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Objective:To explore the feasibility and advantages of planned initiation of extracorporeal membrane oxygenation(ECMO)prior to liver transplantation.Methods:From November 2017 to July 2021, clinical data were retrospectively reviewed for 3 liver transplantation recipients assisted by ECMO.There were such preoperative symptoms of right ventricular dysfunction as fatigue, chest tightness and palpitations.In the first case, right heart catheterization was not performed due to patient refusal; another two patients were screened by transthoracic Doppler echocardiography(TDE)and diagnosed through right heart catheterization as portopulmonary hypertension(POPH)and pulmonary hypertension.Results:Three recipients with pulmonary hypertension received catheterization in right femoral artery and vein.After freeing of diseased liver and before blocking inferior vena cava, V-A ECMO support was performed.The dose of heparin was adjusted according to activated clotting time(ACT)and perioperative vital signs remained stable.They were ventilated for 54, 12 and 62 hours and supported by ECMO for 27, 61 and 14 hours.All were smoothly discharged.During a mean follow-up period of 26(9-22)months, liver functions were normal.Conclusions:Patients with end-stage liver disease with pulmonary hypertension should undergo routine TDE examinations during waiting period before liver transplantation.Those with pulmonary hypertension should undergo further right heart catheterization to confirm the diagnosis and severity of the disease.Planned application of ECMO through multidisciplinary consultations can expand surgical indications for liver transplantation, maintain intraoperative hemodynamic stability and facilitate smooth liver transplantation and postoperative patient recovery.
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OBJECTIVES@#The waiting room for surgery is an area set up to improve the surgical turnover rate, but the waiting time for surgery is uncertain. Patients are prone to negative emotions that affect their physiological state during waiting time. This study aims to explore the effect of Mandala painting intervention based on Mandala-self theory on the emotion and physiological state of patients waiting before operation.@*METHODS@#The patients in the control group (@*RESULTS@#Diastolic pressure, heart rate, and happiness and excitement showed no statistical significance in the time effect, intervention effect, and interaction between the 2 factors (all @*CONCLUSIONS@#The application of Mandala painting in the operation waiting room is feasible and can effectively regulate the patients' negative mood and systolic pressure, as well as shorten the waiting time of perception.
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Humans , Anxiety , Emotions , Heart Rate , Pain , Waiting RoomsABSTRACT
Objective ToexplorethevalueofMRIindifferentiatingbetweenmass-formingchronicpancreatitis(MFCP)andpancreatic carcinoma(PC).Methods MRIdataof19caseswith MFCP,36caseswithPCand30normalcontrolcasesconfirmedbypathology orfollow-upwereanalyzedretrospectively.AllofthesubjectsunderwentroutineMRIandDWIscan.MRIcharacteristicsofdiseases andnormalpancreaswereanalyzed,andADCvalueswerecomparedamongthethreegroups.Results TheaverageADCvalueofthe MFCPgroupwas(1.41±0.25)×10-3 mm2/s,higherthanthatofthePCgroup (1.13±0.11)×10-3 mm2/s(P<0.05),andlower thanthatofthenormalcontrolgroup(1.50±0.27)×10-3 mm2/s(P<0.05).IntheT2WI,enhancedscanningarterialphase,andenhanced scanningportalphase,thesignalcharacteristicsofthelesionswerestatisticallydifferentbetweentheMFCPandPCgroup (P<0.05).The sensitivityandspecificityofthecombinationT2WI,enhancedarterialimagingandADCvaluewere86.9%and88.9%indifferentiatingMFCPand PC,whichwasbetterthananysinglemethod.Conclusion MRImulti-sequencecombinationisoneoftheeffectivemethodsforidentifyingPCand MFCP,andhasreferencevalueforclinicaldiagnosis.
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Objective@#To investigate the current status of occupational mental health and job satisfaction in university teachers in Shenyang, China and related influencing factors.@*Methods@#A total of 1500 teachers from 6 universities in Shenyang were randomly selected as study subjects from November 2013 to January 2014. Self-administered questionnaires were used to investigate mental health, including effort-reward imbalance questionnaire, Minnesota Satisfaction Questionnaire, Center for Epidemiological Survey-Depression Scale, and Psychological Capital Questionnaire.@*Results@#Of all teachers, 58.9% had depressive symptoms. Depressive symptoms in university teachers were negatively correlated with the scores of psychological capital, supervisory commitment, and perceived organizational support (r=-0.461, -0.306, and -0.366, all P<0.01) and were positively correlated with the score of occupational stress (r=0.414, P<0.01) . Job satisfaction was positively correlated with psychological capital, perceived organizational support, and supervisory commitment (r=0.650, 0.715, and 0.636, all P<0.01) and negatively correlated with occupational stress (r=-0.475, P<0.01) . The direct effects of occupational stress, perceived organizational support, and supervisory commitment on job satisfaction were -0.30, 0.26, and 0.14, respectively, and their indirect effects were -0.0176, 0.0656, and 0.0368, respectively. The direct effects of occupational stress, perceived organizational support, and supervisory commitment on depressive symptoms were 0.20, -0.08, and -0.05, respectively, and their indirect effects was 0.033, -0.123, and -0.069, respectively.@*Conclusion@#Occupational mental health is closely associated with job satisfaction in university teachers in Shenyang, and psychological capital has a mediating effect on perceived organizational support, supervisory commitment, occupational stress, job satisfaction, and depressive symptoms.
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By using R language to deal with practical problems,we introduce two methods of obtaining time related receiver operation characteristic [ROC(t)] curves from survival data:1) nearestneighbor estimator of bivariate distribution (NNE) estimation:to obtain cumulative/dynamic ROCC/D(t) curves;2) Cox estimation:to obtain incident/dynamic ROCI/D (t) curves.The areas under the ROC(t) curves (AUC) obtained from the two methods fluctuate over time.The one obtained through NNE has bigger fluctuation than that obtained through Cox,while the mean of AUC of the two methods are similar.Time related ROC (t) can be effectively used to evaluate the diagnostic capacity of the marker in clinical trials,and help to select the best diagnostic time of the marker.According to the different scientific interests,researchers should select relevant methods for more accurate evaluation.
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By using R language to deal with practical problems,we introduce two methods of obtaining time related receiver operation characteristic [ROC(t)] curves from survival data:1) nearestneighbor estimator of bivariate distribution (NNE) estimation:to obtain cumulative/dynamic ROCC/D(t) curves;2) Cox estimation:to obtain incident/dynamic ROCI/D (t) curves.The areas under the ROC(t) curves (AUC) obtained from the two methods fluctuate over time.The one obtained through NNE has bigger fluctuation than that obtained through Cox,while the mean of AUC of the two methods are similar.Time related ROC (t) can be effectively used to evaluate the diagnostic capacity of the marker in clinical trials,and help to select the best diagnostic time of the marker.According to the different scientific interests,researchers should select relevant methods for more accurate evaluation.
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Objective To explore the moderating and mediating roles of psychological capital in the associations of effort?reward imbalance and overcommitment with job burnout among iron?steel workers. Methods Totally 1 700 male iron?steel workers from an iron and steel company were enrolled for the study. A set of questionnaires that included demographic and working factors,the Maslach Burnout Inventory?General Survey,the Ef?fort?reward Imbalance Scale and the Psychological Capital Questionnaire,as well as perceived work environment was distributed to the subjects. A to?tal of 1 254 effective respondents(73.76%)were collected. Hierarchical linear regression analysis was performed to explore moderating role,and as?ymptotic and resampling strategies were used to detect mediating role. Results There was no moderating role of psychological capital on the associa?tion between effort?reward imbalance and job burnout. Psychological capital had significant and positive moderating roles on the associations of over?commitment with emotional exhaustion and cynicism. Psychological capital showed significant mediating role in the associations of effort?reward im?balance with emotional exhaustion and cynicism,and the proportion of mediating role was 5.84%and 18.75%,respectively. Conclusion In work?ers with high level of psychological capital,emotional exhaustion and cynicism would be significantly increased with overcommitment,and there is a weak increasing trend of emotional exhaustion and cynicism in workers with low level of psychological capital. Effort?reward imbalance could lead to emotional exhaustion and cynicism through the reduction of psychological capital of iron?steel workers.