Objective To analyze and summarize the real-life experiences of cancer patients using infusion ports both domestically and internationally. Methods Literatures were searched in the Cochrane Library, Embase, CINAHL, PubMed, Web of Science, ProQuest Dissertations & Theses Global (PQDT), CNKI, Wanfang Database, VIP, and China Biology Medicine up to May 1, 2023. After rigorous evaluation of the retrieved literature, the themes related to the real-life experiences of cancer patients with infusion ports were analyzed and synthesized. Results A total of 13 articles were included, with 6 in Chinese and 7 in English. From these, 64 findings were extracted, comprehensively categorized into 7 groups, and further consolidated into 3 main results: diverse needs across different stages of cancer patients with infusion ports, dynamically intertwined positive and negative psychological states in response to encountered events, and the establishment of a new normal in life experiences for cancer patients with infusion ports. Conclusion Clinical nurses should recognize and address the varying needs of cancer patients with implantable venous access ports at different stages, strengthen their positive experiences, alleviate their negative experiences, assist in adapting to life with implantable venous access ports, improve the quality of nursing services, and enhance patients' sense of happiness.

Objective:To explore the clinical effects of two kinds of nasal bone reductors used for shortened and displaced overlapping external nasal fracture reduction under nasal endoscopy and the impact on ventilation function. Methods:From January 2020 to February 2022, 82 patients with shortened and displaced overlapping external nasal fractures diagnosed and treated in the Department of Otolaryngology, the Second People's Hospital of Hefei were collected as the study subjects. The patients were divided into control group（41 cases） and observation group（41 cases） by random number table method. Both groups underwent closed reduction under nasal endoscopy. The control group was treated with traditional straight nasal bone reductor, and the observation group was treated with gun-shaped hook type nasal bone reductor. The success rate of reduction, follow-up rate, clinical effect, and complications were compared between the two groups. The visual analogue scale（VAS） was used to evaluate the aesthetic effect and functional recovery. Rhinomanometry and acoustic rhinometry were used to evaluate nasal ventilation function. Results:The success rate of one-time reduction in the observation group was significantly higher than that in the control group, and the nasal reduction adaptation time was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups. The success rate of one-time reduction in observation group was significantly higher than that in the control group, and the adaptation time for nasal reduction in observation group was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups in six months after surgery. the total clinical effective rate in observation group was higher than that in the control group（94.87% vs 76.32%, P<0.05）. After surgery, the scores of nasal aesthetics, nasal congestion and olfactory function in both groups were significantly lower compared with the preoperative scores. All the scores in the observed group were lower than that in the control group（P<0.05）. After surgery, there were significant increases in the minimum cross-sectional area of nasal cavity, volume of nasal cavity and total nasal expiratory volume in both groups. Above indicators in observation group were significantly greater than that in control group. The nasal exhalation and inhalation resistance was significantly lower than that before operation, and the resistance in observation group was significantly lower than that in control group（P<0.05）. The total incidence of complications was lower than that in observation group（P<0.05）. Conclusion:The application of gun-shaped hook-type nasal bone reductor in patients with shortened and displaced overlapping external nasal fractures has better success rate of one-time reduction, adaptation time of nasal reduction and treatment outcome. Moreover, it has more advantages in aesthetic effect of nasal appearance, nasal ventilation function and reduction of complications.
Humans ; Nasal Bone/injuries* ; Male ; Female ; Endoscopy/methods* ; Adult ; Treatment Outcome ; Nose/surgery* ; Middle Aged

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

Objective:To investigate the application and effect of the virtual reality (VR) combined with the augmented reality (AR) integrated teaching system in stomatology general medical education of clinical medicine students.Methods:A total of 160 undergraduates from the five-year clinical medicine Batch 2015 of Naval Medical University were randomly divided into VR+AR group and traditional group, with 80 students in each group. A comparative analysis was made on the previous and teaching achievements of the two groups of students, and a questionnaire survey was conducted after the completion of the class. Epidata 3.0 was used to input questionnaire data, and SPSS 23.0 software was used to carry out t test, chi-square test and Fisher precision test. Results:There was no statistical difference in written test scores between the VR+AR group and the traditional group [(52.65±3.76) vs. (51.90±3.46), P=0.516], but the VR+AR group was significantly higher than the traditional group in case analysis scores [(35.85±2.56) vs. (31.40±2.96), P < 0.001] and overall performance [(88.50±4.95) vs. (83.30±4.86), P= 0.002]. The questionnaire survey results showed that the scores of "teaching mode" [(92.30±6.90) vs. (85.20±7.30), P<0.001], "teaching method" [(91.70±5.90) vs. (86.00±6.70), P=0.012] and "teaching improvement" [(90.70± 8.70) vs. (82.30±8.40), P<0.001] in VR + AR group were significantly higher than those in the traditional teaching group. Conclusion:The VR combined with AR integrated teaching system can significantly improve teaching performance and teaching quality, and is convenient for teaching demonstrations and simulation operations in small oral spaces, and is especially suitable for oral general medical education for clinical medicine.

Objective:To understand changes in psychological resilience of nurses rushing to ICU in Wuhan under COVID-19 epidemics, and provide a theoretical basis for the psychological adjustment and psychological intervention of nurses in public health emergencies.Methods:Using phenomenological research method, the first batch of nurses from Nursing Department of Taizhou People's Hospital to assist Wuhan medical team in February 2020 were selected as the research objects based on Richardson psychological resilience model by the purposive sampling method. The diaries of 9 nurses who assisted Wuhan ICU were used as the original data, and the data collection time was based on the principle of data saturation. The data reached saturation after 18 days of rushing to Wuhan. A total of 9 nurses all completed the diary writing, with a total of approximately 28 452 words. The Colaizzi method was used to analyze the data and extract the topic.Results:A total of 3 first-level themes and 8 second-level themes were extracted, namely the stress period (intrusive thoughts, physical challenges, psychological distress) , buffer zone (psychological capital mobilization, team resilience stimulation, comprehension of social support) and restructuring period (balance restoration, self-transcendence) .Conclusions:Psychological resilience is not a constant psychological feature, but a constantly changing process in the game of destruction and reorganization. The psychological resilience of nurses rushing to ICU in Wuhan is in a dynamic process of stress-buffer zone-reorganization period, while enhancing team resilience and external support is conducive to the healthy development of the balance of psychological resilience of nurses who rushed to wuhan.

Objective To investigate and analyze the reasons for the omission of adjuvant radiotherapy after breast-conserving surgery (BCS) in patients with breast cancer.Methods The clinicopathologial characteristics and socioeconomic data of 55 breast cancer patients undergoing BCS without postoperative adjuvant radiotherapy in our hospital from 2012 to 2016 were retrospectively analyzed.Results Among the 55 patients who did not receive radiotherapy,25 patients were due to low local recurrence risk,12 patients were due to economic or family reasons,12 patients were due to fear of adverse reactions of radiotherapy,and 5 patients were not recommended by primary physicians for radiotherapy.In addition,3 cases with multiple distant metastases and 3 cases with concomitant thyroid cancer didn't received radiotherapy.Conclnsions Low risk local recurrence is the main reason for the omission of adjuvant radiotherapy,followed by the fear of radiation-induced toxicity and poor financial support.Patient education and medical insurance may improve the adjuvant radiotherapy compliance.

Background:Previous study has found that harmine inhibited the proliferation of gastric cancer cells by down-regulating cyclooxygenase-2(COX-2)expression. However,its molecular mechanism is not fully clear. Aims:To investigate the effect of harmine on proliferation and apoptosis of gastric cancer cells,and explore the role of PTEN/Akt/MDM2 signaling pathway in this process. Methods:Human gastric adenocarcinoma cell line SGC-7901 and MKN-45 were treated with harmine at different concentrations(2,4,8,16,32 μg/mL)for 24,48,and 72 hours. The cell proliferation and apoptosis were detected by MTT assay and Hoechst staining,respectively. The expressions of PTEN,COX-2, phosphorylated Akt(p-Akt)and p-MDM2 were measured by Western blotting. Results:Harmine dose- and time-dependently inhibited proliferation and induced apoptosis of SGC-7901 and MKN-45 cells. Also,harmine dose-dependently increased PTEN expression,and inhibited p-Akt,p-MDM2 and COX-2 expressions in SGC-7901 and MKN-45 cells. Conclusions:Harmine may inhibit proliferation and induce apoptosis of gastric cancer cells via down-regulating COX-2 expression through PTEN/Akt/MDM2 signaling pathway.

Background: Previous study has found that ursolic acid (UA) inhibited the proliferation of gastric cancer cells by the down-regulation of cyclooxygenase-2 (COX-2) expression.However,its molecular mechanism is not fully clear.Aims: To investigate the role of adenosine monophosphate-activated protein kinase (AMPK)/signal transducer and activator of transcription 3 (STAT3)/COX-2 signaling pathway in UA-mediated inhibition of gastric cancer cells proliferation.Methods: AMPK-pLVX,AMPK-shRNA,STAT3-pLVX,STAT3-shRNA plasmids were constructed,and then were transfected into human gastric cancer cell lines SGC-7901 and MKN-45,respectively.Gastric cancer cells were cultured with different concentrations of UA for different times.The expressions of phosphorylated AMPK (p-AMPK),phosphorylated STAT3 (p-STAT3) and COX-2 were measured by Western blotting,and cell proliferation was detected by CCK-8 assay.Results: UA dose-and time-dependently increased p-AMPK expression,inhibited p-STAT3 and COX-2 expressions in SGC-7901 and MKN-45 cells.Knockdown of AMPK blocked UA-induced inhibition of STAT3 phosphorylation and COX-2 expression.Overexpression of STAT3 blocked UA-induced down-regulation of COX-2 expression.Knockdown of AMPK and overexpression of STAT3 blocked UA-induced inhibition of proliferation of gastric cancer cells.Conclusions: UA may inhibit the proliferation of gastric cancer cells via down-regulation of COX-2 expression through AMPK/STAT3 pathway.

Objective To explore the application and the effect of the situation-background-assessment-recommendation (SBAR) communication mode in the transfer and the handover of surgical patients. Methods One hundred patients who had orthopedic surgeries from June 2015 to December 2015 were included into the control group. They were managed with the traditional method for the surgical transfer and handover. One hundred patients who had orthopedic surgeries from January 2016 to June 2016 were included into the research group. They were managed with the SBAR communication mode for the surgical transfer and handover. The success rate of the surgical transfer and handover, the satisfaction of medical workers, the incidence of adverse events and the average time of the surgical transfer and handover in the patients in the 2 groups were compared. Results In the surgical transfer and handover, the incidence of adverse events such as falling down from bed, the pipeline disconnection, the fluid extravasation, the disease exacerbation in the research group was 2.0%, which was significantly less compared to the control group (20.0%)(χ2=2.020,P<0.05). The average time of the surgical transfer and handover in the research group was (8.5±5.5)min, which was significantly shorter compared to the control group (11.7±8.5)min(t=3.025,P<0.05).Conclusions The application of the SBAR communication mode in the transfer and handover in surgical departments can effectively reduce adverse events and shorten the time of the surgical transfer and handover. It also improves the efficiency of the surgical transfer and handover, ensures patients' safety and promotes the satisfaction.

Objective To explore the application value of the situation-background-assessment-recommendation(SBAR) communication mode in the patients with acute myocardial infarction (AMI).Methods Ninety-four cases of AMI patients who were hospitalized in the department of cardiology in Wuxi No.2 People's Hospital of Nanjing Medical University were included and were randomly divided into the conventional group and the SBAR group. There were 47 cases in each group. The patients in the conventional group were given the routine care; the patient in the SBAR group was given the SBAR communication mode. The nursing satisfaction and the incidence of adverse events in the 2 groups were compared.Results The nursing satisfaction in the SBAR group was 95.74%, which was significantly higher compared to the conventional group (70.21%,P<0.05). The total incidence of adverse events in the SBAR group was 4.25%; in the conventional group the incidence was 25.53%. The difference between the 2 group was significant (χ2=6.42,P<0.05).Conclusions The SBAR communication model can effectively improve the quality of the nurses' disease observation and the nursing satisfaction and reduce the incidence of clinical adverse events, which was worth clinical promotion.