小气道病变曾经是全球呼吸界研究的热点，许多肺功能测定方法和指标被用于小气道功能的诊断，其后热度骤减，最近又引起一些学者的重视。
Lung cancer is a malignant tumor with the highest incidence and mortality in China. Early diagnosis and early treatment is the key to improve the survival and prognosis of patients with lung cancer. In recent years, many studies have focused on biomarkers of lung cancer. Emerging biomarkers tests have shown some potential in lung cancer screening. Combining biomarkers, imaging omics and artificial intelligence to establish a comprehensive model for lung cancer screening and prediction may be the development direction for improving lung cancer screening in the future. This paper summarizes the application of biomarkers in lung cancer screening, introduces the emerging biomarkers and new technologies, and discusses the application prospects of biomarkers in lung cancer screening, in order to providea theoretical basis for improving screening, early diagnosis and early treatment of lung cancer.
Objective To study the effect of comprehensive nursing on the treatment compliance and depression of patients with pulmonary tuberculosis complicated with depression. Methods Fifty-seven patients with pulmonary tuberculosis complicated with depression treated between May 2012 and June 2014 were randomly divided into study group (n=30) which was given comprehensive nursing, and control group (n=27) which accepted routine nursing. The scores of depression, treatment compliance and clinical treatment outcome were compared between the two groups. Results The scores of Hamilton Depression Scale were respectively 19.18±2.36, 18.65±2.61, 17.43±1.78 and 16.57±2.05 at the time of 3, 4, 5 and 6 months after nursing intervention, while the same scores of the control group were 22.05±3.03, 21.88±2.85, 20.96±2.06 and 20.04±1.39. The sputum negative conversion rates in the study group at those time periods were respectively 66.7%, 76.7%, 80.0% and 86.7%, while the rates in the control group were 37.0%, 44.4%, 51.6% and 63.0%. The CT lung lesions absorption rates in the study group were 43.3%, 56.7%, 63.3% and 76.7%, while the rates in the control group were 18.5%, 25.9%, 35.3% and 40.7%. The above indicators between the two groups were all statistically significant (P<0.05). The compliance of treatment in the study group was 90.0%, which was significantly higher than that in the control group (63.0%) (P<0.05). Conclusion Comprehensive nursing can help to improve negative emotion, enhance treatment compliance and clinical treatment effect, and promote the early recovery of patients with pulmonary tuberculosis combined with depression.
Objective To observe the feature of post-operative hyperglycemia after coronary artery bypass grafting(CABG) surgery in department of intensive care unit（ICU） patients.Methods Patients who had CABG surgery in Zhongshan Hospital from January 2005 to December 2005 were enrolled.Data were collected including the history of diabetes，pre-operative and post-operative blood glucose(BG) levels，and the time that post-operative hyperglycemia and peak BG occurred.The patients were divided into diabetic and non-diabetic groups according to the diabetic history.The data were compared and analyzed between the two groups.Results 200 patients were enrolled in this study.The incidence of post-operative hyperglycemia was 77%，and about 99.4% occurred in the first 24 hours admitted to ICU，which was independent on diabetic history (χ2=2.58，P=0.108)，but was related to the BG level above 6.1 mmol/L (χ2=12.31，P=0.000).In 80% of the patients，peak BG occurred in the first 24 hours admitted to ICU，which was significantly earlier in the non-diabetic group compared with the diabetic group (8.5 h vs 18.5 h，P=0.02 ).In the patients who had post-operative hyperglycemia，the median time of the BG peak is 10 hours，and 75.3% of the BG peak occurred in the first 24 hours admitted to ICU.Conclusion There is a high incidence of post-operative hyperglycemia in post-CABG patients which always occur within 24 hours after operation and relate to pre-operative high BG.
ObjectiveTo systematically review the incidence of financial toxicity among cancer patients in China. MethodsThe Cochrane Library, Web of Science, PubMed, Embase, CINAHL, CNKI, and WanFang databases were searched to collect studies on the prevalence of financial toxicity among cancer patients in China from January 2016 to April 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was performed by using Stata 16.0 software. ResultsA total of 24 studies involving 8 799 participants were included. Meta-analysis results showed that the prevalence of financial toxicity among cancer patients was 67.4% (95%CI 60.9% to 74.0%) in China. The subgroup analysis showed that sex, educational level, type of medical insurance, cancer site and stage, the cut-off of the instrument, and region were all influential factors of financial toxicity among cancer patients. ConclusionCurrent evidence shows that high prevalence of financial toxicity among cancer patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To study the special traits of primiparae’s compliance with labor analgesia, so as to offer individualized analgesia solutions during spontaneous labor. Methods The uniparous primiparae with cephalic presentation between gestational weeks 38 and 40 were divided into two groups based on their educational background (college education or above, and high school education or below), each group with 20 cases. The demographical statistics of the two groups including their State-Trait Anxiety Inventory (STAI) grading, PCA results, and delivery situation were recorded and analyzed. Results Differences in age, height, and weight were not statisticallysignificant (Pgt;0.05); differences in T-AI were not statistically significant (Pgt;0.05); differences in S-AI were statistically significant (Plt;0.05); differences in anxiety and numbers of adding anesthetics were not statistically significant (Pgt;0.05); differences in failure to tolerate labor pains and requiring caesarean section were statistically significant (Plt;0.05). Conclusion Primiparae with higher educational degree tend to have higher S-AI grading and perform poorly in compliance with labor analgesia.
【摘要】 目的 观察窄谱中波紫外线联合复方甘草酸苷治疗寻常性银屑病的疗效。 方法 2007年2月—2010年11月，将收治的126例银屑病患者随机分为治疗组和对照组，治疗组72例采用注射复方甘草酸苷与窄谱中波紫外线联合治疗，对照组54例则仅采用窄谱中波紫外线治疗，以银屑病皮损面积和疗效指数（PASI）评价对比两组疗效。 结果 两组治疗后PASI评分均明显低于治疗前；治疗后治疗组PASI评分低于对照组，且差异有统计学意义（Plt;0.05）；两组治疗有效率分别为87.5%和79.6%，治疗组疗效明显优于对照组（Plt;0.05）。 结论 窄谱中波紫外线与复方甘草酸苷联合治疗寻常性银屑病，不良反应小，治愈率高，值得临床推广。【Abstract】 Objective To observe the clinical efficacy of compound glycyrrhizin combined with narrow-band ultraviolet B (NB-UVB) in treating patients with psoriasis vulgaris. Methods A total of 126 patients with psoriasis vulgaris treated in our hospital from February 2007 to November 2010 were randomly divided into the treatment group and the control group. Seventy-two patients in the treatment group were treated with NB-UVB radiotherapy combined with compound glycyrrhizin, and 54 patients in the control group were treated with NB-UVB radiotherapy alone. The curative effects were evaluated in terms of the area of injury and therapeutic effect indexes. Results The PASI score after treatment for both groups was obviously lower than before, and the score of the treatment group was significantly lower than the control group after treatment. The efficacy rate was respectively 87.5% and 79.6% for the treatment group and the control group, with a significant difference (Plt;0.05). Conclusion NB-UVB combined with compound glycyrrhizin is safe and effective in treating psoriasis vulgaris, and it is worth popularizing.
Objective To investigate the relative factors of sleep disorders in patients after arthroscopic knee surgery.MethodsThe clinical data of 155 patients undergoing arthroscopic knee surgery in West China Hospital of Sichuan University from October 1st 2017 to April 1st 2018 were analyzed. The sleep quality index was assessed by the Pittsburgh Sleep Quality Index. According to the scores, the patients were divided into two groups: the sleep disorder group and the non-sleep disorder group. Mindfulness level were evaluated by Mindful Attention Awareness Scale (MAAS). The binary logistic regression was used to assess the relationship between MAAS and sleep disorders.ResultsAmong the enrolled cases, there were 135 males and 20 females, with an average age of (34.12±12.13) years; 64 patients had poor sleep quality. The results of univariate analysis showed that the payment method, single or bilateral lesions, and MAAS score were the factors affecting sleep (P<0.05). The results of multivariate analysis indicated that with medical insurance [odds ratio (OR)=0.118, 95% confidence interval (CI) (0.021, 0.671), P=0.016], postoperative pain [OR=3.379, 95%CI (1.164, 9.812), P=0.025], bilateral lesions [OR=3.842, 95%CI (1.040, 14.191), P=0.044], and MAAS score ≥68 [OR=0.046, 95%CI (0.018, 0.121), P<0.001] were independent predictive factors for sleep disorders (P<0.05). Conclusion Postoperative pain reduction and mindfulness training may improve the patients’ sleep quality and reduce the incidence of sleep disorders.
ObjectiveTo analyze the risk factors of postoperative cognitive dysfunction (POCD) in elderly patients after abdominal surgery. MethodsThe clinical data of 2 286 patients over 60 years old after abdominal surgery were retrospectively analyzed, which were divided into non-POCD group with 2 248 patients and POCD group with 38 patients. The influencing factors of POCD in elderly patients after abdominal surgery, including the age, gender, anesthetic way, the premedication, cormobided with lung or heart disease, diabetes, jaundice, anemia or hypoproteinemia, the duration of surgery, and postoperative analgesia protocols, were analyzed between two groups. ResultsThe age, anesthetic way, cormobided with lung or heart disease, diabetes, jaundice, with or without continuous postoperative effective analgesia, and surgery duration over four hours were relevant with POCD (Plt;0.05), while gender, the premedication, and preexisted anemia or hypoproteinemia were not relevant with that (Pgt;0.05). ConclusionAge over 70 years, general anaesthesia, cormobided with lung or heart disease, diabetes, jaundice, surgery duration over four hours, and incomplete postoperative analgesia are the risk factors of POCD after abdominal surgery.
Family members are crucial for medical disputes. From the psychology and social perspective, the paper analyzes a specific medical dispute case, and discusses the psychological care for (potential) " shidu” (loss of the only child) family. Based on the current social context, an early intervention suggestion is proposed, that is to provide the whole-process psychological intervention to the special patients’ families. The intervention includes: regular psychological evaluation and psychological support if necessary; providing disease knowledge and death education; providing continuous psychological care by the hospital and community; offerring more psychological care for " shidu” family by society.