2022. After literature screening and data extraction， the qualities of included literature were evaluated and rated by using Cochrane manual and GRADE system. Meta-analysis and Egger’s were performed with RevMan 5.3 software， and TSA 0.9.5.10 Beta software was used for trial sequential analysis. RESULTS Seventeen studies were included， with a total sample of 1 355 patients. The quality grade evidence of GRADE was all low. Meta-analysis showed that cardiac function efficacy [RR＝1.23， 95%CI （1.16，1.30）， P＜0.000 01]， the decrease of brain natriuretic peptide [MD＝－96.06， 95%CI （－116.47， －75.64）， P＜0.000 01] and the increase of left ventricular ejection fraction [MD＝5.32， 95%CI （4.03，6.60）， P＜0.000 01] in trial group were significantly better than control group； there was no statistical significance in the incidence of ADR between 2 groups [RR＝0.52，95%CI（0.22，1.22），P＝0.13]. The results of sequential analysis showed that the sample size included in this study met the requirements of meta-analysis； the results of Egger’s test showed that the results were robust and publication bias had no significant effect on the results. CONCLUSIONS Shenfu injection combined with chemical medicine in the treatment of coronary heart disease combined with heart failure can further improve the clinical symptoms and related indicators， and no serious adverse reaction is observed.