【摘要】目的探討喉癌手術后患者對兩種不同霧化方式的耐受性,為選擇最佳霧化方式提供參考。方法將49例喉癌手術后患者隨機分為觀察組(25例)和對照組(24例),觀察組采用氧氣霧化吸入,對照組采用空氣壓縮泵霧化吸入。分別記錄兩組患者霧化吸入前及吸入15 min時脈搏血氧飽和度(SpO2)及心率;霧化過程中患者有無心慌、氣緊等不適以及霧化后痰液的性質及量。采用SPSS 13.0軟件進行統計分析。結果兩組患者霧化吸入15 min時的SpO2差異有統計學意義(Plt;001),觀察組高于對照組;而兩組患者霧化吸入前SpO2、心率、不適主訴及霧化后痰液的性質差異均無統計學意義(Pgt;005)。結論氧氣霧化吸入可以提高喉癌手術后患者霧化過程中的SpO2,使患者感覺更加舒適。【Abstract】Objective To investigate postoperative patients with laryngeal carcinoma atomization of two different forms of tolerance, in order to choose the best means of atomization. Methods Fifty postoperative patients with laryngeal carcinoma were divided into observation group using oxygen inhalation and control group using the air compression pump inhalation. Two groups of patients were recorded the value of SpO2 and heart rate before 15 minutes after the inhalation,as well as the discomforts such as flustered,gas tight during the atomization process and the nature and olume of sputum. Results The results of two groups of patients at the time of 15 minutes inhalation SpO2 statistically significant difference (Plt;001), the observation group than in the control group average SpO2 high; and two groups of patients with preinhalation SpO2 average, average heart rate, Discomfort chief complaint and the nature of sputum after aerosol compared no significant difference (Pgt;005). Conclusion Oxygen inhalation in patients with laryngeal cancer can improve the atomization process SpO2 value, so that patients feel more comfortable.
Lung cancer is one of the malignant tumors with the greatest threat to human health, and studies have shown that some genes play an important regulatory role in the occurrence and development of lung cancer. In this paper, a LightGBM ensemble learning method is proposed to construct a prognostic model based on immune relate gene (IRG) profile data and clinical data to predict the prognostic survival rate of lung adenocarcinoma patients. First, this method used the Limma package for differential gene expression, used CoxPH regression analysis to screen the IRG to prognosis, and then used XGBoost algorithm to score the importance of the IRG features. Finally, the LASSO regression analysis was used to select IRG that could be used to construct a prognostic model, and a total of 17 IRG features were obtained that could be used to construct model. LightGBM was trained according to the IRG screened. The K-means algorithm was used to divide the patients into three groups, and the area under curve (AUC) of receiver operating characteristic (ROC) of the model output showed that the accuracy of the model in predicting the survival rates of the three groups of patients was 96%, 98% and 96%, respectively. The experimental results show that the model proposed in this paper can divide patients with lung adenocarcinoma into three groups [5-year survival rate higher than 65% (group 1), lower than 65% but higher than 30% (group 2) and lower than 30% (group 3)] and can accurately predict the 5-year survival rate of lung adenocarcinoma patients.
Objective To explore the characteristics of vibration response imaging ( VRI) among heavy smokers whose pulmonary function is normal. Methods 67 heavy smokers with normal pulmonary function, 60 healthy non-smokers, and 60 patients with COPD were recruited. History taking, physical examination, lung function test, chest X-ray, and VRI examination were performed. The difference of VRI dynamic imaging between the three groups was analyzed. Results VRI vibration energy curve which appeared low, flat, sunken-in, and single peak accounted for 43.3% , 16.4% , 16.4% , and 14.9% respectively in the heavy smokers, accounted for 6.7% , 3.3% ,0% , and 0% respectively in the healthy nonsmokers, accounted for 60% , 33.3% , 18.3% , and 16.7% respectively in the COPD patients. The results between the heavy smokers and the healthy non-smokers were significantly different. Compared with the heavy smokers, the COPD patients exhibited more low and flat in expiration period. The energy peak value ratio of inspiration and expiration phase in the heavy smokers, the healthy non-smokers, and the COPD patients were 0.56,0.74, and 0.54 respectively. There was no significant difference between the heavy smokers and the COPD patients in peak value ratio of inspiration and expiration phase. Conclusion The vibration energy curve of the VRI in heavy smokers with normal pulmonary function is significantly different fromhealthy nonsmokers, but there is no significant difference between heavy smokers and COPD patients.
【摘要】 目的 分析臨床實習對護理本科生專業認同的影響，探討提高專業認同的措施。 方法 2010年6—10月，對某綜合性大學60名2007級普通全日制護理本科生進行抽樣調查，評價其實習前1個月和實習后3個月的專業認同情況，比較實習前、后的變化并分析影響因素。 結果 實習后專業認同的專業價值觀得分[（3.13±0.85）分]高于實習前[（2.78±1.00）分]，實驗專業期望得分[（12.09±2.13）分]低于實習前[（13.13±1.30）分]，差異有統計學意義（P=0.045，0.002）；而專業認識、情感、意志、技能和專業認同總分方面，實習前、后差異無統計學意義（Pgt;0.05）；其影響因素由強到弱依次為:帶教老師（37.04%）、實際的護理工作（33.33%）、實習科室（22.22%）、他人態度（7.41%）。 結論 臨床實習可提高護理本科生的專業價值觀，帶教老師及實際護理工作對專業認同影響較大。【Abstract】 Objective To analyze the effect of clinical practice on student nurses’ professional identity and explore measures to develop their professional identity. Methods Convenience sampling was used to select 60 general full-time student nurses who entered a comprehensive university in 2007. Then we assessed their professional identity at the time of one month before, and three months after clinical practice, compared the two results, and analyzed the related factors. Results The score of professional value dimension after clinical practice was higher than before (3.13±0.85 vs. 2.78±1.00, P=0.045), while the professional expectation dimension was lower than before (12.09±2.13 vs. 13.13±1.30, P=0.002), and the differences in above-mentioned indexes were statistically significant. There was no statistical difference before and after clinical practice in professional knowledge, professional affection, professional volition, professional skill dimensions, and total score of professional identity (Pgt;0.05). The related factors in a order from b to weak were clinical teacher (37.04%), practice work (33.33%), training department (22.22%), and others’ attitudes (7.41%). Conclusion Clinical practice may improve professional values but impair professional expectations of the student nurses, and clinical teacher and practice work have a great effect on student nurses’ professional identity.
Objective Colorectal cancer (CRC) is one of the most prevalent malignant tumors worldwide, posing a significant threat to human health. Tumor budding (TB), as a critical pathological feature of CRC, is closely associated with tumor invasion, metastasis, and prognosis. MethodsThis review synthesizes recent advances in TB research within CRC. Through a systematic analysis of the literature,it focuses on elucidating the pathological processes and molecular mechanisms underlying TB formation,highlighting its complex interplay with the tumor microenvironment. The review also summarizes methodologies for TB counting and grading, spanning from conventional histopathological evaluation to innovative approaches leveraging radiomics and artificial intelligence. ResultsTB play an essential role in clinical decision-making for CRC patients, demonstrating how TB grade influences surgical strategy selection and the planning of neoadjuvant and adjuvant therapies. Additionally, TB is also a key prognostic indicator of CRC, high-grade TB being consistently associated with increased risk of recurrence and reduced survival rate. Future research should further unravel the molecular mechanisms of TB, refine TB assessment methodologies,and validate the clinical utility of TB in personalized treatment strategies through multicenter trials. These efforts are expected to improve therapeutic outcomes and prognosis for CRC patients.
Myasthenia gravis (MG) is a common antibody mediated, cell-mediated, and complement dependent neuromuscular junction immune disease. The treatment mainly includes drug therapy (symptomatic therapy, non-specific immunosuppressive therapy, targeted immunotherapy), immune regulation (intravenous injection of human immunoglobulin and plasma exchange), and thymectomy. With the continuous deepening of research on MG treatment, targeted immune regulation of B cells, complement system, and neonatal Fc receptors has become a current research hotspot in the treatment of MG. Compared with traditional immunosuppressants, MG patients have better tolerance to new biological agents. This article elaborates on the research of MG targeted therapy related drugs and summarizes their efficacy and safety in MG treatment, aiming to find more treatment options.
ObjectiveTo provide reference for further treatment by analyzing the relationship between mutant genes of breast cancer and histological classification and molecular typing of breast cancer.MethodsRetrospectively collectted the pathological specimens of 46 breast cancer patients who treated by the Dongguan Maternal and Child Health Hospital and the Dongguan Houjie Hospital between February 2016 and August 2017 without chemotherapy. Among the selected 46 breast cancer patients, we detected tumor tissue estrogen receptor (ER)/ pregnancy hormone receptor (PR)/human epidermal growth factor receptor-2 (HER-2) status by immunohistochemistry and classified the pathological tissue section. By using multiple PCR techniques, we detected 207 hot mutation regions of the 50 extended tumor-related genes on the semiconductor sequencing platform.ResultsThere were 8 cases of grade Ⅰ, 18 cases of grade Ⅱ, 20 cases of grade Ⅲ in 46 breast cancer patients according to histological grade. Of the 46 cases, there were 23 cases of Luminal B, 9 cases of Luminal A, 9 cases of HER-2 (+), 5 cases of type besal-like according to ER/PR/HER-2 expression status. Moreover, we found that there were 33 gene locus mutations of 8 genes, including AKT1, APC, BRAF, CDKN2A, KRAS, PTEN, PIK3CA, and TP53. Among of them, the mutation of PIK3CA gene took the most of 24 cases, followed by TP53 (18 cases), 2 cases of CDKN2A gene mutation, and 1 case in the remaining four types of genes respectively. we found that the gene mutations of breast cancer were not related to the histological classification and molecular type (P>0.05), the PIK3CA gene mutation was related to the histological classification of breast cancer, the lower the histological classification level, the higher PIK3CA gene mutation rate (P<0.05). TP53 gene mutation was not related to histological grading and molecular type (P>0.05).Conclusions The PIK3CA gene mutation rate in patients with histological grading Ⅰ level increased significantly. The combination of PIK3CA gene mutation and histological grading of breast cancer may become a molecular biological indicator to judge the degree of malignancy and prognosis of breast cancer.
【摘要】 目的 探討使用營養風險篩查（nutritional risk screening，NRS）2002與生理生化指標聯合評估大腸癌患者術前營養及二者的定量關系。 方法 對2008年4月-2009年3月收治的367例大腸癌患者，用NRS 2002與生理生化指標分別評估其術前營養風險和營養狀況，對其進行相關性分析。 結果 有28%的大腸癌患者術前即存在營養風險，各評價指標對營養不良狀況的檢出率存在差異（9.3%～31.6%），且NRS 2002營養風險評分與血紅蛋白（r=-0.117，P=0.025）、血清前白蛋白（r=-0.205，P=0.046）、血清白蛋白（r=-0.175，P=00.001）、體量質指數（r=-0.231，P=0.000）均呈負相關。 結論 大腸癌患者術前即存在較高的營養風險和營養不良，且營養風險與術前營養狀況有關。【Abstract】 Objective To assess the preoperative nutritional risks and status of patients with colorectal cancer by nutritional risk screening 2002 (NRS 2002) combined with physiological-biochemical indicators, and explore their quantitative relationship. Methods NRS 2002 combined with physiological-biochemical indicators were applied on the 367 patients with colorectal cancer in Gastrointestinal Surgery Center in West China Hospital between April 2008 and March 2009 to assess their nutritional risks and status, and correlation analysis was done to explore their quantitative relationship. Results Among all the patients, 28% had preoperative nutritional risks. Different physiological-biochemical indicators detected different rates of malnutrition (9.3% to 31.6%), and there was a negative correlation between NRS 2002 and such physiological-biochemical indicators as hemoglobin (r=-0.117,P=0.025), pre-albumin (r=-0.205,P=0.046), albumin (r=-0.175,P=0.001), and body mass index (r=-0.231,P=0.000). Conclusion Many colorectal cancer patients have preoperative nutritional risks and malnurtrion, and the nutritional risks are correlated with preoperative nutritional status.
Objective To explore the clinical characteristics, diagnose and treatment of bronchiolitis obliterans (BO) associated with lymphoma and paraneoplastic pemphigus (PNP). Methods One patient with BO associated with lymphoma and paraneoplastic pemphigus was presented and literatures which searched through Wanfang Med online and PubMed on this subject were reviewed. Results A 44-year-old woman was admitted to this hospital because of oral ulcer for two years, and persistent dyspnea for fourteen months. She had been diagnosed with PNP one year earlier. Pulmonary function displayed severe obstructive ventilator dysfunction, negative response to the bronchodilator. Chest CT showed bronchiolectasis. The ratio of neutrophils increased in bronchoalveolar lavage fluid. The pathology of ultrasound-guided neck and inguinal lymph node biopsy showed non-Hodgkin’s lymphoma. Based on the clinical presentation, the image and pathology of this patient, the diagnosis of having PNP with BO secondary to the lymphoma was made. After 10 cycles of CHOP chemotherapy, lymphoma and PNP went into remission, but the patient died from respiratory failure. The literatures were reviewed and 15 patients were found, out of them 60% (9/15) were female, 47% (7/15) follicular lymphoma and 47% (7/15) diagnosis of clinical BO which did not be supported by pathology. Lymphoma-PNP-BO was a clinical syndrome and 67% of the initial presentations were PNP. Patients died within 7 to 60 months. Conclusions BO associated with lymphoma and PNP is rare and the most common initial presentation is PNP. BO is the major cause of death. Treatments included chemotherapy, corticosteroid and immunosuppressor, lymphoma and PNP can be alleviated, but BO is aggravating.
