The PICC application in tumor chemotherapy patients has the advantages of simple operation, long time of implanting catheter, small pain and protect vein. They can ensure the chemotherapy smoothly, and further promotion in the clinical application, but when the patients took the tube back, the complications increased significantly. Health education is the mail channel for patient and family to get the major way to maintain PICC knowledge and skills. Through literature review of PICC health education at home and abroad, in our country, according to the present situation of PICC health education, the health education model, method and effect evaluation were summarized and looked for the problems in the present education of PICC health education. It can provide a basis for exploring new pattern of health education for improving the sevice life of the catheter and the patients’ life quality.

Objective To investigate the resilience of primary caregivers of cancer patients undergoing chemotherapy and explore the influencing factors. Methods General information questionnaire and Cornor-Davidson resilience scale (CD-RISC) were used in the survey among 173 cancer patients undergoing chemotherapy as well as their primary caregivers. Results The score of resilience of primary caregivers was (70.76 ±13.34), at middle or above level. Multiple linear regression analysis showed that caregivers'resilience was affected by gender, age, family income and religious belief (all P<0.05). Conclusion The resilience among primary caregivers of cancer patients undergoing chemotherapy is at a relatively high level. Clinically, we should pay more attention to female and young patients with lower family income and no religious beliefs.

Objective To explore the pharmaceutical care approaches for patients with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy. Methods An elderly patient with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy faced inevitable safety risks.Clinical pharmacists considered it as an intervention point, and provided individual pharmaceutical care. Results Clinical pharmacists fully assessed the safety risks of the case receiving pemetrexed chemotherapy with clinicians, assisted in improving the therapeutic regimen, and carried out medication education for the patient. No serious adverse drug reactions occurred in the patient, and anti-tumor efficacy was obtained. Conclusion For patients of lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy, clinical pharmacists should focus on creatinine clearance rate, and decide whether the combined use of platinum anti-tumor drugs, non steroidal anti-inflammatory drugs and zoledronic acid can be adopted, and follow-up on adverse drug reactions and anti-tumor efficacy.

Objective To investigate the method of handmade microwire lasso device for the management of coil migration during intracranial aneurysm embolization. Methods Two migration coils were removed from intracranial arteries using handmade microwire lasso rings. The first coil prolapsed completely from an aneurysm sac and flowed to the middle cerebral artery M2 segment. The second coil partially prolapsed out into a parent artery. The microwire lasso device was made of 4-0 silk thread and fixed using 0. 36 mm (0. 014 inch)microwire and 0. 43 mm (0. 017 inch)microcatheter. Results After removing 2 migration coils from intracranial arteries,angiography did not reveal vascular injury and thrombosis. There was no aneurysm rupture. After awaking from anesthesia,the patient did not have neurological deficit. The patient was followed up for 3 months after procedure. MR angiography confirmed the patency of related arteries. Conclusion The handmade microwire lasso device for the management of coil migration in the process of aneurysm embolization is a simple,effective,and economical method.

Objective To investigate the influencing factors for late-preterm birth of twins. Methods We retrospectively analyzed the clinical data of 301 twins delivered in Beijing Haidian Maternity and Child Health Hospital between August 1, 2011 and August 31, 2013. Twins with late-preterm births were classified as the observation group(n=138) and those delivered at term were classified as the control group (n=163). Comparison between the two groups was conducted on both maternal and neonatal complications. Two independent sample Student's t test, Chi-square test and logistic regression analysis were performed for statistical analysis. Results (1) The ratio of two male fetuses, dichorionic diamniotic twins, and iatrogenic preterm birth were 41.3% (57/138), 76.1% (105/138) and 65.2% (90/138), respectively, in the observation group, while 23.9% (39/163), 89.6% (146/163) and 96.9% (158/163), respectively, in the control group (χ2=10.40, 9.81 and 53.59, respectively, all P<0.05). Mean birth weight of twins in the observation group was less than that in the control group [(2 450±349) vs (2 640±304) g, t=7.12, P<0.05]. Maternal age, gravidity, parity, history of abortion, mode of conception and 1 min Apgar score of the neonates between the two groups were not significantly different (all P>0.05). (2) The risk factors for late-preterm birth of twins included hypertension diseases complicated pregnancy, gestational diabetes mellitus, premature rupture of membranes, fetal distress, anemia and umbilical cord abnormality [OR=0.190(95%CI: 0.094-0.387), 1.980 (95%CI: 1.009-3.883), 0.030(95%CI: 0.007-0.131), 0.062(95%CI: 0.006-0.642), 0.470(95%CI:0.243-0.908) and 2.779(95%CI:1.093-20.736), respectively, all P<0.01 or 0.05]. (3) The incidences of hyperbilirubinemia, respiratory diseases, hypoglycemia, anemia, and neonatal infection were 27.9%(77/276), 4.4%(12/276), 4.7%(13/276), 4.4%(12/276) and 3.6%(10/276), respectively, in the observation group, which were all higher than those in the control group [9.5%(31/326), 0.6%(2/326), 1.2%(4/326), 0.6%(2/326) and 0.3%(1/326), respectively,χ2=34.33, 9.18, 6.61, 9.18 and 9.16, respectively, all P<0.05]. The incidence of small for gestational age in the observation group was lower than that in the control group [3.6%(10/276) vs 12.3%(40/326),χ2=3.86, P<0.05]. Other complications in the two groups (intracranial hemorrhage, acidosis, and hemolysis) were not significantly different (all P>0.05). Conclusions Late-premature births in twin pregnancies are related to many maternal and fetal risk factors. Therefore, clear understanding of these risk factors might improve the pregnancy outcomes.

Objective To explore the clinical significance of oral pancreatin capsules for patients after total gastrectomy.Methods Ninety cases of total gastrectomy patients in Nanyang City Center Hospital were selected and randomly divided into trypsin group and control group,with 45 patients in each group.The control group were treated by conventional therapy,and the patients of trypsin group were treated by pancreatin capsules on the basis of conventional therapy after 3 weeks postoperation.Scores of EORTC QLQ-C30,korenaga and fecal fat contents were compared between two groups six months postoperation.Results No statistically significant difference was found in the scoring system of EORTC QLQ-C30,korenaga and fecal fat contents in two groups before administered,The score of role function,emotional function and overall health status in the scoring system of EORTC QLQ-C30 of patients in trypsin group were higher than control group after 6 months administration.The differences were statistically significant (P<0.05 ).The score of fatigue,loss of appetite,nausea,vomiting,diarrhea in the scoring system of EORTC QLQ-C30 of patients in trypsin group were lower than control group after 6 months administration.The differences were statistically significant (P<0.05).The loss of appetite,swelling postprandial satiety,insomnia and the extent of weight loss in the scoring system of korenagain trypsin group were lower than control group after 6 months administration.The differences were statistically significant (P<0.05 ).The fecal fat contentsin trypsin group were lower than control group at 24 h and 72 h.The differences were statistically significant (P<0.05).The cases of 24h fecal fat content>7g in trypsin group was lower than control group at 24 h.The differences were statistically significant (P<0.05).Conclusion Oral pancreatin capsules could significantly improve the quality of life of patients after total gastrectomy, which is worthy of promoting.

Objective: To establish an HPLC method for the determination of diclofenac sodium sustained-release preparations, and compare the in vitro dissolution of diclofenac sodium sustained-release capsules and tablets from different manufacturers to provide reference for the clinical reasonable medication. Methods: According to the first dissolution method described in Chinese Pharmaco-poeia (2010 edition),the dissolution of each sample was determined by HPLC and the cumulative release percentage was calculated. The dissolution parameters were fitted by Weibull-equation and the results were analyzed. Results:The HPLC method for the determi-nation of diclofenac sodium release was accurate with good reproducibility, and the dissolution parameters of different manufacturers had remarkable difference. Conclusion:The in vitro dissolution of diclofenac sodium sustained-release capsules and tablets from different manufacturers is various, which should be paid attention in the clinical use.

Objective To study the value of imaging characters in diagnosing mediastinal tumors.Methods X-ray and CT findings of pathologically proved mediastinal tumors in 58 cases were analysed,the findings enabling qualitative diagnosis were recommended. Results There were 40 cases of anterior mediastinal tumors including intrathoracic thyroid tumors [n=32,5 tyroid carcinomas and 1 thyroid cyst ,thymomas (n=3) and teratomas (n=5, 3 cases ruptured)]. All the other 18 cases in posterior mediastinum were neurogenic tumors.Conclusion Based on the combination of the mediastinal compartment knowledge, X-ray and CT findings of the tumors and the clinical information, the qualitative diagnosis of mediastinal tumors will be characterized correctly.

Objective To study the effects of nitric oxide (NO) on the growth and metastasis of tumor.Methods The literatures of recent years were reviewed.Results NO had double effects on the growth and metastasis of tumor. NO promoted the growth and metastasis by regulating the expression of tumor proliferation gene and inducing tumor angiogenesis. On the other hand, NO had antitumor effects by interfering with the metabolism of tumor cells, inducing the damage of DNA, forming high toxic free radical, inducing apoptosis of tumor cells and mediating the antitumor action of endothelial cells and macrophages.Conclusion Selective blockage or induction of synthesis of NO may be a new way for tumor therapy.

[Objective]To explore clinical class,surgical treatment and clinical results of clavicle fracture with internal fixation.[Method]A retrospective analysis of 146 cases of clavicle fracture was reported.Totally 146 cases of clavicle fracture accepted by our department from January of 1996 to June of 2006 were carried out the operation using plate shaft.There were 98 males and 78 females.Aged from 8 to 84 years,average of 38.6 years.The average age of the patients at surgery were 38.6 years(ranged 8 to 84 years).There were 9 cases in proximal 1/3,115 cases in middle 1/3 and 12 cases in distal 1/3 of clavicle,accompanied by 7 cases of brachial-plexus injury,4 cases of vascular injury,16 cases of another fracture.There were 7 cases of old clavicle fracture.Surgical methods: Both proximal 1/3 and middle 1/3 of clavicle fracture were treated by AO reconstruction plate or similar plate.Fracture pieces of clavicle were enlaced with screws or steel wire before fixation with plate.The distal of clavicle fracture should be fixed with 3 screws.The distal 1/3 of clavicle fracture with acromioclavicular luxation was treated by reconstruction plate or c clavicle hook plate.Patient could exercise their shoulder joint at 48 hours postoperatively.Post operative evaluation: Clinical results of clavicle fracture with internal fixation were evaluated with appearance,fracture healing time, shoulder joint function and living quality around fracture.[Result]Patients were followed up more than 6 months after operation.Adopt Neer standard to evaluate the patient's function after the operation.There were excellent results in 96 cases and good in 50 without injury of subclavicular nerve and blood vessel,infection,loose and prolapse of internal fixation devices and fracture disunion and malunion and macrosis bony callus.X-ray shows clavicle fracture healing completely.The patients can get painless free-running.[Conclusion]Internal fixation for treatment of clavicle fracture is characterized by little wound,firm fixation and early movement of the joint and is an effective method to cure clavicle fracture.