OBJECTIVETo explore the improvement the dingle technology through the PICC catheter puncture point elbow hemostatic effect. Selection.

METHODSBetween January 2013 and December 2013, chest hospital affiliated to Shanghai jiaotong university under the guidance of ultrasound improved the Ding Gehang PICC catheter patients of 997 cases were randomly divided into three groups A, B, C, respectively, using gauze pad, calcium alginate wound dressings, calcium alginate wound dressings with hemostatic gauze pad three methods to puncture point, compare the three groups within 48 h after puncture biopsy in patients with some local bleeding, treatment times and catheter after 1 week of the maintenance costs of the catheter.

RESULTSCompared with A, B two groups, patients of group C tube after 48 hours the puncture point local oppression hemostasis effect is better than that of group A and B, the difference was statistically significant (all P < 0.05); Catheter maintenance: group C within 1 week after catheter tube after local lowest maintenance cost.

CONCLUSIONPICC for surgery after the puncture point of oppression hemostasis method choice, the effect of calcium alginate dressings hemostatic gauze pad is better than that of gauze pads and calcium alginate dressings, calcium alginate dressings and gauze pad is more effective and economic, in clinical use.

Alginates ; Bandages ; Catheters ; China ; Glucuronic Acid ; Hemorrhage ; Hemostatic Techniques ; Hexuronic Acids ; Humans ; Punctures

Objective To evaluate the effect of risk early warning management in preventing peripherally inserted central catheter (PICC)-related thrombosis in lung cancer patients,in order to improve the efficacy and safety of PICC application in lung cancer patients.Methods A total of 761 patients receiving PICC in Shanghai Chest Hospital between January 2012 and December 2013 were observed.Based on the assessment of PICC-related thrombosis risk using Autar scale,the patients were divided into 3 groups,namely low risk group (n =332),medium risk group (n =364),and high risk group (n =65).Patients in the 3 groups were given grading nursing intervention,physical intervention and basic drug intervention for low and medium risk groups,compared with physical intervention,basic drug intervention plus emergency intervention for high risk group.873 lung cancer patients with PICC in the period from January 2008 to December 2011 served as controls.Results 32 cases in the control group (3.66％) developed PICC-related thrombosis,compared with 12 cases in the observation group (1.58％) (P =0.009).The incidence of PICC-related thrombosis was 1.51％ (5/ 332),1.37％ (5/364),and 1.54 (1/65) in low,medium,and high risk groups,respectively.None of the patients developed pulmonary embolism.Conclusion Risk early warning management can help reduce the risk of PICC-related thrombosis in lung cancer patients in hypercoagulable state.

Objective To study the reactive oxygen level and the expression of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax after treatment of DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (5-Aza-2'-dc) and paraquat in V79 cells.Methods Cultured V79 cells were divided into 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B),5-Aza-2'-dc and paraquat treatment group (group C,V79 cells were pretreated with 5-Aza-2'-dc for 12h followed by exposure to paraquat for 12h) and control group (group D).Reactive oxygen level in V79 cells was measured by DCFH-DA flow cytometry and expression of Bcl-2 and Bax was detected by Western blot.Results Reactive oxygen levels and expression levels of Bcl-2 and Bax in V79 cells were significantly different (P＜0.05) in 5-Aza-2'-dc and paraquat treatment group (group C),compared with 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B) and control group (group D).Expression levels of Bcl-2 and the ratio of Bcl-2 and Bax were lower while reactive oxygen levels and expression levels of Bax were higher in group C than in groups A,B and D.Conclusion 5-Aza-2'-dc regulates DNA methylation by the imbalancing the reactive oxygen metabolism and apoptosis,thus up-regulating the toxic effect of paraquat on V79 cells.

Objective To study the effect of DNA methylation regulation on the toxic effect of paraquat on the sensitized V79 cells t pretreated with 5-aza-2'-deoxycytidine.Methods V79 cells were treated by 5-aza-2'-deoxycytidine (5-Aza-2'-dc) for 12h,which is a DNA methylation inhibitor,and then treated with paraquat for 12h.The morphological changes of V79 cells were observed by microscopy and the cell viability was determined by MTT assay and trypan blue staining method.Results Microscopic examination showed that the combination of 5-Aza-2'-dc and paraquat had stronger effect in inhibiting the growth of V79 cells(the cells became smaller and poorer adhensive ability) than single 5-Aza-2'-dc or paraquat.MTT assay showed that cell viability in the combination group (54.47 ± 3.04) ％ was significantly lower than the 5-Aza-2'-dc group (95.52 ± 0.90) ％ and paraquat group (89.68 ± 4.26) ％ (P＜0.05).Trypan blue staining assay showed that the death rate of ceils in the combination group (53.58 ± 1.57) ％ was significantly higher than the 5-Aza-2'-dc group (7.44 ± 2.31) ％ and paraquat group (12.90 ± 1.21) ％ (P＜0.05) Conclusion 5-Aza-2'-dc promotes V79 cells damage caused by paraquat.

Objective To explore the effect of Enhanced Recovery after Surgery in patients undergoing thoracoscopic lobectomy with pain management. Methods A total of 160 patients with lung cancer admitted from September 20 to July 2017 at the Affiliated Chest Hospital of Shanghai Jiaotong University were randomly divided into observation group and control group. The observation group was treated with enhanced recovery care and the control group was treated with routine care. Results The incidence of postoperative complications, hospitalization time and hospitalization decreased, the difference was not statistically significant (P>0.05). The early postoperative ambulation time, postoperative exhaust time, postoperative nausea and vomiting, postoperative pain intensity at 6h, postoperative pain intensity at 12 h, postoperative pain intensity at 24 h and postoperative pain intensity at 48 h were (18.35 ± 7.18) h, 28.75％,(1.17 ± 0.84) points, (1.79 ± 1.36) points, (2.45 ± 1.12) points and (2.14 ± 1.26) points in research group,(28.11 ± 9.07) h, (36.35 ± 16.95) h, 45.00％(36/80), (1.91 ± 0.88) points, (3.05 ± 1.33) points, (4.20 ± 1.31) points and (3.89 ± 1.20) points in controlled group. There was significant difference between the two groups (t=-7.36-78.34,χ2=4.54, P<0.05). Conclusions The idea of Enhanced Recovery after Surgery for thoracoscopic lobectomy has a good clinical effect. It can reduce the perioperative stress, shorten the hospital stay and reduce the hospital cost, and have the clinical value.

Objective To observe the alterations in brain gray matter volume(GMV)in idiopathic generalized epilepsy(IGE)patients with typical absence seizure. Methods Nine IGE patients with typical absence seizure and 16 healthy volunteers were prospectively recruited from People's Hospital of Zhengzhou University from September 2012 to January 2014. By using a 3. 0T magnetic resonance imaging(MRI)and voxel - based morphometry(VBM)method, their whole brain structures and their brain GMV were scanned and analyzed,respectively,then the changes in GMV were observed. Results Compared with healthy control group,brain GMV extensively decreased in IGE patients with typical absence seizure. Thirteen regions with significant differences were as follows:the right rectal gyrus(t = 3. 13,P ﹤0. 01),the left rectal gyrus(t = 4. 82,P ﹤ 0. 01),the right calcarine/ cuneus/ gyrus lingualis/ occipital gyrus/ inferior oc-cipital gyrus(t = 6. 86,P ﹤ 0. 01),right gyrus lingualis(t = 4. 01,P ﹤ 0. 01),the left gyrus lingualis/ inferior occipital gyrus(t = 3. 73,P ﹤ 0. 01),the left inferior occipital gyrus/ gyrus lingualis(t = 5. 42,P ﹤ 0. 01),the left middle occipi-tal gyrus(t = 3. 76,P ﹤ 0. 01),the right middle occipital gyrus/ superior occipital gyrus/ middle temporal gyrus( t =3. 85,P ﹤ 0. 01),left middle temporal gyrus/ superior temporal gyrus(t = 5. 06,P ﹤ 0. 01),the right precuneus/ cuneus (t = 3. 33,P ﹤ 0. 01),and the right superior parietal lo-bule(t = 3. 66,P ﹤ 0. 01),right precentral gyrus(t = 3. 44,P ﹤0. 01),right superior frontal gyrus/ paracentral lobule/ supplementary motor area(t = 3. 50,P ﹤ 0. 01). However,GMV increase was not found. Conclusions Brain GMV extensively decreased in 13 brain regions of IGE patients with typical absence seizure,and among them occipital lobe is the most significant.

Objective:To explore the impact of applying micro-video tracing training model to emerging infectious diseases (EIDs) knowledge training on the autonomous learning ability and learning outcomes among emergency department nurses.Methods:In this study, the training content was developed from the perspective of the historical development of EIDs. The training program was constructed in the form of a micro-video classification module and periodic WeChat group push-based autonomous learning. Convenience sampling was used to select 85 emergency nurses ( n=85) from a grade A tertiary general hospital in Shanghai for micro-video tracing training. The nurses were provided with EIDs knowledge training using a module consisting of 11 episodes, each of which included 5 sessions, i.e., enlightening thinking, micro-video learning, key point consolidation, key point analysis, and extension and expansion. After the intervention, the nurses were compared for their autonomous learning ability and their knowledge, belief, and action levels of EIDs, and their degree of satisfaction with the training model was evaluated. SPSS 20.0 and GraphPad Prism 9.3.0 were used for non-parametric Wilcoxon paired tests of quartiles ( Q25, M, and Q75). Results:After the training, the emergency department nurses had significantly higher scores in overall autonomous learning ability ( Z=-4.69, P<0.001) and in each dimension: concept of self-motivation ( Z=-4.48, P<0.001), task analysis ( Z=-4.06, P<0.001), self-monitoring and regulation ( Z=-4.50, P<0.001), and self-evaluation ( Z=-4.82, P<0.001); they had significantly higher scores in overall knowledge, belief, and action levels of EIDs ( Z=-4.65, P<0.001) and in each dimension: knowledge ( Z=-4.04, P<0.001), belief ( Z=-3.24, P=0.001), and action ( Z=-4.05, P<0.001). Emergency department nurses had a high degree of satisfaction with the training model (degree of satisfaction for each item >90%). Conclusions:The micro-video tracing training model can effectively improve the autonomous learning ability of emergency department nurses and their knowledge, belief, and action levels of EIDs, with a high degree of satisfaction among the nurses, making it promising for wide use.

Objective To construct a nomogram model to predict the risk of pressure injuries (PI) in mechanically ventilated patients in the intensive care unit (ICU). Methods Clinical data of mechanically ventilated patients in the ICU of Zhongshan Hospital, Fudan University from January 1, 2020 to March 15, 2023 were retrospectively collected as the training set, and data from ICU of the same hospital from October 1, 2023 to December 11, 2023 were collected as the external validation set. Risk variables for PI were selected using LASSO regression and Cox proportional hazards model, and a nomogram model was constructed. Receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the model. Calibration curve and decision curve analysis (DCA) were used to assess the model’s calibration and clinical applicability. The external validation was performed using the validation set data. Results A total of 580 mechanically ventilated patients were included in the training set, with 84 cases (14.5%) of PI. LASSO regression and Cox proportional hazards model selected 10 variables to construct the nomogram model. The ROC curve showed an AUC of 0.830 for predicting PI in mechanically ventilated patients. Calibration curve and DCA indicated good calibration and predictive performance of the model. The external validation set included 100 patients, with 12 cases of PI, and the AUC was 0.870. Calibration curve and DCA showed good model performance. Conclusions The nomogram model based on LASSO-Cox regression has good predictive performance and can be used to screen high-risk population for PI in mechanically ventilated patients.