Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective:To explore the effect of narrative nursing plan on patients with cancer fatalism at the initial stage of radiotherapy for nasopharyngeal carcinoma.Methods:Convenience sampling was used to select 126 patients with nasopharyngeal carcinoma who were admitted to the Third Ward of Radiotherapy, Affiliated Tumor Hospital of Guangxi Medical University from July 2019 to June 2020 with cancer fatalism at the initial stage of radiotherapy. Among them, 62 cases from July to December 2019 were set as the control group, and 64 cases from January to June 2020 were set as the observation group. Routine nursing intervention and narrative nursing intervention were given respectively, and before the intervention (the second day after admission), after 7 weeks of intervention, the Fatalism Scale and Center for Epidemiologic Studies-Depression scale scores of the two groups were compared.Results:Before the intervention, the cancer fatalism and depression scores of the two groups were at a high level and the difference was not statistically significant ( P>0.05); after the implementation of the narrative nursing intervention program, the cancer fatalism and depression scores of the observation group were (37.23±6.12), (9.42±1.36) points, lower than (47.78±9.14), (15.65±2.03) points of the control group. There was statistical significance ( t values were 7.698, 7.524, P<0.05). Conclusion:In the early stage of radiotherapy, patients with nasopharyngeal carcinoma have a strong concept of cancer fatalism, and narrative nursing intervention can effectively reduce their cancer fatalism and depression.

Objective To construct the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms so as to provide an objective evidence for the standardizing and popularizing the traditional Chinese medicine (TCM) nursing operation in end-of-life patients. Methods The initial syndrome differentiation nursing recommendations for end-of-life patients with digestive symptoms were constructed based on literature review combined with digestive symptoms characteristics of end-of-life patients including the digestive syndromes end-of-life patients, TCM nursing operation, operation method and considerations. The method of Delphi expert consultation was used to two rounds of consultation by 16 experts and to calculate the expert positive coefficients and expert authority coefficient (Cr); item importance was analyzed with the mean, variation coefficient (CV) and Kendall's concordance coefficient (Kendall's W) to finally determine the syndrome differentiation nursing plan for end-of-life patients with digestive symptoms. Results Around two rounds of expert consultation, there were 16 valid questionnaires respectively. The expert positive coefficients and Cr were 100％ and 0.89 respectively. Variation coefficients of all indexes ranged from 0.05 to 0.27,which were <0.03; the Kendall's W ranged from 0.13 to 0.43 (P<0.01). Conclusions The syndrome differentiation nursing plan for end-of-life patients with digestive symptoms based on literature review and Delphi method standardizes the application of TCM nursing operation in end-of-life patients which has practical value on improving the quality of life of end-of-life patients and availability of medical resources.

Objective To observe the curative effect of chymotrypsin and danshen mixture treatment to moist skin damage caused by radiotherapy.Methods 90 NPC patients who underwent radiotherapy plus concurrent chemotherapy were randomized into the observation group(46 cases)and the control group(44 cases).Patients in the observation group received external application of chymotrypsin and danshen mixture;while patients in the control group received laser irradiation treatment.The healing progress of skin injury of two groups was observed and compared.Results Time of detumescence,pain relieving,itching and healing of the observation group was shorter than the control group.Nursing effect for level 2 & 3 radiation-induced skin injury in the observation group was better than the control group.Conclusions Chymotrypsin and danshen mixture has a great nursing efficacy on radiation-induced skin injury.It should be used in the early stage.