Bladder perfusion is one of the main methods for the treatment of bladder cancer. In order to further improve the standardization of bladder cancer bladder perfusion operation for nursing staff, this paper, guided by evidence-based methods, formed the expert consensus on the whole process management of bladder perfusion for bladder cancer through Delphi expert consultation and expert demonstration meeting, and provided guidance for the standardization of clinical nursing practice and management institutionalization of bladder cancer bladder perfusion from seven aspects, namely, perfusion environment, operators, drug allocation, operation process, adverse reactions, health education and continuous nursing.

Objective:To summarize the clinical and high resolution CT(HRCT) characteristics of 141 patients with COVID-19.Methods:From January 20 to 28, 2020, 141 COVID-19 patients, 77 males and 64 females, with a median age of 49 (9, 87), were enrolled in the study. The clinical features, laboratory test results and HRCT findings of all patients were analyzed retrospectively.Results:In all of the patients, the decreasing leukocyte countin 38 (26.95%) and lymphocyte ratio in 71 (50.35%), a fever over 37.5 ℃ in 139 (98.58%), coughing in 106 (75.18%), headache in 11 (7.80%), expectoration in 41 (29.08%), chest distress in 93 (65.96%), and diarrhea in 4 (2.84%) were found. The HRCT of all patients were abnormal, including ground glass opacity (GGO) with patchy opacity in 52 (36.88%) mainly distributed along subpleural area, GGO with focal consolidation in 23 (16.31%),small patchy opacity in 27 (19.15%),large patchy consolidation in 20 (14.18%),thickened bronchovascular bundleing and blood vessel crossing the lesion in 48 (34.04%), air bronchus sign in 5 (3.55%), small nodule in 7 (4.96%),fibrous stripes and reticular opacities in 5 (3.55%), bilateral pleural effusion in 7 (4.96%), and mediastinal or bilateral hilar lymphadenopathy in 4 (2.84%).Conclusions:The clinical and HRCT manifestations of COVID-19 are various. Under the specific epidemiological background of COVID-19, chest HRCT scan should be carried out as soon as possible for early warning of this disease.

Objective: To summarize the clinical characteristics of 141 patients with novel coronavirus pneumonia (NCP) and the imaging characteristics of High Resolution CT(HRCT) in the chest. Methods: From January 20, 2020 to 28, 141 NCP patients, 77 males and 64 females, with a median age of 49 (9,87), were retrospectively analyzed. The clinical features, laboratory examination indexes and HRCT findings of 141 NCP patients were analyzed. Results: In 141 NCP patients, 38 (26.95%) had a decrease in leukocyte count and 71 (50.35%) had a decrease in lymphocyte ratio. Among 141 NCP patients, 139 (98.58%) had fever (over 37.5 ° C), 106 (75.18%) coughed, 11 (7.80%) had headache, 41 (29.08%) coughed up sputum, 93 (65.96%) had chest distress, and 4 (2.84%) had diarrhea. HRCT of 141 NCP patients were abnormal, 52 (36.88%) showed ground glass shadow (GGO) and patchy shadow, mainly subpleural distribution; 23 (16.31%) showed GGO with focal consolidation; 27 (19.15%) had small patchy blur; 20 (14.18%) had large patchy consolidation; 48 (34.04%) had bronchovascular bundle thickening and vascular perforator sign; 5 (3.55%) had Air bronchus sign; small nodule shadow in 7 cases (4.96%); fibrosis, grid shadow or strip shadow in 5 cases (3.55%); bilateral pleural effusion in 7 cases (4.96%); mediastinal or bilateral hilar lymphadenopathy in 4 cases (2.84%). Conclusions The clinical features and HRCT images of NCP are various. Under the specific epidemiological background of NCP, HRCT scan of chest should be carried out in time to make early warning of disease.

Objective:To translated and Chinesize Craniofacial Pain and Disability Inventory (CF-PDI) and test its reliability and validity in patients with temporomandibular joint disease.Methods:The Spanish version of CF-PDI was translated into Chinese and revised. Using the convenient sampling method, a total of 250 patients with temporomandibular joint disease who were hospitalized in the Second People's Hospital of Foshan from January to December 2019 were selected as research objects. The Chinese version of CF-PDI was used to investigate and the reliability and validity of the questionnaire were verified.Results:In this study, a total of 250 questionnaires were issued and 231 valid questionnaires were collected, with an effective recovery rate of 92.4%. The Chinese version of CF-PDI retained 21 items of the original questionnaire, and the total content validity of the questionnaire was 0.917. Through exploratory factor analysis and principal component analysis, a total of 2 common factors with characteristic roots over or equal to1 can be extracted, the cumulative variance contribution rate was 67.4%, and the loading degree of the factor of each item was 0.486 to 0.744. The Pearson correlation coefficient between the two factors was 0.476, and the Pearson correlation coefficient between factors 1 and 2 and the total questionnaire were 0.785 and 0.814. The differences were statistically significant ( P<0.01) . The correlation coefficient between The Chinese version of CF-PDI and the Pain Digital Rating Scale was 0.496 to 0.532, and he correlation coefficient between The Chinese version of CF-PDI and the total score and scores of each dimension of Pain Catastrophizing Scale was 0.246 to 0.476. The differences were statistically significant ( P< 0.01) . Cronbach's coefficient of the Chinese version of CF-PDI was 0.843, and test-retest reliability was 0.812. Conclusions:Chinese version of CF-PDI has good reliability and validity, which is suitable for pain effect and functional evaluation for patients with temporomandibular joint disease.

Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.

Objective To analyze the changes of metabolites in the left posterior cingulate cortex (PCC)in patients with type 2 diabetes mellitus (T2DM),diabetic encephalopathy(DE)and healthy control(HC),to discuss the pathogenesis and to provide the biological information for the early diagnosis of DE.Methods 46 patients with clinical diagnosis of T2DM and 26 matched HC were received single-voxel MRS on the left PCC using Siemens Verio 3.0T MR scanner.Participants were divided into two groups based on MoCA scoring criteria and diabetic retinopathy,including DM group (n=31)and DE group (n=15).All T2DM patients were received fasting blood glucose,glycated hemoglobin (HbAlc)and other clinical labortory tests before MR scans.SPSS 21.0 software package was used for statistical analysis.Results (1)Ins and Ins/Cr were increased gradually in DE compared with HC and DM groups(P＜0.05).(2) NAA/Ins ratio in DE group was significant lower than that in DM and HC group,but no significant difference was observed between DM and DE groups(P＞0.05).No significant differences exsited in NAA/Cr among these three groups(P＞0.05).Conclusion MRS can be more sensitive to detect DE patients on the left PCC-related metabolic abnormalities and help DE with early screening and preliminary clinical diagnosis.The increase Ins/Cr in the left PCC area is more sensitive to the brain injury of T2DM and can refelect the progress degree.It is necessary to expand the sample size to verify its diagnostic efficacy and early warning of the brain injury.

Objective To investigate the prevalence and specific manifestations of enduring psychological distress in patients with breast cancer after operation. Methods Totally 263 patients of the newly diagnosed breast cancer treated with the operation from August 2014 to August 2015 were collected by convenience sampling. Distress Thermometer (DT) and Problem List recommended by national Comprehensive Cancer Network was used to assess the persistent psychological distresses in the 6th, 15th, 20th, 25th, 30th months after the disease diagnosis,while a self-designed questionnaire was for the demographic data. Results The results of the DT screening showed that 16％(42/263) patients had persistent psychological problems;the incidences of five stages of significant psychological distress (DT≥4) was 43％(113/263), 34％(89/263), 31％(81/263), 28％ (73/263) and 25％ (65/263), respectively. The main manifestations of persistent psychological distress were:fatigue 59 cases (22.4％) , sleep disorders 51 cases (19.4％), nervous 48 cases (18.2％), anxiety 24 cases (9.1％), fear of appearance 23 cases (8.7％) and the difference in persistent psychological distress scores between different demographic characteristics (age, educational level, marital status, economic situation, operation method, disease stage) were statistically significant (t=-2.295-2.966, P<0.05). Conclusion The incidences of persistent psychological distress in patients with breast cancer is higher and the manifestation is different,which should be paid attention to by medical workers.

Objective     To recognize the risk factors of unplanned re-interventions within 30 days after pediatric cardiac surgery and evaluate the outcome of re-interventions. Methods     We retrospectively analyzed the clinical data of 202 children in Fuwai Hospital between January 1, 2015 and August 31, 2017. There were 115 males and 87 females at average age of 32.4 months with range of 3 days to 14 years. Results     There were 202 children who underwent unplanned re-intervention during 30 days post-operation, including 54 re-adjustments of pulmonary blood flow, 34 re-corrections for residual cardiac abnormalities, 28 cardiopulmonary resuscitations, 38 for coagulation problems, 19 pericardial drainages, 11 palliative re-operations to deliver heart load and 6 diaphragmatic folds and 12 others. The mortality rate among children who underwent unplanned re-inventions after cardiac surgery was 10.9% (22/202). It was much higher than those free from re-interventions (0.7%). Time of mechanical ventilation was 284.3 (11–2 339) h, and mean ICU stay was 17.7 (1–154) d, significantly longer than those free from re-interventions at the same period. Conclusion     Unplanned re-interventions after pediatric cardiac surgery is associated with higher mortality rate and longer recovery time. Early identifying risk factors and re-intervention can reduce the complications and improve the prognosis.

Objective To explore the effects of systematic nursing intervention on calcium and phosphorus metabolism and pruritus in hemodialysis patients. Methods A total of 60 patients undergoing hemodialysis in the Department of Nephrology at Wuxi Second Hospital Affiliated to Nanjing Medical University from February to August 2017 were selected and divided into control group and observation group by random number method, with 30 cases in each group. The control group was given routine care. Dietary guidance, psychological care and comprehensive health education were implemented in the observation group on the basis of routine nursing. Diet, skin pruritus and calcium and phosphorus metabolism were compared between the two groups. Results The dietary compliance rate in the observation group (83.33%) was higher than that in the control group (60.00%) after the intervention, and the difference was statistically significant (P＜0.05). There was no significant difference in serum calcium levels between the two groups (P＞0.05). The differences in the total parathyroid hormone and serum phosphorus levels between the two groups were statistically significant (P＜ 0.05). The degree of pruritus, the distribution of the skin and the score of sleep disturbance in the observation group were significantly lower than those in the control group, with statistical difference (P＜0.05). Conclusions Systematic nursing plays a positive role in calcium and phosphorus metabolism and pruritus in hemodialysis patients and is worthy of promotion and application.

Objective To investigate the effects of Baduanjin exercise on the fatigue and quality of life in patients with moderate inflammatory bowel disease (IBD).Methods Totally 63 moderate IBD patients who were treated via the IBD diagnosis and treatment platform Nanjing Hospital of Chinese Medicine between March and July 2017 and met the inclusion criteria were selected and randomly divided into the control group (n=31) and the observation group (n=32) according to the random number table. Patients in the control group received general guidance for anti-fatigue via the WeChat platform on the basis of conventional medication, while patients in the observation group did Baduanjin exercise in addition to general guidance and medication. The fatigue and quality of life scores were compared between the two groups.Results The observation group scored lower on the whole and in the dimensions of general fatigue, physiological fatigue, less physical activities and mental fatigue than the control group after intervention (t=6.403, 6.746, 4.440, 3.409, 3.893;P< 0.05); but there was no significant difference in the dimension of lower enthusiasm between the two groups (t=0.486,P>0.05). In terms of the quality of life, the observation group scored higher on the whole and in the dimensions of bowel symptoms and general symptoms (t=-2.045, -2.254, -6.870;P<0.05); but there was no significance in the dimensions of emotional function and social function between the two groups (t= -0.041, 0.257;P>0.05).Conclusions Baduanjin exercise in traditional Chinese medicine can alleviate the fatigue symptoms in moderate IBD patients and improve their quality of life.