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Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.
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Objective:To explore the coping trajectory of primary caregivers in patients with permanent enterostomy, and to provide theoretical basis for clinical intervention.Methods:A semi-structured interview was conducted among 20 primary caregivers of patients with permanent enterostomy hospitalized in Qilu Hospital of Shandong University from May to July 2021. The data were analyzed by three-level coding and continuous comparison.Results:The coping trajectory of primary caregivers of permanent enterostomy patients experienced confusion and fatigue period, coping exploration period, acceptance and coexistence period, transformation and transcendence period.Conclusions:Medical staff should give corresponding health education and timely formulate effective intervention measures according to different stages. At the same time, we should effectively integrate external resources to promote the construction of "Hospital-Family-Community" tripartite care model to relieve the care pressure of caregivers.
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Objective:To construct of occupational protection ability system for nursing staff, in order to improve the ability of occupational protection of nursing staff.Method:based on knowledge attitude/belief practice theory, the occupational protection ability system for nursing staff were established by literature review, Delphi method, expert group discussion and semi-structured interviews.Results:The rates of questionnaires return were 19/20 and 15/16 in the first and second round expert consultation. The authority coefficient of expert were 0.892 and 0.921. The coordination coefficient of experts′ opinion were 0.377 and 0.456. The training system included 3 first-level indexes, 11 second-level indexes and 109 third-level indexes.Conclusion:The results of ability system are reliable, which can provide reference for training the nursing staff′s occupational protection ability.
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Objective:To analyze the surgical method and clinical effect of modified anterolateral approach in the treatment of posterolateral tibial plateau fractures.Methods:From January 2014 to December 2017, 21 patients with posterolateral tibial plateau fractures were treated by the modified anterolateral approach in the second people's Hospital of Tangshan, Hebei Province were retrospectively analyzed.The outpatient department conducted regular reexaminations 1, 3, 6 and 12 months after the operation.Rasmussen radiology score, hospital for special surgery (HSS) score of knee function and Lysholm score were used to evaluate the postoperative knee function, and the score results were statistically analyzed.Results:The Rasmussen radiological score of 21 patients immediately after surgerywas (16.96±1.67), ranging from 15.00 to 18.00, with excellent in 15 cases, good in 6 cases, and the excellent and good rate was 100%.Rasmussen radiology score (16.57±1.51) in the last follow-up, ranging from 15.00 to 18.00, showed no significant difference between the last follow-up and the immediate postoperative ( t=0.935, P>0.05). At the last follow-up, the HSS score of knee joint function was (88.55±7.25), ranging from 80.00 to 9.00.At the last follow-up, Lysholm score (86.64±4.34), ranging from 82.00 to 90.00, was excellent in 15 cases, good in 6 cases, and excellent in 100%. Conclusion:The modified anterolateral approach for the treatment of posterolateral tibial plateau fractures is effective and simple, and can achieve good clinical results.
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Objective:To understand the needs of end-stage cancer patients for hospice care, so as to provide a basis for the development of human-centered quality nursing services in hospice care.Methods:13 patients with end-stage cancer in tumor ward were interviewed by personal in-depth interview, and the data were sorted and analyzed by Colaizzi's seven-step analysis method.Results:A total of four themes of hospice care needs of patients with end-stage cancer were extracted. The need to maintain self-subject: the desire to maintain self-efficacy and self-image of dignity in life; the need to relieve the symptoms of self-discomfort. The need to relieve the physical symptoms and psychological discomfort. Meet the needs of self-determination: participate in medical care decisions and choose comfortable social relationships. Express their own emotional needs: the past farewell and remembrance and future wish to achieve the expectationsConclusions:Patients with end-stage cancer have diverse needs for hospice care. In clinical work, medical staff should adhere to the people-oriented concept, explore patients' needs and preferences, and implement individualized quality nursing measures to meet patients' needs for hospice care.
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Objective@#To invest the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy during the course of chemotherapy.@*Methods@#Total 100 patients with cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI-C).@*Results@#The top severity of symptoms were lack of appetite and nausea during chemotherapy; weary was the highest score during the intermission of chemotherapy. Exploratory factor analysis showed four main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters, mental symptom clusters and subjective feeling clusters. There were no significant difference in the scores of subjective feeling clusters between chemotherapy and the first day after discharge (P>0.05), other symptom clusters also declined slowly; the symptom clusters began to ease significantly from the three day after discharge (P<0.05).@*Conclusion@#Patients with cancer suffer from multiple symptoms during FOLFOX6 chemotherapy and during the intermission of chemotherapy. The results are good for establishing early predictions of symptom clusters in intermission of chemotherapy.
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Objective To invest the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy during the course of chemotherapy. Methods Total 100 patients with cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI- C). Results The top severity of symptoms were lack of appetite and nausea during chemotherapy; weary was the highest score during the intermission of chemotherapy. Exploratory factor analysis showed four main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters, mental symptom clusters and subjective feeling clusters. There were no significant difference in the scores of subjective feeling clusters between chemotherapy and the first day after discharge (P>0.05), other symptom clusters also declined slowly; the symptom clusters began to ease significantly from the three day after discharge (P<0.05). Conclusion Patients with cancer suffer from multiple symptoms during FOLFOX6 chemotherapy and during the intermission of chemotherapy. The results are good for establishing early predictions of symptom clusters in intermission of chemotherapy.
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Objective To investigate the recovery of knee joint function in patients with recurrent patellar dislocation treated by reconstruction of medial patellofemoral ligament with EndoButton double bundles.Methods A retrospective analysis was performed for 26 patients with recurrent patellar islocation who were treated in The Second Hospital of Tangshan from February 2014 to July 2016,with a total of 26 knees,aged 14-29 years.All patients underwent medial patellofemoral ligament reconstruction with autologous semitendinosus muscle.Double tunnel technique was used in medial patella and single tunnel technique was used in femoral side.Twenty-four patients were followed up for 12 to 24 months.The recovery of knee joint function was evaluated by Kujala score,Lysholm score,patellar fitness angle and patellar tilt angle before and after treatment.Results None of the follow-up patients had dislocation again,and the fear test was negative.The preoperative Kujala score and Lysholm score were (59.67 ± 5.28) and (61.75 ± 5.45) respectively.The corresponding scores at the last follow-up were (87.21±4.21) and (90.13±2.47).There were significant differences between the two scores (t =-19.98,-23.24,all P ＜0.01).The patellar fit angle changed from (23.17±3.63)degrees before operation to (14.17±2.01)degrees after operation.There was significant difference between the two scores.(t =10.62,P＜ 0.01);Patellar tilt angle changed from preoperative (18.33±3.92)degree to postoperative (2.45± 1.10)degree,the difference was significant (t =19.10,＜0.01).Conclusion EndoButton double-bundle reconstruction of medial patellofemoral ligament is effective in the treatment of patellar dislocation with satisfactory recovery of knee joint function.
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Objective To explore the differences in autophagic expression levels between hypertrophic scar (HS) tissue and normal skin tissue,and further investigate the relationship between hypertrophic scar formation and autophagy protein expression through the rabbit ear hypertrophic scar model.Methods 30 patients with hypertrophic scar were collected.One hypertrophic scar tissue and one normal skin tissue were harvested.The relative expressions of LC3,P62 and Beclin-1 in each tissue specimen were detected by immunohistochemistry and Western blot.Western blot was used to detect the autophagic-associated protein LC3 (MAPLC3),P62 and Beclin-1 in the hypertrophic scar tissue of rabbit ear and the corresponding normal tissue of rabbit ears at 4 weeks,8 weeks,12 weeks,and 24 weeks,and further explore their clinical significance.Results In vivo,the expression of hypertrophic scar tissue protein LC3 and Beclin-1 was significantly stronger than that in normal skin tissue (P ＜ 0.05).The expression of P62 was significantly weaker than that in normal skin tissue (P ＜ 0.05).In animal experiments,during the process of HS formation,the protein expression of LC3 gradually increased,while the protein expression of P62 gradually decreased;the protein expression of Beclin-1 was higher than that of normal rabbit ears tissue,with statistically significant differences (P ＜ 0.05).Conclusions The expression of LC3 and Beclin-1 in human hypertrophic scar tissues is higher than that in normal tissues.While the expression of P62 is lower than that in normal tissues.That is,the expression of autophagy in human hypertrophic scar tissue showed an upward trend in a certain period of time,and was significantly higher than that in normal tissue.
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Objective To investigate the diagnostic performance of ADC value for predicting proliferation and invasiveness of cervical squamous cell carcinoma (SCC).Methods Totally 96 patients with pathologically confirmed SCC underwent preoperative conventional MRI and DWI.Mini-ADC value,mean-ADC value and mini-ADC ratio (mini-ADC/meam ADC) were measured and compared for various patient groups divided based on Ki-67 labeling index and clinicopathological characteristics.Results The mini-ADC values were significantly lower in patients with high Ki-67 expression,tumor size ≥4 cm,high FIGO staging,low pathological grade,depth of cervical stromal infiltrating ≥ 1/2,parametrial involvement,lymphovascular invasion (LVI),lymph node metastasis and perineural invasion (PNI,all P＜ 0.05).Compared with mean-ADC value and mini-ADC ratio,mini-ADC value exhibited the most effective diagnostic performance in predicting clinicopathological characteristics with the highest areas under the ROC curve and efficacy.Mini-ADC value showed negative correlation with Ki-67 index (r=-0.48,P＜0.001) as well as other clinicopathological characteristics,including tumor size,FIGO staging,pathological grading,depth of cervical stromal infiltrating,parametrial involvement,LVI,lymph node metastasis and PNI (r=-0.36,-0.34,-0.27,-0.40,-0.33,-0.60,-0.61,-0.41,respectively,all P＜0.05).Conclusion Mini-ADC value can effectively reflect the proliferation and invasiveness of cervical SCC.
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With the development of modern medical technology,accurate resection of tumor and timely repair and repair of defective tissues and organs are important concerns in the field of tumor research.The precise excision of tumor,refers to the preoperative assessment of systemic and local detection based on detailed to personalized surgical planning,the use of precise operation in operation,ensure as much as possible while minimizing surgical trauma to patients after removal of the lesions,creating the optimal conditions of recovery for trauma patients.Repair and regeneration of defective tissues and organs refers to the deletion or damage of tissues and organs,and gradually resume its anatomical structure and function process under the action of a variety of cells,extracellular mechanisms and related regulatory factors.Then from the tumor resection,tumor resection and accurate regeneration after three point repair technology to change rapidly in the tissue of tumor plastic organ regeneration in tissue of origin.
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Objective Using Omaha system to construct continuing nursing assessment system in patients with cancer at the intermission of chemotherapy.Methods Based on the Omaha system as the theoretical basis,combined with literature review and semi structural interview,a preliminary construction of sensitive index system for continuous nursing of cancer patients was constructed,and the index system was deleted and supplemented through Delphi 2 rounds of expert consultation.Results The expert's positive coefficients of 2 rounds were 90.91%(20/22)and 16/18 respectively,authority coefficient were 0.839 and 0.853,generally coordination coefficients were 0.213 and 0.606 respectively.The continuing nursing assessment system in patients with cancer at intermission of chemotherapy was constructed containing 4 one-level indicators,24 secondary indicators and 71 third indicators.Conclusions The continuing nursing assessment system in patients with cancer at intermission of chemotherapy is analyzed by Delphi could comprehensively reflect characteristic of cancer patients'continue nursing demand.
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Objective To investigate the status and influencing factors of symptom clusters in patients with gastrointestinal cancer receiving FOLFOX6 chemotherapy. Methods Totally 100 patients with gastrointestinal cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI-C) and Social Support Rating Scale (SSRS). Results The top incidences and severity of symptoms was lack of appetite.Exploratory factor analysis showed three main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters and mental symptom clusters. The number of courses of chemotherapy was the influencing factor of gastrointestinal symptom clusters, physical symptom clusters. For mental symptom clusters, social support was the influencing factor. Conclusions Patients with gastrointestinal cancer suffer from multiple symptoms during FOLFOX6 chemotherapy. The results are good for establishing early predictions of symptoms and providing scientific evidence for the interventions of symptoms clusters.
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Custom ocular prosthesis as a kind of product to make up the eye defects. It can not only improve patient's comfort adaptation and restore the normal structures but also let the patient regain confidence. However, it is in infant stage in our country for custom ocular prosthesis that the professional engineer is not enough, standards for the products are shortage. These factors together result in poor understanding of product management control and impede the development of ocular prostheses. This article gives the suggestions for quality management mainly focus on human resources, raw material, production and so on.
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Medical Device Single Audit Program is one of the key projects in International Medical Device Regulators Forum, which has much experience to be used for reference. This paper briefly describes the procedures and contents of the Witnessed Audit in Medical Device Single Audit Program. Some revelations about the work of Witnessed Audit have been discussed, for reference by the Regulatory Authorities and the Auditing Organizations.
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Equipment and Supplies , Medical AuditABSTRACT
The audit of the quality management system in the medical device single audit program covers the requirements of several national regulatory authorities, which has a very important reference value. This paper briefly described the procedures and contents of this audit. Some enlightenment on supervision and inspection are discussed in China, for reference by the regulatory authorities and auditing organizations.
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China , Equipment and Supplies , Medical Audit , Quality ControlABSTRACT
Objective To investigate the expression of TAZ in peripheral blood and tumor tissue of the patients with colorectal cancer and to analyze their relationship and clinical significance.Methods Eighty-five cases of pathologically verified colorectal cancer treated by radical operation were selected as the operation group,and 35 cases with postoperative relapse served as the recurrent group.Meanwhile 50 age and sex-matched healthy persons were selected as the control group.The immunohistochemical(SP)technique was adopted to detect the expression of TAZ in tumor tissues and expression of TAZ in peripheral blood was tested with enzyme linked immunosorbent assay(ELISA).Results The level of preoperative TAZ in peripheral blood of the operation group was significantly higher than that of the control group(P＜0.05).The level of peripheral blood TAZ after operation in the operation group had no significant change compared with the control group (P＞0.05).The level of peripheral blood TAZ in the recurrent group was significantly higher than preoperative level of operation group(P＜0.05).The expression of tumor tissue TAZ was significantly higher than that of normal mucosal tissue(P＜0.05);the expression of tumor tissue TAZ in the recurrent group was higher than that in the operation group(P＜0.05).The tumor tissue TAZ level in the operation group and recurrent group had obvious correlation with peripheral blood TAZ level(P＜0.05).Conclusion Monitoring the TAZ level has obvious reference value for predicting colorectal cancer staging and timely understanding tumor recurrence.
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Objective To investigate the expression of TAZ in peripheral blood and tumor tissue of the patients with colorectal cancer and to analyze their relationship and clinical significance.Methods Eighty-five cases of pathologically verified colorectal cancer treated by radical operation were selected as the operation group,and 35 cases with postoperative relapse served as the recurrent group.Meanwhile 50 age and sex-matched healthy persons were selected as the control group.The immunohistochemical(SP)technique was adopted to detect the expression of TAZ in tumor tissues and expression of TAZ in peripheral blood was tested with enzyme linked immunosorbent assay(ELISA).Results The level of preoperative TAZ in peripheral blood of the operation group was significantly higher than that of the control group(P＜0.05).The level of peripheral blood TAZ after operation in the operation group had no significant change compared with the control group (P＞0.05).The level of peripheral blood TAZ in the recurrent group was significantly higher than preoperative level of operation group(P＜0.05).The expression of tumor tissue TAZ was significantly higher than that of normal mucosal tissue(P＜0.05);the expression of tumor tissue TAZ in the recurrent group was higher than that in the operation group(P＜0.05).The tumor tissue TAZ level in the operation group and recurrent group had obvious correlation with peripheral blood TAZ level(P＜0.05).Conclusion Monitoring the TAZ level has obvious reference value for predicting colorectal cancer staging and timely understanding tumor recurrence.
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The etiology and pathogen of diabetic cystopathy is mainly due to qi deficiency of spleen and kidney, which leads to bladder and Sanjiao hypo-function of vital energy, losing opening and closing. In addition to blood stasis injury essence, it blocks the urinary tract. The main pathogen is qi deficiency and blood stasis. The qi deficiency of spleen and kidney is the fundamental aspect, while the blood stasis is the surface aspect. Excess resulted from deficiency, intermingled deficiency and excess, belong to asthenia in origin and asthenia in superficiality. Clinical application of method of invigorating qi, removing blood stasis and eliminating stagnation for diabetic cystopathy has a good clinical efficacy.
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BACKGROUND:Bone morphogenetic protein 7 (BMP-7) can induce bone and cartilage formationin vivo, and induce chondrogenic and osteogenic differentiation of mesenchymal cels in muscles and around the vessels. OBJECTIVE:To observe the structure of domestic tantalum-muscle interface fibrous capsule, growth of muscle and smal blood vessels into the porous tantalum and the ability of ectopic osteogenesis after implantation of porous tantalum loaded with BMP-7 into the erector spinae of rabbits. METHODS: Porous tantalum slices loaded with BMP-7 (experimental group) and porous tantalum slices (control group) were implanted into the erector spinae muscle of New Zealand white rabbits. And the porous tantalum slices with surrounding muscle tissues about 0.5 cm thick were removed at 2, 4, 8 weeks after implantation, and observed under scanning electron microscope for hematoxylin eosin staining, Masson staining and hard tissue slice observation. RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining: Fibrous capsule formation was observed around the materials in the two groups, and with the extension of time, the fibrous capsules were slightly dense, and thinned. There was no obvious inflammatory reaction in the interface between the material and the muscle. There was no significant difference between the two groups in the fibrous capsules thickness. (2) Scanning electron microscope: 2 weeks after the surgery, a smal amount of colagen and muscle fibers were formed in the porous tantalum pores in the two groups, and some of colagen fibers attached to the pore wals. At 8 weeks after the surgery, al the pores of porous tantalum were ful of muscle fibers that were combined with the pore wal closely. There was no significant difference between the two groups. (3) Hard tissue slices: 2 weeks after the surgery, a smal amount of fibroblast cels and muscle fibers grew into the pores of porous tantalum in the two groups and new capilaries grew into the pores of porous tantalum in the experimental group. At 8 weeks after the surgery, the porous tantalum and al the pores were ful of muscle fibers that were combined with the pore wal closely, the number of smal blood vessels and cels decreased, and the tantalum and the muscle were fused closely. (4) Masson staining: 8 weeks after the surgery, a large number of mesenchymal cels, ossein and cartilage matrix formed in the muscle gaps and a few cartilage bone tissues were formed in the experimental group, but no cartilage was found in the control group. The study showed that porous tantalum carrying BMP-7 has good biocompatibility and osteogenic induction ability. Subject headings: Tantalum; Bone Morphogenetic Protein 7; Tissue Engineering.