Objective To formulate a practical nursing education project,improving hemodialysis patients'self -maintenance compliance for central venous catheter with dacron cuff and reducing patients'catheter dysfunction rate.Methods 17 patients with hemodialysis who newly had the central venous catheter with dacron cuff from March 2014 to October 2014 in our hospital,were selected and carried out a guidance of daily maintenance according to Lewin's action research theory.Four steps including plan,action,study and reflection were done spirally.The feasibility and validity of the nursing education project were evaluated by assessing the patients'catheter self maintenance com-pliance,and counted up the catheter dysfunction rate within 12 months.Results The action research practice was conducted for 8 weeks,and included 3 rounds circulation.According to the nursing education team's management method,with the improved education method and adjusted education schedule,refined nursing process,family support system and multi -disciplinary coordination,the knowledge of self -maintenance of the hemodialysis patients were improved,and increased the compliance,reduced the dysfunction rate.Conclusion The dialysis catheter nursing education project of this study has been modified and perfected according to the practice of action research,which could improve patients'self maintenance compliance and effectively reduce catheter dysfunction rate.

Objective To analyze the falls of female inpatients with the psychotics diseases and summarize effective nursing intervention. Method Two hundred and eighty-nine psychiatric female inpatients from April 2014 to August 2014 were collected, and the reasons of falls cases during this period were analyzed and nursing methods were formulated. Result Nine patients fell, with an incidence of 3.11%(9/289) including the reason of lack of risk dynamic evaluation, lack of fall prevention measures and shortage of nursing personnel. Conclusions The reasons for the falls of the hospitalized psychiatric female patients include lack of risk dynamic evaluation, lack of fall prevention measures, shortage of nursing personnel. The nursing countermeasures include risk assessment of dynamic management and the implementation of the fall prevention measures , strengthening training and health education so as to prevent and reduce the occurrence of falls and ensure patients'safety.

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.

Objective:To learn about the current situation of prevention and control results of three-year campaign for Kashin-Beck disease (KBD) in Pingliang City, and to provide scientific basis for prevention and control of KBD.Methods:A retrospective analysis was carried out to collect the KBD surveillance data of all villages in the counties (cities, districts) affected by KBD in Pingliang City, Gansu Province during 2019 - 2020 from the "National Integrated Management System for Endemic Disease Prevention and Control (Three-year Campaign Action Management System)", including, the prevalence of children aged 7 to 12 years old, the implementation of prevention and control measures, and the case investigation, the establishment, management of health files and treatment of current patients.Results:Patients with KBD were distributed in 6 counties (cities, districts), 64 townships (towns), and 690 villages in Pingliang City, and all of them were seriously ill area. In 2019 and 2020, 40 537 and 41 053 children aged 7 to 12 years old were examined, respectively, and the clinical detection rate was 0.08% (31/40 537) and 0.03% (12/41 053), respectively; the X-ray detection rate was 0 in each year. In the dietary structure of residents in Pingliang City from 2018 to 2020, the consumption proportions of rice, flour and other diets was 15.03%, 76.63% and 8.34%, respectively, and the purchase proportion of staple food was 19.28%. From 2018 - 2020, 9 564 households and 36 282 people had been relocated from the affected areas, 4 831 children aged 7 to 12 years old had been raised in different places, 14.81% (420 914/2 842 939) of the original cultivated land had been converted to cash crops, 21.81%(620 045/2 842 939) of the original cultivated land had been converted from farmland to forest (grass), and 231 811 nutrition package for children aged 6 to 24 months had been given. A total of 6 269 KBD patients were investigated and registered, including 3 722 males and 2 547 females, with a gender ratio of 1.00 ∶ 0.68. The most clinical grading was grade Ⅰ, accounting for 78.00% (4 890/6 269), followed by grade Ⅱ (15.89%, 996/6 269) and grade Ⅲ (6.11%, 383/6 269); the age of onset was (64.57 ± 10.01) years old, ranging from 16 to 87 years old; most patients were over 50 years old, accounting for 86.57% (5 427/6 269). In 2019, 1 659 KBD patients were treated. The apparent efficiency, effective efficiency and ineffective efficiency were 25.38% (421 cases), 52.92% (878 cases) and 21.70% (360 cases), respectively. In 2020, 1 395 KBD patients were treated; the apparent efficiency, effective efficiency and ineffective efficiency were 19.50% (272 cases), 61.65% (860 cases) and 18.85% (263 cases), respectively.Conclusions:All villages in KBD area in Pingliang City have reached the elimination standard and achieved the elimination goal. We should continue to do a good job in the dynamic monitoring of the disease, strengthen the implementation of prevention and control measures and rehabilitation intervention for patients with KBD, and improve the quality of life of patients.

Objective:To study the effect of Compound Duzhong Jiangu Granules on joint function, quality of life and inflammatory factors in patients with Kashin-Beck disease.Methods:By group design, 135 patients with Kashin-Beck disease in Chongxin County, Pingliang City, Gansu Province, were selected and divided into intervention group (100 cases treated with Compound Duzhong Jiangu Granules, 12 g/bag, 1 bag/time, 3 times/day, treatment for 1 month) and control group (35 cases treated with ibuprofen, 0.3 g/capsule, 1 capsule/time, 2 times/day, treatment for 2 weeks) according to the randomized, single-blind principle. The changes of joint dysfunction index score, joint function improvement rate, total scores of Kashin-Beck disease quality of life (KBDQOL) and scores of each dimension were analyzed before treatment, 1 month and 3 months after treatment. The serum levels of interleukin-6 (IL-6), nuclear factor κB (NFκB)-p65, inducible nitric oxide synthase (NOS2), nitric oxide (NO), and prostaglandin E2 (PGE2) were detected by enzyme-linked immunosorbent assay before treatment and 1 month after treatment.Results:The total scores of joint dysfunction index of the intervention group and the control group 1 month after treatment and 3 months after treatment were lower than those before treatment, but 3 months after treatment was higher than 1 month after treatment ( P < 0.001). One month after treatment, the total effective rates of joint function improvement in the intervention group and the control group were 68.00% (68/100) and 54.55% (18/33), respectively; 3 months after treatment, the total effective rates of the intervention group and the control group were 36.00% (36/100) and 39.39%(13/33), respectively. The total scores and scores of each dimension of KBDQOL were not significant for the main effect of the group ( P > 0.05), but significant for the main effect at the time point ( P < 0.05), and there was no interactive effect ( P > 0.05). There were significant differences in the scores of social support and mental status dimensions in the intervention group at different time points ( P < 0.001). And in the intervention group, the total score, the scores of physical function, activity limitation, economy and overall health dimensions were statistically significant between before treatment and 1 month after treatment, 1 month after treatment and 3 months after treatment( P < 0.05); however, there was no significant difference between before treatment and 3 months after treatment ( P > 0.05). One month after treatment, the serum PGE2 levels of both groups were decreased ( P < 0.05), and there was no difference in other inflammatory factors at different groups and time points ( P > 0.05). Conclusion:Compound Duzhong Jiangu Granules can effectively inhibit the inflammatory reaction of patients with Kashin-Beck disease, promote the improvement of joint function and improve the quality of life in various aspects.

Relying only on the ethics committee to protect subjects is not enough, and the construction of the subject protection system is an inevitable trend for the protection of subjects’ rights. This paper elaborated on the current situation of Chinese subject protection system from four aspects: the lack of laws and regulations and administrative supervision, the insufficient attention of hospitals, poor construction of the subject protection system, and the absence of responsibilities of relevant personnel. Then this paper put forward countermeasures from three aspects: improving laws and regulations and strengthening supervision, mobilizing relevant departments to participate, and strengthening relevant training, in order to standardize the construction of the subject protection system and promote the development of the subject protection work.

Objective:To establish and effect evaluate of management process of Da Vinci robotic surgical instrument based on bar code, and evaluate its application effect.Methods:This study was a randomized controlled trial using convenient sampling method. A total of 172 Da Vinci robotic surgeries from Jiangsu Cancer Hospital from September to November 2020 were selected as the control group, and 118 Da Vinci robotic surgeries from September to November 2021 were selected as the observation group. The control group adopted the traditional Da Vinci surgical instrument management mode, while the observation group adopted the management mode of Da Vinci surgical instrument based on bar code. The incidence of management problems related to Da Vinci surgical instruments, the number of reported adverse events of instruments rate and the impact of staff work effect were compared between two groups.Results:The incidence rates of non-traceable information, counting error, usage charge and bar code irregularity were 9.3% (11/118), 0, 0.8% (1/118) and 2.5% (3/118), respectively, which were lower than 26.7% (46/172), 17.4% (30/172), 12.2% (21/172) and 16.9% (29/172) of the control group. The differences were statistically significant ( χ2 values were 12.89-24.68, all P<0.01). The reporting rate of device adverse events in the control group was 0, and the observation group was 4.2% (5/118), and the difference between the two groups was statistically significant ( χ2=7.42, P<0.05). The number of sterilization package turnover sets in the observation group was 2(2, 3), which was lower than 2(2, 4) of the control group, and the difference was statistically significant ( Z=-2.50, P<0.05). The average amount of pre-purchased surgical instruments per surgical instrument in the observation group was 7 858.0 (6 712.1, 14 119.9), which was lower than that of the control group of 7 858.0 (7 858.0, 2 0385.0), and the difference was statistically significant ( Z=-2.97, P<0.05). Conclusions:The management process of Da Vinci Xi robotic surgical instrument based on bar code can reduce the incidence of related management problems, increase the reporting rate of adverse events, improve the work efficiency of the management of mechanical arm to optimize hospital of reusable medical equipment management level, thus further ensure medical safety and improve medical quality.

OBJECTIVE: To investigate the difference of tumor formation in different mouse strains bearing patient-derived xenograft of esophageal squamous cell carcinoma(ESCC) and establish a better animal model for preclinical study of individualized treatment of ESCC. METHODS: The tumor tissues collected from 22 ESCC patients were used to establish tumor-bearing mouse models in B-NDG (NSG) mice and BALB/c nude mice. The tumor formation rate and tumor formation time were compared between the two mouse models, and HE staining, immunohistochemistry and genome sequencing were carried out to assess the consistency between transplanted tumor tissues in the models and patient-derived tumor tissues. RESULTS: The tumor-bearing models were established successfully in both NSG mice (50%, 11/22) and BALB/c nude mice (18.18%, 4/22). The average tumor formation time was significantly shorter in NSG mice than in BALB/c nude mice (75.95 91.67 days, < 0.001). In both of the mouse models, the transplanted tumors maintained morphological characteristics identical to those of patient-derived ESCC tumors. Genetic analysis showed that the xenografts in NSG mice had a greater genetic similarity to the patients' tumors than those in BALB/c nude mice ( < 0.0001). CONCLUSIONS Mouse models bearing xenografts of patient-derived ESCC can be successfully established in both NSG mice and BALB/c nude mice, but the models in the former mouse strain can be more reliable.
Animals ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; Esophageal Squamous Cell Carcinoma ; Heterografts ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Xenograft Model Antitumor Assays