Objective:To investigate the comfort of postoperative rectal cancer patients with indwelling anal tube and analyze the influencing factors, so as to provide a basis for the formulation of prevention and improvement measures.Methods:The subjective comfort self-report method of digital score and visual analog score was used to investigate and analyze 64 patients with indwelling anal canal in anorectal surgery.Results:The main discomfort of patients with indwelling anal tube were difficulty in sitting and getting in and out of bed, of which 43 cases (61.9%) reported moderate and severe sitting difficulty, and 30 cases (46.88%) reported moderate and severe difficulty in getting up and down the bed. The exposed length of anal canal was the influencing factor of discomfort ( Fvalues were 22.018, 18.213, P<0.01). Conclusion:Rectal cancer patients with indwelling anal tube have serious difficulties in sitting position and getting in and out of bed. Corresponding measures should be taken according to the influencing factors and effective intervention methods should be used to improve the comfort of the patients.

The expressions of Ki67 and FHIT were detected by immunohistochemical staining in 15 cases of adrenocortical carcinoma, 42 cases with adrenocortical adenoma,6 cases of adrenocortical hyperplasia, and 10 cases of normal adrenocortical tissue. The results showed that the highest expression of Ki67 and the lowest expression of FHIT were found in adrenocortical carcinoma. There were significant differences in the Ki67 and FHIT between adrenocortical adenoma and adrenocortical carcinoma ( both P < 0. 05 ). There existed negative correlation between the expressions of Ki67 and FHIT( r=-0. 712, P<0.05 ). Ki67 over-expression and loss of FHIT expression may be involved in the occurrence and development of adrenocortical carcinoma. It is suggested that combined detections of Ki67 and FHIT may have reference significance in the differentiation of adrenocortical adenoma from adrenocortical carcinoma.

Objective To find the best time to remeasure temperature after cooling with evidence-based practice. Methods Used Johns Hopkins′ Evidence Based Practice Tool to find the best time to remeasure temperature after cooling. That tool included three steps which were establish problem, evidence synthesis and transfer evaluation. Results The best time to remeasure temperature after physical cooling was 30 minutes. The best time to remeasure temperature after drug cooling was 60 minutes. The best time to remeasure temperature after physical and drug combination cooling was 30 minutes after physical cooling and 60 minutes after using drug. Conclusion The best time to remeasure temperature after cooling was different because of the different cooling methods.

Objective To investigate the inhibition effect of liraglutide (lira) on high glucose-induced adhesion of endothelial cells to monocyte.Methods Human umbilical vascular endothelial cells (HUVECs) induced by high glucose (20 mmol/L) were incubated with different concentrations of liraglutide (0,0.3,3,30 nmol/L) for different time.THP-1 cells were pre-labeled with Calcein-AM and then incubated with HUVECs for 1 h,M199 medium were used for washing the nonadherent cells for 3 times,and the adhesion of HUVECs to THP-1 cells were measured by Fluorence microplate reader;real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) were employed to detect the mRNA and protein expression of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1),respectively.Western blot was used to measure the content of IκBα,p-IκBα and the distribution of p65 in plasma and nuclear.GST-IκBα was introduced as substrate to test the activity of IκB-kinase (IKK).Results The adhesion of HUVECs to THP-1 (P ＜ 0.01),the mRNA and protein expression of VCAM-1 and ICAM-1 (P ＜ 0.05,P ＜ 0.01),the phosphorylation of κBα (P ＜ 0.05,P ＜ 0.01),the translocation of p65 subunit from plasma to nuclear and the activity of IKK (P ＜ 0.01) in HUVECs were all elevated by stimulation with 20 mmol/L glucose,and the content of IκBα was decreased accordingly (P ＜0.01).Pre-incubation with lira could reverse the above effect of high concentration of glucose.Conclusions Lira could reduce VCAM-1 and ICAM-1 expression through IKK/NF-κB pathways in 20 mmol/L glucose-induced HUVECs,which finally suppress THP-1-HUVECs adhesion.

Objective:To investigate the current situation of diet management in patients with colorectal cancer after stent-based diverting technique, and to provide basis for formulating relevant nursing intervention strategies.Methods:Objective sampling method was used to conduct semi-structured interviews on 15 patients who underwent stent-based diverting technique for colorectal cancer and had the bypass tube removed from Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University from March to July 2023. The interview outline was established based on information-motivation-behavioral skills(IMB) model, and the data were analyzed, summarized and extracted by Colaizzi 7-step analysis method.Results:There were 10 males and 5 females, aged 34-76 years old. According to the three elements of the IMB model, the current situation of diet management was summarized into nine themes. The information included the difficulty in obtaining effective diet guidance information, the lack of specific diet guidance content, the need for individualized diet information guidance mode, and the poor continuity of information exchange after discharge. The motivations included ignoring the importance of diet management, dislike the taste of oral nutritional preparations, and weak support from family members. Behavioral skills include inadequate tube care skills and lack of oral nutrition preparation skills.Conclusions:There are many problems in the diet management of patients after colorectal cancer stent-based diverting technique. Medical staff should optimize the diet education information of colorectal cancer patients after surgery, provide multi-level, multi-time and multi-form continuous care, mobilize the active participation of family members, improve the motivation of patients′ diet management, refine the nursing process of the bypass tube, strengthen the application guidance of oral nutrition preparation skills, and improve patients′ diet management ability.

In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients′ practice guidelines.

OBJECTIVES: To explore the factors that influence self-management behavior in cancer patients based on the theoretical domain framework. METHODS: Studies in Chinese and English about factors influencing self-management behavior in cancer patients were searched from Wanfang database, CNKI, VIP, SinoMed, PubMed, Embase, CINAHL, Web of Science Core Collection, Cochrane library and Medline from inception to June 2022. Two investigators independently identified, extracted data, and collected characteristics and methodology of the studies. Factors were analyzed with Nvivo12, and the theoretical domain framework was mapped to the theoretical domain. Then the secondary node was generalized by theme analysis. Finally, the specific influencing factors were summarized and analyzed. RESULTS: Thirty-four studies were included for analysis. A total of 194 factors were mapped to 13 theoretical domains, and 31 secondary nodes were summarized. Theoretical domains environmental context and resources, social/professional role and identity, and beliefs about consequences were the most common factors. Knowledge, age, self-efficacy, disease stage, social support, gender, economic status and physical status were the most influential factors for self-management in cancer patients. CONCLUSIONS The influencing factors of self-management of cancer patients involve most of the theoretical domains, are intersectional, multi-source and complex.
Humans ; Self-Management ; Neoplasms/therapy*