目的 探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法 对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果 妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。
目的 探讨老年患者特发性结肠穿孔的临床特点。方法回顾性分析我科2000年5月至2010年5月期间收治的28例特发性结肠穿孔老年患者的临床资料。 结果28例患者中男16例，女12例; 年龄60～87岁，中位年龄69.2岁。所有患者表现为急性腹痛或腹膜炎； 术前5例确诊，23例误诊； 均行急诊剖腹探查手术，穿孔位于乙状结肠与直肠交界处有18例，位于降结肠4例，乙状结肠中段5例，直肠上段1例。 8例行穿孔部位结肠外置，再择期行二次手术； 16例行乙状结肠下段及直肠上段切除、结肠造瘘术； 4例行病变部位一期切除吻合、回盲部导管减压引流术。术后病理报告: 结肠壁局灶性炎性反应坏死，穿孔边缘清楚，肌层断裂整齐，黏膜剥脱，其中10例伴黏膜溃疡。 住院时间为2～4周，平均2.6周。 20例患者痊愈出院，死亡8例，其中4例死于中毒性休克，2例因吻合口漏并发腹腔脓肿死于严重感染和多器官功能衰竭，2例死于并发肺部感染、呼吸衰竭。 结论诊断性腹腔穿刺及CT检查对老年患者的特发性结肠穿孔诊断极为重要，一旦确诊或疑诊应尽早手术治疗。
ObjectiveTo investigate the expression of a disintegrin and metalloproteinase with thrombospondin typeⅠmotif (ADAMTS1) in colorectal cancer tissues, and to study the relationship with clinicopathological features and prognosis of it. MethodsExpression of ADAMTS1 was evaluated by immunohistochemistry (SP method) in 65 specimens, which obtained by resection from patients with colorectal cancer, including corresponding adjacent benign tissues. Chi-square test was used for analyzing the relationship between expression of ADAMTS1 and clinicopathological features of colorectal cancer tissues. Cox proportional hazard model was used to explore the relationship between expression of ADAMTS1, other clinicopathological parameters, and patients' survival situation. ResultsThe positive expression rate of ADAMTS1 was 40% (26/65) in the colorectal cancer tissues and 85% (55/65) in the adjacent benign tissues, which was significantly higher in adjacent benign tissues (χ2=27.546, P < 0.001). The positive expression rate of ADAMTS1 was significantly lower in the colorectal cancer tissues with lymph node metastasis than that of the colorectal cancer without lymph node metastasis (χ2=5.329, P=0.021). Results of survival analysis showed that median survival time were 27 months in the ADAMTS1-negative group and 70 months in the ADAMTS1-positive group respectively, and the survival situation was better in latter group (χ2=10.151, P=0.001). Results of multivariable prognostic analysis of Cox proportional hazard model showed that colorectal cancer withⅠ-Ⅱstage (RR=3.782, 95% CI:1.509-9.476, P=0.005), without lymph node metastasis (RR=3.107, 95% CI:1.186-8.138, P=0.021), and with positive-expression of ADAMTS1 (RR=2.020, 95% CI:1.071-3.809, P=0.030) had better survival situation. ConclusionsExpression of ADAMTS1 is down-regulated in colorectal cancer tissues and it is associated with lymph node metastasis. The prognosis of patients in ADAMTS1-positive group is better than that of ADAMTS1-negative group, suggesting that ADAMTS1 may be an independent prognostic factor in colorectal cancer.
Objective To investigate the risk factors of multidrug-resistant organism (MDRO) infection in patients with car accident injuries in intensive care unit (ICU), providing clinical guidance for reducing MDRO infection in car accident patients. Methods The clinical data of patients with car accident injuries in Sichuan Provincial People’s Hospital between January 1st 2019 and February 28th 2023 were collected, and the relevant data were analyzed retrospectively to explore the risk factors of MDRO infection. Results A total of 141 patients with car accident injuries were collected, of whom 30 had MDRO infection. The proportions of males (P=0.012), indwelling catheters (P=0.005), mechanical ventilation (P=0.001), length of hospital stay (P<0.001), and total treatment costs (P<0.001) in the infection group were higher than those in the non-infection group. Multiple logistic regression analysis showed that male [odds ratio (OR)=3.797, 95% confidence interval (CI) (1.174, 12.275), P=0.026], mechanical ventilation [OR=4.596, 95%CI (1.538, 13.734), P=0.006], and length of hospital stay≥20 d [OR=1.014, 95%CI (1.001, 1.028), P=0.037] were independent risk factors for MDRO infection in car accident patients. Conclusions Male, mechanical ventilation, and increased length of hospital stay are independent risk factors for MDRO infection in car accident patients. For such patients, the prevention and control measures of hospital infection should be strictly implemented to reduce the risk of infection.