Objective:To explore the correlation between occupational stress and the current working environment of clinical nurses.Methods:The cluster sampling method was used to select clinical nurses from First Affiliated Hospital of Xi'an Jiaotong University from March to September 2019 as the research objects. The research tools included nurses' general condition questionnaire, Occupational Stress Inventory Revised edition (OSI-R) and Profession Practice Environment (PPE) Scale. A total of 560 questionnaires were distributed and 540 valid questionnaires were recovered.Results:The Occupational Role Questionnaire (ORQ) score of 540 clinical nurses was (152.09±20.65) , the score of Personal Strain Questionnaire (PSQ) was (104.04±17.04) , the score of Personal Resources PPE Scale Questionnaire (PQR) was (125.84±19.75) and the total average score of PPE Scale was (3.00±0.28) . Pearson correlation analysis showed that the ORQ and PSQ scores of nurses were negatively correlated with the scores of the PPE Scale, and the PQR scores of nurses were positively correlated with the scores of PPE Scale ( P<0.05) . Conclusions:The overall performance of nurses is moderate occupational stress, the sense of occupational stress of nurses is negatively correlated with the working environment, and the coping resources of occupational stress are positively correlated with their professional working environment. Managers should take targeted measures to intervene to improve the professional working environment of nurses, reduce the level of occupational stress and guide nurses to improve their professional coping skills.

Objective: To explore the safety and feasibility of colonoscopy - assisted transanal minimally invasive surgery via glove port (CA-TAMIS-GP) in the treatment of early rectal tumors. Methods: A total of 67 patients evaluated as early rectal tumors (adenoma limited within mucosal layer) with diameter ≤4.0 cm at Department of Anal-Colorectal Surgery, Hangzhou Third People′s Hospital from July 2013 to March 2017 were prospectively enrolled in the study. Benign tumors were diagnosed by preoperative imaging in all the patients with the distance to anal edge of 4 to 20 cm. Patients were randomly divided into treatment group and the control group according to the random number table. The treatment group (n=32) underwent CA-TAMIS-GP, including 19 males and 13 females with mean age of (55.6±11.2) years and mean tumor size of (3.3±0.4) cm, while the control group (n=35) underwent endoscopic submucosal dissection (ESD, control group), including 20 males and 15 females with mean age of (52.9±12.3) years and mean tumor size of (3.4±0.5) cm. Differences of baseline data between two groups were not significant (all P>0.05). The specific method of CA-TAMIS-GP was as follows: a surgical rubber glove sleeve (No.6) was passed through the anal device; the glove was fixed at the anvil device; after fully expanding the anus, the anal sac was placed into the anus with the fingers outside; then, the cuff and the anal sac were sutured and fixed to the perianal; a well-tight glove path was established; the ultrasonic scalpel, grasper and the colonoscopy lens connected to the host platform and the electric negative pressure suction were inserted into the three finger sleeves respectively and fixed by rubber band or silk thread; the laparoscopic instruments such as the grasper and the ultrasonic scalpel were used for pulling, grasping, cutting, electrocoagulation, suturing and other operations to complete the resection of rectal lesions. Efficacy, postoperative complication and operative cost, etc. between two groups were compared using the student′s t test, chi-square tests, and Fisher′s exact test. Results: Operations of two groups were completed successfully without conversion to laparotomy. Histopathologic examination showed all specimens had negative margins with the surgical resection of the layer to the submucosa, and showed no significant differences between two groups (P>0.05). Compared to the control group, the operation time was shorter [(49.5±14.6) minutes vs.(66.1±17.6) minutes, t=-4.235, P<0.001], and the intraoperative hemorrhage was less [(4.2±1.6) ml vs. (6.2±2.1) ml, t=-4.349, P<0.001] in the treatment group with significant differences. In the treatment group, 6 patients had mild anal pain or discomfort after operation, and 1 patient in the control group showed anal foreign body sensation. The difference was statistically significant [18.8% (6/32) vs. 2.9% (1/35), P=0.048]. The incidence of postoperative hematochezia in the treatment group was lower than that in the control group [9.4% (3/32) vs. 20.0% (7/35), P=0.310] without significant difference. The cost of consumables in the treatment group was (1586.9±204.4) yuan, which was lower than (7694.4±1123.2) yuan in control group, and the difference was statistically significant (t=-30.880, P<0.001). All the patients were followed up for 6 to 36 months after operation, and no recurrence or long-term complication occurred in the treatment group, while 1 case developed local recurrence in the control group. Conclusion CA-TAMIS-GP is a safe and effective method for early rectal tumors with simple and economical characteristics, which broadens the application of colonoscopy.

Objective To explore the safety and feasibility of colonoscopy?assisted transanal minimally invasive surgery via glove port (CA?TAMIS?GP) in the treatment of early rectal tumors. Methods A total of 67 patients evaluated as early rectal tumors (adenoma limited within mucosal layer) with diameter≤4.0 cm at Department of Anal?Colorectal Surgery, Hangzhou Third People′s Hospital from July 2013 to March 2017 were prospectively enrolled in the study. Benign tumors were diagnosed by preoperative imaging in all the patients with the distance to anal edge of 4 to 20 cm. Patients were randomly divided into treatment group and the control group according to the random number table. The treatment group (n=32) underwent CA?TAMIS?GP, including 19 males and 13 females with mean age of (55.6±11.2) years and mean tumor size of (3.3 ± 0.4) cm, while the control group (n=35) underwent endoscopic submucosal dissection (ESD, control group), including 20 males and 15 females with mean age of (52.9± 12.3) years and mean tumor size of (3.4±0.5) cm. Differences of baseline data between two groups were not significant (all P>0.05). The specific method of CA?TAMIS?GP was as follows: a surgical rubber glove sleeve (No. 6) was passed through the anal device; the glove was fixed at the anvil device; after fully expanding the anus, the anal sac was placed into the anus with the fingers outside; then, the cuff and the anal sac were sutured and fixed to the perianal; a well?tight glove path was established; the ultrasonic scalpel, grasper and the colonoscopy lens connected to the host platform and the electric negative pressure suction were inserted into the three finger sleeves respectively and fixed by rubber band or silk thread; the laparoscopic instruments such as the grasper and the ultrasonic scalpel were used for pulling, grasping, cutting, electrocoagulation, suturing and other operations to complete the resection of rectal lesions. Efficacy, postoperative complication and operative cost, etc. between two groups were compared using the student′s t test, chi?square tests, and Fisher′s exact test. Results Operations of two groups were completed successfully without conversion to laparotomy. Histopathologic examination showed all specimens had negative margins with the surgical resection of the layer to the submucosa, and showed no significant differences between two groups (P>0.05). Compared to the control group, the operation time was shorter [(49.5 ± 14.6) minutes vs. (66.1 ± 17.6) minutes, t=-4.235, P<0.001], and the intraoperative hemorrhage was less [(4.2 ± 1.6) ml vs. (6.2 ± 2.1) ml, t=-4.349, P<0.001] in the treatment group with significant differences. In the treatment group, 6 patients had mild anal pain or discomfort after operation, and 1 patient in the control group showed anal foreign body sensation. The difference was statistically significant [18.8% (6/32) vs. 2.9% (1/35), P=0.048]. The incidence of postoperative hematochezia in the treatment group was lower than that in the control group [9.4% (3/32) vs. 20.0% (7/35), P=0.310] without significant difference. The cost of consumables in the treatment group was (1586.9±204.4) yuan, which was lower than (7694.4±1123.2) yuan in control group, and the difference was statistically significant (t=-30.880, P<0.001). All the patients were followed up for 6 to 36 months after operation, and no recurrence or long?term complication occurred in the treatment group, while 1 case developed local recurrence in the control group. Conclusion CA?TAMIS?GP is a safe and effective method for early rectal tumors with simple and economical characteristics, which broadens the application of colonoscopy.

Objective To explore the safety and feasibility of colonoscopy?assisted transanal minimally invasive surgery via glove port (CA?TAMIS?GP) in the treatment of early rectal tumors. Methods A total of 67 patients evaluated as early rectal tumors (adenoma limited within mucosal layer) with diameter≤4.0 cm at Department of Anal?Colorectal Surgery, Hangzhou Third People′s Hospital from July 2013 to March 2017 were prospectively enrolled in the study. Benign tumors were diagnosed by preoperative imaging in all the patients with the distance to anal edge of 4 to 20 cm. Patients were randomly divided into treatment group and the control group according to the random number table. The treatment group (n=32) underwent CA?TAMIS?GP, including 19 males and 13 females with mean age of (55.6±11.2) years and mean tumor size of (3.3 ± 0.4) cm, while the control group (n=35) underwent endoscopic submucosal dissection (ESD, control group), including 20 males and 15 females with mean age of (52.9± 12.3) years and mean tumor size of (3.4±0.5) cm. Differences of baseline data between two groups were not significant (all P>0.05). The specific method of CA?TAMIS?GP was as follows: a surgical rubber glove sleeve (No. 6) was passed through the anal device; the glove was fixed at the anvil device; after fully expanding the anus, the anal sac was placed into the anus with the fingers outside; then, the cuff and the anal sac were sutured and fixed to the perianal; a well?tight glove path was established; the ultrasonic scalpel, grasper and the colonoscopy lens connected to the host platform and the electric negative pressure suction were inserted into the three finger sleeves respectively and fixed by rubber band or silk thread; the laparoscopic instruments such as the grasper and the ultrasonic scalpel were used for pulling, grasping, cutting, electrocoagulation, suturing and other operations to complete the resection of rectal lesions. Efficacy, postoperative complication and operative cost, etc. between two groups were compared using the student′s t test, chi?square tests, and Fisher′s exact test. Results Operations of two groups were completed successfully without conversion to laparotomy. Histopathologic examination showed all specimens had negative margins with the surgical resection of the layer to the submucosa, and showed no significant differences between two groups (P>0.05). Compared to the control group, the operation time was shorter [(49.5 ± 14.6) minutes vs. (66.1 ± 17.6) minutes, t=-4.235, P<0.001], and the intraoperative hemorrhage was less [(4.2 ± 1.6) ml vs. (6.2 ± 2.1) ml, t=-4.349, P<0.001] in the treatment group with significant differences. In the treatment group, 6 patients had mild anal pain or discomfort after operation, and 1 patient in the control group showed anal foreign body sensation. The difference was statistically significant [18.8% (6/32) vs. 2.9% (1/35), P=0.048]. The incidence of postoperative hematochezia in the treatment group was lower than that in the control group [9.4% (3/32) vs. 20.0% (7/35), P=0.310] without significant difference. The cost of consumables in the treatment group was (1586.9±204.4) yuan, which was lower than (7694.4±1123.2) yuan in control group, and the difference was statistically significant (t=-30.880, P<0.001). All the patients were followed up for 6 to 36 months after operation, and no recurrence or long?term complication occurred in the treatment group, while 1 case developed local recurrence in the control group. Conclusion CA?TAMIS?GP is a safe and effective method for early rectal tumors with simple and economical characteristics, which broadens the application of colonoscopy.

OBJECTIVE: To prepare Formononetin (FMN) inclusion compound liposome and evaluate its quality. METHODS: FMN inclusion compound liposome was prepared by film dispersion method. The morphology, particle size, Zeta potential, encapsulation efficiency and in vitro release properties were studied. RESULTS: The particle size, Zeta potential and encapsulation efficiency of prepared FMN inclusion compound liposome were (255. 34 ± 12. 87) nm, (25. 32 ± 3. 51) mV, (81. 63 ± 0. 79)％, respectively (n=3). The 24 h accumulative release rate of prepared FMN inclusion compound liposome was 56. 12％. CONCLUSIONS: FMN inclusion compound liposome with good sustained-release effect is prepared successfully and in line with related quality standard.

OBJECTIVETo investigate the expression of prostaglandin transporter (PGT) in colorectal cancer (CRC) tissues and its relationship with clinicopathological features.

METHODSThe mRNA and protein levels of PGT were determined by real-time PCR, Western blot and immunohistochemical methods in cancer tissues and adjacent normal tissue from 80 patients with colorectal cancer and their relationship with clinicopathological features was analyzed.

RESULTSCompared with the adjacent normal tissue of colorectal cancer, the PGT mRNA relative expression (0.57 ± 0.33 vs. 2.33 ± 1.20) and the PGT protein expression in cancer tissues decreased significantly [PGT/GAPDH 0.45 ± 0.16 vs. 0.78 ± 0.23, integral A 718.7 ± 359.4 vs. 10412.0 ± 6423.3, average A 0.03 ± 0.01 vs. 0.12 ± 0.09, all P<0.01]. Lower mRNA and protein expressions of PGT in colorectal cancer were associated with depth of invasion T3 to T4 and TNM stage III( to IIII( (P<0.01), while not associated with gender, age, tumor location and differentiation degree (all P>0.05).

CONCLUSIONExpression levels of PGT mRNA and protein in colorectal cancer tissue are significantly down-regulation. PGT expression is associated with invasion depth and late stages.

Colorectal Neoplasms ; Down-Regulation ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; Organic Anion Transporters ; RNA, Messenger

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

Objective To investigate the expression of prostaglandin transporter (PGT) in colorectal cancer (CRC) tissues and its relationship with clinicopathological features. Methods The mRNA and protein levels of PGT were determined by real-time PCR , Western blot and immunohistochemical methods in cancer tissues and adjacent normal tissue from 80 patients with colorectal cancer and their relationship with clinicopathological features was analyzed. Results Compared with the adjacent normal tissue of colorectal cancer , the PGT mRNA relative expression (0.57 ±0.33 vs. 2.33 ±1.20) and the PGT protein expression in cancer tissues decreased significantly [PGT/GAPDH 0.45 ±0.16 vs. 0.78 ±0.23, integral A 718.7 ±359.4 vs. 10412.0 ±6423.3, average A 0.03 ±0.01 vs. 0.12 ±0.09, all P<0.01]. Lower mRNA and protein expressions of PGT in colorectal cancer were associated with depth of invasion T3 to T4 and TNM stage Ⅲ to Ⅳ (P<0.01), while not associated with gender, age, tumor location and differentiation degree (all P>0.05). Conclusion Expression levels of PGT mRNA and protein in colorectal cancer tissue are significantly down-regulation. PGT expression is associated with invasion depth and late stages.

Objective To investigate the expression of prostaglandin transporter (PGT) in colorectal cancer (CRC) tissues and its relationship with clinicopathological features. Methods The mRNA and protein levels of PGT were determined by real-time PCR , Western blot and immunohistochemical methods in cancer tissues and adjacent normal tissue from 80 patients with colorectal cancer and their relationship with clinicopathological features was analyzed. Results Compared with the adjacent normal tissue of colorectal cancer , the PGT mRNA relative expression (0.57 ±0.33 vs. 2.33 ±1.20) and the PGT protein expression in cancer tissues decreased significantly [PGT/GAPDH 0.45 ±0.16 vs. 0.78 ±0.23, integral A 718.7 ±359.4 vs. 10412.0 ±6423.3, average A 0.03 ±0.01 vs. 0.12 ±0.09, all P<0.01]. Lower mRNA and protein expressions of PGT in colorectal cancer were associated with depth of invasion T3 to T4 and TNM stage Ⅲ to Ⅳ (P<0.01), while not associated with gender, age, tumor location and differentiation degree (all P>0.05). Conclusion Expression levels of PGT mRNA and protein in colorectal cancer tissue are significantly down-regulation. PGT expression is associated with invasion depth and late stages.

OBJECTIVETo explore the feasibility and clinical significance of the detection of serum neutrophil gelatinase-associated lipocalin (NGAL) in human colorectal cancer.

METHODSLevels of NGAL in serum samples from 133 healthy people, 125 colorectal polyps patients and 100 colorectal cancer patients respectively were determined by sandwich ELISA assay. Relationship of NGAL level with clinicopathological features of colorectal cancer patients was analyzed. The optimal cut-off value of serum NGAL for diagnosing colorectal cancer was determined by ROC curve and compared with CEA and CA19-9. Univariate and multivariate analyses were performed to examine the relationship of NGAL level with the prognosis of patients with colorectal cancer.

RESULTSThe median serum NGAL protein level in 100 colorectal cancer cases was 67.96 (53.30-79.86) μg/L, significantly higher than that in healthy people and colorectal polyps patients. The differences were statistically significant (all P<0.01). Serum NGAL protein level was significantly associated with tumor diameter, TNM stage, lymph node metastasis and vascular involvement (P<0.05). The optimal cut-off point of serum NGAL protein level for diagnosing colorectal cancer was 49.78 μg/L, and the sensitivity and specificity were 88% and 81% respectively. As for colorectal cancer patients with stage I, the sensitivity of serum NGAL (78.9%) was significantly higher as compared to CA19-9 (31.6%) and CEA (36.8%); as for those with stage II, the sensitivity of serum NGAL(88.0%) was also significantly higher compared to CA19-9 (48.0%) and CEA (52.0%). Kaplan-Meier analysis showed that patients with positive NGAL (≥49.78 μg/L) had worse survival than those with negative NGAL (P=0.002). Multivariate analysis showed that NGAL was an independent prognostic factor (HR=2.060, 95%CI:1.023-4.150, P=0.043).

CONCLUSIONSNGAL can be served as the novel malignant biological phenotype marker for human colorectal cancer and can be used for the risk stratification. NGAL may be an independent prognostic factor in colorectal cancer.

Acute-Phase Proteins ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Colorectal Neoplasms ; blood ; diagnosis ; Early Detection of Cancer ; Female ; Humans ; Lipocalin-2 ; Lipocalins ; blood ; Male ; Middle Aged ; Prognosis ; Proto-Oncogene Proteins ; blood