Endometrial Neoplasms ; pathology ; Female ; Humans ; Pregnancy ; Trophoblastic Neoplasms ; pathology ; Trophoblasts ; pathology

Objective:To examine the status of career decision-making and its influencing factors among nursing postgraduate students.Methods:From October 2018 to December 2019, 249 nursing postgraduate students from universities were selected by convenience sampling method and were investigated using general information questionnaire, Career Decision-making Difficulties Questionnaire, Professional Identity Scale and Proactive Personality Scale.Results:The score of postgraduate nursing students' career decision-making difficulties was (58.10±8.98). Correlation analysis showed that the score of the career decision-making difficulties was positively correlated with professional identity and proactive personality of nursing postgraduate students ( r=0.187, 0.581, P<0.01). Multiple linear regression analysis showed that gender, whether they had received career counseling and proactive personality scores were influencing factors of career decision-making difficulties which explained 38.0% of the total variation. Conclusions:The career decision-making difficulties of nursing postgraduate students is at a medium level. Educators can reduce the career decision-making difficulties of nursing postgraduate students by conducting career counseling, improving professional identity or enhancing career initiative.

Objective To investigate the relationship between serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and clinicopathological features and prognosis of serous ovarian cancer retrospectively. Methods A total of 73 patients with serous ovarian cancer treated in the Department of Obstetrics and Gynecology of Tianjin Medical University General Hospital from January 2000 to December 2015 were included in this study. The relationship between serum FSH, LH, PRL and clinicopathological features was analyzed by Mann-Whitney U method. Kaplan-Meier (K-M) method was used to analyze survival rates of patients with different clinical features. Multivariate Cox proportional hazards regression analysis was used to analyze prognostic factors of serous ovarian cancer patients. Results The mean concentrations of serum FSH and LH were significantly higher in the>50 year-old group than those in the<50 year-old group (P<0.05). The mean concentrations of FSH and LH were significantly higher in menopause group than those in non-menopause group (P<0.05). There were no significant differences in serum levels of FSH and LH in patients with other different clinicopathological features (P>0.05). There was no significant correlation between serum PRL concentration and clinicopathological features (P>0.05). Analysis results showed that poor prognosis of patients was related with high serum levels of FSH (>40.13 IU/L), PRL (>14.96 μg/L) and FIGO stage (Ⅲ+Ⅳ) (P<0.05). There was no significant correlation between serum LH concentration and prognosis (P>0.05). COX regression analysis showed that the serum PRL>14.96 μg/L was risk factor for prognosis of serous ovarian cancer [HR(95%CI): 3.530(1.180-10.557),P=0.024]. Conclusion The serum levels of FSH and LH are significantly increased in postmenopausal women than those in menopause women. The serum level of PRL is correlated with the prognosis of serous ovarian cancer.

A 10-year and 9-month-old female patient presented with skin rashes all over the body,fever and superficial lymphadenectasis for 18 days after an intravenous drip of fosfomycin.Skin examination showed generalized swollen erythema all over the body,whose surfaces were covered with a large number of sticky furfuraceous grey-white scales.Laboratory examination revealed markedly increased levels of alanine aminotransferase and aspartate aminotransferase,as well as an increased number of eosinophils.Histopathological examination of skin lesions showed infiltration of scattered lymphocytes in the superficial dermis,as well as around skin appendages.Immunohistochemical study demonstrated that the infiltrating lymphocytes mainly included T lymphocytes,and no atypical cells were observed.The patient was diagnosed with druginduced hypersensitivity syndrome.After the treatment with intravenous glucocorticoids,immunoglobulin and oral cyclosporine,favorable therapeutic effects were achieved.

Objective To compare the diuretic efficacy of torasemide as a 2-hour continuous infusion and as a bolus injection of equal dose in patients with nephrotic syndrome,and to investigate a preferable administration mode of torasemide for these patients.Methods Twenty-three hospitalized patients were randomized to receive torasemide 20 mg or 40 mg per day by either 2-hour intravenous infusion or bolus injection,and interchanged after 48 hours of washout.Results Patients received torasemide by 2-hour intravenous infusion exhibited significantly higher daily urinary volume,chloride excretion,sodium excretion and fractional excretion of sodium (FENa) within 24 hours than those by bolus injection (P ＜ 0.05).Significantly lower bound-state torasemide excretion,higher ratio of urinary volume to torasemide excretion and a markedly larger area under the curve in the plasma concentrationtime profiles were also observed in the infusion group (P ＜ 0.05).Conclusion 2-hour continuous infusion delivers a better diuretic effect compared with a bolus injection of equal dose of torasemide in patients with nephrotic syndrome.

Objective: To explore the clinical application indications, filter selection and filter removal techniques of inferior vena cava filter. Methods: Retrospective analysis of the clinical data of 108 cases of inferior vena cava filter implantation in the Department of Vascular Surgery, People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to February 2019 was performed. One hundred and eight patients with inferior vena cava filter were eligible for filter placement, including 50 males and 58 females; the average age was 59 years, and the age ranged from 23 to 90 years. Different types of inferior vena cava filters were selected according to the patient's condition, the location of the thrombus, the type of surgery and the prognosis of the disease. In this study, lower extremity vascular ultrasound was performed by the outpatient in 2 weeks after the filter placement, 1 month after the operation, 2 months after the operation, and 3 months after the operation. The inferior vena cava filter was recovered by a catcher. Loop technology, Loop and biopsy forceps were used for patients with difficult filter recovery. After removal of the filter, the angiography confirmed the integrity of the inferior vena cava wall. Observe whether the filter was completed, deformed, broken and whether there was thrombus in the filter. Results: The removal of inferior vena cava filter was performed in patients with no free floating thrombus or fresh thrombus in popliteal, femoral, iliac and inferior vena cava confirmed by ultrasound. In this group, 108 patients with inferior vena cava filter implantation included 11 patients anticoagulant contraindications, 11 patients with pulmonary embolism, 5 patients with floating thrombosis in iliac vein, femoral vein or inferior vena cava, 35 patients with acute deep venous thrombosis of lower extremity received catheter-directed thrombolysis or percutaneous mechanical thrombectomy, 46 patients with abdominal, pelvic or lower extremity surgery for acute deep venous thrombosis of lower extremity and high risk factors of pulmonary embolism. One hundred and three patients received retrievable inferior vena cava filters and 5 patients received temporary inferior vena cava filters. Ninety-two patients were followed up successfully in this group. In 74 patients, the filter trap was recovered using a catcher, and the inferior vena cava filter of 12 patients were successfully removed by Loop technology and Loop with biopsy forceps.The success rate of the filter removal was 93.5%. After removal of the filter, angiography of inferior vena cava showed smooth wall, blood flow patency and no extravasation of contrast agent. The removal filters have normal shape, no fracture and no deformation. Conclusions Operators should strictly observe the indication of inferior vena cava filter placement, master a variety of filter removal methods to improve the success rate of filter removal and maximize the benefit of patients with inferior vena cava filter implantation.

Objective To explore the diagnostic value of pink sign of iodine staining for early esophageal carcinoma. Methods Data of 312 lesions of 306 patients with suspected early esophageal carcinoma who received iodine staining from November 2015 to October 2017 were analyzed retrospectively. Lesions were divided into positive pink sign group and negative pink sign group according to the result of iodine staining. The relationship between pink sign and pathology were analyzed. Lesions recorded onset time of pink sign were divided into 4 groups by the onset time of pink sign, 0-30 s,>30-60 s,>60-90 s and>90-120 s, the diagnostic value of which was assessed with the receiver operating characteristic ( ROC) curve. Results Among the 312 lesions, 208 were identified positive pink sign, including 28 of inflammation or low-grade intraepithelial neoplasia ( LGIN ) , 180 of high-grade intraepithelial neoplasia ( HGIN ) or carcinoma, and 104 lesions were identified negative pink sign, including 69 of inflammation or LGIN, 35 of HGIN or carcinoma. The sensitivity, specificity and accuracy of positive pink sign in the diagnosis of HGIN and early esophageal carcinoma was 83. 7％, 71. 1％ and 79. 8％, respectively. Multivariate analysis showed a significant association between the onset time of pink sign and histopathology ( P=0. 000, OR=0. 016, 95％CI=0. 042-0. 324) . The onset time of pink sign was recorded in 89 lesions in the positive group. The area under ROC curve of the onset time of pink sign was 0. 899, and the optimal cut-off value was 60 s, which indicated the good validity of the test with the sensitivity, specificity and accuracy of 92. 8％, 84. 2％and 91. 0％, respectively. Conclusion The pink sign of iodine staining for diagnosis of early esophageal carcinoma shows a high consistance rate, especially that appears within 60 s.

Objective To explore the role of serum Irisin,Nesfatin-1 and chitinase like protein 40(YKL-40)levels detection in evaluating the condition of patients with multiple sclerosis(MS).Methods A total of 160 MS patients who visited the First Hospital of Handan City from August 2017 to November 2023 were selected as the study subjects.According to clinical classification,they were separated into a remission group(n=115)and a progression group(n=45),and according to the severity of condition,they were separated into a mild group(n=109)and a severe group(n=51).ELISA method was applied to detect the levels of Irisin,Nesfatin-1 and YKL-40 in serum.Pearson was applied to analyze the correlation between serum Irisin,Nesfatin-1,YKL-40 levels and expanded disability status scale(EDSS)score in MS patients.Multivariate Logistic regression was applied to analyze the influencing factors of Ms Necerity.ROC curve was applied to analyze the evaluation value of serum Irisin,Nesfatin-1 and YKL-40 levels for the progression of MS patients.Results In the advanced stage group,the serum levels of Irisin(8.25±2.17 ng/ml)and Nesfatin-1(5.94±1.76 ng/ml)in MS patients were lower than those in the remission stage group(14.94±3.58 ng/ml,9.92±2.15 ng/ml),while the YKL-40(42.98±10.89 ng/ml)level was higher than that in the remission stage group(22.78±7.95 ng/ml),and the differences were statistically significant(t=11.709,11.048,12.956,all P<0.05).In the severe group,the serum levels of Irisin(8.86±2.21 ng/ml)and Nesfatin-1(6.32±1.91 ng/ml)in MS patients were lower than those in the mild group(15.02±4.42 ng/ml,9.96±2.30 ng/ml),while the disease course(5.84±1.65 years)and YKL-40(37.28±10.15 ng/ml)levels were higher than those in the mild group(3.65±1.45 years,24.34±7.62 ng/ml),and the differences were statistically significant(t=8.514,9.407,9.823,8.971,all P<0.05).Serum Irisin and Nesfatin-1 levels in MS patients were negatively correlated with EDSS scores(r=-0.504,-0.517,all P<0.05),while YKL-40 levels were positively correlated with EDSS scores(r=0.509,P<0.05).Irisin(OR=0.724,95%CI:0.589～0.889)and Nesfatin-1(OR=0.813,95%CI:0.669～0.945)were protective factors for disease progression in MS patients,while YKL-40(OR=2.964,95%CI:1.795～4.894)was a risk factor for disease progression in MS patients(all P<0.05).The AUCs of serum Irisin,Nesfatin-1 and YKL-40 levels in evaluating the progression of MS patients were 0.844,0.849 and 0.823,respectively,which were lower than the AUC(0.957)of their combination(Z=3.158,3.096,3.324,all P<0.05).Conclusion Serum Irisin,Nesfatin-1 and YKL-40 detection levels can effectively evaluate the progression of MS patient condition.

Objective:To retrospectively summarize and evaluate the efficiency and safety of percutaneous ultrasound-guided radiofrequency ablation (RFA) for adrenal metastasis (AM) from hepatocellular carcinoma (HCC).Methods:From October 2009 to September 2018, 16 patients with AM from HCC who underwent percutaneous RFA in the First Affiliated Hospital of Sun Yat-Sen University were enrolled in the study. The complete ablation and local tumor progression rates were elevated, and the side effects and complications were summarized.Results:The median ablation time of AM was 16 min. The complete ablation rate was 87.5% (14/16). After the follow-up period of 3 to 55 months, among the patients with complete ablation, there were 3 patients were detected local tumor progression (LTP), the LTP rate was 21.4% (3/14). As for the side effects and complications, 3 patients were diagnosed as hypertension crisis (3/16, 18.8%), 2 showed reduced heart rate and 1 of them exhibited frequent premature ventricular contraction which resulted in termination of ablation. There was no ablation-related death or adrenal failure.Conclusions:Percutaneous US-guided RFA is safe and effective in the treatment of AM originated from HCC.

Objective To study the feasibility,efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) in the caudate lobe.Methods From November 2006 to June 2017,31 patients with 31 HCCs located in the caudate lobe were treated with percutaneous RFA at the First Affiliated Hospital of Sun Yat-sen University.The treatment efficacy,complications,and the local tumor progression (LTP),disease-free survival (DFS) and overall survival (OS) rates were analyzed.Results Residual tumors were detected in 5 patients after the first treatment.Complete necrosis was achieved in all the patients after the second treatment.The mean number of ablation sessions was 1.16±0.37.At a follow-up period which ranged from 3 to 65 months,19 patients had died,10 patients were still alive,and 2 patients were lost to follow-up.The 1-,2-,3-,and 5-years OS rates were 78.4％,48.5％,12.1％ and 12.1％,respectively.On follow-up,9 caudate lobe HCC lesions were detected to have LTP.The 1-,2-,and 3-years LTP rates were 21.5％,41.6％ and 41.6％,respectively;while the 1-,2-,and 3-years DFS rates were 22.3％,11.2％ and 11.2％,respectively.Ablationrelated complications were detected in 4 patients.Conclusions Ultrasound-guided percutaneous RFA was safe and effective for patients with HCC in the caudate lobe.These patients should be followed-up closely to detect LTP.