【摘要】 目的 探讨125I粒子植入治疗中晚期胰腺癌的临床并发症及相关护理措施。 方法 回顾分析2006年10月-2010年4月121例行125I粒子植入治疗的胰腺癌患者的临床治疗及护理，采取积极有效的护理措施，预防及处理并发症，促进患者康复。 结果 121例患者接受放射性125I粒子植入治疗后，7例出现胰瘘，13例出现胃肠道反应，经对症处理和精心护理后均治愈。 结论 125I粒子组织间植入近距离治疗中晚期胰腺癌近期疗效好、安全、副反应少，良好的护理对改善中晚期胰腺癌患者预后具有重要意义。【Abstract】 Objective To observe the complications in patients with middle and advanced pancreatic carcinoma due to treatment of 125I particle implantation, and the investigate the proper nursing methods. Methods The clinical data including the therapy and nursing methods for the complications in 121 patients with middle and advanced pancreatic carcinoma due to treatment of 125I particle implantation from October 2006 to October 2010 were retrospectively analyzed. The treatment and care for complication were analyzed. Results In the 121 patients who had been treated by 125I particle, pancreatic fistula occurred in seven, and severe gastrointestinal upset was found in 13. The patients with the complications recovered after postoperative treatment and nursing. Conclusion 125I particle implantation for patients with middle and advanced pancreatic carcinoma is effective and safe with a few side reactions; proper nursing is important to improve the prognosis.
目的 总结胰十二指肠切除术后早期行肠内营养的护理效果。 方法 对2010年5月－12月30例胰十二指肠切除术后经鼻肠管行肠内营养患者的护理方法及措施进行回顾总结。 结果 全部患者术前均顺利完成留置鼻肠管，术后除7例患者分别发生堵管、咽炎、腹胀、营养液返流等并发症予以及时处置外，其余患者均顺利安全完成肠内营养治疗，患者营养状况在短时间内得到有效改善和恢复。 结论 胰十二指肠切除术后经鼻肠管行早期肠内营养，能促进肠功能早期恢复，良好的护理可保证肠内营养的顺利实施，显著改善患者围术期的营养状况。
Objective To investigate the effect of TNF-related weak inducer of apoptosis/fibroblast growth Factor-inducible 14 (TWEAK/Fn14) on the cell proliferation by transfecting Fn14 shRNA to PANC-1 cells. Methods The shRNA gene targeting Fn14 gene was constructed and transfected into pancreatic cancer cell line PANC-1 to specifically silence the expression of Fn14 gene. The effect of shRNA interference sequence on the expression of Fn14 was detected by flow cytometry and immunofluorescence. CCK-8 was used to detect the cell proliferation of PANC-1 after blocking TWEAK-induced signal pathway. Western blotting method was used to detect the expressions of downstream factors such as nuclear factor-kappa B (NF-κB), TWEAK and caspase-3 to explore the pathway mechanism of TWEAK/Fn14. Results The absorbance value (A value) in the Fn14 shRNA group was significantly lower than the control groups in 24 hours after transfected (P<0.000 1). After the specific shRNA sequences transfected PANC-1 cells, NF-κB, TWEAK and caspase-3 protein expressions were also significantly lower than the control group (P<0.05), and the apoptosis of PANC-1 cells increased after inhibition of TWEAK/Fn14 signaling pathway. Conclusions TWEAK/Fn14 involved in the progression of pancreatic cancer. The Fn14 expression could influence the process of cell apoptosis.
ObjectivesTo systematically review the efficacy and safety of new oral anticoagulants (NOACs) for cancer-associated venous thromboembolism.MethodsStudies about the efficacy and safety of NOACs versus low molecular weight heparins (LMWHs) or vitamin K antagonists (VKAs) for cancer-associated venous thromboembolism were collected by searching PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases from inception to August, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsA total of 8 studies involving 2 448 patients were included. The results of meta-analysis showed that: there was no significant difference in the recurrent VTE rate (OR=0.74, 95%CI 0.49 to 1.11, P=0.15) or bleeding rate (OR=0.80, 95%CI 0.57 to 1.13, P=0.21) between NOACs group and VKAs group. The major bleeding rate was significantly higher in the VKAs group than in the NOACs group (OR=0.47, 95%CI 0.27 to 0.84, P=0.01). The incidences of recurrent VTE (OR=0.84, 95%CI 0.16 to 4.14, P=0.83), bleeding (OR=0.46, 95%CI 0.18 to 1.20, P=0.11), major bleeding (OR=0.45, 95%CI 0.12 to 1.60, P=0.21) were similar between NOACs group and LMWHs group.ConclusionsThe current evidence indicates that for cancer patients with VTE, NOACs are superior to warfarin and comparable to LMWHs. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the above conclusion.
Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.
Objective To explor the influence of the hospital-community-family mental rehabilitation mode on the quality of life of patients with schizophrenia. Methods We selected 101 patients diagnosed as schizophrenia according to ICD-10, who were hospitalized in mental health center of the West China Hospital and took part in rehabilitation voluntarily after discharge. Those patients were randomly assigned to two groups. Hospital-community-family mental rehabilitation mode intervention was applied to the patients based on inpatient rehabilitation in the trial group (n=52), while inpatient rehabilitation alone was applied in the control group (n=49). The total score of quality of life, psycho-social dimension, motivation and energy dimension, score of mental disability and social function, and family social care index were recorded. Then, statistical analysis was performed using SPSS 17.0 software. Results After 3 months and 6 months, the trial group had lower scores of the total score of quality of life, psycho-social domain, and motive and energy dimension than those of the control group (Plt;0.05). After 6 months, the trial group had lower scores of mental disability and social function (Plt;0.05) but a higher score of family social care index (Plt;0.05). The scores of WHO-DSA II and SQLS were positively correlated, while the scores of APGAR and SQLS were negatively correlated. Conclusion The integral mode of hospital-community-family mental rehabilitation effectively improves the quality of life of patients with schizophrenia, which also positively improves patients’ rehabilitation.