1.Predictive value of tumor deposit for the prognosis of patients with yp-stage Ⅲ rectal cancer
Qiaoping ZHU ; Anchuan LI ; Benhua XU
Chinese Journal of Radiation Oncology 2021;30(1):47-53
Objective:To analyze the predictive effect of tumor deposit(TD) on the prognosis of yp-stage Ⅲ rectal cancer patients, and its effect on postoperative adjuvant chemotherapy benefit.Methods:Clinical data of 338 ypⅢ stage rectal cancer patients who received multidisciplinary treatment in Union Medical College Affiliated Hospital of Fujian Medical University from 2007 to 2017 were retrospectively analyzed. All patients were divided into the TD(-) group( n=301) and TD(+ ) group( n=37). Survival analysis was conducted by Kaplan- Meier method, log-rank test and univariate prognostic analysis. Multivariate prognostic analysis was performed by Cox’s regression model. Results:The 5-year overall survival(OS), progress-free survival(PFS), and distant metastasis-free survival(DMFS) in the TD(-) group were significantly higher than those in the TD(+ ) group(59.3% vs. 42.0%, P=0.001, 79.1% vs. 55.0%, P<0.001, 55.6% vs. 38.0%, P<0.001), whereas no significant difference was observed in local recurrence-free survival(LRFS) between two groups(96.7% vs. 85.5%, P=0.679). Univariate prognostic analysis revealed that the number of TD was not correlated with the prognosis of patients( P=0.923), and postoperative adjuvant chemotherapy exerted no significant effect on the prognosis of patients in two groups( P=0.103). In multivariate analysis, TD was associated with worse OS( HR=2.343, 95% CI: 1.257-4.363, P=0.007). Conclusions:For patients with ypⅢ stage rectal cancer undergoing multidisciplinary treatment, the prognosis of patients with TD is even worse. TD is an independent predictor for survival. No benefit can be obtained from postoperative adjuvant chemotherapy regardless of the presence or absence of TD.
2.Construction and validation of a risk prediction model for pneumoconiosis patients complicated with chronic pulmonary heart disease based on Tei index
Yunxiang LI ; Xin LI ; Shaoping PAN ; Qiaoping GAO ; Min ZHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(11):836-839
Objective:To conduct a statistical analysis on the condition of patients with pneumoconiosis complicated with chronic pulmonary heart disease based on the Tei index, and to establish a relevant prediction model.Methods:In March 2022, a retrospective analysis of 226 patients diagnosed with pneumoconiosis in the Department of Occupational Disease of Yantai Yantaishan Hospital from January 2016 to January 2022 was conducted. The patients with pneumoconiosis complicated by pulmonary heart disease were included in the pulmonary heart disease group and others were included in the non-pulmonary heart disease group. logistic regression analysis was used to screen out the relevant factors and establish a risk prediction model. Hosmer-Lemeshow test was applied to determine the goodness of fit of the model, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to evaluate the predictive effect of the model.Results:Among the 226 patients with pneumoconiosis, 58 patients had chronic pulmonary heart disease, accounting for 25.7% of the surveyed population. The logistic analysis showed that the course of disease, pneumoconiosis stage and Tei index were influencing factors of pneumoconiosis complicated with pulmonary heart disease ( P<0.05). A risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease was developed: Z=6.253 X1+1.265 X2+1.423 X3+9.264, in which X1 was the stage of pneumoconiosis, X2 was the course of disease, and X3 was the Tei index. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease, the results indicated that the prediction model was in good agreement with the actual situation (χ 2=11.59, P=0.254). The diagnostic ability of the model was evaluated by the ROC curve, and the results showed that its AUC was 0.897, the sensitivity was 0.947, and the specificity was 0.784. Conclusion:The course of disease, pneumoconiosis stage and Tei index are the influencing factors of pneumoconiosis complicated with pulmonary heart disease. The model constructed based on these factors has a good prediction effect, which can provide a basis for the early detection and intervention of pneumoconiosis complicated with pulmonary heart disease.
3.Construction and validation of a risk prediction model for pneumoconiosis patients complicated with chronic pulmonary heart disease based on Tei index
Yunxiang LI ; Xin LI ; Shaoping PAN ; Qiaoping GAO ; Min ZHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(11):836-839
Objective:To conduct a statistical analysis on the condition of patients with pneumoconiosis complicated with chronic pulmonary heart disease based on the Tei index, and to establish a relevant prediction model.Methods:In March 2022, a retrospective analysis of 226 patients diagnosed with pneumoconiosis in the Department of Occupational Disease of Yantai Yantaishan Hospital from January 2016 to January 2022 was conducted. The patients with pneumoconiosis complicated by pulmonary heart disease were included in the pulmonary heart disease group and others were included in the non-pulmonary heart disease group. logistic regression analysis was used to screen out the relevant factors and establish a risk prediction model. Hosmer-Lemeshow test was applied to determine the goodness of fit of the model, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to evaluate the predictive effect of the model.Results:Among the 226 patients with pneumoconiosis, 58 patients had chronic pulmonary heart disease, accounting for 25.7% of the surveyed population. The logistic analysis showed that the course of disease, pneumoconiosis stage and Tei index were influencing factors of pneumoconiosis complicated with pulmonary heart disease ( P<0.05). A risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease was developed: Z=6.253 X1+1.265 X2+1.423 X3+9.264, in which X1 was the stage of pneumoconiosis, X2 was the course of disease, and X3 was the Tei index. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease, the results indicated that the prediction model was in good agreement with the actual situation (χ 2=11.59, P=0.254). The diagnostic ability of the model was evaluated by the ROC curve, and the results showed that its AUC was 0.897, the sensitivity was 0.947, and the specificity was 0.784. Conclusion:The course of disease, pneumoconiosis stage and Tei index are the influencing factors of pneumoconiosis complicated with pulmonary heart disease. The model constructed based on these factors has a good prediction effect, which can provide a basis for the early detection and intervention of pneumoconiosis complicated with pulmonary heart disease.
4.Research on back scraping skin symptoms of sub healthy population based on constitution theory of traditional Chinese Medicine
Qiaoping LI ; Jiali CHEN ; Xiaoyu WANG ; Juan WU ; Xiaoxia LI ; Xiurong TANG
Chinese Journal of Practical Nursing 2023;39(25):1942-1947
Objective:To observe the characteristics of back scraping skin symptoms in sub-health people through diagnostic scraping, and explore the characteristics of back scraping skin symptoms in sub-health people with different constitutions.Methods:By adopting a cross-sectional study method, the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine recruited volunteers through a combination of offline and online methods from March 2021 to September 2022. Totally 2 239 sub-health people were treated for TCM constitution identification and were diagnostic scraped with Wentong scraping cup. The differences of back scraping skin symptoms in the color, speed, amount, shape, nature of pain and feeling characteristics under scraping board were compared between sub-health people with different TCM constitutions and gentle constitution.Results:There were differences in the characteristics of Sha Xiang among sub-health individuals with different constitutions. Among them, 49.02% (351/716) of individuals with a gentle constitution had a bright red color, 90.64% (649/716) had a fast rate of appearance, 5.73% (41/716) had a large amount of sha, 3.35% (24/716) had a patchy shape, 3.35% (24/716) felt a stabbing pain, and 0 felt nodules under the scraping plate. Among individuals with a damp-heat constitution, 86.72% (457/527) had a bright red color, 95.64% (504/527) had a fast rate of appearance, 100.00% (527/527) had a large amount of sha, 88.80% (468/527) had a patchy shape, 95.64% (504/527) felt a stabbing pain and 97.72% (515/527) felt nodules under the scraping plate. There was a statistically significant difference between the two groups ( χ2 values were 11.27 to 1 243.00, all P<0.05). Conclusions:The characteristics of back scraping skin symptoms of sub-health people with different constitutions are different. It is expected that the type of TCM constitution of sub-health people can be judged according to the characteristics of scraping skin symptoms in the future, in order to guide patients in health management and improve their satisfaction with traditional Chinese medicine scraping treatment.
5.Hyperbaric oxygen therapy can effectively treat diabetic foot wounds
Yunxiang LI ; Haihua XIU ; Qiaoping GAO ; Tao FANG ; Chunni CAO ; Min ZHANG
Chinese Journal of Physical Medicine and Rehabilitation 2022;44(8):722-726
Objective:To observe the effect of supplementing vacuum sealing drainage with hyperbaric oxygen in the short term treatment of diabetic foot ulcers.Methods:A total of 156 persons diagnosed with diabetic foot ulcers were randomly divided into a control group and a treatment group, each of 78. Both groups received life guidance and active treatment to lower blood sugar and lipids, as well as anti-infection treatment guided by bacterial cultures. Both groups′ wounds were debrided. The wound was then covered with foam, sealed, and negative pressure of -75 to -100mmHg was applied during 1 week of drainage. Two courses of this treatment were applied. In addition, the treatment group received hyperbaric oxygen daily during the two weeks. The exposure pressure was incrased to 0.25MPa over 15min with 100% oxygen. That was inhaled in two 30min sessions with a 10min interval. The pressure then decompressed at a constant rate for 25 minutes. Wound healing, hemorheology, wound granulation tissue staining and any changes in TGF-β1 were observed before as well as after 7 and 14 days of the treatment.Results:The average wound size and symptom score of both groups had improved significantly after the treatment, with the largest effect in the treatment group during the first week. Both groups′ hemorheology had improved significantly after one week, but the treatment group′s improvement was greater. After 2 weeks, however, there was no significant difference in the average hemorheologic indicators for either group compared with before the treatment. Hematoxylin-eosin staining of the wound tissues showed that there were many inflamed cells before the treatment, with relatively little fresh granulation tissue or new blood vessels. After one week of treatment much new granulation tissue was observed under the microscope in both groups, with no significant difference between them. One week later, there was still much granulation tissue in the control group, but slightly less in the treatment group. The ave-rage post-treatment TGF-β1 protein levels in the wound tissues of both groups were significantly higher than before the treatment, but after two weeks the average TGF-β1 protein level had decreased significantly in the treatment group compared with the control group.Conclusions:One week of hyperbaric oxygen treatment can effectively improve the hemorheology of persons with diabetic foot ulcers, promote the proliferation of granulation tissue and fibroblasts, and increase the level of TGF-β1 protein in the wound tissues. However, the effects of hyperbaric oxygen treatment weaken gradually with time.
6.Application effect of multidisciplinary teamwork model in patients with minimally invasive partial nephrectomy
Weihong WANG ; Li ZOU ; Qiaoping WANG ; Qinqin LU ; Huiping ZHOU ; Haofen XIE ; Zejun YAN
Chinese Journal of Modern Nursing 2021;27(30):4119-4123
Objective:To explore the application effect of multidisciplinary teamwork mode in patients with laparoscopic partial nephrectomy of renal carcinoma.Methods:A total of 86 patients with renal cancer who received laparoscopic partial nephrectomy in Ningbo First Hospital of Zhejiang Province from February to December 2019 were selected by the convenient sampling method. According to admission time, the patients were divided into the control group and the observation group, with 43 cases in each group. The control group implemented urological nursing routines and various measures recommended in the accelerated rehabilitation surgery guidelines, while the observation group adopted a multidisciplinary team collaboration model based on evidence-based nursing on the basis of the control group. The Kolcaba General Comfort Questionnaire (GCQ) and Numerical Pain Rating Scale (NPRS) were used to evaluate the comfort and low back pain of the two groups at 1, 3, and 5 days after surgery. Hamilton Anxiety Scale was used to evaluate anxiety of patients in both groups 5 days after surgery, and postoperative rehabilitation indicators (postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time, postoperative hospital stay) were collected in both groups.Results:The total score of GCQ of observation group was higher than that of control group on 1, 3, and 5 days after operation, and lower back pain score was lower than that of control group. The postoperative anxiety score, postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwelling time and postoperative hospitalization days in the observation group were lower than those in the control group. There were statistically significant differences between the two groups ( P< 0.05) . There was no postoperative bleeding or deep venous thrombosis (DVT) in the lower limbs of patients of the two groups. Conclusions:The multidisciplinary teamwork model can alleviate the postoperative anxiety of patients with partial nephrectomy, improve their overall comfort, shorten the postoperative hospital stay and promote postoperative recovery.
7.Application and effect of information management in nursing of incontinence associated dermatitis among elderly patients
Qiaoping LYU ; Qin JIA ; Xiang'ai SUN ; Danying QIU ; Qin ZHOU ; Jun LI
Chinese Journal of Modern Nursing 2020;26(23):3166-3169
Objective:To explore the application and effect of information management in nursing of incontinence associated dermatitis (IAD) among elderly patients.Methods:From April 2019, the Cadre Department of Zhejiang Provincial People's Hospital carried out information management of IAD in elderly patients. Relying on the Ding Talk platform to provide nurses with information training and assessment of IAD knowledge, and to carry out information management of skin management in the elderly incontinent patients. Using before-after study, we randomly selected data of 80 elderly patients from October 2018 to March 2019 as control group, and selected data of 80 elderly incontinent patients from April to September 2019 as experimental group. We observed the incidence and time of IAD between two groups.Results:After information management, the incidence of IAD of experimental group patients was 13.75% (11/80) lower than that 33.75% (27/80) of control group with a statistical difference ( P<0.05) . The time of IAD of experimental group was (10.46±2.01) d, which was significantly later than that [ (5.47±2.29) d] of control group ( P<0.05) . Conclusions:Information management can effectively reduce the incidence of IAD in elderly patients, delay the occurrence time and improve the nursing effect.