Objective:To study the effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients, and to explore the application of continuing nursing services and ICU diary to ICU traffic accident patients.Methods:A total of 47 patients who were admitted to the ICU of Suzhou Science and Technology City Hospital from January to December 2019 due to traffic accidents were selected by convenient sampling method. Twenty-three patients admitted to the hospital in the first 6 months were selected as the control group (before the introduction of medical social workers and ICU diaries) for routine ICU treatment and nursing mode. Twenty-four patients admitted to the hospital in the last 6 months were selected as the experimental group (after the introduction of medical social workers and ICU diaries), and the medical social workers combined with the ICU diary were intervened. The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups of patients when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU. The incidence of post-traumatic stress disorder was evaluated and compared by the scores of the Impact of Event Scale-Revised of the two groups of patients one month after leaving the ICU, three months after leaving the ICU, and six months after leaving the ICU.Results:The scores of SAS in the experimental group were 58.67 ± 7.45, 44.13 ± 5.47 and 39.08 ± 5.52 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 58.17 ± 6.75, 50.87 ± 6.35 and 42.74 ± 4.85, respectively in the control group. There was no statistical difference in the scores of the SAS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups with time changes and different interventions ( Ftime = 110.98, P<0.01), there were also differences between groups ( Fbetween groups = 5.91, P<0.05). Compared with the control group, the SAS score of the experimental group decreased more significantly( Finteraction = 0.28, P<0.05). The scores of SDS in the experimental group were 57.75 ± 4.06, 45.29 ± 3.39 and 36.63 ± 3.49 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 57.48 ± 2.29, 49.04 ± 5.65 and 43.57 ± 4.07 respectively in the control group. There was no statistical difference in the scores of the SDS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups of patients with time changes and different interventions ( Ftime = 248.24, P<0.01), there are also differences between groups ( Fbetween groups = 24.39, P<0.05). Compared with the control group, the SDS score of the experimental group decreased more significantly ( Finteraction=10.44, P<0.05). The incidences of post-traumatic stress disorder in the experimental group were 9, 8, 6 cases at one month, three months and six months after leaving the ICU, which were lower than 12, 11, 8 cases in the control group. The generalized estimation equation showed that the difference was statistically significant ( χ2=4.21, P<0.05). Conclusions:The intervention model of medical social workers combined with ICU diary is conducive to the use of ICU diary and the development of continuous nursing, which improves patients′negative emotions and reduces the incidence of post-traumatic stress disorder.

Objective:To explore the effect of moxibustion pretreatment on bone marrow suppression in cancer patients after chemotherapy, so as to provide a basis for clinical nursing.Methods:From May 2019 to May 2020, we selected 70 cancer patients who met the criteria in the Oncology Department of a ClassⅢ Grade A hospital in Xuzhou City, Jiangsu Province by convenient sampling. There were 65 patients who finally completed the trial including moxibustion pretreatment group ( n=20) , moxibustion group ( n=22) , and control group ( n=23) . All three groups received regular chemotherapy. Patients in moxibustion pretreatment group received moxibustion 7 days before the start of chemotherapy, once a day, for 14 days; patients in moxibustion group were treated with moxibustion at the beginning of chemotherapy, once a day, for 7 days; control group carried out conventional chemotherapy. We compared the white blood cell count, neutrophil count, incidence and degree of bone marrow suppression, and the use of recombinant human granulocyte colony stimulating factor among the three groups. Results:The white blood cell and neutrophil counts of the three groups were compared between the groups and at different times, and the differences were statistically significant ( P<0.05) . The incidences of bone marrow suppression on the seventh and fourteenth day after chemotherapy of the three groups of patients were compared between the groups and at different times with statistical differences ( Wald χ2groups=6.628, P=0.036; Wald χ2times=43.018, P<0.001) . A total of 7, 14 days after chemotherapy, there were statistical differences in the use of recombinant human granulocyte colony stimulating factor in patients among the three groups ( P<0.05) . Conclusions:Moxibustion pretreatment can stabilize the white blood cell and neutrophil counts of cancer patients after chemotherapy, reduce the incidence of bone marrow suppression, the degree of bone marrow suppression as well as the use of recombinant human granulocyte colony stimulating factor.

Objective:To explore the status quo of meaning of life in patients undergoing radical mastectomy and analyze the influencing factors.Methods:The convenient sampling method was used to select 302 patients with breast cancer who were treated in 2 Class Ⅲ Grade A hospitals in Zhenjiang from June 2019 to February 2020 as research objects. The general data questionnaire, Chinese version of Meaning in Life Questionnaire (C-MLQ) , Health-related Hardiness Scale (HRHS) and Cognitive Reassessment Strategy Scale were used to investigate them.Results:A total of 315 questionnaires were issued and 302 valid questionnaires were collected.The total score of C-MLQ of 302 patients undergoing radical mastectomy was (31.65±6.71) , the total score of HRHS was (92.59±5.68) and the total score of Cognitive Reassessment Strategy Scale was (16.23±5.04) .The results of multiple linear regression analysis showed that cognitive reassessment, postoperative time, health-related hardiness and its control dimension, family monthly income, gender, radiotherapy and chemotherapy were the influencing factors of meaning of life in patients undergoing radical mastectomy ( P<0.05) , which explained 85.8% of the variation in meaning of life. Conclusions:The meaning of life of patients undergoing radical mastectomy is at a medium low level. Clinical medical staff should take effective intervention measures to improve cognitive reassessment ability of patients, so that they can have correct cognition of the disease. They should also encourage them to face the disease actively and bravely and strengthen their own health-related hardinessin order to improve the meaning of life.

Objective:To investigate the pathogenesis and prognosis of transformation of primary myelofibrosis (PMF) to B-cell acute lymphoblastic leukemia (B-ALL).Methods:The diagnosis and treatment process of a patient transferred from PMF to B-ALL in Affiliated Tumor Hospital of Zhengzhou University in November 2018 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was a 64-year-old female, she was initially diagnosed with PMF, and then she developed B-ALL 17 months later after receiving treatment of prednisone, danazole, levamisole, aspirin, thalidomide and jaktinib. After induction therapy, the patient received 8 months of continuous remission, and then the reexamination showed relapse. There was no remission after reinduction therapy. The patient gave up treatment and was discharged 2 months later. JAK2 V617F gene mutation was positive before and after leukemia transformation.Conclusions:The patients with transformation of PMF to B-ALL have poor clinical prognosis and short survival time. The possible mechanism of its transformation may be related to additional genetic events or certain high-risk genes. However, the specific mechanism is still unclear, and further investigation of the etiology is needed to seek targeted treatment.