Objective To investigate the utility of serum prostate specific antigen(PSA) density (PSAD),prostate antigen transition zone density(PSAT) and the ratio of free/total PSA with PSAD [(F/T)/PSAD] in the diagnosis of prostatic carcinoma (PCa) by three-dimensional ultrasonography.Methods Seventy-eight patients (serum prostate-specific antigen between 4-20 μg/L ) were involved.The prostatic volume and its transition zone volume were measured by three-dimensional ultrasonography.Then the relative parameters of PSA [PSAD,PSAT and (F/T)/PSAD] were calculated.Pathologic types were determined by using needle biopsy of prostate.Results Among them,27 patients were suffering from PCa,while the other 51 benign prostate hypertrophy (BPH).The difference of PSAD,PSAT and (F/T)/PSAD between PCa and BPH had arrived statistical significance (P<0.05).Proportions under the PCa curves were 0.736,0.760,0.800 respectively.Considering both sensitivity and specificity,a cutoff was recommanded:PSAD>0.20,PSAT>0.33,(F/T)/PSAD<0.8.Conclusions When the serum PSA level is between 4 μg/L and 20 μg/L,PSAD,PSAT and (F/T)/PSAD are of significant value to differentiate PCa from benign prostatic hyperplasia patients.The data are more reliable if prostatic volume are calculated by three-dimensional transrectal ultrasonography.

Objective The article is prepared to evaluate the efficacy of Chinese acupressure and ventral massage on prevention and treatment of constipation.Methods Electronic databases such as CNKI,VIP,CBM,Wanfang,EBSCO,PubMed and the Cochrane Library were searched from their establishment to December 2013 to meet the inclusion criteria of randomized and quasi-randomized controlled trials.Meta-analysis was conducted using RevMan 5.2 and Stata 12.0 software.Results A total of 29 RCTs involving 3 084 participants were included.The Meta analysis showed that compared with the control group,the new option for prevention and treatment tended to be more effective for constipation.Compared with the control group,first defecation time,defecation difficulty rate,defecation time,dry stool rate and defecating unfinished feeling rate of the experimental group were lower.Laxative provided for the experimental group was less than that of the control group.Conclusions On the basis of available evidence,the traditional Chinese acupressure and ventral massage treatment are effective and safe in prevention and treatment of constipation.

Objective To evaluate the effectiveness of Percu Twist (PT) tracheostomy comparing with that of operative tracheostomy(OT)in intensive care unit(ICU). Methods Related data were retrieved from CBM,CNKI,Wanfang Data,VIP,PubMed,EMBASE,CENTRAL,and Web of Science from the time of their establishment to May 15th 2014,and the data of randomized controlled trials(RCTs)concerning PT and OT were selected. The risk of bias assessment and data extraction were performed by two independent reviewers. Meta analysis was conducted using RevMan 5.2 software. Results A total of 12 RCTs were identified,and 893 patients in ICU were involved. The results of Meta-analysis showed that PT could significantly shorten the operation time〔mean difference (MD)=-15.11,95% confidence interval(95%CI)=-17.14 to -13.07,P<0.000 01〕,reduce the volume of blood loss(MD=-17.59,95%CI=-21.90 to-13.28,P<0.000 01),reduce the size of incision(MD=-2.20, 95%CI=-2.57 to -1.82,P<0.000 01),shor ten the time of healing(MD=-3.60,95%CI=-4.15 to -3.05, P<0.000 01),and reduce complications such as infection of the wound〔odds ratio(OR)=0.20,95%CI=0.10-0.44,P<0.000 1〕and cutaneous emphysema/mediastinal emphysema(OR=0.22,95%CI=0.10-0.47,P<0.000 1)compared with OT group. The funnel plot suggested that publication bias might be found among 12 researches. Conclusions PT was shown to be more effective than OT in ICU with lower incidence of complications. As number of RCT cases is still small with unsatis factory quality,further clinical use is warranted for a better assessment.

Objective To investigate the efficacy of the single-injection technique of PECS Ⅰ and Ⅱ blocks for postoperative analgesia in patients undergoing modified radical mastectomy. Methods Sixty female patients who would undergo elective unilateral modified radical mastectomy, aged 30-65 years, falling into ASA physical status Ⅰ or Ⅱ, were selected and randomly divided into PECS group (group P) or control group (group C), 30 cases in each. After induction, patients in group P underwent ultrasound-guided combined PECS Ⅰ and Ⅱ blocks in a single-injection technique before surgery, 30 ml of 0.5％ ropivacaine was given to these patients. Patients in group C received general anesthesia alone. Anesthesia maintenance was performed by total intravenous anesthesia. The dosage of intraoperative propofol and remifentanil, postoperative recovery time, the requirement of sufentanil at 48 h after operation and the first time pressing the analgesic pump button, rescue analgesic requirements at 48 h after operation and the pressing frequency of analgesic pump were recorded in the two groups. Results The usage of propofol and remifentanil in group P were significantly less than those in group C (P ＜ 0.05). The recovery time after operation was significantly shorter than that in group C (P ＜ 0.05). The total consumption of sufentanil after 48 h was significantly less than that in group C (P ＜ 0.05). The first pressing time of the analgesic pump in group P was significantly later than that in group C (P ＜ 0.05).The rescue analgesic requirements in group P at 48 h were lower than those in group C (P ＜ 0.05).The pressing frequencies of analgesic pump in group P at 24 h were less than those in group C (P ＜ 0.05). Conclusion For patients undergoing modified radical mastectomy, ultrasound-guided combined PECS Ⅰ and Ⅱ blocks in a single-injection technique can reduce the dosage of opioid drugs in the perioperative period, and can provide better analgesic effect after operation.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.