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Nonalcoholic fatty liver disease (NAFLD) is a disease caused by multiple factors and can progress to liver cirrhosis and hepatocellular carcinoma. At present, the pathogenesis of NAFLD remains unclear and there are still no effective therapeutic drugs in clinical practice; therefore, it is particularly important to search for new therapeutic drugs that have few side effects and can effectively delay or reverse disease progression. Some studies have shown that related hormones produced by gastric tissue have a variety of effects in the regulation of energy homeostasis and obesity, and the expression level of inflammation-related genes in gastric fundus is consistent with the severity of liver disease; thus we have reason to believe that the stomach is one of the important participants in NAFLD. This article summarizes the role of ghrelin and obestatin produced by the stomach in the progression of NAFLD, which provides a new idea for the pathogenesis of NAFLD and a new direction for treatment.
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Objective To compare the diagnostic values of γ-glutamyl transpeptidase-to-platelet ratio index (GPRI) ,aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fib-4) for chronic hepatitis B (CHB) fibrosis and cirrhosis .Methods According to the Metavir score ,262 CHB patients were divided into F0 — F1 group (n= 131) ,F2 — F3 group (n= 102) and F4 group (n = 29 ) . The age , gender , alanine aminotransferase (ALT ) , aspartate aminotransferase (AST ) ,γ-glutamyl transpeptidas (γ-GT ) and platelet count were recorded .GPRI ,APRI ,Fib-4 scores were calculated separately .Statistical analysis was performed by t test ,Kruskal-Wallis H test ,and χ2 test .The correlations between serum models and liver fibrosis stages were analyzed using the Spearman test .Results The scores of GPRI in F0 — F1 group ,F2 — F3 group and F4 group were 0 .39 (0 .21 , 0 .95) ,1 .05 (0 .38 ,2 .39) and 2 .11 (1 .12 ,3 .33) ,respectively .The difference was statistically significant (χ2 = 40 .645 ,P< 0 .01) .APRI scores in the three groups were 0 .49 (0 .32 ,0 .97) ,0 .77 (0 .52 ,1 .52) and 1 .12 (0 .77 ,2 .50) ,respectively .The difference was statistically significant (χ2 = 32 .636 , P < 0 .01) . Fib-4 scores in the three groups were 1 .36 (0 .92 ,2 .05) ,2 .34 (1 .28 ,4 .35) and 3 .86 (3 .03 ,8 .99) , respectively .The difference was statistically significant (χ2 = 48 .943 , P< 0 .01) .Age ,γ-GT ,AST and liver fibrosis were all positively correlated with liver fibrosis (r = 0 .322 ,0 .301 and 0 .199 ,respectively , all P< 0 .05) .Platelet was negatively correlated with liver fibrosis (r = — 0 .455 , P< 0 .05) ,while ALT was not significantly associated with hepatic fibrosis (r= 0 .111 ,P= 0 .073) .GPRI ,APRI and Fib-4 were positively correlated with liver fibrosis (r = 0 .625 ,0 .417 and 0 .399 ,respectively ,all P < 0 .05) .The areas under the operating characteristic curve of GPRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .818 ,0 .864 and 0 .837 ,respectively .APRI for significant hepatic fibrosis , advanced liver fibrosis and cirrhosis were 0 .694 ,0 .766 and 0 .722 ,respectively ,while Fib-4 were 0 .696 , 0 .770 and 0 .724 ,respectively .The low cutoff values of GPRI for various stages of liver fibrosis were 0 .99 ,1 .04 and 1 .06 ,respectively ,and the sensitivity ,specificity ,positive predictive value (PPV ) and negative predictive value (NPV) were all higher than those of APRI and Fib-4 .The high cutoff values of GPRI for liver fibrosis at each stage were 2 .49 ,3 .69 and 6 .77 , respectively , and the sensitivity , specificity ,PPV and NPV of the diagnosis were all higher than those of APRI and Fib-4 .Conclusion The diagnostic value of GPRI for CHB liver fibrosis is higher than those of APRI and Fib-4 .
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Recent studies have found that inflammatory response is positively associated with the progression of liver cirrhosis,acute-on-chronic liver failure,and primary liver cancer and can affect their prognosis,and as a marker for inflammatory response,neutrophil/lymphocyte ratio (NLR) is easy to calculate,has good repeatability,and holds promise for prognostic evaluation.This article introduces the research advances in the association of NLR with the prognosis of liver cirrhosis,acute-on-chronic liver failure,and primary liver cancer and points out that NLR plays an important role in evaluating the prognosis of liver cirrhosis,acute-on-chronic liver failure,and primary liver cancer.However,there are still controversies over the selection of optimal cut-off values for different diseases,and further studies are needed.
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Chronic obstructive pulmonary disease (COPD) is the leading death cause of pulmonary diseases, ranking the fourth of global death causes. Self-management program is able to gradually improve the Airways of COPD patients with ventilation, reduce the degree of lung failure, elevate the health status as well as promoting self-efficacy, which is the key process to effectively control COPD relapse. In recent years, more and more domestic and foreign academic employ the widely-used network technology and carry out a large number of information study on COPD self-management intervention. This article reviewed literatures about the intervention methods on self-management of patients suffered from COPD, aimed at providing a better basis for exploring more effective self-management.
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The peptides,proteins and other biological molecules in transudative pleural effusion correlate directly or indirectly with specific physiological and pathological state,reflecting the information regarding the lungs or other parts of the body.In the present study,the peptide fraction in transudative pleural effusion was isolated by uhrafiltration.After desalted and enriched by C18 tips,the peptide mixture was analyzed by nano LC-MS/MS.The results showed that 314 peptides,which were originated from 52 proteins,in pleural transudate were identified.More than half of the peptides were derived from fibrinogen.Many peptides were characterized as displaying ladder sequences.In addition,a large number of proline oxidation modifications were detected in the peptides derived from collagen and fibrinogen.Gene ontology enrichment analysis showed that the most of the proteins extracellular properties of pleural transudate polypeptide components were protein with exocytosis.The study provided a rapid and efficient separation and analysis methods for lung disease markers related peptide compounds in pleural fluid leakage.Also this research provided a rapid and effective method for screening peptide biomarkers related to lung diseases from transudative pleural effusion.
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Early and accurate diagnosis of hepatic fibrosis and application of antiviral therapy are the key to improving the prognosis of patients with chronic hepatitis B (CHB).Liver biopsy and transient elastography cannot be widely used for the diagnosis of hepatic fibrosis in clinical practice,and therefore,the serological diagnostic model has become a hot research topic in recent years.This article introduces a new serological diagnostic model,γ-glutamyl transpeptidase-to-platelet ratio (GPR),which has a high value in the diagnosis of hepatic fibrosis in CHB patients;however,the accuracy of GPR varies between different populations and different areas.GPR is also an excellent predictor for the prognosis of hepatitis B-associated liver cancer.It is pointed out that GPR has a promising future in the diagnosis of hepatic fibrosis in CHB patients,but due to a lack of clinical research data on GPR,further studies are needed to support its application in China.
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PURPOSE: The aim of this study was to evaluate the effects of reflective trainings for nursing students on their critical thinking disposition. METHODS: A total of 157 senior undergraduate nursing students sampled from Hainan Medical University in China participated in this study in 2014. They were randomly divided into experimental and control groups. The experimental group students were provided the reflective training during their entire 12-month clinical internship, whereas students in the control group were requested to keep their reflective diaries but without a formal training. Before and after the intervention, nursing students' critical thinking disposition was rated using the Chinese version of Critical Thinking Disposition Inventory (CTDI-CV). RESULTS: Before the start of the intervention, the critical thinking disposition scores of the two groups had no significant differences. At the end of the intervention, it was found that the experimental students performed better in each subscale of CTDI-CV. These include the search for truth, open mind, analytical ability, systematic ability, critical thinking, self-confidence, curiosity, and cognitive maturity. By summing the scores of all categories, the results showed that the experimental group had a significantly higher total score than that of the control group (p ≤ .044). Evaluating the score difference in each function indicated that there was a range of improvements on the critical thinking disposition because of the reflective training intervention. CONCLUSION: Reflective training during the internship period improves nursing students' disposition of critical thinking and promotes their readiness for their clinical practices in the rapidly increasing demands of the healthcare field.
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Humans , Asian People , China , Delivery of Health Care , Education, Nursing , Exploratory Behavior , Internship and Residency , Nursing , Students, Nursing , ThinkingABSTRACT
Objective To evaluate a somatostaitn analogue (Octreotide) in the treatment of hepatocellular carcinoma (HCC). Methods In this study 62 HCC patients were divided into therapy group (30 cases) and control group (32 cases) based on patients' own will. Patients in treatment group were assigned to receive an average dosage of 339.43±165.53 mg of octreotide. Treatment results and patients' life quality were evaluated on 3rd and 6th month. Result (1) The average live time of the treatment group was (12.89±6.21) months much longer than that of the control group (5.36±6.36) months (P < 0.05). The 6 month, 12 month survival rate of treatment group (73.3% ,50.0% ) was better than that of the control group(40.6% ,9.37% ) (χ2 =4.02 ,χ2 =9.67,all P <0.05). (2) Appetite was improved in 21 patients, body weight increased in 12 patients. Debility ameliorated in 17 patients in therapy group. (3) Tumor grew larger in 8 cases in control group on the sixth month based on liver CT and 6 of them had extrahepatic metastasis. While in therapy group tumor size decreased in 6 cases; did not change in 9 cases; 3 grew larger, and 1 had extrahepatic metastasis. (4) As for side-effects of octreotide therapy, 6 patients had diarrhea at the beginning, as the treatments continued, the symptoms disappeared within one month. Conclusion Octreotide prolongs the surviving time of patients with hepatocellular carcinoma, increases the 6 and 12 months survival rate, causing mild side-effects, and improves the life quality of patients with hepatocellular carcinoma.