ABSTRACT
@#<b>Objective</b> To discuss the shielding calculation method for proton therapy room, and to provide a scientific basis for shielding design of proton therapy room and improvement of existing national standards. <b>Methods</b> Using the calculation formula and key characteristic parameters from national standards and Chinese and foreign literature, combining with the FLUKA Monte Carlo method, empirical formula calculation and Monte Carlo simulation were conducted for the neutron ambient dose equivalent rates of the focuses outside the shielding of proton therapy room. The estimation results of the two methods were analyzed. <b>Results</b> Relative to the calculation results of the single exponential formula in the two directions of 0° and 50° in the beam loss point of divergence slit (0.13 and 12.4), the calculation results of the double exponential formula (0.40 and 17.9) were more consistent with the Monte Carlo simulation results (0.32 ± 0.19 and 18.2 ± 4.98). The Monte Carlo simulation results of copper target and nickel target were similar, suggesting that the key characteristic parameters of concrete shielding for copper target could be well applied to the calculation of nickel target, but the neutron ambient dose equivalent rates were underestimated when applied to tantalum target, with a difference of 5.7 times and 1.3 times in the two directions of 0° and 40°, respectively. <b>Conclusion</b> The dose rate estimates based on the calculation formula and key characteristic parameters from Chinese and foreign literature are consistent with FLUKA simulation results, and this method can be used in the shielding design of proton therapy room as a supplement and improvement to the existing national standards.
ABSTRACT
Objective:To explore the mediating effect of illness perception between type D personality and quality of life in patients with acute myocardial infarction.Methods:From January 2018 to January 2020, 282 patients with acute myocardial infarction who were hospitalized in the Department of Cardiology, Renmin Hospital of Wuhan University and Zhongnan Hospital of Wuhan University were selected by convenience sampling method and investigated using the type D personality scale, brief illness perception questionnaire, and myocardial infarction multi-dimensional assessment scale.Results:The incidence of type D personality in patients with acute myocardial infarction was 32.27%. The total scores of illness perception and quality of life among myocardial infarction patients with type D personality were (49.10±11.62) and (71.54±7.79), respectively. The total scores of illness perception and quality of life among myocardial infarction patients without type D personality were (35.06±13.39) and (59.24±9.31), respectively. There were significant differences in the total scores of illness perception and for the scores of each dimensions between type D personality and non-type D personality patients with acute myocardial infarction ( P<0.001). The total scores of illness perception and quality of life were (39.59±14.42) and (63.21±10.54), respectively. Type D personality was positively correlated with illness perception ( r=0.456, P<0.01), Type D personality was positively correlated with quality of life ( r=0.546, P<0.01), with illness perception found to be positively correlated with quality of life ( r=0.684, P<0.01). Illness perception played a mediating role in the relationship between type D personality and quality of life in patients with acute myocardial infarction ( β=0.294, P<0.001). Conclusions:As an intermediary variable, illness perception can affect the relationship between type D personality and quality of life in patients with acute myocardial infarction. Therefore, medical staff should pay attention to the personality characteristics of patients and implement targeted nursing intervention measures to improve the illness perception of patients, in order to improve their quality of life.
ABSTRACT
Purpose@#To investigate the effectiveness of a structured death education program for older adults with chronic illness and their family caregivers. @*Methods@#This study adopted two-group, nonrandomized quasi-experimental design. Patient–caregiver dyads in the intervention group (N = 40 dyads) engaged in the death education program at the bedside once a week for 5 weeks, and were compared with participants (N = 40 dyads) in the control group who received usual health education. The program consisted of five sessions based on the Interaction Model of Client Health Behavior. Death attitude, death competence, well-being, family function, and satisfaction were measured at baseline (T0), immediately after the intervention (T1), and 1 month later (T2). Data collection was conducted from July 30, 2019, to December 30, 2019. @*Results@#The intention-to-treat analysis The intention-to-treat analysis of between groups at 1-month follow-up revealed that the intervention group had greater decreases in the fear of death (p=.002, 95% CI -2.53, -0.47; p<.001, 95% CI -3.61, -1.65) and death avoidance (p<.001, 95% CI -3.46, -1.84; p<.001, 95% CI -3.89, -2.43), had greater increases in the neutral acceptance (p=.032, 95% CI 0.05, 1.38;p<.001, 95% CI 0.99, 2.56) and death competence (p<.001, 95% CI 4.10, 8.01; p<.001, 95% CI 7.80, 12.11) in patients and caregivers, respectively. There were significant intergroup differences over time for patient well-being of (p<.001, 95% CI 3.06, 9.74) and satisfaction of (p<.001, 95% CI 2.01, 4.59). Results were consistent with the results from the sensitivity analysis. @*Conclusion@#This study demonstrated the feasibility and benefits of death education in hospitals and provided an implementation plan for nursing professionals. Nurses should consider providing death education for older adults with chronic diseases and their families to promote the development of palliative care and the quality of end-of-life.
ABSTRACT
Objective:To explore the teaching effect of case-based learning (CBL) in patient safety course.Methods:A self-made CBL teaching effect questionnaire was used to conduct an online survey on 212 clinical medical undergraduates from a medical college in Chongqing.Results:A total of 212 questionnaires were collected, with 100% of effective recovery rate. Among the students, 91.0% believed that CBL teaching quality was high; 92.4% were satisfied with CBL teaching; 62.7% were the first to experience CBL teaching; 96.7% preferred CBL teaching; 94.3% said that in the future teaching, they would like to accept CBL Teaching. Most students thought that CBL played a vital role in stimulating learning interest, improving learning enthusiasm, activating classroom atmosphere, broadening learning ideas, exercising independent thinking ability, and facilitating the ability of theory connected with practice. Suggestions for the CBL teaching of patient safety courses are summarized into the following three keywords: multiple cases, more interactions, and more similar teaching.Conclusion:The application of CBL in the patient safety course is worth promoting, which is conducive to improving the teaching quality.
ABSTRACT
Purpose@#To investigate the effectiveness of a structured death education program for older adults with chronic illness and their family caregivers. @*Methods@#This study adopted two-group, nonrandomized quasi-experimental design. Patient–caregiver dyads in the intervention group (N = 40 dyads) engaged in the death education program at the bedside once a week for 5 weeks, and were compared with participants (N = 40 dyads) in the control group who received usual health education. The program consisted of five sessions based on the Interaction Model of Client Health Behavior. Death attitude, death competence, well-being, family function, and satisfaction were measured at baseline (T0), immediately after the intervention (T1), and 1 month later (T2). Data collection was conducted from July 30, 2019, to December 30, 2019. @*Results@#The intention-to-treat analysis The intention-to-treat analysis of between groups at 1-month follow-up revealed that the intervention group had greater decreases in the fear of death (p=.002, 95% CI -2.53, -0.47; p<.001, 95% CI -3.61, -1.65) and death avoidance (p<.001, 95% CI -3.46, -1.84; p<.001, 95% CI -3.89, -2.43), had greater increases in the neutral acceptance (p=.032, 95% CI 0.05, 1.38;p<.001, 95% CI 0.99, 2.56) and death competence (p<.001, 95% CI 4.10, 8.01; p<.001, 95% CI 7.80, 12.11) in patients and caregivers, respectively. There were significant intergroup differences over time for patient well-being of (p<.001, 95% CI 3.06, 9.74) and satisfaction of (p<.001, 95% CI 2.01, 4.59). Results were consistent with the results from the sensitivity analysis. @*Conclusion@#This study demonstrated the feasibility and benefits of death education in hospitals and provided an implementation plan for nursing professionals. Nurses should consider providing death education for older adults with chronic diseases and their families to promote the development of palliative care and the quality of end-of-life.
ABSTRACT
Objective To study the differences of symptoms and pathological features of Wistar and Lewis rat models of collagen-induced rheumatoid arthritis. Methods Wistar and Lewis rats were injected with intermixture of bovine TypeⅡ collage and complete Freund's adjuvant(CFA)for first immunization, then strengthen it after 14 days and observed the incidence of Wistar-RA group and Lewis-RA group. The degree of paws swelling and the titer of serum anti CII antibody were determined. The pathological changes in toe and joint tissues were examined at 12 weeks, and the expressions of VEGF, IL-6, IL-10 and IL-17A in the synovial membrane of ankle joint were detected. Results After collagen induction,the Wistar and Lewis rats showed paw swelling after 10 d and 14 d,and peaked at 21 d and 24 d,the titer of serum anti CII antibody was significantly increased at third week(P< 0.01), and arthritis index(AI)was also significantly increased(P< 0.01). In the Wistar-RA rat group, the rate of molding was 80%, and at fifth weeks, the swelling of the paws subsided and went into a flat level. The molding rate of the Lewis-RA group was 100%,at the seventh week,the swelling of paws subsided and went into a flat level. At 12 weeks,the two model groups showed severe articular cartilage erosion, synovial hyperplasia and inflammatory cell infiltration, neovascularization and pannus formation in the joint synovium,and the bone mineral density of the femur and tibia of the hind limbs was significantly decreased(P<0.01). The expression of VEGF,IL-6 and IL-17A in synovium was significantly increased(P< 0.05,P< 0.01). The expression of IL-10 was obviously decreased(P< 0.01). Compared with the Wistar-RA group,the paw volume and paw thickness were increased for a longer time in the Lewis-RA group,AI was higher than that of the Wistar-RA group,synovial angiogenesis and pannus formation were more distinct, the expression of VEGF in synovium was significantly higher than that of Wistar-RA group(P< 0.05), while the expression of IL-17A was significantly lower than that in the Wistar-RA group(P< 0.05). Conclusions Both the Wistar-RA rat model and Lewis-RA rat model show joint swelling,deformation and decreased activity. AI is increased,the expression of VEGF,IL-6 and IL-17A increased,and the expression of IL-10 decreased,which are consistent with the clinical manifestation. The Wistar-RA rat model has a short duration of swelling, while the Lewis-RA rat model has a longer swelling duration and more severe joint damages. The neovascularization and pannus formation are more obvious. The expression of IL-17A in the Wistar-RA rat model is higher, while the Lewis-RA model has a highly expressed VEGF,which may be related to its pathological characteristics.
ABSTRACT
Objective To observe the pathological changes of brain tissues in the WHBE rabbit model of sporadic Alzheimer disease (AD). Methods Thirty 3 -4-month old male WHBE rabbits were randomly divided into 3 groups:normal control (NC) group, high cholesterol diet (HCD) group, high cholesterol diet + copper drinking water ( HCD+ Cu2+) group, 10 in each group. Another 10 senile (36-48-month old) male WHBE rabbits were taken as senile group. The NC group and the senile group were fed a normal basic diet, the HCD group fed a 2% cholesterol diet, and the HCD+Cu2+group fed a 2% cholesterol diet plus 0. 12 PPM copper drinking water for 12 weeks. The levels of total cholesterol (TC) and β-amyloid protein (Aβ) 1-42 were measured at 12 weeks. The activity of superoxide dismutase ( SOD) and the content of malondialdehyde (MDA) in the cortex and the hippocampus were detected. In addition, the covered area of Aβ, β-site APP cleaving enzyme 1(BACE1) and phosphorylated tau (p-tau) protein in coronal sections of brain tissues were also observed by immunohistochemical staining. The senile plaques and the neurofibrillary tangles were observed by Congo red and Bielschowsky staining, respectively. Results The body weight of WHBE rabbits in the senile group was significantly higher than that of the NC group ( P ＜ 0. 01 ), and the plasma TC and Aβ1 -42 in each group were significantly higher than that in the NC group (P ＜ 0.05, P ＜ 0.01). The activity of SOD in brain tissues was significantly lower than that of NC group (P＜ 0. 05), and the MDA content was significantly higher than that of NC group (P＜ 0. 05, P ＜ 0. 01). Immunohistochemical staining showed that the covered area of Aβ, BACE1 and p-tau in brain tissues of all groups were significantly higher than that of NC group (P ＜ 0. 05, P ＜ 0. 01), and the covered area of BACE1 and p-tau protein in the brain tissues of HCD + Cu2+group was also significantly higher than that of the HCD group (P ＜ 0. 05, P ＜ 0. 01). Congo red and Bielschowsky staining showed that the number of senile plaques and neurofibrillary tangles were observed in the brain tissues of the HCD, HCD+Cu2+and senile groups. Conclusions High cholesterol diet or supplemented with trace copper drinking water can induce obvious AD pathological changes in WHBE rabbit models of sporadic AD with obvious oxidative damage, increased Aβ deposition and senile plaque in the brain, and pathological changes of tau. WHBE rabbit can be used in the study of animal models of neurodegenerative diseases.
ABSTRACT
With population aging and socio?economic development, the sedentary time and behavior of the elderly are increasing, resulting in an increase in health risks as well. This review aimed to investigate the effects of sedentary behavior on the health of the elderly, factors contributing to sedentary behavior in the elderly, and sedentary behavior interventions for the elderly, as well as provide reference for sedentary behavior investigation and intervention study, to eventually achieve health promotion for the sedentary elderly.
ABSTRACT
@#Objective To investigate the clinical efficacy of low-frequency transcranial magnetic stimulation (rTMS) on post-stroke upper limb spasticity and its mechanism. Methods From September, 2015 to December, 2017, 23 patients with post-stroke upper limb paralysis were randomly divided into control group (n=13) and experimental group (n=10). Both groups received routine rehabilitation, and the experimental group received 1 Hz rTMS at primary motor area (M1) for eight weeks. They were assessed with modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after treatment, while the activation under fMRI in the task state was observed and the laterality index (LI) was calculated. Results The scores of MAS, FMA-UE and MBI improved after treatment in both groups (Z>2.121, t=6.248, P<0.05), and improved more in the experimental group than in the control group (Z>2.084, t=-2.095, P<0.05). The ipsilateral M1, ipsilateral sensory motor cortex and bilateral supplementary motor area were activated more in the control group than in the experimental group during the movement of affected hand. LI in the M1 increased after treatment in both groups (Z>2.366, P<0.05), and was more in the experimental group than in the control group (Z=-2.430, P<0.05). There was a positive correlation between the change of LI in the M1 and the improvement of the MAS and FMA-UE (r>0.612, P<0.05). Conclusion Low-frequency rTMS may improve the motor function and spasticity of upper limb after stroke by promoting reorganization of the cortex and inducing normalization of cortical function.
ABSTRACT
Objective To observe the effect of nursing intervention on caesarean section rate in grass-roots hospitals. Methods 240 parturient women who were to infanticipate were divided into the experimental group and the control group with 120 patients in each group according to hospitalization sequence. Parturient women in the experimental group received nursing intervention with new nursing model during the delivery, while women in the control group just finished parturition using routine procedures. The caesarean section rate of the two groups were compared with χ2 test. Results The caesarean section rate of parturient women in the experimental group was significantly lower than that in the control group. Conclusions Nursing inter-vention has certain effect on decreasing the caesarean section rate in grassroots hospitals.