临床护理路径在脑出血患者护理中的应用评价

目的:评价分析临床护理路径在脑出血患者护理中的应用效果。方法:选取我院2013年1月-2013年12月间收治的68例脑出血患者,随机分为对照组(34例)和观察组(34例)。对照组患者给予常规护理,观察组患者给予临床护理路径护理,观察比较两组患者的护理效果。结果:在依从性、知晓率、满意度、ADL评分、并发症发生率、住院时间方面比较,观察组明显优于对照组,两组比较,P0.05具有显著性差异,有统计学意义。结论:临床护理路径在脑出血患者护理中的应用效果明显,能够提高依从性、知晓率、满意度,降低并发症发生率,提高患者的生活质量。     

临床护理教学路径在内科的建立与应用

目的 建立内科临床护理教学路径,探讨其在临床护理教学中的效果.方法 将60名入科实习护生随机分成两组,对照组采用传统的教学方法进行综合教学,实验组采用临床护理教学方法路径进行教学.结果 实验组护生的成绩明显优于对照组,对带教老师的满意度及学习兴趣比对照组高.结论临床护理路径可以提高临床教学效果,激发护生学习兴趣,提高对老师的满意度.     

临床护理路径在骨科护理中的应用

目的:探讨临床护理路径在骨科护理中的应用效果。方法:选择我院近期收治的100例骨科患者作为实验研究对象。将所选实验对象随机分成观察组和对照组,每组50例。观察组采用临床路径护理管理;对照组采用常规护理管理。比较两组的护理效果。结果:观察组经护理后,平均住院时间、住院费用比对照组有明显缩短和减少;患者满意程度、对疾病认知程度以及锻炼掌握情况同对照组比较要好于对照组;两组各指标比较统计学差异显著(P<0.05)。结论:采用临床路径对骨科病人进行护理管理,提高患者对疾病的认知度和满意度,节省住院时间和住院费用,值得推广应用。     

临床路径在神经外科护理中的应用

目的:研究临床路径在神经外科护理中的应用价值。方法:选择2012年1月-2013年4月我院收治的86例神经外科病人,将其随机分成研究组(43例)与对照组(43例)。对照组运用常规性的神经外科护理方法,研究组则在常规性护理的基础之上采用临床路径护理方法。比较分析2组病人护理依从性评分与疾病知识的知晓率。结果:研究组服药依从性评分、饮食依从性评分、疾病知识知晓率都显著优于对照组(P<0.05)。结论:临床路径在神经外科护理中的应用价值比较高,可以提高病人的依从性以及提升护理质量。     

临床护理路径在烙铁头蛇咬伤患者中的应用

目的探讨临床护理路径在烙铁头蛇咬伤患者护理中的应用效果。方法将我院收治的80例烙铁头蛇咬伤患者随机分为对照组和观察组各40例,对照组给予常规护理,观察组实施临床护理路径,比较两组患者住院时间、并发症发生率和患者满意度。结果观察组患者的住院时间明显缩短,而且并发症发生率低,患者满意度提高,与对照组比较差异均有统计学意义(P0.05)。结论实施临床护理路径能规范护理行为,减少并发症,缩短住院日,提高患者满意度。     

临床护理路径在白内障患者中的应用观察

目的观察临床护理路径在白内障患者中的应用效果。方法对我院2013年6月~2014年6月收治的132例白内障手术患者采用数字表随机法分为观察组和对照组,观察组66例采用临床护理路径进行护理,对照组66例采用常规护理,比较两组住院时间、治疗费用、白内障相关知识掌握情况及并发症发生率。结果观察组平均住院时间、治疗费用及并发症发生率与对照组比较,差异均具有显著性(均P0.05)。观察组90.91%的患者掌握白内障相关知识,7.58%的患者基本掌握,观察组患者对白内障相关知识的掌握明显高于对照组,差异具有显著性(P0.05)。结论临床护理路径使护理工作科学化、系统化,相比传统护理具有明显的优势。     

临床护理路径在脑出血微创介入治疗中的应用评价

目的：探讨临床护理路径在脑出血微创介入治疗中的效果评价。方法：选择我院神经内科脑出血进行微创介入治疗的住院患者120例作为研究对象,将目标患者随机分为两组,每组各60例患者,普通组实施常规护理,对照组采用临床护理路径模式进行护理,对两组患者的护理满意度等进行对比。结果：对照组在住院费用、住院时间、护理满意度等方面均好于普通组,两组患者间有明显差异,P〈0.05,有统计学意义。结论：临床护理路径的实施有利于护理满意度的提高,对促进患者生存质量也有积极作用。     

临床护理路径管理糖尿病足患者效果评价

目的:观察临床护理路径对糖尿病足患者的效果。方法:将100例糖尿病足患者随机分为两组:实验组(50例)应用临床护理路径模式,对照组采用常规护理模式,比较两组患者的住院时间、医疗费用、患者满意率、血糖、溃疡愈合时间和糖尿病足知识评分。结果:实验组患者的住院日数、医疗费用、血糖和溃疡愈合时间显著低于对照组(P<0.05),患者满意率和糖尿病足知识评分显著高于对照组(P<0.05)。结论:应用临床护理路径可以有效地降低糖尿病患者的血糖、溃疡愈合时间、住院时间和医疗费用,提高患者糖尿病足知识水平和满意率。     

妇产科临床护理教学路径的建立与应用

目的探讨临床护理路径在妇产科临床护理教学中的建立及应用效果。方法选取2014~2015年实习护生164名为研究对象,其中以2014年的实习护生为对照组,2015年的实习护生为观察组。对照组采用传统教学模式,观察组采用临床护理路径进行教学,比较两组护生的综合考核成绩、教师和护生对临床护理路径的效果评价。结果观察组实习护生的综合考核成绩显著高于对照组,差异有统计学意义(P0.05);而且观察组教师与实习护生对临床护理教学路径的评价较高,与对照组比较差异有统计学意义(P0.05)。结论在妇产科临床教学中应用临床护理教学路径能提高教学效率,弥补传统教学中不足,并能激发教师的教学积极性,提升学生学习效率和学习主动性。     

临床路径在老年性白内障手术患者中的应用评价

目的 探讨临床路径在老年性白内障手术患者中的应用及实施效果。方法 选取2009年6月—2012年6月期间在某三甲医院住院手术治疗的3 758 例老年性白内障病人为研究对象,采用对照研究,经患者同意,将其分为对照组（1 995例）和观察组（1 764例）,比较两组平均住院日、平均住院费用、西药费用、辅助诊断费、患者满意度、健康知识知晓程度。结果 观察组的平均住院日、平均住院费用、西药费用、辅助诊断费、并发症发生率均低于对照组（P <0.000 1）, 患者满意度及健康知识掌握情况均高于对照组（P<0.05）,差别具有统计学意义。结论 临床路径应用于白内障手术,可以缩短住院天数,降低医疗费用及辅助诊断费,提高患者的满意度,提高患者对健康知识的掌握率,减少术后并发症的发生。     

Immunoglobulin allotypes in patients with nasopharyngeal carcinoma

Gm phenotypes and the Km(1) allotype were studied in Tunisian patients with nasopharyngeal carcinoma (NPC). A highly significant association was found between the Km(1) allotype and the NPC disease. Two rare Gm haplotypes, Gm(1, 17; 11, 15, 21) and Gm(1, 3, 5, 11), were found to be significantly increased among the NPC patients.     

鼻咽癌患者鼻咽灌洗液菌群检测及结果分析

目的 采用聚合酶链式反应－变性梯度凝胶电泳（PCR-DGGE）技术,通过观察鼻咽癌患者与健康对照者鼻咽灌洗液菌群的变化,初步探讨菌群异常在鼻咽癌发生中的作用。方法 以7例明确诊断且尚未治疗的鼻咽鳞癌患者和5例健康对照者为研究对象,提取鼻咽灌洗液DNA,观察两组研究对象菌群分布差异,进行相似性、多样性分析。结果 鼻咽癌患者与健康对照者之间鼻咽灌洗液的菌群分布存在差异,与健康对照者比较,咽颊炎链球菌和不动杆菌数量增加,但嗜热链球菌数量减少。结论 鼻咽癌患者鼻咽灌洗液菌群分布与健康对照者比较出现明显差异,可为鼻咽癌预防及治疗提供实验依据。     

DEU教学模式在临床护理教学中的运用

目的 探讨实习专用病房(Dedicated education unit,DEU)教学模式在临床护理实习教学过程中的应用效果.方法 选择2019年6月17日～2020年3月15日在我科实习的2017级护理大专班实习护生106名,按教学方法的不同进行分组,其中使用传统带教方式的为对照组,采用DEU临床护理教学方法的为实验...     

鼻咽癌患者外周血循环内皮细胞的检测及临床意义分析

目的分析鼻咽癌患者外周血循环内皮细胞（CECs）的水平及临床意义。 方法选取2016年1月至2018年10月期间于陆军军医大学第二附属医院接受单纯放疗或同期放化疗的55名初诊鼻咽癌患者为研究对象,归为鼻咽癌组,并随机选取同期来医院进行体检的50例健康成人为对照组。比较两组外周血CECs水平,并分析鼻咽癌组不同临床病理资料患者的外周血CECs水平,以及治疗前后的外周血CECs水平变化。根据疗效分为完全缓解（CR）组和未完全缓解组（包括部分缓解、疾病稳定和疾病进展）。两组间比较采用两样本t检验;计量资料采用百分比表示,比较采用χ²检验。 结果鼻咽癌组患者治疗前的外周血CECs水平为（21.13±8.33）个/μl,高于对照组的（5.03±2.25）个/μl,差异有统计学意义（t = 13.230,P < 0.01）。鼻咽癌组治疗前的外周血CECs水平T3~T4期（23.23±8.09）?个/μl高于T1~T2期（16.01±5.22）个/μl,差异具有统计学意义（t = 3.290,P < 0.01）;N1~N3期（22.82±8.16）?个/μl高于N0期（15.06± 3.98）个/μl,差异具有统计学意义（t = 3.176,P < 0.01）;M1期（28.30±3.33）?个/μl高于M0期（19.91±8.23）?个/μl,差异具有统计学意义（t = 2.826,P < 0.01）;Ⅲ~Ⅳ期（23.26±7.93）个/μl高于Ⅰ~Ⅱ期（17.93±5.63）?个/μl,差异具有统计学意义（t = 2.726,P < 0.01）。CR组患者治疗前（20.03±8.12）?个/μl、治疗后3个月（12.61±5.33）?个/μl的外周血CECs水平低于未完全缓解组（26.75±3.29）?个/μl、（19.03±2.62）?个/μl,差异具有统计学意义（t = 5.181、5.507,P均< 0.01）。 结论鼻咽癌患者的外周血CECs水平明显升高,与病情进展、放化疗效果有关,可能成为潜在的肿瘤标志物。     

Hippo pathway contributes to cisplatin resistant-induced EMT in nasopharyngeal carcinoma cells

Nasopharyngeal carcinoma (NPC) is a kind of head-neck malignant tumor derived from the nasopharyngeal epithelium and is mainly prevalent in Southern China and Southeast Asia countries. Cisplatin (DDP) provides the first-line therapeutic administration in NPC patients. However, chemoresistance has been a main barrier and caused bad treatment outcome in NPC therapy. To understand the molecular mechanism of acquired resistance to DDP, multiple methods were performed to examine the morphocytology and molecular changes in DDP-resistant NPC cells. We found that drug resistance cells displayed epithelial-mesenchymal transition (EMT) characteristics. DDP-resistant NPC cells exhibited enhanced migration and invasion potential. Moreover, overexpression of TAZ, one key gene in Hippo pathway, is closely associated with the DDP resistance of NPC cells and its EMT properties. Depletion of TAZ in DDP-resistant cells reversed EMT phenotypes to MET characteristics and restored chemosensitivity of DDP-resistant cells to DDP treatment. These results suggest that inactivation of TAZ could be a promising approach for the treatment of NPC patients.     

Nogo-B promotes invasion and metastasis of nasopharyngeal carcinoma via RhoA-SRF-MRTFA pathway

Distant metastasis remains the major cause for treatment failure in patients with nasopharyngeal carcinoma (NPC). Thus, it is necessary to investigate the underlying regulation mechanisms and potential biomarkers for NPC metastasis. Nogo-B (neurite outgrowth inhibitor B), encoded by reticulon-4, has been shown to be associated with the progression and advanced stage of several cancer types. However, the relationship between Nogo-B and NPC remains unknown. In this study, we found that higher expression of Nogo-B was detected in NPC cells and tissues. Higher expression of Nogo-B was statistically relevant to N stage, M stage, and poor prognosis in NPC patients. Further functional investigations indicated that Nogo-B overexpression could increase the migration, invasion, and metastasis ability of NPC cells in vitro and in vivo. Mechanistically, Nogo-B promoted epithelial-mesenchymal transition (EMT) and enhanced the invasive potency by interacting directly with its receptor NgR3 in NPC. Additionally, overexpression of Nogo-B could upregulate the protein levels of p-RhoA, SRF, and MRTFA. A positive relationship was found between the expression of Nogo-B and the p-RhoA in NPC patients as well as in mouse lung xenografts. Nogo-B^high p-RhoA^high expression was significantly associated with N stage, M stage, and poor prognosis in NPC patients. Notably, CCG-1423, an inhibitor of the RhoA-SRF-MRTFA pathway, could reverse the invasive potency of Nogo-B and NgR3 in NPC cell lines, and decrease the expression of N-Cadherin, indicating that CCG-1423 may be a potential target drug of NPC. Taken together, our findings reveal that Nogo-B enhances the migration and invasion potency of NPC cells via EMT by binding to its receptor NgR3 to regulate the RhoA-SRF-MRTFA pathway. These findings could provide a novel insight into understanding the metastasis mechanism and targeted therapy of advanced NPC.Subject terms: Head and neck cancer, Drug discovery     

Dosiomics-based prediction of radiation-induced hypothyroidism in nasopharyngeal carcinoma patients

PurposeTo predict the incidence of radiation-induced hypothyroidism (RHT) in nasopharyngeal carcinoma (NPC) patients, dosiomics features based prediction models were established.Materials and methodsA total of 145 NPC patients treated with radiotherapy from January 2012 to January 2015 were included. Dosiomics features of the dose distribution within thyroid gland were extracted. The minimal-redundancy-maximal-relevance (mRMR) criterion was used to rank the extracted features and selected the most relevant features. Machine learning (ML) algorithms including logistic regression (LR), support vector machine (SVM), random forest (RF), and k-nearest neighbor (KNN) were utilized to establish prediction models, respectively. Nested sampling and hyper-tuning methods were adopted to train and validate the prediction models. The dosiomics-based (DO) prediction models were evaluated through comparing with the dose-volume factor-based (DV) models in terms of the area under the receiver operating characteristic (ROC) curve (AUC). The demographics factors (age and gender) were included in both DO model and DV model.ResultsAge, V45 and 37 dosiomics features exhibited significant correlations with RHT in univariate analysis. For prediction performance, DO prediction models exhibited better results with the best AUC value 0.7 while DV prediction models 0.61. In DO prediction models, the AUC values displayed a trend from ascending to descending with the increasing of selected features. The highest AUC value was achieved when the number of selected features was 3. In DV prediction model, similar trend was not observed.ConclusionThis study established a prediction model based on the dosiomics features with better performance than conventional dose-volume factors, leading to early predict the possible RHT among NPC patients who had received radiotherapy and take precaution measures for NPC patients.     

Development and validation of immune inflammation–based index for predicting the clinical outcome in patients with nasopharyngeal carcinoma

Inflammation indicators, such as systemic inflammation response index (SIRI), systemic immune‐inflammation index (SII), neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio (PLR), are associated with poor prognosis in various solid cancers. In this study, we investigated the predictive value of these inflammation indicators in nasopharyngeal carcinoma (NPC). This retrospective study involved 559 patients with NPC and 500 patients with chronic rhinitis, and 255 NPC patients were followed up successfully. Continuous variables and qualitative variables were measured by t test and chi‐square test, respectively. The optimal cut‐off values of various inflammation indicators were determined by receiver operating characteristic (ROC) curve. Moreover, the diagnostic value for NPC was decided by the area under the curves (AUCs). The Kaplan‐Meier methods and the log‐rank test were used to analyse overall survival (OS) and disease‐free survival (DFS). The independent prognostic risk factors for survival and influencing factors of side effects after treatment were analysed by Cox and logistic regression analysis, respectively. Most haematological indexes of NPC and rhinitis were significantly different between the two groups, and PLR was optimal predictive indicators of diagnosis. In the multivariable Cox regression analysis, PLR, WBC, RDW, M stage and age were independent prognostic risk factors. Many inflammation indicators that affected various side effects were evaluated by logistic regression analysis. In conclusion, the combined inflammation indicators were superior to single haematological indicator in the diagnosis and prognosis of NPC. These inflammation indicators can be used to supply the current evaluation system of the TNM staging system to help predict the prognosis in NPC patients.     

Distinctive microRNA expression in early stage nasopharyngeal carcinoma patients

The goal of this study was to investigate microRNAs (miRs) expression at different stages of nasopharyngeal carcinoma (NPC). MiR expression profiling at various stages of NPC was performed by miR array and further verified using quantitative real‐time RT‐PCR. Pathway enrichment analysis was carried out to identify the functional pathways regulated by the miRs. The expression of a selected group of identified miRs was verified in stage I NPC by in situ hybridization (ISH). A total of 449 miRs were identified with significantly different expressions between NPC tissues and normal pharyngeal tissues. Eighty‐four miRs were dysregulated only in stage I NPC, among which 45 miRs were up‐regulated and the other 39 were down‐regulated. Pathway enrichment assay revleaed that three significantly down‐regulated and three significantly up‐regulated miRs involved in 12 pathways associating with tumour formation and progression. Quantitative RT‐PCR confirmed the miR array result. In addition, the low expression levels of hsa‐miR‐4324, hsa‐miR‐203a and hsa‐miR‐199b‐5p were further validated in stage I NPC by ISH. This present study identifed the miR signature in stage I NPC, providing the basis for early detection and treatment of NPC.