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Objective: To investigate the psychological effect of physical function dependence on maintenance hemodialysis (MHD) patients and their primary family caregivers. Methods: The study was a cross-sectional survey. The MHD patients in the hemodialysis centre, the Third Affiliated Hospital of Guangzhou Medical University from March 2022 to June 2022 were enrolled. The patients' demographics and laboratory data were collected. Katz and Lawton-Brody questionnaires were used to assess patients' physical function, and Five Item Mental Health Inventory (MHI-5) was used to evaluate the psychological conditions of the patients and their primary family caregivers. Multiple linear regression analysis was used to analyze the influencing factors of MHI-5 scores of the patients and their primary family caregivers. Results: A total of 116 patients were included, with 61 males and 55 females. There were 47 patients (40.5%) with physical function dependence. In the physical function dependence group, serum albumin (t=-2.512, P=0.013), MHI-5 scores of patients and their primary family caregivers (t=-8.461, P < 0.001; t=-8.533, P < 0.001) and male ratio (χ2=8.467, P=0.002) were significantly lower, and the age (t=9.754, P < 0.001) and the proportions of hypertension (χ2=20.421, P < 0.001), diabetes (χ2=10.470, P=0.002), cardiovascular and cerebrovascular diseases (χ2=9.898, P=0.003) were significantly higher than those in the normal physical function group. The incidence of mental disorders in MHD patients was 39.7%(46/116), and the incidence of mental disorders in the physical function dependence group was significantly higher than that in the normal physical function group [72.3%(34/47) vs. 17.4%(12/69), χ2=35.275, P < 0.001]. The incidence of mental disorders in the primary family caregivers was 32.8%(38/116), and the incidence of mental disorders in the primary family caregivers of physical function dependence group was significantly higher than that in the normal physical function group [66.0%(31/47) vs. 10.1%(7/69), χ2=39.536, P < 0.001]. The incidence of mental disorders in the primary family caregivers of MHD patients who were not spouses was significantly higher than that of spouses [46.0%(29/63) vs. 17.0%(9/53), χ2=11.028, P=0.001], and in physical function dependence group, the incidence of mental disorders in non-spouses was significantly higher than that in spouses [80.6%(25/31) vs. 37.5%(6/16), χ2=8.749, P=0.003]. Multiple linear analysis showed that bathing (β=-5.182, P=0.015), doing laundry (β=-7.053, P < 0.001), taking medication (β=-8.680, P=0.003), and female patients (β=-2.982, P=0.030) were the influencing factors of MHI-5 scores decline in MHD patients. Bathing (β=-4.404, P=0.032), preparing meals (β=-3.954, P=0.041), managing money (β=-5.067, P=0.021), and female patients (β=-2.466, P=0.042) were the influencing factors of MHI-5 scores decline in primary family caregivers. Conclusions: The incidence of physical function dependence in MHD patients is high, and its manifestations and influencing factors are diverse. The incidence of mental disorders in MHD patients and their primary family caregivers is also high, especially in patients with physical function dependence and non- spouse family caregivers. Clinicians should pay attention to and assess the physical function dependence of MHD patients as early as possible, and intervene in time. At the same time, they should also pay attention to the mental health of MHD patients and their primary family caregivers.
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Humans , Male , Female , Caregivers , Cross-Sectional Studies , Renal Dialysis/psychology , Hypertension , Diabetes MellitusABSTRACT
Objective To observe the clinical features ofuveal effusion syndrome (UES) and the efficacy of sclerectomy in the treatment of UES.Methods A retrospective case series.Twenty patients (36 eyes) of UES with sclerectomy were enrolled in this study from June 2012 to December 2016 in Beijing Tongren Hospital.Among them,there were 12 males (22 eyes) and 8 females (14 eyes),with an average age of 37.8 years.All patients suffered from bilateral diseases,including 4 patients in single eye group and 16 patients in double eye group.Visual acuity,intraocular pressure,indirect ophthalmoscope,UBM,FFA combined with ICGA,A/B ultrasonography,axial length (AL) and scleral thickness were measured.All patients underwent lamellar sclerectomy,and those with exudative retinal detachment underwent four quadrant lamellar sclerectomy,followed by four quadrant full-thickness sclerectomy with the size of 1 mm × 2 mm in the center of the scleral bed.The follow-up time after operation was more than 6 months.Visual acuity,intraocular pressure and fundus examination were performed 1,3 and 6 months after operation with the same equipment and methods before operation.Results There was no obvious inflammation in the anterior chamber of all eyes,and intraocular pressure was 24-28 mmHg (1 mmHg =0.133 kPa) in 4 eyes (11.1％).Axial length of 8 eyes (22.2％) were 16-18 mm (true microphthalmia).12 eyes (33.3％) had scleral thickness ＞ 1.0-1.8 mm.Visual acuity ranged from hand movement to 0.05 in 20 eyes,0.1 to 0.3 in l0 eyes and＞0.3 in 6 eyes.Fundus examination showed peripheral choroidal and ciliary detachment;UBM examination showed annular peripheral ciliary and choroidal detachment.32 eyes (88.9％) were complicated with exudative retinal detachment.FFA examination showed that 14 eyes (38.9％) had leopard spot changes.Compared with preoperative vision,the visual acuity improved in 28 eyes (77.8％) and remained unchanged in 8 eyes (22.2％) after surgery.Thirty-two eyes with different degrees of retinal detachment were found before surgery.After surgery,ciliary body detachment,choroidal detachment and retinal detachment were restored.Six eyes (16.7％) recurred and underwent sclerectomy again.Conclusions The mild symptoms and recurrent attack are the characteristics of UES.Sclerectomy is an effective method to treat UES.
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Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3％.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P ＞ 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.
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BACKGROUND: Changes in the immune function of different tissues after long-time exhaustive exercise stress and probiotics intervention are still unclear. OBJECTIVE: To observe the morphological changes and cell membrane protective effects of different tissues and organs in rats after exhaustive exercise and probiotics intervention. METHODS: Forty Sprague-Dawley male rats were randomly allocated into quiet control group, exercise control group, quiet administration group and exercise administration group. Rats in the exercise control and exercise administration groups underwent 6 weeks of exhaustive training, at a speed of 19.3 m/min, slope of 5o, once daily, 6 days weekly. Rats in the quiet administration and exercise administration groups were given 107CFU/mL probiotics via gavage,10.0 mL/(kg?d).The histopathological changes were observed under light microscope and Na+/K+-ATPase, Ca2+/Mg2+-ATPase and T-ATPase in the liver, intestine and stomach were tested after 6 weeks of training. RESULTS AND CONCLUSION: After exhaustive exercise, the liver, stomach and intestinal tissue presented with structure disorders, swelling and inflammatory cell infiltration and an decrease in the activity of Na+/K+-ATPase, Ca2+/Mg2+-ATPase and T-ATPase. After probiotic solution administrated, the structure of liver, stomach and intestine arranged closely and clearly, with no obvious congestion and edema. However, there were a few inflammatory cells and slight ulcers, and the activities of Na+/K+-ATPase, Ca2+/Mg2+-ATPase and T-ATPase were increased. These findings show that probiotic solution can protect the liver, stomach and intestinal tissue from injury caused by long-time exhaustive exercise, and maintain the integrity and fluidity of cell membrane by increasing Na+/K+-ATPase, Ca2+/Mg2+-ATPase and T-ATPase activities.
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BACKGROUND: Fatty acid translocase/CD36 (FAT/CD36) in skeletal muscle has been proved to induce skeletal muscle contraction transport to the outer membrane stimulated by movement, which increases FAT/CD36 content in cellular membrane, further leading to more fatty acids into skeletal muscle cells. OBJECTIVE: To observe the effects of Glycyrrhiza Flavone administration before exercise on the pathological changes of quadriceps and FAT/CD36 in rats. METHODS: Thirty male Sprague-Dawley rats were randomly divided into quiet, exercise and combination groups. The rats in the combination group were administrated with 10 mL/(kg?d) Glycyrrhiza Flavone, while the other two groups were given the same volume of normal saline. The rats in the exercise and combination groups were subjected to 6-week training, 19.3 m/minute at the treadmill slope of 5°. The pathological changes of quadriceps were observed by hematoxylin-eosin staining, and the expression level of FAT/CD36 was detected by immunohistochemistry and Western blot assay. RESULTS AND CONCLUSION: Under light microscope, swollen, ruptured and necrotic muscle fibers in the quadriceps were found in the excise group. In the combination group, muscle fibers tightly arranged in the quadriceps with complete edge, which had no significant difference compared with the quiet group. Immunohistochemistry showed that the expression level of FAT/CD36 in the exercise group was significantly higher than that in the quiet group (P < 0.05); the expression level of FAT/CD36 in the combination group was slightly higher than that in the quiet group, but significnatly lower than that in the exercise group (P < 0.05), all above findings were consistent with the western blot assay. Our results indicate that exercise can induce fatty acid transport and accumulation. Due to the synergistic action of Glycyrrhiza Flavonoids, FAT/CD36 increases the efficiency of fatty acid transport, thereby maintaining lipid metabolism balance in the skeletal muscle, which avoids lipid metabolic disorders.
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AIM:By analyzing optical coherence tomography angiography (OCTA) characteristics of central serous chorioretinopathy (CSC) and comparing the differences of CSC between OCTA and indocyanine green angiography(ICGA), to explore if OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of photodynamic therapy (PDT).METHODS: We reviewed 30 eyes of 30 patients with CSC, who were diagnosed by fluorescein angiography (FFA) and ICGA at Beijing Tongren Eye Center from November 2015 to March 2016.All patients underwent best-corrected visual acuity (BCVA) measurement, intraocular pressure, slit-lamp examination, indirect ophthalmoscope, color fundus photography, FFA, ICGA and OCTA.FFA and ICGA were captured by Spectralis HRA + OCT (Spectralis HRA + OCT;Heidelberg Engineering, Heidelberg, Germany).OCTA was performed by RTVue XR Avanti device (OptovueInc, Fremont, CA) with 6mm×6mm Angio Retina mode.The software (version 2017.100.0.1;OptovueInc) automatically segmented the tissue into four layers, the characteristics of choriocapillaris layer were analyzed.At the same time, the differences between OCTA and ICGA images were compared among CSC patients.The maximum diameters and areas of both choroidal hyperperfusion in ICGA and high flow signal in OCTA were measured.Then, the paired t test was used to analyze the differences between the maximum diameter and area of OCTA and ICGA measurement.RESULTS: Among 30 cases, high blood flow signals of OCTA were clearly visible in 27 cases, namely the coarse grain region;the inner low flow signals surrounded by high blood flow signals were seen in 21 cases;the outer low flow signals surrounding high blood flow signals were seen in 7 cases.High blood flow signals of OCTA were corresponded with the choroidal hyperperfusion of ICGA images;among these 30 cases, there were low reflection shadows in choroidal hyperperfusion with ICGA for 22 cases, for 21 cases out of these 22 cases, low flow signals inside of high flow signals of OCTA could be seen;9 out of 30 cases, there were low reflection halo outside of choroidal hyperperfusion of ICGA, and 7 out of these 9 cases, low flow signals outside of high flow signals of OCTA could be seen;still for those 30 cases, leakage point in late ICGA could be seen with 14 cases, however, special flow signals in OCTA could not be seen for them.For ICGA, the maximum diameter of choroidal hyperperfusion was 1.589±0.295mm, whose area was 0.705±0.131mm2;while for OCTA, the maximum diameter of high flow signal was 1.576±0.293mm, whose area was 0.745±0.138mm2.By using paired t test, there was no statistical difference between the maximum diameter of choroidal hyperperfusion in ICGA and the maximum diameter of high flow signal in OCTA, nor difference between the area of ICGA and OCTA.CONCLUSION: The high flow signals can be clearly visible in OCTA, which are corresponded with choroidal hyperperfusion in ICGA.OCTA can substitute ICGA for diagnosis of CSC patients, and guide the treatment of PDT.
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<p><b>OBJECTIVE</b>To observe the influence of the fusion of bone graft in spine of rabbits which were treated with lower intensity ultrasound.</p><p><b>METHODS</b>Forty 12-month-old rabbits were made to be the models of bone graft in post-lateral between two homonymy processus transverses in lumbar, and divided into treatment group (B) and control group (A) randomly. Twenty rabbits of treatment group were treated with lower intensity ultrasound, killed after six weeks, and took radiological examination, measured indexs of biomechanics.</p><p><b>RESULTS</b>After 6 weeks of fusion of bone graft, treatment group were higher 6%-7% (P> 0.05) in strength, rigidity, torque andantitwist, maxload than that of control group.</p><p><b>CONCLUSION</b>Lower intensity ultrasound can promote the speed and strength fusion of bone graft in young rabbits.</p>
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Animals , Female , Humans , Male , Rabbits , Biomechanical Phenomena , Bone Transplantation , Random Allocation , Spinal Diseases , General Surgery , Therapeutics , Spinal Fusion , Spine , General Surgery , Ultrasonic TherapyABSTRACT
Objective To explore the clinical characteristics, surgical methods and outcome of recurrent retinal detachment in silicone oil-filled eyes after vitreoretinal surgery. Design Retrospective, observational case series. Participants 55 patients (55 eyes) diagnosed as recurrent retinal detachment with silicone oil-filled eyes. Methods To analyze the clinical manifestations of recurrent retinal detachments and adopt different methods to make retina reattach including vitreoretinal surgery with or without silicone oil removal and scleral buckle revision alone. Patients were followed up for 3 months. Main Outcome Measures Clinical manifestations, retinal re-attachment and visual acuity. Results The characteristics of recurrent retinal detachment in silicone oil-filled eyes were inferior location mainly, less than 2 quadrants, with proliferation and hole. Fifty of the 55 patients underwent repeat surgical repair. Surgical methods included re-vitreoretinal surgery in 39 eyes with silicone oil removal, re-vitreoretinal surgery in 9 eyes without silicone oil removal and scleral buckle revision alone in 2 eyes. After a follow-up of 3 months, retina re-attached in 41 eyes, partially attached in 7 eyes, and detached in 2 eyes. Conclusions Repair of recurrent retinal detachment in silicone oil filled eye is challenging. Favorable anatomic outcome may be achieved in selected patients with proper surgical measures according to the characteristics of recurrent retinal detachment.
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· AIM: To study the inhibitory effect of pyrrolidine dithiocarbamate (PDTC) on the inflammatory reaction in an experimental proliferative vitreoretinopathy (PVR)model with laser flare cell meter (LFCM).· METHODS: A total of 20 pigmented rabbits were divided into two groups randomly, with 10 rabbits in each group. After the creation of retinal holes, 0.1mL PDTC was injected intravitreally into the right eyes of Group 1(A1) and the left eyes of Group 1 (A2), and 0.1mL balanced saline solution (BSS) into the right eyes of Group2 (B1). One hour later, 0.1mL BSS into the eyes of A1,and 5000U IL-1 β in 0.1mL BSS was injected intravreally into the eyes of A2 and B1. Clinical evaluation and LFCM examination were performed before retinal injury (PO)and at 4h, 24h, 1, 2 and 4wk after the second injection(P4h, P24h, Plwk, P2wk and P4wk). Histopathologic and immunohistochemical examination were also performed at these time points.· RESULTS: PDTC could inhibit the inflammatory reaction obviously from P24h to P2wk. The eyes of A1 and A2 recovered earlier than those of B1. Although inflammatory reaction in the 3 groups resolved completely by the end of P2wk measured with the slit-lamp microscope,the eyes of the B1 still showed obvious aqueous flare judged by the LFCM compared with those of A1 and A2.Histopathologic and immunohistochemical examination showed that nuclear factor- κ B (NF- κ B) was activated by IL-1 β and the PDTC had inhibitory effect on it without obvious toxicity to retina.· CONCLUSION: Inflammatory reaction involves in the rabbit model of PVR induced by injecting intravitreally IL-1 β and the PDTC can relieve it significantly. The LFCM provides a new, sensitive, objective and noninvasive method to quantify the inflammatory reaction in the PVR model.
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<p><b>BACKGROUND</b>Internal metallic stents have been widely used in clinical practice, but a high postoperative restenosis rate limits its application. The purpose of this study was to determine the effect of intrabiliary radiation on muscle formation and biliary duct remodeling after biliary duct balloon injury in dogs.</p><p><b>METHODS</b>Twenty male dogs (15 - 20 kg) were randomly divided into treatment group (n = 10) and control group (n = 10). Balloon overstretching injury was induced using a balloon catheter placed across the biliary duct. Subsequently, a 103Pd radioactive stent was positioned at the target site in each animal in the treatment group, providing the injured biliary duct with a radiation dose of 12.58 x 10(7) Bq. Dogs in the control group received Ni-Ti stents. All the dogs were killed one month after initial injury. The injured sections were dissected free from the dogs, and were processed for histological and morphological study. Cross-sections were stained with hematoxylin-eosin, Masson's trichrome, and Verhoef-van Giesen. Muscle formation area and lumen area were determined using a computer-assisted image analysis system.</p><p><b>RESULTS</b>Compared with the control group, 103Pd radioactive stents significantly reduced muscle formation area (78.3%, P < 0.01), and percentage area of stenosis [control stents: (60.0 +/- 21.6)%, 103Pd radioactive stents: (31.6 +/- 9.5)%]. In addition, in the treatment group, the biliary duct lumen area was significantly larger than that in the control group (P < 0.01).</p><p><b>CONCLUSIONS</b>103Pd radioactive stents providing a radioactive dose of 12.58 x 10(7) Bq are effective in reducing muscle formation and biliary duct remodeling after balloon overstretching injury.</p>