China ; Clinical Competence ; Educational Measurement ; Employment ; Guidelines as Topic ; Humans ; Licensure, Dental ; Preventive Dentistry ; standards ; Professional Practice

Objective:To investigate the effect of individualized and generalized dual track continuous health education on patients with endometrial cancer after operation.Methods:From January 2019 to January 2020, 96 patients with endometrial cancer in the Second Affiliated Hospital of Henan University of traditional Chinese Medicine were enrolled. They were all treated with surgery. According to the random number table method, they were divided into the control group and the study group, with 48 cases in each group. However, during the whole study period, some patients were affected by various factors, and the final number of patients in the study group was 45 cases (dual track continuous health education combined with individualization and generalization) and 45 cases in the control group(routine continuous health education). Before the intervention and 3 months after the intervention, the obstetrics and Gynecology nurses who had received relevant training adopted self-made health knowledge awareness questionnaire, self-care ability assessment scale (ESCA), Medical Coping Style Questionnaire (MCMQ) and simple quality of life scale (SF-36).The patients' mastery of disease knowledge,self-care ability,coping style and quality of life were evaluated.Results::After the intervention,the awareness of health knowledge was 42.23±2.58 in the study group and 35.71±3.26 in the control group, and the difference was statistically significant ( t value was 4.508, P<0.01). After the intervention, the self-care skills, self responsibility, self-concept, health knowledge level and total score of the study group were 9.45±1.58, 11.82±1.63, 61.12±6.52, 10.56±1.33 and 31.83±2.21 respectively, while those of the control group were 5.34±0.75, 7.85±0.92, 68.23±6.45, 6.35±0.94 and 19.54±1.26 respectively, and the difference between the two groups was statistically significant ( t value was 11.025-16.444, P<0.05). After the intervention, the scores of facing,avoiding and yielding in the study group were 19.39±3.29, 10.58±2.40, 9.20±3.12 respectively, and those in the control group were 15.97±3.77, 14.56±3.00, 13.02±2.50 respectively, with significant difference between the two groups( t value was 4.459, 6.762, 6.220, P<0.01). After the intervention, the scores of physiological function,physical pain,social function,mental health,emotional function,vitality and general health in the study group were 80.23±8.12, 22.19±2.63, 44.98±4.25, 76.25±7.64, 69.58±6.23, 70.05±7.22 and 78.31±7.52 respectively, while those in the control group were 59.63±5.14, 52.37±5.38, 41.16±4.73, 57.28±5.36, 55.25±5.27, 46.89±4.52 and 48.96±4.37 respectively, the difference between the two groups was statistically significant( t value was 3.630-11.870, P<0.05). Conclusions:The implementation of individualized and generalized dual track continuous health education in patients with endometrial cancer after surgery has a significant effect, can significantly improve the patient's mastery of disease health knowledge, enhance their self-care ability and positive coping ability, so as to improve their quality of life, which is worthy of clinical promotion.

Objective To analyze the hospitalization expenses of cancer patients covered with byitem payment and quota payment packages,and probe into the impacts on such expenses for the two payment packages.Methods Inpatient records of 600 cancer patients were sampled by random from the medical insurance databases of Zhengzhou and Fuzhou to learn their hospitalization expenses and impact factors.Results Under the by-item payment package,the expenses of urban workers’ medical insurance were found higher than those of urban residents' medical insurance,with a per capita expense of RMB 32747.70 ± 32035.01 and 23035.83 ± 22875.65 respectively.Under the quota payment package however,there were no significant differences between expenses of the two kinds of inpatients,with a per capita expense of RMB 66043.41±47562.09 and 66576.54±73417.29 respectively.Conclusion There are gaps of reimbursement level between the two basic insurance schemes,which may not disappear in a short time.Under the by-item payment package,the gap exists in the difference of perreimbursement amount; under the quota payment package,the gap is negligible between the two populations under different insurance schemes.It is recommended to make reasonable use of these different payment schemes to minimize the relative gaps in medical service accessibility caused by the difference in reimbursement level.

Objective To investigate the safety and feasibility of intraluminal brachytherapy using iodine-125 seed strand for locally advanced pancreatic ductal adenocarcinoma with obstructive jaundice.Methods Clinical data of 17 consecutive patients,from January 2010 to February 2015,diagnosed with pancreatic ductal adenocarcinoma (4 cases of T4 N0 M0 and 13 of T4 N1M0) with obstructive jaundice and received intraluminal brachytherapy using iodine-125 seed strand were collected and analyzed retrospectively.Liver function was evaluated using paired-samples t test.The iodine-125 seed strand radiation doses were calculated using iodine-125 radiation field distribution calculation software (version 0.1,Institute of Radiation Medicine,Fudan University,Shanghai,China) based on the American Association of Physicists in Medicine TG43U1 brachytherapy formula.Obstruction free survival and overall survival were calculated using the Kaplan-Meier method.Complications were assessed according to the CTCAE 4.0 criteria.Results The estimated mean accumulating dose (r =5 mm,240 days) was 167.2Gy,from 164.19Gy to 170.05Gy.The mean and median obstruction free survival time were (9.62 ± 1.47) months (95％CI:6.73-12.50) and (7.26 ± 1.71) months (95 ％CI:3.90-10.62).The mean and median overall survival time were (9.89 ± 1.59) months (95％CI:6.78-13.00) and (7.26 ± 1.71) months (95 ％ CI:3.90-10.62),retrospectively.Total bilirubin and conjugated bilirubin decreased significantly after the therapy.Two patients had adverse event of Grade 3,one of Grade 4.Stent dysfunction occurred in 1/17 (5.9 ％) patients.Conclusions Intraluminal brachytherapy using iodine-125 seed strand might be considered as a safe treatment option for the locally advanced pancreatic duct adenocarcinoma complicated by obstructive jaundice.

Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.

The severity of disease can be used to evaluate the current situation of patients as well as to predict the diseases outcome.In the meantime, the severity among different diseases has been more and more applied in the evaluation of the patients at hospital level.This study collected and summarized different types of international disea-ses grouping tools'characteristics and applications based on the severity of disease, and their suitability and practical values in hospital performance evaluation were compared and analyzed.

OBJECTIVE: To summarize the clinical effect of TPF regimen in the treatment of hypopharyngeal carcinoma and explore various clinical factors affecting treatment efficacy. METHOD: The clinical data of 20 cases with hypopharyngeal carcinoma, who received TPF treatment, were analyzed retrospectively. After two courses of chemotherapy, based on radiographic outcomes, next treatment plan was developed. To sum up the clinical information, including the clinical type, patterns of tumor growth, pathologic type, tumor stage, lymph node metastasis, age and so on. To analyze possible influencing factors affecting curative effect. RESULT: (1) After 20 cases with hypopharyngeal carcinoma received two courses of TPF treatment, the effect was evaluated. Objective response rate was 65%. (2) In patients with hypopharyngeal carcinoma, the efficacy of TPF therapy was significantly related to the clinical type, patterns of tumor growth and pathologic type; there was no statistical significance in tumor stage, lymph node metastasis and age. CONCLUSION According to the clinical type, patterns of tumor growth and pathologic type of hypopharyngeal carcinoma, resistance to chemotherapy in hypopharyngeal carcinoma can be assessed, which provides important basis for designing individualized treatment plan.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome

Objective To develop a micro-circumstance airtight cabin for in the study of biological aerosols detection with such functions as airflow control and temperature and humidity detection .Methods Wind speed sensors , temperature and humidity sensors , electrical control valves , high efficiency filters and the vacuum pump formed the micro-circumstance regulating system .The techniques of airflow direction control , temperature compensation , air pressure control and aerosol uniformity distribution were used .Numerical simulation of aerosol concentration distribution in the airtight cabin was achieved using Fluent software .The bioaerosol concentration in different locations was tested by experiments .Results The micro-circumstance airtight cabin consisted of an airtight cabin and a control cabin .The control cabin used a single-chip microprocessor to provide air supply and exhaust air to the airtight cabin in a seaparate exhaust mode and cyclic ventilation mode.It worked under a negative pressure condition .Through numerical simulation,the aerosols were distributed through-out the cabin after five minutes of generation and the bottom airflow arrived at the top .The distribution of aerosol concentra-tion was approximately uniform .Conclusion The micro-circumstance airtight cabin is suited to various bioaerosols testing research thanks to its negative pressure working without bioaerosol leakage .

Objective To investigate the aerosolized livability,aerosolized quantity and aerosol particle diameter,etc. of phage D29. Methods Phage D29 aerosol was produced in the aerosol test cabinet in negative pressure laboratory. TSI3321 aerodynamic particle sizer spectrometer was used for detecting the diameter of the aerosol particle. Bioaerosol particle median diameter was tested with Anderson six grade microorganism sampler. The aerosolized livability and quantity of phage D29 were determined by the variations of the concentrations and quantities of phage D29 before and after aerosolization.Results The aerodynamic diameter of phage D29 aerosol was 0.872 μm. Bioaerosol particle median diameter was 2.21 μm. The livability after aerosolization for 5,15,30,45,and 60 min were 89.78％,77.19％,48.86％,33.99％,30.12％,respectively. The aerosolized quantity of phage D29 was 232 μl/min. Conclusion The characters of the aerosolized livability,aerosolized quantity and aerosol particle diameter of phage D29 were thought to be suitable for further research into aerosol inhalation treatment of Mycobacterium tuberculosis infection in animals.

This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis re-lated group tool.The coefficient of variation index ( CV) of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty ( relative weights) for each disease.The study has found that severity-based di-agnosis related group systems are more suitable and consistent.However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups.