Objective To explore epirubicin hydrochloride combined with capecitabine tablets on serum levels of osteopontin (OPN), vascular endothelial growth factor C ( VEGF-C) and its efficacy in the treatment of patients with triple-negative breast cancer.Methods 80 cases triple-negative breast cancer were selected, randomly divided into two groups, 40 cases in each group.The control group were given epirubicin treatment, joint group on the basis of the control group were combined with capecitabine, 21 days for a course of treatment, four courses of treatment.The serum levels of OPN and VEGF-C pre-and post-treatment were detected, the efficacy and adverse reactions were observed.Results Compared with before treatment, the serum levels of OPN and VEGF-C in two groups were lower post-treatment(P<0.05).Compared with control group, the OPN and VEGF-C levels in joint group were lower (P<0.05), the efficacy was higher and the adverse reaction was lower (P<0.05).Conclusion The epirubicin hydrochloride combined with capecitabine tablets could reduce serum OPN and VEGF-C levels in the treatment of patients with triple-negative breast cancer, with high security.

Objective To analyze the effects of Fuzheng Xiaoai decoction joint tamoxifen on serum sex hormone and endometrial thickness with breast cancer.Methods 124 patients with breast cancer were divided into control group and research group by lot drawing method, all as 62 cases, treated with the same surgery, control group was treated with tamoxifen, research group was treated with Fuzheng Xiaoai decoction based on control group, the sex hormones, endometrial thickness, tumor markers, immune function and complications were compared between two groups.Results The prolactin (PRL), progesterone (P), estradiol (E2) of research group were all lower than control group, the difference were statistically significant (P<0.05).The endometrial thickness of research group [(8.61+1.07) mm]was lower than the control group [(9.74+1.21) mm](P<0.05).The tumor markers, immune function of research group were better than that of control group (P<0.05).The complications was no difference between two groups. Conclusion Fuzheng Xiaoai decoction joint tamoxifen can regulation the serum levels of sex hormone, relieve tamoxifen-induced endometrial thickening, can improve tumor markers and immune function .

Objective To explore the application of central venous catheter(CVT) in hemodialysis.Methods The clinical data of 2 206 cases of CVT patients were analyzed retrospectively,and the catheter puncture site,the catheter indwelling time,4 weeks of blood flow rate and the incidence of catheter related infections,and so on were observed.Results Internal jugular vein in 2 033 cases,the femoral vein in 173 cases.Internal jugular vein indwelling catheter time was (40.6 ±32.7) d,the femoral vein catheter indwelling time was (22.4 ± 16.3) d,and the difference was statistically significant (P＜ 0.05).Blood flow patency rate in four weeks was of 96.4％ (1 959/2 033) indwelling catheter in internal jugular vein,which was significantly higher than that of the femoral vein in 83.2％ (144/173),and the difference was statistically significant (P ＜ 0.05).Femoral vein catheter related infection rate was 11.0％ (19/173),significantly higher than that of internal jugular vein in 3.6％ (73/2 033),the difference was statistically significant (P ＜ 0.05).Conclusion Application of CVT for hemodialysis is convenient and reliable,with low infection rate,fewer complications,operation technology level is the key to success.

Objective To investigate the efficacy and safety of different doses of dezocine at different administration time on analgesia after laparoscopic cholecystectomy.Methods 80 patients elected from ASA Ⅰ-Ⅱ grade laparoscopic cholecystectomy were randomly divided into four groups,20 cases in each group.Group Ⅰ was anesthetized by intravenously injected dezocine 0.10mg/kg before the surgery,group Ⅱ was anesthetized by dezocine 0.15mg/kg before the surgery,group Ⅲ was anesthetized by intravenously injected dezocine 0.10mg/kg after stopping anesthetic surgery,and group Ⅳ was anesthetized by intravenously injected dezocine 0.15mg/kg after stopping anesthetic surgery.The postoperative pain scores were observed 1,6,12,24 hours after operation in the four groups by using visual analog scale (VAS),comfort score (BCS),and anesthesia recovery score (modified Aldrete score).Results TheVAS of the four groups 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.308,P =0.036),group Ⅰ and group Ⅳ was significantly different (t =2.106,P =0.042),group Ⅱ and group Ⅲ was significantly different (t =2.711,P =0.014),group Ⅱ and group Ⅳ was significantly different (t =2.317,P =0.037).The BCS 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.108,P =0.042),group Ⅰ and group Ⅳ was significantly different(t =2.069,P =0.048),group Ⅱ and group Ⅲ was significantly different (t =2.353,P =0.033),group Ⅱ and group Ⅳ was significantly different (t =2.361,P =0.036).The VAS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.084,P =0.045),group Ⅱ and group Ⅲ was significantly different(t =2.309,P =0.038),group Ⅱ and group Ⅳ was significantly different(t =2.303,P =0.040).The BCS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.294,P =0.041),group Ⅱ and group Ⅲ was significantly different(t =2.322,P =0.035),group Ⅱ and group Ⅳ was significantly different (t =2.070,P =0.048).The BCS 12 hours after surgery:group Ⅱ and group Ⅲ was significantly different(t =2.518,P =0.047).VAS and BCS scores at other time points had no significant difference (P ＞ 0.05).Conclusion The analgesic after laparoscopic gallbladder surgery using dezocine 0.10mg/kg-0.15mg/kg,especially 0.15mg/kg administered anesthesia before surgery,can effectively relieve postoperative pain and improve postoperative comfort,reduce postoperative analgesic(pain pump) and has less adverse reactions,which is worthy of promotion.

Objective To understand the present situation of happiness of the elderly living in nursing homes and discuss the related factors.Methods Using the method of questionnaire,the happiness of the elderly over sixty years old and its influencing factors in eleven nursing homes in Changchun were discussed.Results Among many influencing factors,health status,the reasons for living,marital status and self-care status affected the happiness of the elderly in nursing homes.Above all,the health status had the most significant effect on happiness.Conclusions Improvement of the health level of the elderly in nursing homes can improve the happiness of them.

Hand ; Humans ; Occupational Exposure ; Vibration ; Workplace

Objective? To explore burden on family caregivers of elderly patients with chronic obstructive pulmonary disease (COPD) and to discuss the influencing factors of caregiver burden. Methods? Totally 190 family caregivers of elderly COPD patients treated in a Class III Grade A hospital in a city between January and December 2017 were selected by convenient sampling. The caregiver burden of these elderly COPD patients were investigated with the general information questionnaire, Zarit Burden Interview (ZBI) and Social Support Rating Scale (SSRS). Multiple linear regression analysis was used to analyze the influencing factors to caregiver burden. Results? The total score of caregiver burden of elderly COPD patients was (52.32±7.42), and the total score of social support was (25.23±5.93). Multiple linear regression analysis showed that age, occupation, time of daily care,medical service availability and social support were the main influencing factors to caregiver burden (P＜ 0.05). Conclusions? The caregiver burden of elderly COPD patients is at a medium level and is affected by multiple factors. More disease and nursing care related knowledge and information should be provided to the caregivers based on their actual conditions so as to improve the social support for caregivers as well as the caregivers' physiological and mental health and their quality of life.

Smart dressings, which show obvious advantage and potential in wound treatment and real-time monitoring, attract widespread attention in recent years. Real-time and dynamic acquiring wound information is vital to the treatment and prognosis of wound. Further research on smart dressings is helpful for wound management, personalized treatment, and realization of medical application translation of health monitoring technology. In the article, we categorize smart dressings and conclude their functions according to the type of micro-environment information of wound gathered by smart dressings.

Sepsis is currently the leading cause of death in the intensive care unit, and its survivors also experience long-term immunosuppression and high rates of recurrent infections. At present, the clinical treatment of sepsis is still based on antibiotics, intravenous rehydration, and vasopressors, and there is no targeted drug treatment. However, as the rate of antibiotic resistance continues to increase, immunotherapy is highly anticipated as a new treatment. Patients with sepsis are often accompanied by acute leukocyte immune dysfunction and immunosuppression, which may be an important risk factor for the increasing morbidity and mortality of patients. Targeted inhibition of specific cell surface inhibitory immune checkpoint receptors and ligands, such as programmed death receptor-1 (PD-1), programmed death-ligand 1 (PD-L1), and other targets, can improve the host’s resistance to infection. In this paper, the research progress of PD-1 and PD-L1 in the immune response to sepsis was summarized to provide a theoretical basis for their further application in the treatment of sepsis in the future.

Objective? To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods? Based on the informationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People＇s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients＇ incontinence risk, position and Incontinence Associated Dermatitis Severity(IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results? After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staff's accuracy rate in the risk assessment of incontinence (χ2=38.095,P＜0.01), IADS (χ2=64.901,P＜0.01), clinical staging accuracy (χ2=42.424,P＜0.01) and the implementation of protective measures (χ2=50.000, P＜0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ2=41.031, P＜0.01). Conclusions? The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.