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Objective:To explore the relationship between kinesiophobia and somnipathy among inpatients with lumbar degenerative disease after surgery, and analyze the mediating effects of post-traumatic stress disorder and family care.Methods:A cross-sectional survey method was adopted, from July 2020 to July 2022, a total of 130 lumbar degenerative disease patients from Wuhan Dongxihu District People′s Hospital were enrolled as research object by convenience sampling method. General information questionnaire, Tampa Scale for Kinesiophobia, Pittsburgh Sleep Quality Index, Posttraumatic Stress Checklist-civilian version and Family APGAR index were used for investigation. A structural equation model was established to evaluate the mediating effect of post-traumatic stress disorder, family care on kinesiophobia and somnipathy.Results:The scores of kinesiophobia, somnipathy, post-traumatic stress disorder and family care were (39.95 ± 3.90), (7.63 ± 0.46), (25.99 ± 4.99), (5.67 ± 1.76) points, respectively. There were significant differences in the scores of somnipathy in terms of age, monthly income, course of disease and pain degree ( F values were 3.21 to 10.12, all P<0.05). The dimensions and total scores of somnipathy were positively correlated with kinesiophobia ( r values were 0.347 to 0.800, all P<0.05) and post-traumatic stress disorder ( r values were 0.385 to 0.825, all P<0.05), negatively correlated with the scores of family care ( r values were - 0.653 to - 0.282, all P<0.05); the scores of family care was negatively correlated with kinesiophobia and post-traumatic stress disorder ( r = - 0.695, - 0.637, both P<0.05); the scores of kinesiophobia was positively correlated with post-traumatic stress disorder ( r = 0.773, P<0.05). The indirect effect of kinesiophobia on somnipathy was identified, and the total indirect effect value was 0.44; the indirect effect value of family care and post-traumatic stress disorder was 0.09, which accounted for 12.0% of the total effect. Conclusions:Post-traumatic stress disorder and family care play a multiple mediating role on the relationship between kinesiophobia and somnipathy in patients with lumbar degenerative disease after surgery.
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Objective To investigate the effect of intensive insulin therapy in parenteral nutrition for patients with abdominal operation.Methods 50 patients with 1 week or more complete intestinal nutrition after abdominal surgery and parenteral nutrition stress hyperglycemia were selected and randomly divided into control group (25 cases) and treatment group (25 cases).The control group adopted conventional insulin treatment(10.0 ~11.1 mmol/L blood glucose target value),the treatment group adopted intensive insulin treatment (7.8 ~10.0 mmol/L blood glucose target).The blood glucose time,hospitalization time and cost were compared between the two groups,and the occurrence of complications was recorded.Results In the treatment group,the blood sugar control standard time was (5.16 ±1.25)d,hospitalization time was (7.69 ±2.14)d,which were shorter than those in the control group,the hospitalization expense in the treatment group was (1 045.16 ±114.17)yuan,which was lower than (2 217.18 ± 242.18)yuan of the control group,the differences were statistically significant(t =6.460,6.270,14.499,all P <0.05).The incidence rate of complications of the treatment group was 8.00%,which was significantly lower than 28.00% of the control group,the difference was statistically significant (χ2 =13.550,P <0.05).The mortality rate of the treatment group was 4.00%,which of the control group was 8.00%,the difference was not statistically signifi-cant between the two groups(χ2 =1.418,P =0.233).Conclusion Intensive insulin therapy can effectively control the blood glucose level in patients with non diabetes after abdominal operation,and can reduce the incidence of complications,it is worthy of recommending.
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Objective To study the significance of S100A12 in patients with acute pancreatitis (AP).Methods 139 patients with AP were divided into the severe acute pancreatitis (SAP) and moderate acute pancreatitis (MAP) groups.61 patients in the SAP group were further subdivided into the infection group (n =32) and the non-infection group (n =29) based on the presence/absence of secondary infection.Serum samples of these patients were collected on the 3rd,7th and 14th day after treatment.ELISA was used to determinate the S100A12,IL-1 β and IL-6 levels in serum.The area under ROC was used to evaluate the predictive role of S100A12,IL-1β,IL-6 and CRP for infection in patients with SAP.Results The S100A12,IL-1β and IL-6 levels in SAP patients were markedly higher than those in MAP patients and normal controls on the 3rd,7th and 14th day after treatment.These levels decreased toward normal range in MAP patients.They were persistently high in SAP patients after treatment for 7 days,but decreased significantly after 14 days.The serum levels of S100A12,IL-1β,IL-6 and CRP were significantly higher in the infection subgroup(647.5 ± 300.1,155.9 ±48.5,95.7 ±25.5,166.8 ±53.0) than the non-infection subgroup(249.0 ± 176.3,108.0 ± 46.1,64.0 ±38.5,117.9 ±34.9) (P ＜0.05).The sensitivity and specificity of serum S100A12 in diagnosing secondary infection in SAP were 96.8％ and 83.3％,which were higher than those of serum IL-1β,IL-6 or CRP.Conclusion The level of S100A12 was associated with systemic inflammatory response syndrome (SIRS) in AP,and it may serve as a new marker in early diagnosis of SAP and in secondary infection in SAP.
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Objective To identify the factors related to the influence of medical research papers. Methods The influence of 1146 research papers by the hospital in the period 1996-2003 and its relationship with such factors as the backgrounds of the authors and the quality of the papers were studied u-sing regression analysis. Results Nine factors, including the impact factor, the status of the paper (being or not being one based on fund-supported research or representing research achievements), and the status of the author (being or not being chosen for talent cultivation and undertaking or not undertaking research projects), were significantly correlated with the influence of the papers. Conclusion In order to enhance the influence of medical research papers, it is necessary for research' management departments not only to encourage research personnel to publish papers in journals with high impact factors but also to step up efforts to better personnel cultivation, degree education, and project and achievement management so as to set up a quality and distinguished research contingent.