Self-management experience of family caregiver with dementia: a systematic review of qualitative studies / 中国实用护理杂志

Objective:To conduct a systematic review on the experience of family caregivers of dementia patients during self-management, so as to provide reference to offer targeted self-management intervention for the family caregivers.Methods:Five English ( MedLine, Embase, CINAHL, PsycINFO, Web of Science) and four Chinese (CBM, CNKI, WANFANG,VIP) databases were chosen to retrieval literatures on self-management experience of family caregivers of dementia patients from inception to October 31st ,2019. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. Integrating method was applied to integrate the results.Results:Totally 18 findings were extracted from 6 qualified studies, 7 new categories were generated and finally 2 synthesized results were obtained: obstacles to self-management: insufficient information and service support; neglect of physical health and social interaction; heavy economic burden; mental and emotional trauma. Promote self-management: self-adjusting emotions. Actively managing physical health. Seeking for help and support.Conclusion:The external support for self-management of family caregivers is actually needed. And support that aim to help caregivers overcome the obstacles of self-management and facilitate self-management should be provided from various ways.

Diagnostic value of serum amyloid A and retinol binding protein in patients with early type 2 diabetic kidney disease / 中国综合临床

Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD).Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People's Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumincreatinine ratio (UACR),all subjects were divided into three groups of normal albuminuria group (NA,60 cases),microalbuminuria group (MA,63 cases) and clinical proteinuria (CP,59 cases).In the same period,60 healthy persons were selected as normal control (NC).The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated.Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group,MA group and CP group were (16.33±5.98),(40.97± 15.62),(54.43±22.91) mg/L respectively.The levels of RBP were (37.56± 10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group,MA group and CP group were (52.66 ± 14.31),(69.66 ± ± 15.52),(85.70± 19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t =10.36,P＜0.05;t =11.11,P＜0.05) and increased with DKD progression (F =83.6,P＜ 0.05;F =59.2,P＜ 0.05).Diagnostic sensitivity of serumSAA,RBP in DKD was 81.8％ and 84.1％ respectively.Diagnostic sensitivity of combined detection was 90.9％.Regression analysis showed that SAA,RBP and UACR were independent risk factors for DKD (OR (95％ CI) =1.391 (1.068-1.812),1.212 (1.085-1.353),1.148 (1.038-1.270);all P ＜0.05).Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD.

Comparative analysis of shaping ability of three Ni-Ti rotary systems assessed by micro-CT / 实用口腔医学杂志

Objective: To compare root canal transportation and centering ability of TF Adaptive (TFA), Reciproc (R) and Pro Taper Next (PTN) . Methods: 30 single rooted premolars extracted from orthodontic treatment were randomly divided into 3 groups (n = 10) and prepare by TFA, R and PTN Respectively. The teeth were scanned by Micro-CT before and after instrumentation. The images were reconstructed and exported to Adobe Photo-shop software for analysis. Canal transportation and centering change were determined accordingly. SPSS19. 0 software was used to analyze the data. Results: There was no statistical difference in canal transportation and centering ability for coronal and middle root canal among the 3 groups (P＞ 0. 05) ; for root apical, the canal transportation in group TFA was the smallest, followed by PTN group, that of group R was the largest (between each 2 groups, P ＜ 0. 05), the centering ability of TFA group was the best, followed PTN group, that of group R was the last (between each 2 groups, P ＜ 0. 05) . Conclusion:TFA Ni-Ti instrument is superior to Reciproc and Pro Taper Next for the maintenance of the original orientation of the root canal in root canal preparation.

A preliminary investigation of relationship between serum apelin level and pulmonary artery pressure in children with congenital heart disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To preliminarily investigate the relationship between serum apelin level and pulmonary artery pressure in children with congenital heart disease.</p><p><b>METHODS</b>One hundred and twenty-six children with congenital heart disease undergoing surgical treatment were enrolled as subjects. The serum level of apelin was determined before surgery and at 7 days after surgery. The ratio of pulmonary artery systolic pressure to aortic systolic pressure (Pp/Ps) was calculated before extracorporeal circulation. According to the Pp/Ps value, patients were classified into non-pulmonary arterial hypertension (PAH) group, mild PAH group, moderate PAH group, and severe PAH group. Pulmonary artery mean pressure was estimated by echocardiography at 7 days after surgery.</p><p><b>RESULTS</b>The non-PAH group had the highest serum level of apelin before and after surgery, followed by the mild PAH group, moderate PAH group, and severe PAH group (P<0.05). All groups had significantly increased serum levels of apelin at 7 days after surgery (P<0.05). The serum level of apelin was negatively correlated with pulmonary artery pressure before surgery (r=-0.51, P<0.05) and at 7 days after surgery (r=-0.54, P<0.05).</p><p><b>CONCLUSIONS</b>The decrease in serum apelin level is associated with the development of pulmonary hypertension in children with congenital heart disease. The significance of serum apelin in predicting the development and degree of pulmonary hypertension in children with congenital heart disease deserves further studies.</p>

Concurrent raltitrexed plus oxaliplatin and radiotherapy versus PF synchronous radio-therapy on advanced esophageal cancer / 中国肿瘤临床

Objective:To compare the therapeutic and adverse effects of concurrent raltitrexed plus oxaliplatin and radiotherapy with those of PF synchronous radiotherapy in the treatment of advanced esophageal cancer. Methods:A total of 84 pathologically con-firmed patients with advanced esophageal carcinoma were randomly distributed to the concurrent raltitrexed plus oxaliplatin and ra-diotherapy group (experimental group, n=40) and to the PF synchronous radiotherapy group (control group, n=44). All patients were treated with 3DCRT at a total dose of 60 Gy/30f. The chemotherapy in the experimental group consists of raltitrexed at 2.5 mg/m2, d1, plus oxaliplatin at 130 mg/m2, d2. The chemotherapy of the control group consists of DDP at 25 mg/m2, Dd1-3, plus 5-FU 500 mg/m2, d1-5. Two cycles of concurrent chemotherapy were administered during radiotherapy on d1 and d29. The comparison results were used to estimate the therapeutic and adverse effects of the two groups. Results:The rerponse rate, complete response, and one-year overall survival rate of the experimental group were higher than those of the control group [(87.50%vs. 79.54%, P=0.3293), (32.50%vs. 18.18%, P=0.13), and (82.50%vs. 79.50%, P=0.701)], but the difference was not statistically significant. The incidence rates of nau-sea and vomiting, appetite degression, leucopenia, radiation-induced esophagitis, and cardiotoxicity were significantly lower (P0.05). Conclusion:Simi-lar to PF chemotherapy and radiotherapy, the concurrent raltitrexed plus oxaliplatin and radiotherapy achieved a similar short-term therapeutic effect but lower adverse effects on patients with esophageal cancer.

Clinical Features and Antibiotic Sensitivity of Gram-Negative Diabetic Foot Osteomyelitis / 天津医药

Objective To investigate the clinical features and antibiotic susceptibility of osteomyelitis infected by Gram-negative bacteria (G-) in patients suffered from diabetic foot ulcers (DFU). Methods The clinical data of 91 DFU pa-tients accompanied with osteomyelitis (DFO) were retrospective studied. These patients hospitalized in the Tianjin Metabolic Diseases Hospital were divided into two groups, Gram-negative bacteria (G-) group (n=44) and Gram-positive bacteria (G+) group (n=42), respectively. The clinical features were compared between two groups. Logistic regression analysis was used to determine the risk factors for Gram-negative bactreial infection. The Gram-negative antibiogram was summarized. Results A total of 112 pathogens were isolated from 91 patients. G-bacteria were the most frequent pathogens (48.2%), following by G+ bacteria (47.3%) and fungi (4.5%). Pseudomonas aeruginosa was the majority of the G-bacteria. Comparing the two groups, the rate of antibiotic use within the previous 6 months was significantly higher in G-group (75.0%) than that of G+group (52.4%, P<0.05). There were no significant differences in the other indicators between two groups. The Logistic re-gression analysis revealed that the history of antibiotic use was the independent risk factor of G-bacterial infections in DFO patients. Antibiotics susceptibilities reflected G- bacteria were more prevalent to resist to cephalosporins and quinolonem, but sensitive to imipenem, ceftazidine and cefperazone-sulbactam. Conclusion Gram negative bacteria were not only the main pathogens isolated from DFO patients, but also frequently resistant to several popular antibiotics in China. The proper bacteria culture and antibiotic sensitivity test are especially emphasized to patients with DFU.

Effects of different arterial oxygen partial pressures on serum protein S100β and neuron specific enolase during cardiopulmonary bypass in infants with cyanotic congenital heart disease / 中华儿科杂志

<p><b>OBJECTIVE</b>A prospective study was conducted to probe into the relationship between arterial oxygen partial pressure (PaO2) and brain injury during cardiopulmonary bypass (CPB) in infants with cyanotic congenital heart disease (CHD).</p><p><b>METHOD</b>Enrolled in the study were 45 cyanotic infants, who were less than three years old and underwent corrective cardiac surgery from August 1(st), 2010 to January 31(st), 2011 at Guangdong General Hospital. All the infants had a pulse oxygen saturation (SpO2) lower than 85% and were randomly allocated into three groups by a specific computer program. In controlled group 1 (G1 group), PaO2 levels were controlled at 80 - 120 mm Hg (1 mm Hg = 0.133 kPa) during CPB; in controlled group 2 (G2 group), PaO2 levels at 120 - 200 mm Hg during CPB; while in uncontrolled group (G3 group), PaO2 levels were at 200 - 400 mm Hg during CPB. Blood samples were collected just before starting CPB, at the end of CPB, and at 3 h, 5 h, and 24 h after CPB (T1, T2, T3, T4, T5) for the determination of serum concentrations of protein S100β, neuron specific enolase (NSE), and adrenomedullin (ADM) by ELISA.</p><p><b>RESULT</b>Protein S100β rose significantly after starting CPB. In group G3, it reached a peak of (699 ± 139) ng/L by the end of CPB, significantly higher than those in groups G1 and G2 [(528 ± 163) ng/L and (585 ± 155) ng/L], and was positively correlated with PaO2 levels (r = 0.526, P < 0.01). NSE levels of group G1 were continuously rising after starting CPB and reached significantly high levels at 3 h or 5 h after CPB [(12.2 ± 3.4) µg/L and (12.3 ± 3.7) µg/L], while those of group G2 rose significantly during CPB [(10.9 ± 4.8) µg/L] and even higher at 3 h or 5 h after CPB [(12.6 ± 5.1) µg/L and (13.2 ± 5.4) µg/L]. NSE levels of group G3 rose significantly during CPB and maintained at a high level [(12.2 ± 5.7) µg/L] afterwards. There was no significant difference in serum ADM concentrations among different time points in each group and among these three groups. All the infants were discharged from the hospital without any obvious nervous symptom and sign.</p><p><b>CONCLUSION</b>High PaO2 during CPB in infants with CHD might cause an increase of serum protein S100β and NSE, indicating that brain injury might become worse with a higher PaO2 and might be positively correlated with PaO2 during CPB.</p>

Clinical features and drug resistance of pseudomonas aeruginosa isolates from patients with diabetic foot infections / 中华内分泌代谢杂志

Objective To investigate clinical features and antibiotic resistance of pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infections (DFI) in Tianjin Metabolic Diseases Hospital.Methods Eighty-five PA strains were isolated from 428 patients with diabetic foot in the hospital from Jan 2008 to Dec 2010.The clinical features of patients were summarized.Relationships between the isolates and depth of ulcer or severity of infection were analyzed.The disk-diffusion method was performed to examine antimicrobial susceptibility.Results Gram positive (G+) and Gram negative (Gˉ) isolates were 50.47％ and 41.12％,respectively.Multidrug-resistant PA composed 32.9％ of the total PA isolates.The size of ulcers with PA infections was bigger than those with non-PA bacterial infections (P＜0.05).Compared to G+ strains,patients with PA strains were older,had lower hemoglobin,but higher serum sensitive C-reactive protein; and more frequently,they had ischemic ulcer and osteomyelitis.Compared to G+ strains,the PA strains were more frequently isolated from deeper ulcers and with more serious infections(P＜0.05).The resistant rates of PA to cephalosporins,fluoroquinolones,and aminoglycosides were between 32.9％-61.2％,37.6％-42.4％,and 37.6％-62.4％,respectively.Only one out of 85 PA strains was imipenem-resistant.However,sensitiveness of all PA isolates to cefoperazone and sulbactam reached 100％.Conclusion PA strains are mainly found in patients with deeper ulcers and more serious infections.Multidrug-resistant PA is common in DFI.It is important to isolate pathogens and determine their antibiotic resistance correctly in diabetic foot patients in order to provide appropriate drug administration and to reduce the production and dissemination of drug resistant strains.

SCCmec genotypes of methicillin-resistant Staphylococcus epidermidis in diabetic foot infections / 中华微生物学和免疫学杂志

Objective To investigate SCCmec genotypes and drug-resistance profiles of the methieillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the patients suffered from diabetic foot infections (DFI) in the Tianjin Metabohc Diseases Hospital. Methods After dabridement, specimens of 390 infectious diabetic foot ulcers in the hospital from Jan 2008 to Jun 2010 were collected from the wound basal parts by cotton swab for culture. The disk-diffusion method was performed to examine antimicrobial susceptibility. DNAs of the MRSE strains were extracted, and their SCCmec genotypes were identified by PCR. Results Twenty of the seventy(28.6% ,20/70)Staphylococcus epidermidis strains were mecA posifive. Among the MRSE isolates, 2 ( 10.0% )were SCCmec Ⅱ ,9 (45.0%)were SCCmecⅢ and 9 (45.0%)were SCCmec Ⅳ. None of the isolates were genotyped as SCCmec Ⅰ or Ⅴ. No mater which genotypes they were, all the MRSE isolates were multi-drug resistant. They were resistant not only to β-lactams (including penicillins, cefoxitin and cephems), but also to non-β-lactams (including macrolides, fiuoroquinolones and sulfonamides ) . Resistance to voncomycin and rifampicin were not found in these strains . Conclusion SCCmec Ⅲ and SCCmecⅣ are major genotypes of the MRSE isolates from the infectious diabetic foot ulcers.The SCCmec Ⅳ genotype strains with multi-drug resistant profiles are prevalent in the diabetic foot infections.

Smoking Aggravates Large and Midio Arterial Stiffness in Patients with Essential Hypertensive / 中华高血压杂志

Objective To investigate the effect of smoking on large arterial stiffness in patients with essential hypertensive.Methods The aortic,carotid and brachial arterial dimension,intimal-medial thickness were determined by vascular ultrasound technique.Wall cross sectional area and indices of compliance and distensibility were calculated in essential hypertensive patients with smoking(n=75) or without smoking(n=70).Results Hypertensive patients with smoking have increased wall intimal-medial thickness and wall cross sectional area in aortic,carotid and brachial arteries associated with decreased compliance and distensibility.After adjusting for the confounding effects of other variables including Age,BMI,HR,BP,PP,FPG,LDL-C and TG,covariance analysis show smoking remained as predisposed factors for vascular remodeling.Conclusion Smoking aggravates large arterial stiffness in essential hypertensive patients.

Relationship between leptin level and glycometabolism in pregnancy with abnormal glucose challenge test / 上海第二医科大学学报

Objective To investigate the relationship between serum leptin(LP) level and glycometabolism in pregnancy with abnormal glucose challenge test(GCT) and the corresponding outcome of pregnancy. Methods Serum LP level,fasting serum insulin(FINS) and fasting blood glucose(FBG) levels were measured by radioimmunoassay in 23 patients with abnormal GCT but normal oral glucose tolerance test(OGTT),20 with impaired glucose tolerance(IGT),20 with gestational diabetes mellitus(GDM)(studied groups above) and 30 normal pregnant women(control group).LP,FINS,FBG, insulin resistance index(HOMA-IR) and ?-cell function index(HOMA-IS) were compared among the groups and the outcomes of pregnancy were observed. Results ①There were significant differences in LP,FINS,FBG,HOMA-IR and HOMA-IS between the studied groups and the control group(P0.05).③There were signi-ficant differences in the gestational weeks of delivery,cesarean section rate and neonatal weight between the studied groups and the control group(P0.05). Conclusion Both insulin secretion and insulin resistance are elevated in pregnancy with abnormal glycometabolism,and are closely correlated to the increased serum level of LP.There existed abnormal glycometabolism in patients with abnormal GCT but normal OGTT,which is correlated to the outcome of pregnancy.

Study on tissue culture of pasqueflower / 中国中药杂志

<p><b>OBJECTIVE</b>To speed up seedling production of pasqueflower (Puzlsatilla chinenses) and their modernization in pasqueflower.</p><p><b>METHOD</b>With tissue culture method, primary culture of different explants, culture of cluster buds and their rooting culture were conducted on medium of treatment combinations of adding different hormones.</p><p><b>RESULT</b>The appropriate medium for different culture stages were MS + 6-BA 1.0-3.0 mg x L(-1) + NAA 0-0.05 mg x L(-1) + Sucrose 30 g x L(-1) in primary culture, MS + 6-BA 0.2 mg x L(-1) + NAA 0.02 mg x L(-1) + BR 0.00001 mg x L(-1) + Sucrose 30 g x L(-1) in differentiation and subculture of cluster buds, 1/2 MS + NAA 0.4 mg x L(-1) + Sucrose 20 g x L(-1) in rooting.</p><p><b>CONCLUSION</b>Applying stem tip and flower buds as explants, high frequency propagation of seedlings can be achieved with plant tissue culture in Pasqueflower.</p>

Expression of Toll-like receptor 2 and 4 on colons of experimental colitis rats and the therapeutic effects of probiotics / 中华消化杂志

Objective To investigate the protein and mRNA expressions of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) on colons of rats with trinitrobenzene sulfonic acid (TNBS)- induced colitis,and to evaluate the effects of probiotics.Methods Thirty male Wistar rats were randomly divided into normal control group (NC group),model control group(UC group) and probiotics-treated group(PC group).The experimental colitis was induced by TNBS/ethanol enema.Rats in PC group were fed with Bifico [live probiotics of combined hifidobacterium(Bif),lactobaeillus(Lac) and enteroeoccus] by 2.2?10~9 CFU/d for 4 weeks.Inflammatory scores were studied.Expressions of protein and mRNA of TLR2 and TLR4 were measured by Western blot and real-time quantitative polymerase chain reaction (PCR),respectively.Results Inflammatory scores in NC group,UC group and PC group were 4.35?0.88,10.25?1.36 and 7.94?0.85,respectively.The inflammatory scores in PC group were decreased compared with that in UC group (P

Effects of probiotics on the gut flora and mucosal tumor necrosis factor?expression in rats with experimental colitis / 中华消化杂志

Objective To evaluate the effects of probioties on inflammation,intestinal flora and mucosal tumor necrosis factor alpha(TNF-?)expression in experimental colitis rats.Methods Thirty Wistar rats were randomly divided into normal control group(NC),model control group(UC),and pro- biotics treatment group(PC).The experimental colitis were induced by trinitrobenzene sulfonie acid (TNBS)/ethanol enema.Rats in PC group were fed with Bifico[live probiotics of combined bifidobacte- rium(Bif),lactobacillus (Lac) and enterococcus]by 2.2?10~9 colony-forming unit (CFU)/d for 4 weeks.Inflammatory scores and mucosal morphological changes under light microscopy were studied. Plasma endotoxin levels,expressions of TNF-?and interleukin-6 (IL-6) in mueosa were measured. Enteric microorganisms in cecum were fostered with standard methods.Results Inflammatory scores in PC group decreased compared with those in UC group(7.94?0.85 vs 10.25?1.36,P＜0.05),but still higher than those in NC group(7.94?0.85 vs 4.35?0.88,P＜0.01).There was a significant alteration in the enteric microbial flora,Bif and Lac were decreased significantly in UC group,Bifico supplement ameliorated this imbalance.Plasma endotoxin and mucosal TNF-?levels in PC were lower than those in UC group[endotoxin:(93.33?21.22)pg/ml vs (121.25?39.07)pg/ml;TNF-?:67.51?14.63 vs 85.99?18.17,P＜0.05],but higher than those in NC group[endotoxin:(93.33?21.22) pg/ml vs(35.20?15.12)pg/ml;TNF+?:67.51?14.63 vs 43.28 4?19.98,P＜0.01].There was no statistically significant difference in mucosal IL-6 levels between PC group and UC group,though its level in PC group was lower than that in UC group(155.22?34.01 vs 184.09?29.11,P＞0.05),but higher than that in NC group(155.22?34.01 vs 108.73?37.35,P＜0.01).Conclusions Probiotics can attenuate inflammation of experimental colitis of rats through reinstituting gut flora bal- anee.Improving gut flora imbalance,reducing endotoxin and pro-inflammatory cytokines may be the effects of probiotics.