1.The nutritional status of radical gastrectomy patients during the late course of chemotherapy and its main influencing factors
Qingrong QU ; Yige XU ; Weifang HE ; Chengshu YANG
Chinese Journal of Practical Nursing 2017;33(20):1530-1535
Objective To explore the nutritional status of radical gastrectomy patients during the late course of chemotherapy and its main influencing factors, providing reference for the development of targeted nursing intervention. Methods The Scored Patient-Generated Subjective Global Assessment, The Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to collect clinical data that received complete chemotherapy after radical surgery from September 2014 to March 2016. Results A total of 103 cases finally involved in this study. The incidence of malnutrition in patients during pre-chemotherapy and late course of chemotherapy was 45.63%(47/103) and 73.79%(76/103) respectively, and there was significant difference (χ2=16.97, P<0.05). The nutritional assessment score, the hemoglobin levels and body mass index of patients pre-chemotherapy was (3.64±0.78) points, (124.11± 21.78) g/L, (21.29±2.77) kg/m2 , (8.07±3.75) points, (108.54±11.68) g/L, (20.29±2.68) kg/m2 late course of chemotherapy and there were significant differences(t =-11.74, 6.39, 2.63, all P<0.05). The symptom of depression was at a higher level 65.05%(67/103), patients with anorexia in late course of chemotherapy accounted as much as 75.73%(78/103). Logistic regression analysis showed that educational level, loss of appetite and parenteral nutrition were the main factors which influenced the nutritional status of patients during the late course of chemotherapy. Conclusions With the increase in the number of chemotherapy, the nutritional status of the patient is getting worse. The study suggests medical personnel should pay more attention to the patients with low educational level, give patients and their families targeted diet counseling, correct the mistaken conceptions thus enhance their understanding of dietary knowledge. Strengthening the management of complications during chemotherapy, reducing the adverse factors that affect the patient′s nutritional status to improve the nutritional status of patients.
2.Nutritional risk assessment and inspiration for patients in chemotherapy after radical gastrectomy
Qingrong QU ; Chengshu YANG ; Weifang HE ; Yige XU
Chinese Journal of Practical Nursing 2017;33(16):1201-1204
Objective To investigate the nutritional status of patients with chemotherapy after radical gastrectomy and to provide dietary guidance and nutritional support for patients in time. Methods Patients who received chamotherary after radical gastrectomy inthe Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included in the study. The nutritional status was assessed by unified training investigators within 48 h after hospitalization. The questionnaires of Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to investigatethe patients by trained investigators. Results The scores of the nutritional status of patients with different stages of chemotherapy were 6.107 ± 2.947, 6.505 ± 3.134, 8.068 ± 3.748, which was statistically significant (F=10.202, P<0.01). The incidence of anorexia was the highest rate of diet-related symptoms, the rate of early, mid-term and later chemotherapy rates were 34.95%(36/103), 56.31%(58/103), and 75.73%(78/103) respectively. Patients acquired the diet knowledge mainly from medical staff. The proportions of early, middle and later stages of chemotherapy were 92.23% (95/103), 79.61% (82/103), 75.73%(78/103). Conclusions With the increase of chemotherapy times, the nutritional status of patients with radical gastrectomy is getting worse. The results suggested that medical staff should provide an effective basis dietary guidance in time, improving the patients′nutritional status and clinical outcomes.
3.Practice research on the construction of health education ability of higher vocational nursing students by a "trinity" system
Yige HE ; Yu ZHAO ; Sheng HE ; Shanshan LI ; Yunlong ZHONG ; Gaojun HU
Chinese Journal of Medical Education Research 2021;20(6):671-676
Objective:To explore the effect of the "trinity" training mode with curriculum training as the core, lecture training as supplement and community training as reinforcement, and to improve the health education ability of higher vocational nursing students.Methods:A total of 209 nursing students were selected as the research objects by random cluster sampling, and they were randomly divided into experimental group and control group. The experimental group adopted the "trinity" system to improve the health education ability of higher vocational nursing students, while the control group carried out the routine teaching. The health education ability of nursing students was evaluated by using the health education ability scale of nursing staff, and the nursing students of the experimental group were investigated by questionnaire. Statistics analysis was made by SPSS 15.0 software, the t test was conducted for analysis of measurement data, and Z test was used for counting data. Results:The health education ability of the nursing students in the experimental group was significantly higher than that of the control group ( P < 0.001). Nursing students in the experimental group generally had high recognition of the training mode of "trinity" system. The pass rate was 98.13%. Among them, 68.87% of the nursing students thought it would be a big gain to attend the special lectures; 69.81% of the nursing students thought it would be a big gain to participate in the community activities. Conclusion:The "trinity" health education ability training model can significantly improve the health education ability of higher vocational nursing students.
4.Clinical application of titanium ossicular prostheses in intact canal wall tympanoplasty with mastoidectomy.
Yige QIU ; Rong HE ; Yongguo CHEN ; Ning MA ; Xin GUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(22):1034-1037
OBJECTIVE:
To evaluate the effects of intact canal wall tympanoplasty with mastoidectomy (ICWT) with titanium ossicular prostheses.
METHOD:
A retrospective review was performed on 31 patients who underwent ICWT from 2008 to 2011. Patients' postoperative hearing results and complication rates were evaluated based on different types of ossicular prosthesis: partial ossicular replacement prosthesis (PORP), total ossicular replacement prosthesis (TORP).
RESULT:
The total effectiveness was 87.1%. No prosthesis was extruded. There was no significant difference in postoperative hearing results (average postoperative gain and ABG) between the two prostheses. In the low frequency (0.5 kHz), significant difference in ABG was found.
CONCLUSION
No significant difference in postoperative hearing results was found between PORP and TORP, which could be useful materials for tympanoplasty and obviously improve the hearing of otitis media patients after operation. As for the low incidence of postoperative complications in our short-term study, long-term follow-up visit is necessary.
Adult
;
Cholesteatoma, Middle Ear
;
surgery
;
Female
;
Humans
;
Male
;
Ossicular Prosthesis
;
Retrospective Studies
;
Titanium
;
Tympanoplasty
;
instrumentation
;
methods
5.Improvement of continence with preservation of pelvic stabilized structure in patients undergoing robot-assisted laparoscopic radical prostatectomy
Xiang LI ; Mingjing HE ; Yige BAO ; Shi QIU ; Kun JING ; Lu YANG ; Zhenhua LIU ; Qiang WEI
Chinese Journal of Urology 2018;39(10):733-739
Objective To investigate the effect of pelvic floor stabilized structure preservation (PPSS) during robot-assisted laparoscopic radical prostatectomy (RARP)on postoperative continence recovery.Methods From October 2017 to April 2018,86 patients with prostatic cancer who underwent traditional RARP and RARP plus PPSS were included.There were 31 patients in non-PPSS group and 55 patients in PPSS group.In non-PPSS group,patients age was (68.48 ± 7.79) years old,BMI was (24.79 ± 3.05) kg/m2,median prostate volume was 63.54 (53.00-99.36) cm3,clinic T-stage T1-T2,T3,T4 accounted for 49.39%,22.58%,6.45% and ISUP grade 1,2,3,4,5 accounted for 22.58%,22.81%,12.90%,12.90%,19.35% respectively.In PPSS group,patients age was (69.53 ± 6.81)years old,BMI was (23.95 ± 3.03) kg/m2,median prostate volume was 73.39 (54.88-94.23) cm3,clinic T-stage T1-T2,T3,T4 accounted for 72.73%,7.27%,3.64% and ISUP grade 1,2,3,4,5 accounted for 21.82%,18.18%,23.64%,18.18%,10.91% respectively.The preoperative PSA,BMI,clinical T-stage,ISUP grade,and postoperative hospital days had no significant differences (P > 0.05)between the two groups.Both groups were operated via transperitoneal approach.In the non PPSS group,endo-pelvic fascia and pubic prostate ligament was cut,and dorsal vessel complex was ligated.In PPSS group,the partial endo-pelvic fascia was bluntly pushed to the pelvic wall to preserve tendon arch,and pubic prostate ligament also was preserved without suturing and ligating dorsal vascular complex.The catheter was removed 7 d after RARP.The continence recovery were compared between the two groups,including pad number on the day of I,7,14,30,90 and ICI-Q-SF scores on the day of 30 and 90 after catheter removal.Results There was no significant difference in pad numbers used between the two groups on the day of 1,7,14,30 after catheter removal.On the 90th day,the proportions of using pad ≥4 in PPSS group were significantly lower than those in non-PPSS group (1.89% vs.20.69%,P =0.004).No significant difference was found in ICI-Q-SF scores on the 30th and 90th day between the two groups.Univariate analysis showed that PPSS group used less pads than non-PPSS group on the 90th day [OR =0.07(95% CI 0.01-0.65),P =0.019];T3 patients used more pads than T1-T2 patients [OR =9.19 (95% CI 1.32-63.87),P =0.025].After adjusting for age,ISUP grading,T staging,and PSA,multivariate regression analysis showed that the risk of using pad ≥ 4 in PPSS group compared with non-PPSS group was 0.46,0.34,0.27,0.25,and 0.03 on the day of 1,7,14,30 and 90 after catheter removal,respectively.The PPSS approach didn't increase the risk of positive surgical margin.Conclusions Preservation of pelvic stabilized structure in RARP is very efficient in term of continence rate after RARP,and it does not increase the risk of positive surgical margin.
6.Effects of electroacupuncture preconditioning of "Neiguan"(PC 6) on myocardial ischemia reperfusion injury via Akt/mTOR pathway
Dongdong LIU ; Miaoying HE ; Yige ZHANG ; Dan LI ; Chengcheng ZHANG ; Chao WANG
International Journal of Traditional Chinese Medicine 2023;45(6):703-708
Objective:To observe the effects of electroacupuncture preconditioning on the autophagy-related pathway protein kinase B (Akt)/mammalian target of rapamycin (mTOR) in myocardial tissue of rats with myocardial ischemia reperfusion injury (MIRI); To investigate the protective mechanism of "Neiguan"(PC 6) on myocardial injury.Methods:Totally 48 SD rats were randomly divided into blank group, sham-operation group, model group and Neiguan group ( n=12 in each group). The Neiguan group was applied to bilateral "Neiguan"(PC 6) by electroacupuncture for 30 min, once daily for consecutive 7 days before model replication. Except in the blank group, the MIRI model was established by ligation of the descending anterior branch of the left coronary artery in the rest groups after the intervention. The histomorphological changes in the myocardium of the rats were observed by HE staining, and the expression levels of Akt, phosphorylated Akt (p-Akt), mTOR and phosphorylated mTOR (p-mTOR) in the myocardium were measured by protein immunoblotting. The ratio of p-Akt/Akt and p-mTOR/mTOR was calculated. Results:In the blank group, the myocardial fibres were arranged regularly and neatly, and no inflammatory cell infiltration or haemorrhage was seen in the interstitium; in the sham-operation group, the arrangement of myocardial fibers was slightly irregular, no rupture was found, and a small amount of myocardial fiber gap was slightly enlarged; in the model group, the distribution of myocardial fibers was disordered, hypertrophic cardiomyocytes increased, some mitochondria were red and swollen or the outer membrane was ruptured, and inflammatory infiltration and hemorrhage were seen in the interstitium; the extent of myocardial lesions in the Neiguan group was less than that in the model group, with a small amount of interstitial hemorrhage and inflammatory cell infiltration. There was no statistical significance in the levels of Akt and mTOR in the myocardial tissues of the rats in each group ( P>0.05); compared with the sham-operation group, the levels of p-Akt, p-mTOR and p-Akt/Akt, p-mTOR/mTOR in the model group decreased ( P<0.01); compared with the model group, the levels of p-Akt, p-mTOR and p-Akt/Akt, p-mTOR/mTOR in the Neiguan group increased ( P<0.01). Conclusion:Electroacupuncture preconditioning may inhibit excessive autophagy by activating the Akt/mTOR pathway in cardiomyocytes of MIRI rats, thereby exerting a protective effect on the myocardium.