Objective To understand the current situation of nursing human resources at tertiary hospitals in Guiyang city , and to recommend on strategies for nursing human resource management under the universal two-child policy .Methods Stratified sampling method was adopted , and 141 head nurses were sampled from 5 tertiary hospitals in Guiyang city for a customized questionnaires survey .The survey aimed at learning the nursing human resource allocation and work scheduling model in the face of growing number of pregnant and puerperal nurses .Results The 141 departments surveyed in Guiyang tertiary hospitals had a total of 2667 nurses and 6604 beds, with a nurse-bed ratio of 0.4:1 for the hospital in general , but only 34.1％of the departments reached this standard .The number of second-time pregnant nurses and second-time maternity leave nurses posed a significant impact on nursing human resource management (P<0.05). Conclusions Currently tertiary hospitals in Guiyang city seriously lack nursing human resource and the allocation was uneven .With the implementation of the universal two-child policy , the increased number of pregnant and maternity leave nurses placed a great pressure to clinical departments , It is recommended that nursing managers increase the number of nurses , raise bed-nurse ratio up to national requirements , recruit and retain male nurses , call back retired and capable nurses , and minimize factors affecting human resource stability;establish a survey mechanism to learn nurses fertility intention , avoid excessive concentration of pregnant nurses over the same period , and make a reasonable scheduling , for nursing quality stability .

Objective To study the change of vascular endothelial growth factor(VEGF) in myocardial tissue and serum of myocardial ischemia in rats.Methods Twenty SD rats were randomly divided into normal control group and test group. Test group was ligated coronary artery,and the control group was pulled on line but not ligated,then observed the change of VEGF.The histological and immunohistochemical method were used for observing the change of VEGF serum in myocardial ischemia in rats' heart.VEGF levels were measured by image analysis.Results Compared with control group,the expression of VEGF in the myocardial ischemia group was increased obviously(P

OBJECTIVETo investigate the relationship between monoamine oxidase A (MAOA) gene polymorphisms and schizophrenia in a Chinese Han population.

METHODSTwo hundred and twelve schizophrenic patients and 168 healthy controls were recruited according to CCMD-3. The polymorphisms of MAOA gene were determined with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The case-control association analysis was adopted to analyze the frequencies of genotype and allele in schizophrenic patients and controls.

RESULTS(1) The genotypes of MAOA gene were consistent with Hardy-Weinberg equilibrium in patient group and control group (chi2 = 0.618, df= 2, P> 0.05; chi2 = 3.173, df= 2, P> 0.05). (2) The distributions of genotypes or alleles of MAOA genes had no significant difference between patient group and control group (P> 0.05). (3)Divided by sex, the frequency of CT genotype in male patients was higher than that in male controls (chi2 = 7.654, P= 0.022). (4) There were no significant differences of genotypic and allelic distribution in MAOA genes between schizophrenic patients with positive family history and schizophrenic patients with negative family history and among different clinical subtypes in schizophrenic patients (P> 0.05).

CONCLUSIONNo association between MAOA gene and schizophrenia is found in Chinese Han population, but CT genotype is likely to be a susceptible factor of male schizophrenia.

Adolescent ; Adult ; Alleles ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Male ; Middle Aged ; Monoamine Oxidase ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Polymorphism, Restriction Fragment Length ; Schizophrenia ; genetics ; Young Adult

Two female patients with rectal tumor undergoing proctectomy via vagina, namely natural orifice transluminal endoscopic surgery (NOTES), are reported. The operations were performed on June 8 and August 10, 2010, respectively. No Trocar was used in the abdomen except for the transumbilical incision. There were no visible scars in the abdomen. Tubulovillous adenoma and moderately differentiated adenocarcinoma were diagnosed respectively through postoperative pathological examination. Both patients resumed normal work and life at the most recent follow up. Sexual life was satisfactory.
Adult ; Female ; Humans ; Natural Orifice Endoscopic Surgery ; methods ; Rectal Neoplasms ; surgery ; Vagina ; surgery

OBJECTIVETo explore efficacy and safety of modified FOLFIRINOX (mFOLFIRINOX) regimen by dose attenuation in locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer(MPC).

METHODSBetween April 2014 and October 2015, 35 patients with LAPC (n=18) or MPC (n=17) were treated with mFOLFIRINOX regimen (irinotecan 135 mg/m(2), oxaliplatin 68 mg/m(2), 5-FU 2 400 mg/m(2), no bolus of 5-FU, leucovorin 400 mg/m(2)) in the Second Affiliated Hospital of Zhejiang University School of Medicine. The primary end point was progression free survival. The second end points were overall survival, objective response rate, adverse effects, surgical resection rate for LAPC.

RESULTSAmong 35 patients, 6 patients (17.1%) who dropped out and received less than 2 cycles were excluded for response analysis. Among the other 29 patients, 9 patients had grade 3 or 4 adverse effects. No patients ceased treatment due to adverse effects. The 29 patients received 5 (2-13) cycles were evaluated by efficacy and found partial remission in 16 cases, stable disease in 10 cases, progression disease in 3 cases. Response rate was 55.2%. Nine patients with LAPC accomplished surgery after neoadjuvant treatment without perioperative complication and death, and 6 patients accepted R0 resection.

CONCLUSIONSThe mFOLFIRINOX regimen used in the study is well-tolerated in Chinese population with high treatment efficacy on patients with LAPC and MPC. Further investigation of efficacy and adverse effects on more advanced pancreatic cancer patients is necessary.

Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; administration & dosage ; analogs & derivatives ; Disease Progression ; Disease-Free Survival ; Fluorouracil ; administration & dosage ; Humans ; Leucovorin ; administration & dosage ; Neoadjuvant Therapy ; Organoplatinum Compounds ; administration & dosage ; Pancreatic Neoplasms ; drug therapy ; Tertiary Care Centers ; Treatment Outcome

Objective: To study the clinicopathologic features of intraductal papillary neoplasm of the bile duct(IPNB) and to analyze the diagnostic and therapeutic patterns. Methods: The data of 46 patients with IPNB undergoing surgery in Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to November 2017 were retrospectively analyzed.There were 23 males and 23 females with age of (64±8)years.Patients were followed up by clinics and telephone inquiry.Categorical data were compared with χ² test or Fisher′s exact test. Results: Abdominal pain(in 31 patients), fever (in 15 patients) and jaundice (in 11 patients) were the most common symptoms.Twenty-five patients were accompanied with cholangiolithiasis and 25 were accompanied with liver atrophy.Preoperative laboratory examination was mainly manifested as the abnormal liver function caused by biliary obstruction.Typical imaging findings included bile duct dilation (in 45 patients) and mass within bile duct (in 22 patients). All the patients were diagnosed as IPNB histopathologically.Among them, high-grade intraepithelial neoplasia and related adenocarcinoma were more common in mucus-hypersecretion IPNB ((13/15 vs. 51.6%(16/31))(χ²=5.331, P=0.021). Hepatectomy was performed in 25 patients, hepatectomy combined with biliary resection and reconstruction in 12 cases, biliary resection and reconstruction in 3 cases, pancreatoduodenectomy in 3 cases, hepatopancreaticoduodenectomy in 1 case, liver transplantation in 1 case and radiofrequency ablation in 1 case.Forty-one patients were followed up with a median of 30 (12, 41) months.Seven patients suffered recurrence and 6 died. Conclusion IPNB is a rare disease with limited knowledge currently.Images are the main diagnositc means and surgery is the first choice.

Objective:To understand the work experiences of vaccination nurses in western China under the background of free vaccination with COVID-19 vaccine of the entire population, and provide references for these nurses to better their performance in large-scale COVID-19 vaccination.Methods:Semi-structured interviews were conducted on working experience of COVID-19 vaccination with 11 community outpatient nurses who participated in the " Second Western Immunization Planning and Health Summit Forum" held in Chongqing on April 16 to 18, 2021. The sample size was set as information saturation, and the 7-step Colaizzi analytical methods was used in data clarification and analysis.Results:Such interviews extracted three themes: difficulties and challenges, psychological experience, organization and coordination. Difficulties and challenges included shortage of nursing human resources, shortage of resources for routine vaccination, imperfect online appointments, and epidemic prevention and control risks brought by mass vaccination; psychological experience included strong sense of responsibility, accumulation of anxiety, and lack of social identity; organizational coordination included organizational and the overall integration of vaccination resources.Conclusions:Community vaccination nurses have demonstrated a high sense of responsibility and mission in the work of the COVID-19 vaccination. Software and hardware facilities should be enhanced for higher efficiency; vaccination nurses deserve more psychological assistance to help ease their tension; the localities are recommended to organize their vaccination work to fit local conditions.

OBJECTIVESInvestigate the clinical efficacy of cryotherapy ablation treatment for advanced hepatocellular carcinoma. analyse the predictive factors of cryotherapy ablation treatment.

METHODSThere were 190 cases of hepatitis B-related HCC patients with advanced HCC from 2005 to 2008 in our hospital. By using clinical cohort method, they included cryoablation group (147 cases) and control group (43 cases), The median survival time and time to disease progression were compared. Evaluate clinical significance of age, gender, location of portal vein tumor thrombus, HBeAg, tumor histological grade, Child-Pugh classification, end-stage liver disease (MELD) score, advanced liver cancer prediction system (ALCPS) score and the Eastern Cooperative Oncology Group performance status (ECOG PS) score for predicting the efficacy of cryoablation. Group rates were compared with the x2 test, survival analysis by using Kaplan-Meier method, survival rates were compared by Log-rank analysis; multiple factor survival analysis by using Cox regression model.

RESULTSMedian survival time of cryoablation group and Control group was 7.5 (4.2 to 14.6) months and 3.2 (1.2 to 8.6) months, median TTP was 3.5 (2.5 to 4.5) months and 1.5 (1.0 to 3.5 months), the differences were statistically significant ( P less than 0.05 ). Median OS and TTP of advanced HCC patients who had Well-differentiated tumor, Child-pugh A-class and low score of MELD score, ALCPS score, ECOG PS score were significantly longer than the poorly differentiate, Child-Pugh B-class and the high those scores ( P less than 0.05). ECOG PS ( P less than 0.05, 95% CI 1.074 to 2.143) and ALCPS (P less than 0.05, 95% CI 1.005 to 2.121) were independent predictors for OS of advanced HCC.

CONCLUSIONCryoablation treatment can prolong median OS and TTP of advanced HCC; ECOG PS and ALCPS are important predictors for survival time of advanced HCC.

Carcinoma, Hepatocellular ; surgery ; Cryosurgery ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Rate ; Treatment Outcome

Objective:To monitor and analyze the activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020. Methods:Totally 1 074 atmospheric aerosol samples were collected by high flow air sampler (SnowWhite) including 275 in spring, 266 in summer, 262 in autumn and 271 in winter and subjected to analysis by low background high-purity germanium gamma-ray spectrometery (ORTEC) to determine the activity concentrations of 7Be and 210Pb. Results:The activity concentrations of 7Be in atmospheric aerosol were from 0.56 to 14.84 mBq/m 3, with an avearage of 6.84 mBq/m 3, and from 0.01 to 9.37 mBq/m 3 for 210Pb, with an avearage 3.19 mBq/m 3. The differences in activity concentrations of 7Be and 210Pb in atmospheric aerosol among differernt seasons were statistically significant ( F=32.66, 93.93, P<0.05). Activity concentration of 7Be was highest in spring, followed by autumn, and lowest in summer and winter. Activity concentration of 210Pb ranged from winter, autumn, spring to summer in descending order. Conclusions:The activity concentrations of 7Be and 210Pb in atmospheric aerosol in Beijing from 2017 to 2020 fluctated within the range of normal level.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.