Objective To assess follow-up work status for the patients with breast cancer and analyze the impact factor of the follow-up rate.Methods 331 female patients with complete clinical data in diagnosis and treatment with breast cancer from December 2006 to November 2008 in Shanxi Cancer Hospital were follow-up investigated by telephone.With Logistic regression method,the analysis was preformed on the impact related factors of follow-up effect.Results Telephone follow-up rate was 82.8 ％ (274/331).There was significant difference on the long-term residence between follow-up group and missing group (Fisher exact probability method,P =0.045),the results of regression analysis showed that follow-up results were influenced by the patient's occupation (β=-0.279,s-x =0.116,Wald =5.806,P =0.016,OR =0.757,95 ％ CI 0.603-0.949).Conclusion The telephone investigation for breast cancer patients is an important way for postoperative follow-up.The occupation of patient might influence the investigate results.

Objective:To evaluate the effect of active cycle of breathing techniques (ACBT) on respiratory muscle training in patients undergoing coronary artery bypass grafting (CABG) surgery.Methods:A quasi-experimental trial was performed. Patients were allocated to the control group or intervention group according to their time of admission. Patients who were admitted to hospital from January 2019 to April 2019 were assigned to the control group and patients admitted from May 2019 to October 2019 were allocated to the intervention group. The control group ( n=84) received routine perioperative care, and the intervention group ( n=82) received ACBT in addition to routine perioperative care. Patients in both groups were trained 3 to 5 times a day throughout their stay in the hospital. The primary outcome measure was maximum inspiratory pressure (MIP), peak of expiratory flow (PEF), forced vital capacity (FVC). Other outcomes included the postoperative pulmonary complications (PPC), days of postoperative hospital stay. Results:The MIP, PEF, FVC value of the control group 3 days after extubation were (64.77±9.80) cmH 2O (1 cmH 2O=0.098 kPa), (139.52±23.74) L/min, (1.07±0.20) L, the intervention group were (69.89±10.92) cmH 2O, (150.37±28.65) L/min, (1.15±0.22)L, the differences between the two groups were statistically significant ( t values were -3.177,-2.657,-2.409, P <0.05). The MIP, PEF, FVC value of the control group 5 days after extubation were (71.13±8.64) cmH 2O, (270.48±44.36) L/min, (2.02±0.29) L, the intervention group were (74.72±12.48) cmH 2O, (287.07±58.61) L/min, (2.21±0.35) L, the differences between the two groups were statistically significant ( t values were -2.161,-2.060,-3.605, P <0.05). The days of postoperative hospital stay of control group and intervention group were (8.15±0.98) and (7.80±1.23) d, there were significant differences ( t value was 2.021, P <0.05). Conclusions:ACBT is an effective and economical pulmonary rehabilitation method, it has effect on Respiratory Muscle Training in Patients Undergoing CABG surgery.

Objective To investigate the association between RNF213 rs6565666 polymorphisms and intracranial cystic aneurysms in patients from Guangdong province. Methods Two hundred and fifty patients with intracranial cystic aneurysms, admitted to and conformed by digital substraction angiography (DSA) in our hospital from February 2016 to October 2018, were selected as experimental group; and 250 patients without intracranial aneurysms conformed by DSA, CT angiography or magnetic resonance angiography at the same time period were used as control group. The genotypes of rs6565666 locus of RNF213 gene were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR). Results As compared with those in the control group, percentages of AG and AA genotypes were significantly higher and percentage of GG genotype was statistically higher at rs6565666 locus of patients from the experimental group (P<0.05). The proportion of allele A at rs6565666 locus in the experimental group was statistically higher as compared with that in the control group (P<0.05). In the experimental group, 112 patients had ruptured aneurysms and 138 patients did not have ruptured aneurysms; there was no statistically significant difference in the genotype distribution of rs6565666 between the ruptured group and the non-ruptured group (P>0.05). Conclusion RNF213 gene rs6565666 polymorphism is associated with intracranial cystic aneurysms in patients from Guangdong province.

OBJECTIVETo explore the concentration-response relationship between ambient concentration of PM2.5 and daily total hospital emergency room visits in Beijing during 2012 and 2013. This study also examined the effects of ambient PM2.5 during heavy polluted days on emergency room visits compared with the light polluted days.

METHODSWe collected the daily meteorological factors monitoring data and concentrations of air pollutants in Beijing during October 1, 2012 to December 31, 2013. We also collected the daily emergency room visits from a tertiary hospital in Beijing in the same time period. Generalized additive model was fitted to estimate the association between the ambient PM2.5 and the hospital emergency room visits, by using the smooth function to adjust long term trend of time, public holidays and day of week. In addition, constrained piecewise linear function was then used to estimate the excess risk for different segment of concentration-response function.

RESULTSThe annual average concentration of PM2.5 was 90.9 µg/m(3) during October 1, 2012 and December 31, 2013. There were total 64 260 cases for total emergency room visits, of which respiratory disease had 9 849 cases and cardiovascular disease had 11 168 cases. PM2.5 was positive related with PM10, NO2 and SO2. The corresponding correlation coefficients were 0.87, 0.78 and 0.62, respectively (P<0.05). And PM2.5 was positively related with relative humidity, with correlation coefficient 0.45 (P<0.05). But PM2.5 was negatively related with mean temperature (r=-0.17, P< 0.05) and wind speed (- 0.32, P<0.05). In the single polluted model, after adjusting the effects of temperature, relative humidity and wind, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits was 0.25% (95% CI: 0.07-0.43). In the two-pollutant model PM2.5+SO2 and PM2.5+NO2, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits were 1.07% (95%CI:0.83-1.30) and 0.56% (95%CI: 0.32-0.80) respectively, which were higher than the effect in single pollutant model. Average concentration of ambient particulate matters (PM2.5) was 204.16 µg/m(3) during heavy pollution, higher than control period (85.24 µg/m(3)). When PM2.5 as the primary air pollutants during heavy polluted days, we observed a significant increase in emergency room visits, and the odd ratios was 1.16 (95% CI:1.09-1.22).

CONCLUSIONThere were positive correlation between high concentration of ambient particulate matters (PM2.5) and increasing daily emergency room visits. Especially during the heavy polluted days, the effects of elevated concentration of PM2.5 on hospital emergency room visits were much larger.

Air Pollutants ; analysis ; Beijing ; Cardiovascular Diseases ; diagnosis ; Emergency Service, Hospital ; statistics & numerical data ; Humans ; Meteorological Concepts ; Particulate Matter ; analysis ; Respiratory Tract Diseases ; diagnosis ; Temperature ; Tertiary Care Centers

Objective:To analyze the application effect of health failure mode and effect analysis (HFMEA) model in patients with artificial airways in the cardiovascular surgery intensive care unit (CSICU) by establishing a HFMEA project team, and to develop targeted improvement measures and processes.Methods:The patients undergoing cardiovascular surgeries and with established artificial airways in the Shandong Provincial Hospital Affiliated to Shandong First Medical University were recruited from October 2021 to March 2022. The enrolled patients were divided into the conventional management group and the HFMEA model management group according to random number table method. The conventional management group applied the conventional procedures for monitoring the air bag pressure. The HFMEA model management group used the HFMEA model to implement and improve the airbag pressure monitoring process. The efficacy of HFMEA was assessed by comparing the incidence of ventilator-associated pneumonia (VAP), the pass rate of airbag pressure monitoring, the duration of endotracheal intubation and the length of CSICU stay between two groups. The practicability of HFMEA model was evaluated by analyzing the theoretical assessment scores and practical skill scores of nurses and their satisfaction scores with HFMEA.Results:Compared with the conventional management group, the patients in the HFMEA mode management group had a significantly higher rate of passing airbag pressure monitoring [94.99% (2 994/3 152) vs. 69.97% (1 626/2 324), P < 0.01], shorter duration of endotracheal intubation and length of CSICU stay [duration of endotracheal intubation (hours): 6 (7, 12) vs. 6 (8, 13), length of CSICU stay (hours): 40 (45, 65) vs. 41 (46, 85), both P < 0.05], but the incidences of VAP between the two groups were similar. The theoretical assessment scores and practical skill scores of nurses were significantly higher (theoretical assessment score: 44.47±2.72 vs. 37.59±6.56, practical skill score: 44.56±2.66 vs. 40.03±4.32, total score: 89.03±3.07 vs. 77.63±9.56, all P < 0.05) in the HFMEA mode management group. And the satisfaction scores with airbag pressure management were also significantly higher in the HFMEA mode management group (7.72±1.11 vs. 6.44±1.32, P < 0.05). Conclusions:The application of the HFMEA can improve the airbag pressure measures and standardize the monitoring procedures in patients with artificial airways, and reduce the risk of clinical nursing. It is safe and effective for patients with invasive mechanical ventilation in the CSICU.

Objective:To construct a psychological support training program for palliative care specialist nurses based on positive psychology theory and make a preliminary application.Methods:From August to September, 2020, 142 palliative nursing specialist nurses in Hunan Provincial Palliative Nursing Specialist Training Base were selected as the research objects. Based on positive psychology therapy, using literature review and analysis, semi-structured interviews, expert group meetings and other methods to construct the program, and the work stress, psychological resilience and subjective well-being scores of nurses before and after 8 weeks of psychological support training were compared.Results:The program included three dimensions: cognition, emotion and behavior. After the psychological support training for 8 weeks, the nursing staff′s work stress score 80.76 ± 20.43 was lower than that before the psychological support training 84.70 ± 19.88, the difference was statistically significant( t=6.59, P<0.05), and the psychological resilience score 64.40 ±14.26 was higher than that before the psychological support training 60.19 ±15.85, the difference was statistically significant ( t=-7.39, P<0.05), and the subjective well-being score 75.70 ± 7.70 was higher than that before the psychological support training 74.13 ± 5.98, the difference was statistically significant ( t=-3.52, P<0.05). Conclusions:The psychological support training program based on positive psychology theory can reduce the the work stress, improve psychological resilience and increase subjective well-being of palliative care specialist nurses.

Objective To investigate the role of hesperitin in regulating inflammatory response in early brain injury after subarachnoid hemorrhage (SAH). Methods A total of 96 adult male SD rats were divided into sham-operated group, SAH group, solvent group and intervention group (n=24) by random number table method. The SAH rat models in the latter three groups were prepared by carotid artery puncture method; the rats in the intervention group were given oral administration of hesperidin solution, which was dissolved in 5％ dimethyl sulfolide (DMSO), with a concentration of 1 mg/100 μL and a dosage of 40 mg/kg within 30 min after operation; rats in the solvent group were given oral administration of an equal volume of 5％ DMSO solution. Modified Garcia behavioral scale was used to evaluate the neurobehavior of rats, and the wet/dry weight method was used to measure the water content in the brain tissues of the left and right hemispheres of the rats 24 h after SAH. Immunofluorescence staining was used to detect the microglia activation, Fluoro-dyed Jade C staining was used to assess the brain neuron degeneration, enzyme-linked immunosorbent assay (ELISA) was employed to detect the inflammatory factors interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) content in the brain tissues, and Western blotting was used to detect the nuclear factor-κB (NF-κB) and phosphorylated (p) -NF-κB protein expressions. Results As compared with the solvent group, intervention group had significantly increased improved modified Garcia behavioral scale scores (10.08±1.73 vs. 13.83±1.70), and significantly decreased water content of brain tissues in the left and right hemispheres ([81.44 ± 1.05]％ vs. ([79.14±0.82]％; [80.55±1.55]％ vs. [78.79±1.02]％), significantly smaller number of CD68+ and Iba1+ microglias (30.17±1.04 vs. 10.67±0.75; 29.33±1.16 vs. 12.00±0.41), significantly smaller number of degenerate neurons (53.21±0.94 vs. 31.33±0.28), significantly reduced levels of inflammatory cytokines IL-1β, IL-6 and TNF-α ([429.88±106.32] pg/mL vs. [221.50±48.80] pg/mL; [1015.50±221.80] pg/mL vs. [448.11±93.40] pg/mL; [1021.75±149.17] pg/mL vs. [595.71±190.81] pg/mL), and significantly lower p-NF-κB/NF-κB ratio (1.13±0.07 vs. 0.71±0.02, P<0.05). Conclusion Hesperitin may reduce the inflammatory response mediated by microglia after subarachnoid hemorrhage by inhibiting NF-κB pathway, thereby improving the neurological dysfunction of rats.

Objective To explore the relations of morphologies of intracranial tiny aneurysms with gender,age,hypertension and aneurysm lesions of the patients.Methods A retrospective analysis of clinical data of 112 patients with intracranial tiny aneurysms,admitted to our hospital from January 2009 to December 2012,was performed; according to the aneurysm morphologies,these patients were divided into regular-shape and irregular-shape groups (n=56).The influences of age,gender,hypertension and aneurysm lesions of the patients in aneurysm morphologies were analyzed.Results Gender,age and hypertension were not the independent influence factors of aneurysm morphologies,while aneurysm lesions could significantly affect the aneurysm morphologies,being the independent influence factor of aneurysm morphologies (P=0.005).In the comparison of different distributions of tiny aneurysms,the intemal carotid artery and vertebral basilar artery had less irregular aneurysms than anterior communicating artery; the morphologies of small aneurysms in the anterior cerebral artery,posterior communicating artery and middle cerebral artery showed no significant differences as compared with those in the anterior communicating artery,which tended to having irregular shapes.Conclusion The aneurysm lesions are related to the aneurysm morphologies; anterior communicating artery is prone to having irregular-shape aneurysms.

Objective To explore the effect of Willis circle variation and hemodynamic forces alteration arised from vascular structural abnormity on intracranial aneurysm (IA) rupture using 3D-digital subtraction angiography (DSA) and transcranial color Doppler (TCCD) detection.Methods Two hundred and twenty-three patients with IA,admitted to and conformed by DSA in our hospital from November 2010 to November 2011,were divided into ruptured IA group (n=182) and un-ruptured IA group (n=41).The 3D-DSA was applied in all patients to carefully evaluate the aneurysm sizes,locations,and morphous features,and to confirm the presence of A1 dominance and Willis circle variation.Moreover,aneurysmal neck area,diameter of parent artery,angle between A2 segments of bilateral anterior cerebral artery,angle between aneurysmal longitudinal axis and parent artery,aortic diameter (AD) and aspect ratio (AR) were measured with assistance of 3D-DSA images.Besides,TCCD was applied to all patients,and the hemodynamic parameters were recorded to calculate wall shear stress (WSS) and mechanical stretch.The risk factors of IA rupture were analyzed by receiver operating characteristic (ROC) curve and multivariate Logistic regression with emphasis on Willis circle variation and hemodynamic forces alteration.Results Whether it was in ruptured IA group or in un-ruptured IA group,the incidence rate of variation of anterior Willis circle was higher than that of variation of posterior Willis circle.A1 dominance on the left side was the most common asymmetry.As compared with those in un-ruptured IA group,statistically elder age,smaller AD,larger angle between aneurysmal longitudinal axis and parent artery,decreased WSS and increased mechanical stretch in the ruptured IA group were noted (P＜0.05).ROC curve indicated that angle between aneurysmal longitudinal axis and parent artery,AD,WSS and mechanical stretch could be used to evaluate IA rupture (area under the curve:0.606、0.618、0.396、0.637).Age (OR=8.618,95％CI:2.866-25.917,P=0.000),hypertension (grade Ⅲ OR=16.320,95％CI:1.628-163.556,P=0.018),angle between aneurysmal longitudinal axis and parent artery (OR=3.053,95％CI:1.131-8.242,P=0.028),AD (OR=5.638,95％CI:1.507-20.251,P=0.008) and mechanical stretch (OR=4.230,95％CI:1.554-11.516,P=0.000) were risk factors of IA rupture.A1 dominance (OR=0.242,95％CI:0.074-0.785,P=0.018),small aneurysms (2-5 mm,OR=0.207,95％CI:0.054-0.788,P=0.002) and WSS (OR=0.021,95％CI:0.060-0.672,P=0.009) were identified as protective factors.Conclusions Willis circle variation exists in IA patients.Age,hypertension (grade ⅢD,angle between aneurysmal longitudinal axis and parent artery,AD and mechanical stretch are risk factors of IA rupture,while A1 dominance,small aneurysm (2-5 mm) and WSS are identified as protective factors.Accurate assessment of these factors is of great clinical significance for the prevention and treatment of IA in the future.