Objective To explore how to promote the early medical consultation of patients with advanced esophageal cancer to improve the curative rate and the survival rate. Methods With the phenomenological research method, 12 patients with advanced esophageal cancer were sampled for the research. The semi-structure interview method was conducted to collect the data for analyses. Result There were 6 factors influencing the early consultation from the patients with advanced esophageal cancer in their early medical treatment, which included 6 items: lack of knowledge of the disease, economic burden, ignorance of early symptoms, lower medical level, heavy psychological burden of the disease, ageing and delay in seeking medical care. Conclusions The promotion of early medical treatment to the patients with esophageal carcinoma is in critically emergency. The measures including reducing economic burden, corresponding nursing care and health education can improve the cure rate and life quality.

Objective To explore the application value of improved B-Lynch suture in the treatment of cesarean section refractory hemorrhage.Methods To analyze retrospectively the information of cesarean section refractory hemorrhage patients who have taken conventional treatment or improved B-Lynch suture treatment in our hospital,taken the conventional treatment.the uterus was remove when it's invalid.the improved B-Lynch suture treatment was taken.Results In the improved B-Lynch suture treatment group,the patients have apprently little blood loss,shorter time in the cesarean section operation(t =8.58,6.38,P ＜ 0.05).And none of the cases took the hysterectomy or occured DIC.In the conventional treatment group,the blood loss was more,the operation time was longer,and 6 cases took the hysterectomy,5 cases occured DIC.The two groups were significantly different(x2 =6.98,4.59,all P ＜0.05).Conclusion In the cesarean section,if refractory hemorrhage happen and the conventional measures does not work,the improved B-Lynch suture should be taken into consideration.It has good hemostatic effect.

Objective To observe the effect of lidocaine gargle,gentamicin,dexamethasone mixture on degree and cure time of oral mucositis caused by paraquat poisoning.Methods 61 patients with paraquat poisoning were randomly divided into the experimental group (31 cases) and the control group (30 cases); the experimental group was given lidocaine,gentamicin,dexamethasone mixture gargle,the control group was given dexamethasone dilution as gargle.The degree of oral mucositis and healing time were compared between two groups.Results There was significant difference in degree of oral mucositis and healing time between the experimental group and the control group.Conclusions Lidocaine gargle,gentamicin,dexamethasone mixture gargle can reduce degree of oral mucositis and hasten healing in patients with paraquat poisoning.It can alleviate the suffering of patients,and is worthy of clinical application.

Objective To investigate the status of uncertainty in illness and social support among patients with post-traumatic brain syndrome (PTBS) and analyze their correlation.Methods One hundred and fourteen patients with PTBS were selected by convenience sampling and assessment.They were evaluated by Chinese disease Mishel Uncertainty in Illness Scale (MUIS) and Social Support Assessment Scale (SSAS) and the correlation of two scales was analyzed.Results MUIS total score was(135.23±19.29) scores with a median of 128.74 scores and SSAS total score was (43.14±5.54) scores with a median of 42.00 scores in patients with PTBS.Among 114 patients with PTBS,regarding ambiguity score was negatively correlated with objective support,subjective support,utilization degree of support and SSAS total score,r=-0.301,-0.374,-0.521,-0.509,complexity score was negatively correlated with objective support,sub-jective support,SSAS total score and utilization degree of support,r=-0.367,-0.326,-0.355,-0.533,both lack of information and regarding unpredictability score were negatively correlated with utilization degree of support,r=-0.376,-0.330,MUIS total score was negatively correlated with objective support,utilization degree of support and SSAS total score,r=-0.284,-0.424,-0.305.Conclusion There is high uncertainty of PTBS patients;increase of patients' social support will be good for decreasing the ambiguity and com-plexity among patients' uncertainty;promotion of patients' utilization degree of support will help to reduce patients' lack of information and unpredictability.

Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.

Objective To investigate the status of mental health and related factors in cervical cancer patients received radiotherapy and chemotherapy,and to implement individualized nursing intervention.Methods 60 cervical cancer patients with radiation and chemotherapy were enrolled in this study.The depression self rating scale(SDS),anxiety self-assessment scale(SAS) were evaluated,and the influence factors of self-designed questionnaires were investigated.During the same period,60 healthy women of 4 regions in Shantou were selected as control group.The SDS and SAS were compared in two groups.And combined with the influencing factors of the investigation group after the implementation of nursing intervention 7 d psychological assessment again.Results Cervical cancer patients with radiotherapy and chemotherapy,the SDS and SAS scores were (56.1±7.7)points,(45.2±7.5)points,which were significantly higher than those of healthy women [(45.0±6.3)points,(39.2±6.5)points,t=8.142,4.588,all P<0.01].After 7 days of nursing intervention,the SDS and SAS scores in cervical cancer patients decreased significantly[SDS(49.5±6.8)points,SAS(42.7±6.2)points,P<0.05],and the influence factors of patients' mental health were worry about the hospitalization expenses,do not understand the disease related knowledge,fear,the influence of family and society,and worry about the side effects of treatment on the prognosis of disease(88%,80%,80%,75%,68.3%,65%).Conclusion Cervical cancer patients received radiotherapy and chemotherapy have poor mental health status,in the treatment of diseases at the same time,the nursing staff should give psychological counseling and support,improve the patients' anxiety and depression,promote rehabilitation.

Objective To explore the endoscopic features and careinoembryonic antigen (CEA) ex-pressions of colorectal serrated adenomas (SA). Methods From June 2005 to July 2008, 27 patients with colorectal polyps and 26 cases of advanced colorectal cancer (ACC) were enrolled in the study. The pit pat-tern of the suspected lesions were observed with 0. 4% indigo carmine sodium stain and classified according to Kudo classification. The polyps were removed by biopsy, high-frequency electrical excision or endoscopic mucosa resection and the samples of ACC were collected with biopsy forceps. All specimens underwent rou-tine pathological examination and CEA expression was detected by immunohistochemistry. Results There were 47 SAs and 27 other types of polyps in polyp group. Most SAs located in left-side colon and were char-acterized by the bulge semipedunculation. The diameters of 45 serrated adenomas ranged from 3 to 8ram, and the maximal diameter of other 2 were more than 10ram. The most common type of pit pattern in SA was mixed type Ⅱ and ⅢL, with type Ⅱ predominant in a certain percentage. Expression of CEA in SA glands was significantly higher than that in proliferative polyps (P < 0. O1). Candnsion SA is an unique type of colorectal adenoma, which is capable of expressing CEA, and displays malignant potential and deserves great attention.

Objective To explore the incidences of postpartum depression as well as the influencing factors in Guangzhou.Method Nine hundred and seventy women participated in the investigation with the Edinburgh postnatal depression scale(EPDS)to analyze the influenceing factors.Results The incidence rate was 38.87%(377/970). The influencing factors included age,feeding mode,delivery mode and education level.Conclusions The incidence of postpartum depression is at a higher level.The feeding mode,delivery mode and education level are the influencing factors.

Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.

Objective To assess the overall diagnostic value of computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism with the pulmonary angiography as the gold standard.Methods A search in Cochrane Library,PubMed,OVID,and China National Knowledge Infrastructure (CNKI) was performed to identify relevant English and Chinese-language articles from 01/01/1992 to 01/01/2003 (English) and from 01/01/1994 to 01/01/2003 (Chinese),respectively.Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta-Test version 0.9.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity.Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated.Finally,sensitivity analysis was performed.Results Ten of 407 retrieved articles were included,with a total of 855 patients.The reported sensitivity of CTPA ranged from 0.57 to 1.00,and specificity ranged from 0.78 to 1.00.The pooled weighted sensitivity and specificity for CTPA with 95% confidence interval (95% CI) after correction for standard error were 0.84 (0.73,0.91) and 0.91 (0.87,0.94),respectively.The AUC of SROC was 94.95%. Sensitivity analysis demonstrated no disproportionate influences of individual study.Conclusion CTPA has a highly accurate sensitivity and specificity with a strong ROC curve making it an alternative non-invasive method of pulmonary angiography in the diagnosis of PE.