Objective To explore the nursing effects of self-care body posture in patients after modified radical mastectomy. Methods The clinical data of 102 patients with modified radical mastectomy were randomly divided into the study group and the control group, all patients met the following standard:clear consciousness, effective communication, no paralysis of limbs, no fracture. In the study group, according to Orem"self-care theory" concept, patients carried out self-care body posture with mainly focus on self-emancipated and the body center of gravity position, in the control group patients were given traditional posture care with mainly emancipated assistance. The first time getting out-of-bed, the occurrence of various complications, the comfort level of emancipation and posture, as well as nursing satisfaction on the first day after surgery were observed and compared between the two groups. Results The two groups showed significant difference in the first time out-of-bed, anxiety, the comfort level of emancipation and posture, as well as nursing satisfaction. There was no significant difference between the two groups in dizziness, limb swelling, flap effusion, flap necrosis. No pressure ulcer occurred. Conclusions Making use of self-care body posture in patients after modified radical mastectomy can improve the satisfaction and comfort of the patients, and improve the patients' recovery, without increasing the complication, which is worth promoting.

Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.

BACKGROUND:Procolagen type 1 N-terminal propeptide (P1NP) and β-colagen special sequence(β-CrossLaps) are two bone metabolic markers that are closely related to osteoporosis. Combined detection of bone metabolic markers and bone mineral density is of clinical significance for the diagnosis of osteoporosis. Bone metabolic markers are ideal indicators to predict fractures, which can compensate for the lack of bone density test. OBJECTIVE:To introduce the application of bone metabolic markers in the monitoring of drug efficacy on the treatment of osteoporosis as wel as in the prediction of fracture risks in recent 20 years and to explore the clinical values of P1NP and β-CrossLaps to assess the therapeutic efficacy on osteoporosis and risks for osteoporotic fractures. METHODS:A computer-based search of CNKI and SCI databases were performed for relevant articles published from 2000 to 2014 using the keywords of “serum bone metabolic markers; osteoporosis; bone mineral density” in Chinese and English, respectively. Finaly, 44 articles meeting the inclusive criteria were reviewed. RESULTS AND CONCLUSION:This paper analyzes the source and detection mechanisms of P1NPand β-CrossLaps and then compares their advantages in the therapeutic effect assessment of osteoporosis. Serum bone metabolic markers cannot only reflect the dynamic changes of bone metabolism, but also have earlier changes than the bone mineral density. Both P1NPand β-CrossLaps are very important for assessing the early diagnosis of osteoporosis as wel as anti-osteoporosis drug efficacy.

Purpose To evaluate the application value of using a-cyanoacrylate rapid medical glue in preoperative localization of ground-glass nodules under CT guidance.Materials and Methods 48 cases were retrospectively analyzed,in which the pulmonary ground-glass nodules took preoperative localization under CT guidance.The rapid medical glue was injected in pulmonary ground-glass nodules,which was used for preoperative localization.Results After preoperative localization of rapid medical glue in 48 cases,pulmonary ground-glass nodules of all patients were resected successfully by video-assisted thoracoscope surgery (VATS).The complications of pneumothorax did not occur in all cases,with little pulmonary hemorrhagein in 10 cases.Conclusion When the fast medical glue has been used in the CT-guided preoperative localization of ground-glass nodules,there are advantages of high accuracy of localization and surgery.Moreover,this method is simple,safe and effective.

Objective:To explore the influence of vibration operation on occupational psychological behavior of workers.Methods:From May to August 2021, a total of 384 workers from 20 factories in a city of Guangdong Province were selected as the research objects.According to the workers whether engaged in vibration operations, they were divided into the vibration group and the control group.There were 229 workers in the vibration group and 155 workers in the control group.The occupational stress scale, job burnout scale and job fatigue symptom scale were used for questionnaire survey, and IBM SPSS 24.0 software was used for statistical description and data analysis, and t-test was used for comparison of independent samples between the two groups, one-way ANOVA was used for comparison of means between multiple groups, and LSD test was used for further pin-pide comparison. Results:In the vibration group, the scores of cognitive behavioral stress(3.78±1.79), psychological stress response(4.15±2.29), physical stress(2.81±1.65) and total stress (10.74±5.11) were higher than those of the control group ((2.23±1.23), (2.30±1.62), (1.81±1.07), (6.34±2.88), t=9.31, 8.67, 6.68, 9.72, all P<0.01), and job burnout scale of emotional exhaustion (8.95±3.62), depersonalization (3.24±2.16) were higher than the control group ((5.37±2.72), (1.79±1.20), t=10.48, 7.59, both P<0.01). The score of personal achievement (26.20±2.47) was lower than that of control group ((29.73±2.52), t=13.64, P<0.01). In the job fatigue symptom scale of sleepiness (8.38±1.52), emotional restlessness (6.85±1.74), displeasure (6.38±1.57), sluggishness (8.94±2.05), visual fatigue (7.83±1.95), and total score (38.37±6.56) were higher than those of the control group ((7.89±1.29), (6.21±1.32), (5.61±1.29), (6.54±1.52), (6.67±2.02), (32.92±5.56), t=3.26, 3.90, 5.00, 12.45, 5.61, 8.48, all P<0.01)). There were significant differences in scores of occupational stress, occupational burnout and occupational fatigue symptom among different seniority groups (all P<0.01). The scores of occupational stress, job burnout and job fatigue symptoms of workers in 6-10 years and more than 10 years of service group were higher than those in 0-5 years of service group, and the differences were statistically significant ( P<0.05). Length of service was correlated with occupational stress, job burnout and job fatigue.There was a correlation between the scores of all dimensions and total score of the occupational stress scale and the scores of all dimensions of occupational burnout scale ( r=-0.67-0.63, P<0.01), as well as the scores of all dimensions and total score of the occupational fatigue symptom scale ( r=0.26-0.73, P<0.01). The direct effect of occupational stress on job fatigue was 0.417, and the mediating effect of occupational stress on job fatigue through job burnout was 0.127. Conclusion:Vibration work can lead to occupational stress, job burnout and job fatigue, which is an important factor affecting occupational psychology and occupational behavior.

Objective:To investigate the incidence and related risk factors of refeeding syndrome (RFS) in patients with severe stroke.Methods:Patients with severe stroke admitted to the Department of Neurology, the First Affiliated Hospital of Soochow University underwent nutritional treatment again after fasting between December 2017 and October 2022 were included retrospectively. The incidence of RFS in patients with severe stroke was summarized. Multivariate logistic regression models were used to analyze the independent risk factors for RFS. A restricted cubic spline model was used to explore the dose-response relationship between relevant indicators and RFS. Results:A total of 188 patients were included, including 108 males and 80 females, with a median age of 72 years (interquartile range, 63-77 years); 185 patients (98.4%) had ischemic stroke and 3 (1.6%) had cerebral hemorrhage; 59 (31.4%) received enteral nutrition, 36 (19.1%) received gastrointestinal decompression, 30 (16.0%) received mechanical ventilation; and 60 patients (31.9%) developed RFS. Multivariate logistic regression analysis showed that serum creatinine (odds ratio [ OR] 1.011, 95% confidence interval [ CI] 1.001-1.020; P=0.025), serum potassium ( OR 8.349, 95% CI 3.025-23.039; P<0.001), serum phosphorus ( OR 46.578, 95% CI 6.444-336.661; P<0.001) and diabetes ( OR 2.173, 95% CI 1.087-4.345; P=0.028) were the independent risk factors for the occurrence of RFS. The restricted cubic spline model analysis showed that there was a non-linear relationship between serum creatinine and RFS, and the increased risk of RFS showed an "S" shape with the increase of serum creatinine. When serum creatinine exceeded 70.68 μmoI/L, the risk of RFS continued to increase. There was no non-linear relationship between serum phosphorus and serum potassium and RFS. Conclusions:Serum creatinine, serum phosphorus, serum potassium and diabetes are the independent risk factors for RFS in patients with severe stroke. These risk factors should be utilized to identify the high-risk patients with RFS early and the targeted measures should be taken as soon as possible.

Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure. Results: A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V₁, V₅-V₆ (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V₁ (9/10), RS or Rs wave on V₅-V₆ were found in DGCV1 group; RS or rS wave was seen on lead V₁, R(without S)wave in lead V₅-V₆ (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V₁ of PAIV group.(3)Precordial lead transition zone was in front of V₁ for DGCV1 and DGCV2 groups (23/23), within V₁-V₃ for EDGCV group, but on V₂ or within V₂-V₃ for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V₁-V₂ and R wave on V₅-V₆; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V₁, V₅-V₆ was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V₁ and a Rs wave on V₅-V₆. Conclusion A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V₁-V₆.

【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P<0.01), and when stored at 22℃, the decay rate of factor Ⅷ was slower; 2) When stored at 4℃, the content of factor V was 41.19, 41.31(0.29%), 40.52(-1.64%), 40.27(-2.23%), 39.05(-5.19%) and 36.99(-10.21%) IU/ bag, respectively; Stored at 22℃, the factor V content was 41.19, 41.71(1.25%), 42.54(3.28%), 41.94(1.80%), 39.21(-4.80%) and 35.64(-13.48%) IU/ bag, respectively. Comparison of storage results between the two groups showed that the content of factor V was statistically significant(P<0.05) and significantly significant(P<0.01) at 4℃48 h and 22℃48 h, respectively, and the decay rate of factor V was faster when stored at 22℃; 3) When stored at 4℃, the Fbg content was 268.86, 268.17(-0.26%), 262.46(-2.38%), 270.50(0.61%), 267.52(-0.50%) and 261.92(-2.58%) mg/ bag, respectively; Stored at 22℃, the Fbg content was 268.86, 265.86(-1.12%), 264.12(-1.77%), 265.89(-1.11%), 266.04(-1.05%) and 261.04(-2.91%) mg/ bag, respectively. There was no statistical significance between the 2 groups and the original 0 h content in each time period(P>0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.

ObjectiveTo study the brain network during balance control tasks in older adults. MethodsFrom January to April, 2022, 22 healthy young adults and 20 healthy older adults were recruited from the Fifth Affiliated Hospital of Guangzhou Medical University and communities. They were asked to finish standing tasks on the plantar pressure plate with eyes opening and closing, while the functional connectivities (FC) of prefrontal cortex (PFC) and primary motor cortex (PMC) were measured with functional near-infrared spectroscopy. ResultsCompared with the young adults, the area of the ellipse (Z = -2.884, P < 0.01) and the maximum swing (Z = -2.481, P < 0.05) increased in the older adults as eyes closing. During the standing task, the intra-FC of left (t = 2.978, P < 0.01) and right (Z = -3.123, P < 0.01) PFC decreased in the older adults, and the inter-FC of right PMC to left PFC (t = 2.087, P < 0.05) and right PFC to left PFC (t = 3.471, P < 0.001) decreased, too. ConclusionThe FC of PFC decreased in healthy older adults during balance control tasks, which may be a indicator for aging brain.