Objective To compare the clinical effects of single-puncture and double-puncture subcutaneous tunneling techniques for PICC placement in cancer patients,and to provide references for nurses in selecting appropriate catheterization methods.Methods A continuous sampling method was adopted to select cancer patients who underwent PICC placement in the Department of Oncology at a tertiary general hospital in Nanning from June 2022 to December 2023.According to the actual catheterization technique received by patients,they were assigned to either the single-puncture or double-puncture subcutaneous tunneling group.After 1:1 propensity score matching(PSM),the 2 groups were compared in terms of catheter-related complication rates,pain scores and total catheterization time.Results After propensity score matching,79 patients were included in each group.The results showed that the incidence of catheter-related thrombosis,pain scores,and total catheterization time in the one-needle subcutaneous tunneling group were significantly lower than those in the two-needle subcutaneous tunneling group,with statistically significant differences(P＜0.05).Conclusion The one-needle subcutaneous tunneling method can effectively reduce the incidence of catheter-related thrombosis and pain during catheterization in cancer patients,while also shortening the total catheterization time.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective To compare the clinical effects of single-puncture and double-puncture subcutaneous tunneling techniques for PICC placement in cancer patients,and to provide references for nurses in selecting appropriate catheterization methods.Methods A continuous sampling method was adopted to select cancer patients who underwent PICC placement in the Department of Oncology at a tertiary general hospital in Nanning from June 2022 to December 2023.According to the actual catheterization technique received by patients,they were assigned to either the single-puncture or double-puncture subcutaneous tunneling group.After 1:1 propensity score matching(PSM),the 2 groups were compared in terms of catheter-related complication rates,pain scores and total catheterization time.Results After propensity score matching,79 patients were included in each group.The results showed that the incidence of catheter-related thrombosis,pain scores,and total catheterization time in the one-needle subcutaneous tunneling group were significantly lower than those in the two-needle subcutaneous tunneling group,with statistically significant differences(P＜0.05).Conclusion The one-needle subcutaneous tunneling method can effectively reduce the incidence of catheter-related thrombosis and pain during catheterization in cancer patients,while also shortening the total catheterization time.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To investigate the use of different tools of intravenous infusion and the issues associated with intravenous catheter indwelling in hospitalized children and to provide reference for clinical practices.Methods:Using the convenient sampling method, from July 24th to 31st, 2018, the intravenous infusion treatment of children inpatients in 49 hospitals within the Beijing Children's Hospital Medical Association was selected for investigation. A self-designed Cross-sectional Questionnaire for Children's Intravenous Infusion and a photo of an intravenous infusion tool were used for data collection. Statistical analysis was performed using SPSS 17.0 software.Results:During the data collection period, there were 18 316 hospitalized children in the 49 hospitals, among which there were 14 421 cases of infusions, with the infusions rate of 78.73%. The application rate of indwelling needle was 87.94%. The connector of venous catheter was mainly heparin cap connection (64.23%) . The infusion tools used in 6 398 cases (44.37%) were made by PVC and containing 2-ethyl hexyl phthalate (DEHP) . Aseptic transparent dressing was the main dressing choice. During catheter indwelling, there were some problems such as back-blood in the pipeline or infusion joint, incorrect clamping position of small clips, unclamping, and tube detachment. Indwelling needles had more problems than central venous catheters, including old blood returning in the tube and blood returning in the infusion connector. The difference between the peripheral indwelling needle and the central catheter was statistically significant ( P<0.05) . Conclusions:The rate of intravenous infusion in hospitalized children is relatively high. Although there are various types of intravenous infusion tools, the choice of infusion tools for children was mainly indwelling needle and heparin cap connection, and there were still room for improvement in catheter maintenance.

Objective To analyse and summarise of the clinical effect and operative opportunity laparoscopic cholecystectomy for acute mild unobstructed gallstone pancreatitis.Methods Fify-four gallstone pancreatitis patients were treated as observation group in the first people's hospital of yangzhou from December 2012 to September 2015,which were treated with laparoscopic cholecystectomy after two weeks,while 53 patients which were treated with laparoscopic cholecystectomy after three months were treated as control group.The treatment effect,operation time,hospitalization time and total cost.Results There were no deaths,no bile duct injury and biliary fistula,the total hospitalization time [(19.8 ±2.6)d vs (26.5 ±3.5) d],the total cost [(2.6282 ± 0.2451) vs (3.2892 ± 0.3982)],recurrent pancreatitis rate (0) were lower than the control group(9.4％),the recovery rate of liver function were higher than the control group,there was significant difference between two groups(P ＜ 0.05),however,there was no significant difference between two groups for postoperative complications and operation time (P ＞ 0.05).Conclusions For acute mild unobstructed gallstone pancreatitis patients,the safe and feasible operative opportunity was recommended two weeks after the symptoms were completely improved,Laparoscopic cholecystectomy in the treatment of acute gallstone pancreatitis can promote recovery,shorten the hospitalization time.

Objective To investigate the expression of T cell immunoglobulin-and mucin-domaincontaining molecule-3 (Tim-3) in peripheral CD8 +T cells and its significance in patients with chronic hepatitis B (CHB).Methods Fifty-eight CHB patients and 16 healthy controls were enrolled.Tim-3 expression in CDs + T cells was detected by flow cytometry,and quantities of IFNγ-producing HBV-specific cytotoxic T lymphocytes (CTLs) in HLA-A2 positive subjects were detected by enzyme-linked immunosorbent spot (ELISPOT) test before and after the blockade of Tim-3/Tim-3L pathway.Paired t test was performed to compare the quantities of CTLs before and after the blockade,and nonparametric Spearman correlation analysis was performed to explore the correlation in quantitive data.Results Tim-3 expression in CHB patients was (14.2 ± 8.98 )％,which was higher than that of healthy controls (4.80 ± 2.92)％,and the difference was of statistical significance (x2 =92.48,P ＜ 0.05 ) Tim-3 expressions in 16 severe CHB patients and 42 mild CHB patients were ( 19.54 ± 10.95) ％ and (9.58 ± 7.30) ％,respectively,and the difference was statistically significant (x2 =77.24,P ＜ 0.05 ). Before the blockade of Tim-3/Tim-3L pathway,IFNγ-producing HBV-specific CTLs were 7.27 ± 3.14,and it increased to 19.62 ± 4.97 after the blockade ( t =2.95,P ＜ 0.05 ).Conclusion The upregulation of Tim-3 on peripheral CD8 + T cells may inhibit HBV-specific CTLs,and the blockade of Tim-3 pathway can enhance the proliferation of IFNγ-producing HBV-specific CTLs,thus can enhance antiviral effect.