Objective To identify the risk factors associated with incontinence-associated dermatitis (IAD) in ICU patients with enteral nutrition associated diarrhea (ENAD), and to provide information for taking evidence-based preventive measures. Methods We used a case-control study to collect data. Information of the patients (n=55) and controls (n=55) were retrieved from the medical records of 2 intensive care units (ICUs). The patients with IAD and the controls without IAD were matched with age, gender and ward. Information on disease-related information, perineal environment, drug use and nutritional status were collected. Results The simple factor analysis showed that the risks of IAD were related to coronary heart disease (CHD )(χ2=3.96), composite variable for perfusion (χ2=7.33), APACHE II score (χ2=9.87), FiO2 (Z=-2.96), artificial airway (χ2=93.91), ENAD days (Z=-5.45), stool property (χ2=8.46), antibacterial drug use (χ2=5.55), steroid medicine (χ2=11.34) and enteral nutrition days(Z=-3.33), P<0.05. Logistic regression analysis showed that FiO2(P<0.05,OR=1.03, OR95%CI=1.01-1.06), APACHE Ⅱscore(P<0.05,OR=3.12, OR95%CI=1.01-9.64)and ENAD days(P<0.01,OR=1.64, OR95%CI=1.29-2.10)was independent risk factors for IAD. Conclusions The higher of FiO2, APACHE II score over 15 points and the longer of ENAD days, patients are more likely to occur IAD. Early monitoring and prevention of IAD are recommended to promote skin health.

ObjectiveTo discuss two fixation methods of nasotracheal intubation on the occurrence of nasal pressure sores in patients with maxillofacial surgery.MethodsThree hundred cases of patients under general anesthesia more than 4 hours with the nasal endotracheal intubation were randomly assigned into control group and experiment group with 150 cases in each group.In control group,medical tape was used to fix the endotracheal tube to dorsum,wrapping around the joint of endotracheal tube and threaded pipe.In experiment group,Mepilex foam dressing was used to wrap over the bend of endotracheal tube,with gauze covering the joint of endotracheal tube and threaded pipe before fixing the endotracheal tube to dorsum.Finally,the occurrence of pressure sores from the end of surgery to postoperative 1day were compared between the two groups.ResultsThe incidence of patients with first stage pressure sores was 4.7% in control group while none in experiment group.The incidence of nasal pressure sores was much lower in experiment group than that in control group (P<0.05).ConclusionsThe use of Mepilex foam dressing can reduce the pressure and friction between the endotracheal tube and the dorsum,which effectively prevents nasal pressure sores caused by endotracheal intubation.Therefore when having surgery with nasal general anesthesia and nasotracheal intubation and lastsing over 4 hours,the use of application covering the bend of endotracheal tube can prevent nasal pressure sores.

Ophthalmic microsurgery has its own characteristics: high precision , complicated operation , and long learning curve.It is important for young ophthalmologists to master the basic operation skills through standardized and systematic training during graduate studies .The teaching method , integrating theoretical teaching , animal operation and simulative ophthalmic surgery training , have important meanings in promoting the post-graduate students to master the practical and correct ophthalmic microsurgery technique . The aim of this study was to introduce the curriculum design and practice , and to evaluate the model through the examination scores .

Objective To evaluate the effects of hepatitis B virus on liver function,liver fibrosis,and liver pathological staging at different immune stages.Methods We made a retrospective analysis of 657 patients with chronic hepatitis B diagnosed in the First Hospital of Lanzhou University.Their liver function parameters,liver fibrosis parameters,and hepatitis B virus load were measured by automatic biochemical analyzer,automatic gammaradiation immunity analyzer,and quantitative PCR analyzer,respectively.Effects of hepatitis B virus on liver function,liver fibrosis in different immune stages were analyzed by variance analysis.Effects of hepatitis B virus on liver pathological staging at different immune stages were analyzed by linear trend chi square test analysis.Results In ALT normal chronic hepatitis B patients group,viral load had mild effects on liver function and liver fibrosis parameters.However,in ALT abnormal chronic hepatitis B patients group,viral load had a significant effect on liver function and liver fibrosis parameters,and the effect was most obvious in ALT＞double upper limit of normal group.The specific manifestation was that with viral load increasing,liver function parameters including ALT,AST,TBiL,DBiL,and IBiL increased,while TP and ALB decreased.Liver fibrosis parameters HA,LN,PcⅢ,and CIV all increased (P＜0.05).In ALT normal chronic hepatitis B patients group,viral load had no relationship with liver pathological staging.However,in ALT abnormal chronic hepatitis B patients group,especially ALT≥double upper limit of normal group,viral load was significantly related to liver pathological staging.Conclusion The effects of hepatitis B virus on patients' liver function at different immune stages were different,thus providing evidence-based medicine support for clinical antiviral treatment.

The paper introduces the common methods for automatic de-identification of clinical texts,including the method based on rules,machine learning method,comprehensive method,etc.,states the challenges for clinical texts practicability,system universality and scalability of clinical texts de-identification research,analyzes the further research direction,and provides reference for researchers of this field.

Objective To investigate the effects of plaque staining test on periodontal health of middle-aged and elderly patients with dental implants. Methods Ninety patients with dental implants were included in the study and divided into test group (n=45) and control group (n=45) by using random digit table. In the test group, the patients were all instructed with both routine health education and dental plaque dyeing education, while the control group received routine health education only. The plaque index (PLI) and gingival index (GI) were assessed at months 1 and 6 after implant restoration. Results One month after dental implantation, there were no significant differences in PLI and GI between the two groups (P>0.05), while 6 months after the implantation, the differences in PLI and GI between them were significantly different ( P<0 . 01 ) . Conclusion The plaque dyeing technology applied in the oral health education to elderly patients with dental implants can reduce plaque index and gingival index so that their periodontal health is enhanced.

Objective To explore promoter methylation of HIC1 gene and the expression of HIC1/SIRT1 related to the occurrence, development, and metastasis of papillary thyroid carcinoma. Methods Using Bisulfite sequencing PCR to analyze the promoter methylation of HIC1 gene. Using quantitative real-time PCR and Western blot to analyze expression differences of HIC1 and SIRT1 genes in tissues of papillary thyroid carcinoma(40 cases) and in adjacent normal thyroid(40 cases), of which datas were analyzed by statistics. Results The degree of HIC1 gene promoter methylation was significantly higher than that in adjacent normal tissues(P<0. 01). The degree of HIC1 gene promoter methylation in papillary thyroid carcinoma was related to lymph node metastasis, age, and the tumor-node-metastasis stages(P<0. 01). Compared with the expression of HIC1 mRNA and protein in adjacent normal thyroid tissue, that in papillary thyroid carcinoma was significantly lower(P<0. 01), while the expression of SIRT1 mRNA and protein in papillary thyroid carcinoma was significantly higher(P<0. 01). The lower expression of HIC1 mRNA and protein in the tumor tissues was related to the stage of lymph node metastasis, age, and the tumor-node-metastasis stages(P<0. 05). There was a strong negative correlation between the degree of HIC1 gene promoter methylation and expression of HIC1 in papillary thyroid carcinoma(P<0. 05). The expression of HIC1 mRNA and protein between that of SIRT1 also showed a strong negative correlation(P<0. 01). Conclusion Promoter hypermethylation of HIC1 and aberrant expression of HIC1/SIRT1 in papillary thyroid carcinoma may play a significant role in the oncogenesis and progress of papillary thyroid carcinoma. HIC1 is expected to become a new marker for prevention and treatment of papillary thyroid carcinoma.

Objective To investigatethe quality of life of patients with oral cancer in different period in a hospital, and to explore the impact of patients' psychological status on their quality of life. Methods 50 cases of oral cancer patients in our hospital were investigated in this study by Convenience sampling method. The scale of the hospital anxiety and Depression Scale (HADS, the Japanese version), the quality of life of cancer patients were measured by the scale (FACT-G); the functional evaluation of tumor therapy- head and neck questionnaire (FACT-H&N). Results The comparison of HADS score between patients before and after surgery showed that the improvement of mental status was not obvious in the postoperative patients.The scores of HADS between patients before surgery and after hospital showed that the improvement of mental status was obvious (t=-2.809, P=0.01; t=-3.828, P=0.003). There were significant differences in HADS anxiety and depression-related factors between different periods (F=7.644,P=0.001;F=6.442,P=0.002);Before surgery,patients with low anxiety and depression had higher scores in both emotional and physical functional dimensions, and the difference between the two groups was statistically significant (t=7.882,5.847,6.870,7.262, P<0.05 or 0.01). The scores of the two groups were higher in the whole life quality dimension after surgery,and the difference between the two groups was statistically significant(t=3.640-7.931,P<0.01 or 0.01).There were significant differences in body function and psychological function scores between different periods(F=8.569, P=0.000; F=10.250, P=0.003). Conclusions Oral cancer patients have a higher level of anxiety and depression before and after surgery, and psychological status of patients with a certain impact on quality of life, it should be targeted for individual characteristics of patients with targeted care measures to improve the psychological status of patients,thereby improving the quality of life of patients.

Objective To investigate the prognostic value of metabolic parameters of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(FDG PET-CT)before radiotherapy in patients with esophageal cancer receiving radiotherapy. Methods We retrospectively analyzed the clinical data of 37 patients with stage Ⅱ-Ⅲ esophageal squamous cell carcinoma admitted to Anhui Provincial Hospital from 2010 to 2015,who underwent PET-CT scans within 4 weeks before radiotherapy. The following information was collected:age,sex,the location of primary lesion,clinical stage,and treatment regimen.The maximum standard uptake value(SUVmax), mean standard uptake value(SUVmean), metabolic tumor volume(MTV), PET tumor length(PTL),and total lesion glycolysis(TLG)were calculated. The optimal cut-off values of SUVmax, SUVmean,MTV,PTL,and TLG were determined by the receiver operating characteristic(ROC)curve. The Kaplan-Meier method was used to calculate survival rates,and the log-rank test was used for survival comparison and univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis of significant variables. Results The area under the ROC curve suggested that MTV>TLG>PTL=0.713>0.679>0.670. The Kaplan-Meier survival analysis showed that patients had better survival time when MTV was less than 27.44 cm3,TLG was less than 166.2 g,and PTL was less than 36.74 mm(P<0.05).The Cox multivariate regression analysis showed that only MTV was an independent prognostic factor for radiotherapy in patients with esophageal cancer(P=0.000). Conclusions MTV, TLG and PTL have certain values in predicting the prognosis of patients with esophageal cancer before radiotherapy, and are helpful for selecting and adjust the clinical treatment regimen and improving the survival rate and prognosis.

Objective To investigate the level and influencing factors of quality of life in patients with osteoradionecrosis of the jaws (ORNJ) in order to provide theory basis for nursing intervention. Methods Ninety-five patients hospitalized from January 2015 to Febury 2017 and participated in the investigation by a convenient sampling method. The functional assessment of cancer therapy-head and neck (FACT-H&N), social support rating scale (SSRS) and general information questionnaire were used to assess the quality of life, social support and basic information in ORNJ patients in our hospital respectively. Results The score of quality of life was (79.99 ±15.72). The index value of common module of quality of life was higher than that of additional concern. The average scores of each dimension of common module from low to high were as follows: functional well-being, social/family well-being, physical well-being and emotional well-being. The multiple linear regression analysis showed that the influencing factors of quality of life were social support, severe mouth opening difficulty (grade Ⅲ and Ⅳ), the course of primary disease (3 ～5 years, 5 ～10 years), which explained 35.6％variation in the quality of life. Conclusions The quality of life of ORNJ patients is generally lower than that of other head and neck cancer patients. The social support, severe mouth opening difficulty and course of primary disease can affect the patients' quality of life.The smaller the mouth opening (≤1 cm), the longer the course of primary disease (3～5 years) and the worse the quality of life is. Thus, nursing staff should pay attention to the quality of life of ORNJ patients and give prospective nursing intervention to improve the quality of life according to the characteristics of the development of the disease.