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Objective:To investigate the application effect of paper review combined with situational exercise in the standardized training and teaching of ophthalmology nurses.Methods:A total of 39 ophthalmology nurses who received standardized training from September 2019 to July 2020 were selected as control group, and 42 ophthalmology nurses who received standardized training from September 2020 to July 2021 were selected as study group. The nurses in the control group received traditional teaching, and those in the study group received teaching with paper review and situational exercise. The two groups were compared in terms of the scores of theoretical knowledge and operation skills, comprehensive qualities (autonomous learning ability, independent analysis and problem-solving ability, nurse-patient communication ability, organization and coordination ability, and comprehensive first aid ability) before and after teaching, and the degree of satisfaction with teaching. SPSS 26.0 was used to perform the independent samples t-test, the paired t-test, the chi-square test, and the rank sum test. Results:After standardized training, compared with the control group, the study group had significantly higher scores of theoretical knowledge (93.29±1.82 vs. 90.36±1.51, P<0.05) and operation skills (95.14±1.34 vs. 92.62±1.26, P<0.05). After standardized training, both groups had significant increases in the scores of autonomous learning ability, independent analysis and problem-solving ability, nurse-patient communication ability, organization and coordination ability, and comprehensive first aid ability, and the study group had significantly higher scores of these comprehensive qualities than the control group ( P<0.05). There was a significant difference in the distribution of the degree of satisfaction with teaching between the two groups ( P<0.05), and the study group had a significantly higher degree of satisfaction than the control group. Conclusion:Paper review combined with situational exercise can improve the specialized theoretical knowledge, technical operational level, and comprehensive qualities of ophthalmology nurses receiving standardized training and enhance the degree of satisfaction with teaching.
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Objective:To analyze the prognosis of glucose metabolism and its impacting factors at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy.Methods:In this cross-sectional study, a total of 192 patients with abnormal blood glucose during pregnancy enrolled and delivered in the maternity clinic of Daxing Teaching Hospital of Capital Medical University from December 1, 2019 to December 31, 2020 were collected. The 75 g oral glucose tolerance test (OGTT) was applied for diabetes screening at 6-12 weeks after delivery. According to the results of postpartum blood glucose, the patients were divided into two groups: postpartum normal blood glucose group (148 cases) and abnormal blood glucose group (44 cases). Hypothesis testing was used to compare the clinical data before, during and after the pregnancy between the two groups. Multi-factor logistic regression was performed to analyze the influencing factors of postpartum abnormal blood glucose in patients with abnormal blood glucose during pregnancy.Results:Among the 192 patients with abnormal blood glucose during pregnancy, the incidence of postpartum abnormal blood glucose was 22.92% (44/192), including 6 cases of diabetes mellitus (DM) (13.64%), 38 cases of impaired glucose tolerance (IGT) (86.36%). Neck circumference, waist circumference, multiparous women and insulin use during pregnancy in postpartum abnormal blood glucose group were all significantly higher than those in postpartum normal blood glucose group [34.25(33.00, 36.00) vs 33.55 (32.00, 35.00) cm, 87.00 (82.00, 93.00) vs 84.00 (78.00, 90.00) cm, 54.55% vs 37.16%, 18.18% vs 6.76%] (all P<0.05). Neck circumference ( OR=1.315, 95% CI: 1.026-1.685), multiparous women ( OR=2.261, 95% CI: 1.057-4.836), insulin use during pregnancy ( OR=3.767, 95% CI: 1.236-11.478) were positively correlated with the occurrence of postpartum abnormal blood glucose (all P<0.05). Conclusions:The incidence of postpartum abnormal blood glucose is high at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy. Neck circumference, waist circumference, parity and insulin use during pregnancy are important impacting factors of postpartum abnormal blood glucose.
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Objective:To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods:From October 2017 to May 2021,preterm infants with GA≤ 32 w admitted to NICU of our hospital were retrospectively studied. According to their echocardiography 2 w after birth, the infants were assigned into early-onset pulmonary hypertension (ePH) group and non-PH group. SPSS 21.0 statistical software was used to analyze the general status, complications and clinical outcomes of the two groups. Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results:A total of 183 cases were enrolled, including 24 in the ePH group and 159 in the non-PH group. The incidences of birth asphyxia, hemodynamically significant patent ductus arteriosus (hsPDA), FiO 2≥30% within 6 h after birth, late-onset PH, severe bronchopulmonary dysplasia(BPD) and intracranial hemorrhage(ICH) in the ePH group were significantly higher than the non-PH group( P<0.05). hsPDA was the independent risk factor for early-onset PH ( OR=11.781, 95% CI 4.192-33.108). Conclusions:Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH, late-onset PH and severe BPD, hsPDA is the independent risk factor for early-onset PH.
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BACKGROUND@#Rheumatoid arthritis (RA), a chronic systemic autoimmune disease, is characterized by synovitis and progressive damage to the bone and cartilage of the joints, leading to disability and reduced quality of life. This study was a randomized clinical trial comparing the outcomes between withdrawal and dose reduction of tofacitinib in patients with RA who achieved sustained disease control.@*METHODS@#The study was designed as a multicenter, open-label, randomized controlled trial. Eligible patients who were taking tofacitinib (5 mg twice daily) and had achieved sustained RA remission or low disease activity (disease activity score in 28 joints [DAS28] ≤3.2) for at least 3 months were enrolled at six centers in Shanghai, China. Patients were randomly assigned (1:1:1) to one of three treatment groups: continuation of tofacitinib (5 mg twice daily); reduction in tofacitinib dose (5 mg daily); and withdrawal of tofacitinib. Efficacy and safety were assessed up to 6 months.@*RESULTS@#Overall, 122 eligible patients were enrolled, with 41 in the continuation group, 42 in the dose-reduction group, and 39 in the withdrawal group. After 6 months, the percentage of patients with a DAS28-erythrocyte sedimentation rate (ESR) of <3.2 was significantly lower in the withdrawal group than that in the reduction and continuation groups (20.5%, 64.3%, and 95.1%, respectively; P < 0.0001 for both comparisons). The average flare-free time was 5.8 months for the continuation group, 4.7 months for the dose reduction group, and 2.4 months for the withdrawal group.@*CONCLUSION@#Withdrawal of tofacitinib in patients with RA with stable disease control resulted in a rapid and significant loss of efficacy, while standard or reduced doses of tofacitinib maintained a favorable state.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR2000039799.
Subject(s)
Humans , Quality of Life , China , Arthritis, Rheumatoid/drug therapy , Piperidines/therapeutic use , Treatment Outcome , Antirheumatic Agents/therapeutic use , Pyrroles/therapeutic useABSTRACT
Objective:Taking into account of the current situation that domestic laws and regulations of medical technology ethics review are not perfect, we put forward practical suggestions on ethical review supervision of the clinical application of new medical technologies from the perspective of standardization.Methods:Referring to the relevant laws, regulations and specific implementation guidelines of ethical review of clinical research, combined with the practical experience of the ethics committee of the host Hospital, this paper systematically summarizes the concept and characteristics and existing problems of new clinical applied medical technology, optimizes the working steps of technology access and ethical review, and establishes an ethical continuing review model.Results:A series of measurements are proposed, which including formulate the access process, improve the management system, optimize ethical review methods, etc. At the same time, pay more attention to the annual continuing review, adverse event report review, suspension/termination of approved research, closure report review, as well as site visit to improve the initiative and efficiency of ethical review. At last, it ensures the continuing of ethical review.Conclusions:It is very important to regulate new medical technology project entry and ethical review supervision in the practice. On one hand, it can effectively make up for the possible shortcomings of current laws and regulations and promote the introduction of new regulatory requirement. On the other hand, it can effectively reduce the medical technology risks and build good medical quality management, improve the system to better safeguard people′s health rights and interests.
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Objective:To investigate the safety and efficacy of endoscopic ultrasound-guided coil embolization for gastric varices.Methods:Patients with portal hypertension who received endoscopic ultrasound-guided coil embolization for the prophylaxis of gastric variceal bleeding between November 2016 and August 2020 at Zhongshan Hospital, Fudan University were included in the study. The primary evaluation index was the post-operative loss of blood flow in gastric varices, and the secondary indices included the safety of coil embolization, rebleeding rate, portal vein thrombosis changes and patient survival.Results:A total of 13 patients with isolated gastric varices and portal systemic shunt were enrolled, including 6 males and 7 females with the median age of 58 years. The median maximum diameter of the target vessel was 40 mm and the median number of coils used was 2.7. All puncture sites were in the lower part of the esophagus near the cardia, and no active bleeding occurred after deployment of coils. Flow in the gastric varices were confirmed absent by Doppler imaging. In a median follow-up period of 403 days, 2 patients had rebleeding, with the one-year rebleeding rate of 9.1%.Two patients developed portal venous thrombosis after the operation. Two patients died, and the one-year survival rate was 90.0%.Conclusion:Endoscopic ultrasound-guided coil embolization might be an effective option for the treatment of isolated gastric varices with portal systemic shunts.
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Takayasu′s arteritis (TAK) mainly involves the aorta and its major branches, which is characterized as a chronic, progressive and inflammatory disease. China belongs to one of the regions with a high prevalence of TAK referring to its global distribution. However, it is insufficient for the spread and update of standardized diagnosis and treatment of TAK. Based on the evidence and guidelines from China and other countries, Chinese Rheumatology Association developed the standardized diagnosis and treatment of TAK in China. The purpose is to standardize the methods for diagnosis of TAK, assessment of disease activity and disease severity, strategies of internal treatment and timing of surgical intervention, and further leading to protect the function of important organs and improve the disease prognosis.
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Objective:This study aimed to evaluate the rebleeding risk and prognosis of patients being treated after acute esophageal varices bleeding by two different treatment strategies: sclerosing agent combined with tissue glue injection, esophageal varices ligation (EVL), through comparing the therapeutic effects and securities.Methods:A total of 76 patients who underwent endoscopy and received treatment in Zhongshan Hospital Affiliated to Fudan University due to acute esophageal variceal bleeding were included retrospectively. 6 patients with active bleeding and 70 patients with thrombus in esophagus varices under gastroscopy. Among them, 21 cases were treated with sclerosing agent combined with tissue glue injection (sclerosing tissue glue group), and 55 cases were treated with EVL (EVL group). The emergency endoscopic diagnosis and treatment of the two groups were compared, and the risk factors of rebleeding 6 months after endoscopic treatment were analyzed by univariate and multivariate analysis.Results:All patients received endoscopic treatment successfully. During the follow-up period of 6 months after endoscopic treatment, rebleeding occurred in 13 cases. Kaplan Meier analysis showed that the 6-month rebleeding rate in the sclerosing tissue glue group was significantly higher than that in the EVL group (41.6% vs 12.3%, P=0.011). There were 8 deaths in total. Kaplan Meier analysis showed that there was no significant difference in 6-month mortality between the two groups (17.5% vs 10.1%, P=0.616). Multivariate analysis further showed that malignant tumor ( HR=3.700, 95% CI: 1.187-11.536, P=0.024) and treatment mode of esophageal variceal bleeding ( HR=4.834, 95% CI: 1.443-16.193, P=0.011) were independent risk factors for rebleeding 6 months after endoscopic treatment of acute esophageal variceal bleeding. Conclusions:This study found that EVL and the combining injection of lauromacrogol and cyanoacrylate could be used in emergent hemostatic treatment for acute esophageal varices bleeding. Moreover, EVL is the prioritized approach in endoscopic emergency treatment with a lower rebleeding rate and fewer complications. Sclerotherapy combined with tissue glue can be used as one of the measures of emergency treatment, which is not better than ligation.
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Objective:To study the effects of different sizes of maternal placental chorionic hemangioma (PCH) on neonatal clinical outcome.Methods:February 2013 to December 2020, neonates whose mothers with PCH delivered in our hospital were retrospectively analyzed. According to the diameter of PCH, the neonates were assigned into giant PCH group (diameter≥4 cm) and ordinary PCH group (diameter<4 cm). Clinical characteristics and outcomes were compared between the two groups.Results:A total of 35 cases were enrolled in the study. 13 cases (37.1%) were male, 12 cases (34.3%) were Cesarean section delivered, 11 cases (31.4%) were premature infants, 12 cases (34.3%) had low birth weight and 12 cases (34.3%) were admitted to NICU, 7 cases (20.0%) had intrauterine distress, cardiac enlargement and abnormal hematological indexes, respectively, 6 cases (17.1%) needed respiratory support; 5 cases (14.2%) had increased amniotic fluid and fetal edema, respectively, 4 cases (11.4%) received blood transfusion, 3 cases (8.5%) had postnatal asphyxia, 2 cases (5.7%) had brain injury and 2 cases (5.7%) had congenital malformation. 15 cases were in the giant PCH group and 20 cases in the ordinary PCH group. Compared with the ordinary PCH group, the giant PCH group had significantly higher incidences of prematurity, low birth weight, increased amniotic fluid, intrauterine distress, NICU hospitalization, fetal edema, cardiac enlargement, respiratory support, abnormal hematological indexes, blood transfusion and mortality ( P<0.05). Conclusions:Maternal complications with giant PCH may significantly increase the risk of neonatal complications, thus perinatal monitoring should be strengthened.【 Key words】Placental chorionic hemangioma; Infant, newborn; Clinical outcome
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Objective:To investigate the dignity status of lymphoma patients during perichemotherapy, and to analyze the influencing factors.Methods:The convenience sampling method was used to investigate 230 lymphoma patients during perichemotherapy in Affiliated Tumor Hospital of Xinjiang Medical University from August 2020 to February 2021 by using general data questionnaire and patient dignity scale. Dual logistic regression was used to analyze the influencing factors of dignity.Results:The dignity score of patients with malignant lymphoma during perichemotherapy was 42.1±16.8, and 30.0% (69/230) patients had obvious dignity impairment. Among 5 dimensions of patient dignity, the scores of physical and mental pain, self-cognition, social role function independence and social support were 1.8±0.8, 1.8±0.9, 1.7±0.9, 1.6±0.7 and 1.2±0.5, respectively. Each patient had an average of 4.1 dignity problems, and five items with the highest score were worrying about their future (physical and mental pain dimension) [(2.1±1.1) scores, 50.4% (116/230)], feeling uncomfortable (physical and mental pain dimension) [(2.0±1.1) scores, 56.5% (130/230)], feeling a burden to others (self-perception dimension) [(2.0±1.1) scores, 33.5% (77/230)], feeling depressed (physical and mental pain dimension) [(1.9±1.0) scores, 53.5% (123/230)], feeling like a different person (self-perception dimension) [(1.9±1.1) scores, 49.1% (113/230)]. Logistic regression analysis showed that widowed (compared with unmarried: OR = 2.108, 95% CI 1.562-3.570), barely affordable and difficult to afford (compared with fully affordable: OR = 2.163, 4.307, respectively; 95% CI 1.120-7.469, 1.374-12.807), disease acceptance and negative (compared with positive: OR = 2.003, 3.694, respectively; 95% CI 1.358-6.599, 1.221-9.061), Eastern Cooperative Oncology Group (ECOG) score 2-4 (compared with score 0: OR = 3.753, 4.720, 5.044, respectively; 95% CI 1.352-9.506, 1.514-12.793, 2.221-15.539), patients with B symptom (compared with those without B symptom: OR = 1.962, 95% CI 1.100-3.501), patients with severe chemotherapy reaction (compared with those without severe chemotherapy reaction: OR = 4.814, 95% CI 2.714-8.539) were independent risk factors for obvious dignity loss of patients during perichemotherapy (all P < 0.05), and married was an independent protective factor compared with unmarried ( OR = 0.192, 95% CI 0.036-0.807, P < 0.05). Conclusion:Patients with lymphoma have impaired dignity during perichemotherapy. Medical staff should pay attention to the influencing factors of impaired dignity and develop targeted intervention programs to reduce the impaired dignity of patients.
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Objective:To compare the diagnostic efficacy of Chinese diagnostic model, the 1990 American College of Rheumatology (ACR) classification criteria and the 2018 ACR new classification criteria (draft) for Takayasu arteritis (TA).Methods:A total of 196 TA patients who came to our hospital from January 1, 2009 to May 31, 2019 in the TA database of the department of rheumatology and immunology, Zhongshan Hospital, Fudan University and 131 patients with other vascular diseases visited during the same period were selected. General characteristics, clinical data, laboratory tests and imaging tests of all patients were collected. Categorical variables were presented as numbers and percentages, between-group differences were analyzed using the χ2 test. Continuous variables were presented as the Mean± SD for a normal distribution or median and interquartile range (IQR) for a non-normal distribution. Between-group differences were analyzed using the Student's t-test or Mann- Whitney test, as appropriate. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and receiver operating characteristics of the above diagnostic/classification criteria area under the curve were analyzed. P<0.05 was considered significant. Results:In terms of sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under receiver operating characteristic curve (ROC), Chinese diagnostic models was 85.7%, 96.2%, 89.9%, 97.1%, 81.5%, 0.909, 1990 ACR criteria was 47.4%, 97.7%, 67.6%, 96.9%, 55.4%, 0.726, 2018 ACR classification criteria was 79.1%, 98.5%, 86.5%, 98.7%, 75.9%, 0.888. The difference between the Chinese diagnostic model and the 2018 ACR criteria in AUC was not statistically significant ( Z=1.186 , P>0.05). The sensitivity, accuracy and diagnostic efficiency of Chinese diagnostic model was the best, that of the 1990 ACR classification criteria was the worst, and the specificity of the 2018 ACR classification criteria was the highest. The Kappa value of the 2018 ACR classification criteria and the Chinese diagnostic model was 0.719, which had good consistency, and the Kappa value of the consistency between the 1990 ACR classification criteria and the Chinese TA diagnostic model was 0.516. Conclusion:The Chinese diagnostic model, which is based on the clinical characteristics of the Chinese TA population, has a good diagnostic efficacy for the Chinese population. The 2018 ACR classification criteria (draft) is highly consistent with the Chinese TA diagnostic model, and can be promoted and applied in practice.
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Objective:To analyze the characteristics of patients with Takayasu arteritis (TA) in the east China Takayasu arteritis (ECTA) cohort and their subgroups, and evaluate the disease characteristics.Methods:Patients diagnosed with TA in ECTA cohort from January 2009 to October 2019 were enrolled and their data were analyzed. The characteristics were analyzed and compared within subgroups using t-test or Wilcoxon rank sum test or Chi-square test. Results:A total of 454 patients were included, with the male to female ratio of 1∶4.75(79/375), and the main complaint were dizziness/headache, fatigue, and chest tightness/pain. The type Ⅴ and Ⅰ were the most common angiographic pattern, among which the subclavian artery and carotid artery were most vulnerable, manifested as vascular stenosis. Hypertension, tuberculosis and hepatitis B were common complications. In subgroup comparison, symptoms and inflammation index were much more evident in the active group, female group, <40 years old, and newly diagnosed group. C-reactive protein (CRP)[10(2, 33) mg/L vs 3(1, 14) mg/L, Z=-4.49, P<0.01), erythrocyte sedimentation rate (ESR) [(45±33) mm/1 h vs (25±23) mm/1 h, t=-5.82, P<0.01), in the active group were significantly higher than those in the inactive group, while the ESR in female patients was only higher than that in males, but without statistical significant difference. SAA in the young age group, ESR in the newly diagnosed group was significantly higher than that in the other subgroups [19(6, 95) mg/L vs 10(4, 39) mg/L, Z=2.06, P<0.05] [(44±34) mm/1 h vs (32±28) mm/1 h, t=3.77, P<0.01]. Conclusion:The TA patients are mainly young women, and are in active disease when first being diagnosed. The type Ⅴ and Ⅰ are the most common artery involve-ment pattern. Hypertension and tuberculosis are the most frequent complications.
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Objective:To speculate the effect of birth spacing on the pelvic floor type Ⅰ and Ⅱ fiber muscle strength of postpartum women with parities of two in different delivery modes.Methods:Totally 2 361 parturients who were investigated in Xuzhou Central Hospital from June 2016 to December 2020 were included in the questionnaire, clinical examination and pelvic floor surface electromyography assessment. According to the interval years between two parities and the pelvic floor typeⅠ and Ⅱ fiber muscle strength under different modes of delivery, curve fitting function equation was performed using curve regression method. The accuracy of the equation was verified by the receiver operating characteristic curve and the maximum area under the curve, and calculating the relative error rate.Results:A total of 2 357 parturients were included in the study and were divided into 4 groups based on delivery modes, women with both normal vaginal delivery were assigned to group A (589 cases); women with a first vaginal delivery and a second cesarean section were assigned to group B (480 cases); women with both cesarean deliveries were assigned to group C (1 273 cases); women with a first cesarean section and a second vaginal delivery were assigned to group D (15 cases). All of the curve fitting results were quadratic curves, and the appropriate interval years were selected when the muscle strength of type Ⅰ muscle fibers was>35 μV and that of type Ⅱ muscle fibers was>40 μV: 6-8 years in the group A, 5-10 years in the group B, and 1-11 years in the group C. The peak values of the quadratic curve were as follows: 7-8 years in the group A, 7-8 years in the group B, and 6 years in the group C. The maximum area under the curve of the function equations were all>0.6 (all P<0.05), the average relative error rate was 4.909%. Conclusions:The pelvic floor function of postpartum women with parities of two increases firstly and then decreases over time, showing a quadratic curve shape. In order to protect the pelvic floor function, the appropriate interval of birth spacing is 6-8 years.
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Objective:To investigate the effects of nutritional intake in the first two weeks of life on bronchopulmonary dysplasia (BPD) in preterm infants with gestational age (GA) ≤ 32 weeks.Methods:A retrospective case-control study was conducted 154 preterm infants with birth weight ≤ 1500 g and GA ≤ 32 weeks were enrolled from neonatal intensive care unit (NICU) of Affiliated Hospital of Qingdao University between January 1, 2016 and December 31, 2017. These infants were divided into BPD group or non-BPD group. All clinical and nutritional data were collected and analyzed to investigate the effects of early-life (within 2 weeks after birth) nutritional intake on BPD.Results:Among a total of 154 eligible neonates, 68 were without BPD and 86 with BPD (55.8%). Mild, moderate and severe BPD accounted for 39.5% (34/86), 58.1%(50/86)and 2.4%(2/86)of all BPD cases respectively. GA and birth-weight of BPD group were significantly lower than that of non-BPD group [(28.35 ± 1.55)weeks vs. (30.12 ± 1.23)weeks; (1050.91 ± 190.6)g vs. (1205.88 ± 195.83)g, both P = 0.000]. The duration of mechanical ventilation in BPD group was longer than that in non-BPD group [(2.65 ± 1.08)days vs. (0.47 ± 0.12)days, P < 0.05]. The incidences of complications in BPD group, including neonatal asphyxia, sepsis and patent ductus arteriosus, were all higher than those in non-BPD group( P < 0.05). The fluids and caloric intake, enteral fluids and caloric intake were significantly lower in BPD group on Day 7 and 14 of life ( P < 0.05). The macronutrient intake in BPD group was also consistently lower, reaching statistical significance for carbohydrate intake on Day 7 and 14 of life, and for protein and lipid intake on Day 14 of life ( P < 0.05). Multivariate logistic regression analysis showed that mechanical ventilation ( OR = 2.257, 95% CI: 1.143~4.456, P = 0.019) and GA ( OR = 0.325, 95% CI: 0.215~0.49, P = 0.000) were high-risk factors for BPD. The decreased odds of developing BPD were associated with higher levels of enteral calories on Day 14 of life ( OR = 0.96, 95% CI: 0.94~0.98, P = 0.000), fluids on Day 7 of life ( OR = 0.927, 95% CI: 0.876~0.981, P = 0.009) and protein intake on Day 14 of life ( OR = 0.044, 95% CI: 0.011~0.177, P = 0.000). Conclusions:GA and mechanical ventilation were independent high-risk factors for BPD. Higher intake of protein and enteral calories were protective factors. Proactive early enteral nutrition support, adequate protein intake and decreasing the duration of mechanical ventilation may reduce the risk of BPD.
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Objective:Metabolic syndrome (MS) patients and determine factors related to platelet hyperactivation.Methods:A total of 999 participants (822 males and 177 females) were enrolled. Participants were divided into two groups according to the metabolic index: MS group (501) and normal control (NC) group (498). Platelet function was tested with PFA100 (Siemens USA, Deerfield, Illinois) which measures the time it takes for blood to occlude an aperture (closure time, CT) following stimulation with collagen and adenosine diphosphate. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA).Results:MS group had significantly shorter CT values compared with NC group (106.6±27.8s) vs (113.7±27.9s). Higher BMI, WC, BP, TC, TG, LDL-C, UA, and PRL were correlated with shorter CT values (all P<0.05). Conclusion:Our results indicated platelet hyperactivation exists in MS which was related to obesity and elevated blood pressure, blood lipids, uric acid, and PLR.
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Objective:To explore the structure of maternal verbal scaffolding features and develop a questionnaire on Mother's language scaffolding characteristics, so as to provide a quantitative, convenient and economical self-assessment tool for describing maternal verbal scaffolding features.Methods:On the basis of qualitative research and literature research, a questionnaire survey was conducted among 704 mothers of preschool children. After item analysis and exploratory factor analysis, a formal questionnaire was formed. Two weeks later, 106 mothers were retested to collect test-retest reliability data. Preschool children's expressive vocabulary checklist was used as external criterion.Data were analyzed by SPSS 18.0 and Amos 21.0.Results:(1)The formal questionnaire includes 28 items with two factors-detailed support factor and control rejection factor, the internal consistency coefficients of the two factors were 0.849 and 0.811, the project load was from 0 .482 to 0 .701, and the variance contribution rate was 40.36%.(2) AMOS 21.0 was used for confirmatory factor analysis, indicating that the two-factor structure met the requirements of psychometrics.( χ 2/ df=1.96, RMSEA=0.05, NFI=0.86, CFI=0.90, IFI=0.89). (3)The results of two-factor text-retest reliability were 0.840 and 0.871 as well as the results of split-half reliability was 0.801.The internal consistency reliability was 0.740.The external validity analysis showed that the mother's education level was positively correlated with factor Ⅰ( r=0.288, P=0.000), but not with factor Ⅱ( r=-0.091, P=0.052). There was significant difference in factorⅠbetween mothers with expressive vocabulary development delay children (52.22±10.56) and non delayed children (57.71±7.51) ( t=-5.07, P=0.000). There also was a significant difference in factor Ⅱ between mothers with expressive vocabulary development delay children (37.12±10.09) and non delayed children (31.53±8.59) ( t=4.61, P=0.000). (4)There was no significant difference in the characteristics of language scaffolding between boys(factorⅠ(58.08±8.14), factorⅡ(32.86±9.51)) and girls' mothers(factorⅠ(56.93±8.20), factorⅡ(31.42±8.48)). Analysis of the sample groups showed that age did not affect the verbal scaffolding features of preschool children's mothers( F1=1.633, P1=0.181; F2=0.758, P2=0.518). Conclusion:There are two factors in the questionnaire of the verbal scaffolding features questionnaire, which meet the criteria of psychometrics.The questionnaire of the verbal scaffolding features questionnaire is suitable for evaluating the characteristics of language scaffolding of mothers of preschool children aged 3-6.
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Objective:To construct clinical nursing procedure of pulmonary rehabilitation for thoracoscopic surgery of lung cancer, and to test its application effect.Methods:The control group ( n=41) received routine nursing care from December 2018 to May 2019; the intervention group ( n=41) received clinical nursing pathway of pulmonary rehabilitation from June to October, 2019. The 6MWT, Brog score and incidence of pulmonary complications and quality of life were compared between the two groups. Results:The results showed that 6-minute walk test (6 MWT) was (471.22±54.89) m, (325.38±17.65) m, and (407.27±13.84) m before surgery, at discharge time and 30 d after discharge, in the intervention respectively, which were longer than those of the control group [(440.95±70.51) m, (306.69±21.49) m, and (355.94±26.10) m] ( t values were -2.169, -4.304, -11.128, P<0.05). The total incidence of postoperative pulmonary complications was 4.9% (2/41) in the intervention, which was less than 19.5%(8/41) in the control group ( χ2 value was 0.088, P<0.05). The values of physical function and cognitive function 30 d after surgery was 80(73, 87), 83(83, 83) in the intervention, respectively, higher than those of the control group [73 (33,80), 83 (67,100)] ( Z values were 2.862, 2.448, P<0.05). The fatigue, pain, dyspnea, insomnia and loss of appetite scores was significantly lower (P<0.05). Conclusion:Clinical nursing procedure of pulmonary rehabilitation for patients undergoing thoracoscopic surgery of lung cancer can promote and conducive the cardiopulmonary endurance, reduce the risk of postoperative pulmonary complications, increase the level of physical and cognitive function, improve postoperative symptoms and the quality of life.
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Objective:To analyze the expressions of coordinated stimulating molecular programmed death 1(PD-1) and programmed death ligand 1 (PD-L1) in human glioma and their clinical significances.Methods:A total of 70 postoperative paraffin specimens of brain glioma and 35 normal brain tissues in Heji Hospital Affiliated to Changzhi Medical College from January 2013 to December 2017 were collected. The expressions of PD-1 and PD-L1 in 70 glioma tissues and 35 normal brain tissues were detected by immunohistochemical SP method. The relationship between the expressions of PD-1 and PD-L1 and their correlation with the clinicopathological features were analyzed.Results:The positive expression rates of PD-1 and PD-L1 in glioma tissues were 69% (48/70) and 62% (43/70), respectively, which were higher than those in normal brain tissues [29% (10/35), 31% (11/35)], the differences were statistically significant (χ 2 values were 15.099 and 8.407, both P < 0.05). The positive expression rates of PD-1 and PD-L 1 in high-grade glioma were 81% (30/37) and 73% (27/37), respectively, which were higher than those in low-grade glioma [55% (18/33) and 49% (16/33)], the differences were statistically significant (χ 2 values were 5.699 and 4.415, both P < 0.05). There was no significant difference in the positive expression rates of PD-1 and PD-L1 among patients with different sex, age and maximum tumor diameter (all P > 0.05). There was a positive correlation between the expressions of PD-1 and PD-L1 proteins in glioma tissues ( r= 0.372, P= 0.002). Conclusions:The PD-1 and PD-L1 may become new biological indicators for evaluating the occurrence and development of glioma.
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Primary bile acids were reported to augment secretion of chemokine (C‒X‒C motif) ligand 16 (CXCL16) from liver sinusoidal endothelial cells (LSECs) and trigger natural killer T (NKT) cell-based immunotherapy for liver cancer. However, abundant expression of receptors for primary bile acids across the gastrointestinal tract overwhelms the possibility of using agonists against these receptors for liver cancer control. Taking advantage of the intrinsic property of LSECs in capturing circulating nanoparticles in the circulation, we proposed a strategy using nanoemulsion-loaded obeticholic acid (OCA), a clinically approved selective farnesoid X receptor (FXR) agonist, for precisely manipulating LSECs for triggering NKT cell-mediated liver cancer immunotherapy. The OCA-nanoemulsion (OCA-NE) was prepared
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Objective:To examine the multiple mediating effects of cognitive fusion and network communication in the relationship between interpersonal relationship and mobile phone addiction tendency in college students.Methods:Questionnaire survey was conducted among 708 college students in a medical school using the mobile addiction tendency scale, E-communication inventory, Interpersonal relationship assessment scale and cognitive fusion questionnaire.SPSS 17.0 software was used for descriptive statistics and correlation analysis.Structural equation model was built with AMOS 21.0.The non parametric percentile bootstrap method with variance correction was used to test the significance of mediating effect.Results:(1) The sample mobile phone dependence detection rate was 13.56%.(2)There were statistical differences in conversation scores((3.49±1.85), (2.51±1.64)), making friends ((4.53±1.83), (3.21±1.72)), getting along with opposite gender((2.70±1.55), (2.01±1.60)), dealing with people disturbance(2.02(1.00, 3.00), 1.46(0.00, 2.00))between different mobile phone addiction tendency( t/ Z=2.752-5.072, P<0.05). There were statistical differences in cognitive fusion ((40.60±7.55), (33.91±7.95)) between different mobile phone addiction tendency( t/ Z=5.385, P<0.05). There were statistical differences in negative results of network communication((28.60±6.77), (23.31±7.03)), social perception of network communication((32.36±6.68), (29.17±7.82)), self exposure and emotional experience of network((23.36±6.61), (18.18±6.30)), cognition of network communication((28.19±6.85), (22.75±6.76)), entertainment of network ((6.74±1.81), (6.00±1.67)) between different mobile phone addiction tendency( t/ Z=2.647~5.195, P<0.05). (3) There was a statistically significant positive correlation between interpersonal relationship, mobile phone addiction tendency, cognitive fusion, and E-communication inventory scores ( r=0.226-0.423, P<0.01). (4) Multi-mediating model analysis showed that interpersonal relationship could affect mobile phone addiction tendency through cognitive fusion and network communication not only in a parallel way but also in a chain way.The direct effect from interpersonal relationship to mobile phone addiction tendency was 0.20, and the total indirect effect from interpersonal disturbance to mobile phone addiction tendency through cognitive fusion and network communication was 0.18.And the effects of cognitive fusion, network communication, and the chain mediating accounted for 50.0%, 33.3%, and 16.7% of the total indirect effect respectively.The 95% CI of the Bootstrap output were (0.04-0.19), (0.02-0.14)and(0.01-0.05). Conclusions:College students' interpersonal disturbances affect mobile phone addiction tendency through multiple mediations of cognitive fusion and online communication.