Adult ; Blood Glucose ; analysis ; Diabetes Mellitus ; blood ; Electrophoresis, Agar Gel ; Electrophoresis, Paper ; Female ; Hemoglobin A ; analysis ; Humans ; Male

Objective To understand the psychological experience of primary caregivers of patients with cancer-related pain,care to focus on caregivers psychological health, improve life quality and ability to cope with pain. Methods A qualitative, descriptive, semi-structured research were used in this study. Nineteen primary caregivers of cancer patients with cancer-related pain were in-depth interviewed. Colaizzi′s analytical method was adopted to analyze the data, which were then organized into themes and subthemes. Results The primary caregivers confronting cancer-related pain experienced a series of negative psychological changes, worry, fear, anxiety, vexation, sadness, helplessness and powerlessness, their physical and mental health, life were also affected .The primary caregivers were lack of pain related knowledge and pain management skills generally. Conclusion Medical staff should pay high attention to the psychology status of primary caregivers, to provide support, health education and skill training of pain coping strategies, which then might help relieve cancer patients′pain and in turn improve their quality of life.

Objective To evaluate the effect of operation associated with uterine arerial chemotherapy and embolization preoperation.Methods 31 patients with pathologically confirmed cervical carcinoma were treated with interventional therapy,followed by uterectomyandpelvic lymphadenectomy.Results Curative effect was obvious.The lymph metastasis of Ⅱ and Ⅲ stage was 12% and 66.67%respectively.27 patients followedup for 3 years,23 were survived(85.19%).Conclusion For cervical carcinoma,before operation,the interventional therapy can reduce the size of tumor and the metastasis of lymph,improve the ectomy by operation and the survival rate.

Objective To investigate the prevalence of psychological distress and analyze the relevant factors among patients with bladder tumor so as to provide evidence for future clinical practice. Methods Totally 128 patients were recruited from a urological surgery ward of a comprehensive hospital in Beijing in the study by using self-design questionnaire and the psychological distress thermometer (DT) recommended by the U.S. national comprehensive cancer network (NCCN). The acquired data were analyzed by SPSS17.0. Results The average score of the patients was 4.00(1.00~5.00). The identification rate of psychological stress was 55.47%( 71/128 ) , higher than the Chinese normal ( U = 8 . 28 , P < 0 . 05 ) . The relevant factors of psychological stress based on the rank from high to low scores included emotion problems ( 1 . 63 ± 0 . 67 ) , practical problems ( 1 . 42 ± 0 . 64 ) , communication problems (1.29 ± 0.65), physical problems (1.28 ± 0.33) and religion problems (1.00 ± 0.08). Conclusions The prevalence of psychological distress is higher among patients with bladder tumor and the influence factors mainly include emotional problems , practical problems and communication problems. Nurses should pay attention to the psychological distress of patients with bladder tumors and develop targeted interventions so as to relieve their distress.

Objective To summarize the imaging characteristics and clinical diagnostic value of computed tomography (CT) examination in colon cancer combined with obstruction.Methods The clinical data of 33 patients with colon cancer combined with obstruction who were admitted to the Wuxi No.2 People's Hospital from June 2012 to March 2015 were retrospectively analyzed.All the patients received abdomianl plain scan and dualphase enhanced scan of CT,and the imaging data were summarized.Results Of 33 patients with colon cancer combined with obstruction,obstruction was located at the ascending colon in 9 patients,hepatic flexure of the colon in 2 patients,colon transverse in 7 patients,splenic flexure of the colon in 3 patients,descending colon in 3 patients,sigmoid colon in 7 patients and proctosigmoid in 2 patients.Thirty-three patients had irregular and thickened colonic wall at the obstructive segment and irregular constriction of colonic lumen,with a mean coloric wall thickness of 1.9 cm (range,0.6-3.2 cm).The length of constriction was 2.0-3.0 cm in 3 patients,3.1-4.0 cm in 3 patients,4.1-5.0 cm in 11 patients,5.1-8.0 cm in 12 patients and more than 8.0 cm in 4 patients.The mean length,diameter and mean diameter of the constriction of 33 patients were 5.8 cm,0-0.5 cm and 0.2 cm.The performance at the junction of the normal wall and the stenosis was scuff syndrome in 7 patients and shoulder symptoms in 5 patients.Colonic dilatation above the obstructive segment was detected in 26 patients with multiple gas-fluid levels and in 7 patients with mainly gas.Twenty-nine patients had colonic dilatation at the proximal end of obstruction with the diameter of right colonic dilatation of 6.0 cm,diameter of left colonic dilatation of 4.0 cm and colonic collapse at the distal end of obstruction.Thirty-three patients had different grades of cecal dilatation with a mean diameter of 6.9 cm.Three patients had ischemic colitis including 1 patient with colonic perforation and free underarm gas.The serosal invasion or organ involvement of colon cancer was detected in 25 patients with unclear boundary and cable-strip or nodular opacities.Fourteen patients had lymph node metastases,with surrounding tumor or retroperitoneal heterogeneous enhancement,sacvariable necrosis area,short-tempered edge of lymph node,bar-type exudation surrounding some of lymph node.There was 3 patients with hepatic metastases and 1 with pulmonary metastasis.Conclusion Irregular and thickened colonic wall,irregular constriction of colonic lumen,scuff syndrome and shoulder symptoms at the junction of the normal wall,colonic dilatation above the obstructive segment and multiple gas-fluid levels are mainly characterics of CT examination for colon cancer combined with obstruction.

In order to investigate the clinical value of multi-slice computed tomography (MSCT) in the diagnosis of colonic neoplasms,the clinical data of 57 patients who were confirmed as with colonic neoplasms were admitted to the Wuxi No.2 People's Hospital from June 2013 to June 2014.Patients received plain and enhanced scan of MSCT,multiplannar reconstruction (MPR),sliding thin-slab maximum intensity projection (STS-MIP) and curved planar reformation (CPR),and the results of these examinations were compared with the postoperative TNM stage.Of the 57 patients,tumors located at the cecum in 1 patient,ascending colon in 23 patients,hepatic region of the colon in 9 patients,transverse colon in 11 patients,splenic region of the colon in 1 patient,descending colon in 3 patients and sigmoid colon in 9 patients.The results of the CT examination were in accordance with the results of exploratory laparotomy.The wall of the intestine was irregular ring-like thickened in 57 patients.The thickening of the intestine ranged between 0.6-3.2 cm,and patients had intestinal stricture in different degrees.Sixteen patients had gas-fluid level and dilatation of the intestine and were presented with intestinal obstruction signs.Forty-two patients had nodular or mass shadow in sofi tissues,and the nodules or mass protruded into the intestinal cavity or outside of the intestinal cavity,and resulting in intestinal stricture.The junction of the mass and the adjacent intestinal wall was blurred or clear,and the thickness of the intestinal walls was normal.Carcinomatous ulcer was observed in 20 patients.The shape of the ulcer was crateriform.The serosa and (or) adjacent organs were invaded by the tumors in 47 patients.Twenty-seven patients had lymph node metastasis,including 6 had distal metastasis,4 had hepatic metastasis and 2 had pulmonary metastasis.The sensitivity and accuracy of the preoperative CT examination for T stage were 100.0％ (57/57) and 77.2％ (44/57),respectively.The sensitivity,specificity and accuracy of the CT examination for N stage were 67.9％ (19/28),72.4％ (21/29) and 70.2％ (40/57),respectively.The sensitivity,specificity and accuracy of the CT examination for M stage were 100.0％ (6/6),100.0％ (51/51) and 100.0％ (57/57),respectively.The results of CT examination for TNM stage were well correlated with the pathological examination for TNM stage (κ =0.592,0.514,1.000,P ＜0.05).MSCT scanning and post-processing technique are of important clinical value in depicting tumor location,size and morphology,delineating tumor extension,revealing lymph nodes and metastases,and confirming preoperative tumor TNM stage in patients with colonic neoplasms.

Objective To determine the optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion.Methods A total of 240 patients with lumbar intervertebral disc protrusion were randomly and equally divided into four groups,with 60 patients in each group.Under CT guidance intervertebral injection of ozone was performed.The injection dose of ozone(50 ug/ml)used for patients in group A,B,C and D was 10 ml,20 ml,30 ml and 40 ml respectively.Immediately after the procedure CT scanning was made to check the result. A follow-up lasting 6-12 months was carried out.Clinical observation,including the ablation degree of the nucleus puiposus,the therapeutic results and the adverse reactions,was conducted.The results were statistically analyzed and compared among the four groups.Results A significant difference in the therapeutic effect existed between group A(10 ml)and other three groups(P＜0.05),while no significant difference in the therapeutic effect existed among group B(20 ml),group C(30 ml)and group D(40 ml),with P＞0.05.The occurrence of complications was increasing with the injection dose used.Conclusion The optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion is 20 ml.

Objective To investigate the relationship between tumor location and the risk of developing bladder cancer in pafients treated by nephroureterectomy(NU)for upper urinary tract transitional cell carcinoma(UUT-TCC).Methods The clinical data of 168 UUT-TCC patients who underwent NU were reviewed.Univariate and multivariate analysis were carried out to determine the risk factors for intravesical recurrence after NU.Results The recurrence-free survival rate at 1,3 and 5 years after NU were 88%, 76%and 63%.All patients were followed up for a median period of 45(12-107)months During this period, a total of 49 patients developed bladder tamors after surgery,of which 28 cases were renal pelvic carcinoma, 2 cases were rniddle ureter carcinoma and 19 cases were distal ureter carcinoma.The recurrence-free survival of renal pelvic carcinoma and ureter carcinoma had no significant difference by Log-Rank test(P>0.05).On multivariate analysis,only locating in distal ureter carcinoma was the independent risk predictor for intravesical recurrence after NU (P<0.01).Conclusion Pafients with UUT-TCC at distal ureter carry a higher risk for intraeesieal recunerrce after NU than those with TCC at other location of upper urinary tract.

Objective To elucidate the experience and attitude of bad news delivery from nurses to advanced cancer patients, in order to offer better nursing care to the dying cancer patients as well as to provide evidence for end-of-life cancer care. Methods A phenomenological research method of qualitative study was employed in this study. Fifteen nurses caring for dying cancer patients were in-depth interviewed with semi-structured interview guide. Colaizzi analytical method was adopted to collect and analyze the data, which was then organized into themes and subthemes. Results Three themes wereconflict between will and behavior barriers of bad news delivery delivery with comprehensive assessment of dying cancer patients. Conclusions Though the oncology nurses thought the dying cancer patients should be told they were dying, few nurses did that. Communication and hope maintenance related to end-of-life cancer care training should be offered to oncology nurses, as well bad news delivery to ensure cancer patients′safety.

Objective To study the clinical manifestation,diagnosis,differential diagnosis and the essentials of management and treatment of fibrodysplasia ossificans progressiva (FOP).Methods Three cases of FOP were reported.The features of clinical manifestation and radiography were studied.The literature related to FOP was reviewed.Results FOP affected young children′s age of onset was between 10 days and 2 years (mean age 1 3 years).Mean disease duration was 5 3 years (range 2～11 years),and mean age 5 3 years (range 2～11 years) with sex ratio 1∶2 (boy∶girl).Soft tissue swelling in cervical and dorsal regions with or without local pain and warmth,and low fever were the early clinical manifestations.These nodules usually disappeared spontaneously,but some of nodules gradually developed ossification.The X ray features included ectopiac ossification most frequently in the soft tissue of the upper back and neck,next,the loin,chest and extremities.Two cases showed short hallux and hallux valgus.Exacerbation of the two cases was precipitated after muscle biopsy and careless venepuncture.All patients showed progressive extra articular bony ankylosis of most joints of axial and/or appendicular skeleton with severe movement restriction.Conclusion FOP is a rare and disabling genetic disorder of connective tissue.FOP should be diagnosed as early as possible and non invasively,based upon history,clinical and radiological findings.The finding of abnormalities of the great toe is helpful to diagnose FOP so that management can be early and adequate.Manogement principle includes avoiding conditions potentially provocative of abnormal ossification.The disease should be familiar to pediatricians.