Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75％ (38/51),55％ (28/51) and 22％ ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P ＞ 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P ＜ 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.

Objective To analyze the effect of hand hygiene compliance on the incidence of ventilator-associated pneumo-nia(VAP )in children,and explore the role of hand hygiene in the prevention and control of VAP .Methods Hand hygiene compliance among HCWs in a pediatric intensive care unit (PICU)was intervened,hand hygiene compliance rate of HCWs and incidence of VAP in children with mechanical ventilation from March 1,to October 31,2012 (before intervention)and from January 1,to August 31,2013 (after intervention)were compared.Results Hand hygiene compliance rate after in-tervention was higher than before intervention(37.31%[97/260]vs 24.17% [58/240])(χ2 =10.08,P <0.01);the con-sumption of hand washing liquid and alcohol-based handrub enhanced from 3.48mL /bed day before intervention to 4.49 mL/bed day after intervention,which increasing by 29.02%.The incidence of VAP after intervention was lower than be-fore intervention (2.21‰[5/2 261]vs 6.50‰[13/2 001])(χ2 =4.67,P <0.05).Conclusion Implementation of com-prehensive measures and improvement of HCWs’hand hygiene compliance can reduce the incidence of VAP in chil-dren.

Inflammatory bowel disease ( IBD) is a chronic disease including Crohn′s disease ( CD) and ulcerative colitis ( UC ) .There are no single diagnostic criteria for IBD .Biomarkers are an objective measurement and evaluation of physiological and pathological processes .And they have been widely used in the diagnosis and prognosis monitoring of IBD patients .

Objective To investigate the application and evaluation of objective structured clinical examination( OSCE)in the Comprehensive Nursing Skills and Clinical Thinking Course. Methods We set OSCE assessment program in the Comprehensive Nursing Skills and Clinical Thinking Course,and applied to 214 high vocational nursing students to analyze their exam results,critical thinking ability and the evaluation of OSCE with the method of questionnaire. The differences were compared between the assessment results of OSCE and traditional single course. Results In each OSCE station,the nursing basic skills gained the tiptop score (92. 14 ± 6. 14),while case study gained the lowest score(72. 71 ± 10. 12). There were statistical significance in four OSCE stations performances(F = 261. 171,P < 0. 05). Critical thinking ability score was(263. 85 ± 22. 71),which did not reached positive. The satisfaction score of students to OSEC evaluation method was 88. 26% higher than 85. 45% of traditional one(t = - 3. 995,P < 0. 05). Conclusions OSCE can objectively reflect the weak aspect of students clinical competence,and the students perform it high acceptation. It can provide an evidence for the further improvement of high vocational education.

Objective:To explore the effect of the discharge preparation plan based on community linkage in the out-of-hospital continuous nursing of chronic obstructive pulmonary disease (COPD) patients.Methods:From March 2019 to March 2020, convenience sampling was used to select 206 COPD patients hospitalized in the Respiratory Department of Henan Provincial People's Hospital. The patients were randomly divided into the observation group and the control group, with 103 cases in each group. The control group received routine management of COPD, and the observation group implemented a community-linked discharge preparation plan on the basis of the control group, and carried out a six-month intervention. The COPD Assessment Test (CAT) score, Patient Assessment of Chronic Illness Care (PACIC) score, body mass index, degree of airflow obstruction, dyspnea and exercise capacity (BODE) index, and the patient readmission rate during the intervention period were compared between the two groups before and after the intervention.Results:After the intervention, the item scores and total scores of the CAT of the observation group were lower than those of the control group. Except for cough and sputum, the differences in the other items and total scores were statistically significant ( P<0.05) . The item scores and total scores of the CAT of the observation group after intervention were lower than those before intervention, and the differences were statistically significant ( P<0.05) . The dimension scores and total score of the PACIC of the observation group after the intervention were higher than those before the intervention, and were higher than those of the control group after the intervention, and the difference was statistically significant ( P<0.05) . The BODE index score of the observation group after intervention was lower than that of the control group, and the difference between the two groups was statistically significant ( P<0.05) . The readmission rate in the observation group within six months was 13.59% (14/103) , which was lower than 31.07% (32/103) in the control group, and the difference between the two groups was statistically significant (χ 2=9.068, P=0.003) . Conclusions:The discharge preparation plan based on community linkage can improve the quality of life and lung function of COPD patients, increase the patient's recognition of chronic disease management, reduce the rate of hospital readmission, and achieve the overall quality improvement in continuous nursing of patients.

Objective:To analyze the status quo and hot topics in research on venous thromboembolism (VTE) prevention during the perioperative period and provide references for future research and clinical practice.Methods:Journal articles related to perioperative VTE prevention were retrieved from the Web of Science Core Collection database up to June 30, 2023. Bibliometric analysis was conducted using CiteSpace 6.2.R4.Results:A total of 1 079 articles were included, showing an overall upward trend in the publication volume of perioperative VTE prevention research from 1999 to 2023. Research themes mainly focused on high-risk populations for VTE, high-risk types of surgery, risk factors and assessment, perioperative prevention, and nursing care. Current hot topics include "risk assessment" "anticoagulation therapy" "guidelines" "aspirin" and "rivaroxaban".Conclusions:Perioperative VTE prevention has increasingly garnered the attention of medical and nursing professionals. Future efforts should emphasize international exchange and cooperation to explore strategies for VTE prevention at different stages of the perioperative period and leverage information technology to enhance the quality of perioperative VTE prevention and management.

Objective To study the early survival rate and its influencing factors of extremely preterm infants and extremely low birth weight ( ELBW ) infants.Method All extremely preterm infants and/or ELBW infants in Shandong Provincial Hospital from January , 2010 to December 2015 were studied retrospectively.The factors affecting their survival rate and their complications were analyzed retrospectively . All cases were assigned into the survival group and the death group .On the other hand , they were also assigned into two groups according to their birth , pre-2014 and post-2014.Result A total of 142 extremely preterm infants and/or ELBW infants were enrolled, their gestational age was 28 (27, 29) weeks, birth weight was 925 (830, 965) g.76 cases (53.5%) survived, 66 cases (46.5%) died.Factors associated with the survival rate were early onset sepsis , placental abruption , perinatal asphyxia , birth weight and pulmonary hemorrhage (P<0.05).There were 67 cases pre-2014 in which 30 cases survived (44.8%), while 75 cases post-2014 in which 46 cases survived ( 61.3%) .Comparative analysis between the two groups pre-2014 and post-2014 revealed that the survival rate was significantly different (χ2 =3.900, P=0.048).The top 2 underlying causes of death before 2014 were perinatal asphyxia and early onset sepsis . Furthermore, early onset infection became the first cause of death after 2014.Conclusion Along with the prevalence of neonatal resuscitation program and the optimization of respiratory support strategies in premature infants , the early survival rate of extremely preterm infants and /or ELBW infants has improved significantly.However, early onset sepsis may have been the crucial cause for their perinatal mortality .

Objective:To investigate the diagnosis and treatment for intra-abdominal fistula in China, and to explore the prognostic factors.Methods:A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of patients with intra-abdominal fistula from 18 medical centers from January 1, 2018 to December 31, 2018, including basic information, medical records and prognosis.Results:A total of 106 patients were enrolled in this study, including 57 males and 49 females, with an average age of (48.0±17.8)years. The most common type of intra-abdominal fistula was entero-vesical fistula (34.0%), followed by entero-vaginal fistula (31.1%), entero-enteric fistula (26.4%) and multiple fistula (8.5%). The direct causes of intra-abdominal fistula were mainly surgical operation (66.0%), followed by spontaneous fistula due to Crohn′s disease (18.9%), radiation intestinal injury (11.3%), and 4 cases (3.8%) of unknown reasons. During the whole treatment, 95 patients received nutritional support therapy, mainly EN+ PN (75.8%). Finally, 86 patients (81.1%) received surgical treatment, with a healing rate of 95.3%. After surgery, 8.1% of patients developed surgical site infections (SSI), and 10.5% had a relapse of fistula. 20 patients (18.9%) were treated conservatively, with a self-healing rate of 80.0%. The overall mortality rate was 8.5%, and the highest mortality (15.2%) was found in entero-enteric fistula. Statistical analysis showed that the age ( t=-4.664, P<0.001), leucocyte level ( U=663.000, P=0.010), sepsis ( P=0.002) and multiple organ dysfunction syndrome (MODS) ( P=0.019) were higher in the death group than those in the healing group. Multivariate analysis suggested that advanced age ( OR=1.073, 95% CI: 1.008-1.141, P=0.026) and complications of sepsis ( OR=11.806, 95% CI: 1.064-131.048, P=0.044) were independent risk factors of the death for patients with intra-abdominal fistula. Conclusions:The overall mortality rate of intra-abdominal fistula is still high, and malignant tumor is the most common primary disease. Advanced age and sepsis are independent risk factors for death in patients with intra-abdominal fistula.

Objective:To explore the high risk factors of catheter-related thrombosis (CRT) in breast cancer patients, and provide the basis for the development of appropriate prevention and treatment strategies.Methods:A total of 1 432 breast cancer patients scheduled to receive central venous catheterization in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2015 to August 31, 2019 were selected. Baseline information and catheterization information of patients were collected. The occurrence of CRT was confirmed by vascular ultrasound examination, and the influencing factors of CRT were analyzed.Results:The total number of catheter days were 121, 980 days in 1 432 patients with breast cancer, and the average number of catheter days in each patient was 85.2 days. The incidence of CRT was 6.8% (97/1 432), which was 0.79 cases/1 000 catheter days. Among 815 patients with centrally inserted central venous catheters (CICC), 43 (5.3%) had CRT, which was 0.70 cases/1 000 catheter days. Among 617 patients with peripherally inserted central venous catheters (PICC), 54 (8.8%) developed CRT, which was 0.90 cases/1 000 catheter days. CRT was most common in subclavian vein (63.9%). Multivariate regression analysis showed that age ≥ 60 years old ( OR=1.712, 95% CI: 1.056-2.775, P=0.029), PICC ( OR=1.732, 95% CI: 1.130-2.656, P=0.012), the catheter position except subclavian vein ( OR=10.420, 95% CI: 1.207-89.991), secondary adjustment of catheter position ( OR=3.985, 95% CI: 1.510-10.521, P=0.005) and high D-Dimer level ( OR=1.129, 95% CI: 1.026-1.241, P=0.012)were independent risk factors for CRT. Conclusions:The CRT problem can′t be ignored in the clinical treatment of breast cancer patients with central venous catheterization. Screening the appropriate age of patients and the type of central venous catheters, reducing the secondary adjustment of catheter position, and timely monitoring the level of D-dimer are helpful to the prevention and treatment of CRT.

Objective:To explore the high risk factors of catheter-related thrombosis (CRT) in breast cancer patients, and provide the basis for the development of appropriate prevention and treatment strategies.Methods:A total of 1 432 breast cancer patients scheduled to receive central venous catheterization in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2015 to August 31, 2019 were selected. Baseline information and catheterization information of patients were collected. The occurrence of CRT was confirmed by vascular ultrasound examination, and the influencing factors of CRT were analyzed.Results:The total number of catheter days were 121, 980 days in 1 432 patients with breast cancer, and the average number of catheter days in each patient was 85.2 days. The incidence of CRT was 6.8% (97/1 432), which was 0.79 cases/1 000 catheter days. Among 815 patients with centrally inserted central venous catheters (CICC), 43 (5.3%) had CRT, which was 0.70 cases/1 000 catheter days. Among 617 patients with peripherally inserted central venous catheters (PICC), 54 (8.8%) developed CRT, which was 0.90 cases/1 000 catheter days. CRT was most common in subclavian vein (63.9%). Multivariate regression analysis showed that age ≥ 60 years old ( OR=1.712, 95% CI: 1.056-2.775, P=0.029), PICC ( OR=1.732, 95% CI: 1.130-2.656, P=0.012), the catheter position except subclavian vein ( OR=10.420, 95% CI: 1.207-89.991), secondary adjustment of catheter position ( OR=3.985, 95% CI: 1.510-10.521, P=0.005) and high D-Dimer level ( OR=1.129, 95% CI: 1.026-1.241, P=0.012)were independent risk factors for CRT. Conclusions:The CRT problem can′t be ignored in the clinical treatment of breast cancer patients with central venous catheterization. Screening the appropriate age of patients and the type of central venous catheters, reducing the secondary adjustment of catheter position, and timely monitoring the level of D-dimer are helpful to the prevention and treatment of CRT.