Objective To analyze the correlative differences in the cardiac surgery for patients with end-stage renal disease (ESRD) and non-nephropathy disease, and explore the cardiac perioperative nursing for patients with ESRD. Methods A single-center retrospective comparative analysis was conducted in patients with ESRD (ESRD group, 26 cases) and non-nephropathy disease (control group, 26 cases) treated with cardiac surgery from January 2004 to December 2016 in Peking University First Hospital. Postoperative laboratory indexes, the changes of indexes in the monitoring room and the blood transfusion were compared between two groups. Results At 0, 1 and 2 d after the surgery, hemoglobin levels of patients in ESRD group were significantly lower than those in the control group; creatinine and urea nitrogen levels in ESRD group were significantly higher than those in the control group (P< 0.01). Postoperative serum potassium levels in ESRD group were significantly higher than those in the control group (P<0.01). The amount of erythrocyte and platelet transfusion in ESRD group were higher than those of control group (P<0.01). There was no statistically significant difference between the ESRD group and the control group in the ventilator time, 24-hour pleural drainage and total thoracic drainage (P> 0.05). The duration of stay in ICU and postoperative hospital stay were (101.62±49.10) h and (28.23±20.44) d in the ESRD group, which were significantly longer than those in the control group [(71.35±33.10) h, (16.58±8.43) d]. Conclusions ESRD patients have a higher risk in the cardiac surgery when compared with patients with non-nephropathy disease. Therefore, nurses should pay attention to the perioperative electrolyte balance and infusion of blood products, as well as the prevention of postoperative complications and psychological nursing, to help patients with better prognosis.

Objective? To explore the differences between communication demands of tracheal intubation patients and cognition nurses in intensive care unit (ICU). Methods? We selected 105 tracheal intubation patients after the cardiac surgery and 19 nurses provided nursing for them as subjects at Peking University First Hospital by convenience sampling. All of the patients and nurses were investigated with the communication demands scale of tracheal intubation patients, and the differences between them were compared. Results? The total score of demands of tracheal intubation patients was (99.96±24.93) lower than that (123.11±19.48) of cognition of nurses with a statistical difference (P＜0.05). The highest communication demand of patients was the item of "I want to know the time of tube drawing" with (3.33±1.09) for the score ranked fourth in cognition of nurses. The scores of items in demands of love and belonging as well as self-esteem of patients ranked more than the tenth. Conclusions? There are differences between communication demands of tracheal intubation patients and cognition of nurses in ICU especially in physiological needs, safety needs as well as the need of love and belonging. Encouraging patients to express intentions, understanding patients' intentions and avoiding forming the fixed thinking can carry out nursing service better so as to provide the best scientific basis for patients' disease recovery.

OBJECTIVETo study subtype classification of gastric neuroendocrine neoplasm (NEN) and their clinicopathological characteristics in order to provide reference for clinical practice.

METHODSClinicopathological data of 241 gastric NEN patients (174 cases from China-Japan Friendship Hospital and 67 cases from The First Affiliated Hospital of Sun Yat-Sen University) between January 2011 and June 2016 were retrospectively summarized. According to serum gastrin, 24-hour intragastric pH monitoring and pathological grade, patients with gastric NEN were divided into 4 types: type I( (hypergastrinemia and achlorhydria, related to autoimmune chronic atrophic gastritis), type II( [hypergastrinemia and Zollinger-Ellison syndrome, related to gastrinoma or multiple endocrine neoplasia type I( (MEN-I()], type III( (sporadic disease with normal serum gastrin level), and type IIII( [poorly differentiated gastric neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC)]. Clinicopathological features, treatment and prognosis of 4 types were analyzed.

RESULTSOf 241 gastric NEN cases, there were 86 cases (35.7%) in type I(, 7 cases (2.9%) in type II(, 61 cases (25.3%) in type III( and 87 cases(36.1%) in type IIII(. Among 86 cases of type I( gastric NEN, 73 cases (84.9%) were multiple lesions,tumor size of 66 cases (76.7%) was less than 1 cm, all the 86 cases were polypoid or granular lesions. 2 cases(2.3%)presented distant metastasis, 69 cases (80.2%) had pathological grading as NET G1; most of them received endoscopic surgery treatment and follow-up; somatostatin analogs(SSA) was used in patients with multiple lesions and repeated recurrence after endoscopic treatment. Among 7 cases of type II(, 4 cases were gastrinoma, 3 cases MEN-I(; 5 cases presented distant metastasis; treatment included surgery, SSA and proton pump inhibitor (PPI) therapy. Among 61 cases of type III( gastric NEN, 49 cases(80.3%) were single lesion,tumor size of 25 cases(41.0%) was more than 2 cm, 29 cases(47.5%) had lymph node metastasis or distant metastasis; treatment included endoscopic resection, surgery or SSA therapy according to the tumor staging. Among 87 patients of type IIII( gastric NEN, 74 cases(85.0%) had single lesion,tumor size of 51 cases (58.6%) was more than 2 cm; lesions were found in gastric cardia in 35 cases (40.2%); 65 cases (74.7%) had lymph node metastasis or distant metastasis; treatment included chemotherapy, or surgery plus chemotherapy. At the end of follow-up(June 30, 2016), 58 patients were dead, including 1 case of type I(, 12 cases of type III( and 45 cases of type IIII(. The overall survival rate of all the patients was 74.2%, and was 98.8%, 100%, 79.3%, 39.2% of types I(, II(, III(, IIII( respectively. The overall survival rate between type III( and type IIII( gastric NEN was significantly different(P = 0.000).

CONCLUSIONSSubtype classification of gastric NEN is very significant for making therapeutic decisions and prognostic evaluation. Patients of type I( or type II( gastric NEN have good prognosis,while those of type III( and type IIII( have poor prognosis, and those of type IIII( have the worst prognosis.

Adult ; China ; Female ; Humans ; Lymphatic Metastasis ; Male ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neuroendocrine Tumors ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; therapy ; Survival Rate

OBJECTIVETo explore the primary site and pathological feature of neuroendocrine neoplasm (NEN), especially the NEN of digestive system.

METHODSClinicopathological data of NEN patients at China-Japan Friendship Hospital from January 2012 to December 2016 were retrospectively analyzed. Tumor primary sites were summarized. Association between tumor site and pathological grading in gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN) was examined.

RESULTSThere were a total of 903 cases of NEN. Sites of primary tumor included the digestive system in 699 cases(77.4%), the thorax(including lung, thymus and mediastinum) in 87 cases(9.6%), other sites in 60 cases (6.6%), unknown in 57 cases(6.3%). Among 699 GEP-NEN cases, the primary sites included the stomachin in 207 cases (29.6%), pancreas in 201 (28.8%), rectumin in 185 (26.5%), duodenum in 43(6.2%), jejunum and ileum in 18(2.6%), appendix in 15 (2.1%), gallbladder in 11(1.6%), esophagus in 10(1.4%), and the colon in 9 cases (1.3%). Pathologically, the tumor grading was neuroendocrine tumor (NET) G1 in 336 cases(48.1%), NET G2 in 203 cases (29.0%), neuroendocrine carcinoma (NEC) G3 in 139 cases (19.9%). All the esophagus NEN(10/10), most gallbladder NEN(9/11) and colon NEN(6/9) were poorly-differentiated NEC (G3), while all appendix NEN(15/15), most stomach NEN(147/207, 71.0%), pancreas NEN (156/201, 77.6%), rectum NEN (169/185, 91.4%), duodenum NEN (31/43, 72.1%), jejunum and ileum NEN(16/18, 88.9%) were well-differentiated NET G1 or G2.

CONCLUSIONSThe most common primary site of NEN is the digestive system. The stomach, pancreas and rectum are most common primary sitesof GEP-NEN. Difference in pathological grading is quite greatin different primary sites of GEP-NEN. Most NENs fromesophagus, colon and gallbladder are poorly-differentiated NEC.