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Abstract@#The concepts and theoretical mechanisms of interpersonal psychotherapy are discussed in detail. The review focuses on the effectiveness of interpersonal psychotherapy on depression among adolescents and the expansion of its applications. The feasibility of localized adapted interpersonal psychotherapy interventions in adolescent depression groups is proposed, to provide a reference for the applied practice of interpersonal psychotherapy.
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Purpose@#The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. @*Methods@#Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. @*Results@#Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. @*Conclusion@#This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.
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ObjectiveTo explore the related factors of troublemaking behaviors among patients with mental disorders induced by amphetamine-type stimulants （ATS）， and to provide references for the formulation of relevant intervention measures for ATS-induced mental disorders. MethodsA total of 105 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for ATS-induced mental disorders were included， and classified into troublemaking group and non-troublemaking group. The general demographic data and clinical data of the selected individuals were collected， and all patients were assessed using Social Support Rating Scale （SSRS）. Then univariate analysis and multivariate Logistic regression model were used to screen the related factors of troublemaking behaviors. ResultsThe scores of SSRS， objective support dimension and social support utilization dimension were significantly lower in troublemaking group than those in non-troublemaking group， with statistical differences ［（24.10±6.59） vs. （28.94±5.59）， t=3.364， P=0.001； （5.50±1.96） vs. （8.20±2.13）， t=5.183， P<0.01； （4.60±2.26） vs. （6.28±1.90）， t=3.435， P=0.001］. Multivariate Logistic regression analysis showed that male （OR=6.061， P=0.014） was a risk factor， while high social support level （OR=0.873， P=0.018） was the protective factor for troublemaking behaviors among patients with ATS-induced mental disorders. ConclusionPatients with ATS-induced mental disorders of the males and with low social support level are at high risk of troublemaking behaviors.
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Purpose@#The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. @*Methods@#Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. @*Results@#Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. @*Conclusion@#This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.
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The randomized controlled trials( RCTs) about modified Sanzi Yangqin Decoction in the treatment of patients with exacerbation of chronic obstructive pulmonary disease( AECOPD) were collected from 7 databases( PubMed,CNKI,etc.) till December25,2018 from their inception. All the studies searched were strictly evaluated and independently screened by two researchers according to the inclusion and exclusion criteria,and the methodological quality of included studies was evaluated. In order to systematically review the efficacy and safety of modified Sanzi Yangqin Decoction for treating AECOPD,the Meta-analysis and trial sequential analysis were conducted by using Stata/SE 14. 0 and TSA 0. 9. 5. 10 Beta,respectively. A total of 22 RCTs involving 2 012 patients were included. The results of Meta-analysis suggested that: as compared with the control group,the clinical symptoms in AECOPD patients were improved( RR = 1. 19,95%CI[1. 15,1. 24],P = 0); the pulmonary functions including forced expiratory volume in one second( FEV_1)( SMD= 0. 96,95%CI[0. 39,1. 52],P= 0. 001),the percentage of forced expiratory volume in one second( FEV_1%)( SMD =0. 80,95%CI[0. 20,1. 41],P = 0. 009),forced vital capacity( FVC)( SMD = 0. 69,95% CI[0. 06,1. 31],P = 0. 032),first seconds breathing volume percentage of forced vital capacity( FEV_1/FVC) were improved( SMD = 0. 81,95%CI[0. 64,0. 97],P = 0);the arterial oxygen partial pressure( PaO_2) was improved( SMD= 0. 87,95%CI[0. 41,1. 32],P= 0); the arterial partial pressure of carbon dioxide( PaCO_2) was decreased( SMD =-0. 91,95%CI[-1. 33,-0. 49],P = 0) in the trial group. In addition,the incidence of adverse reactions in the experimental group was low,and there were no serious adverse events. The trial sequential analysis( TSA) showed that the studies included in the improvement of clinical efficacy had passed the conventional and TSA threshold at the same time,further confirming the efficacy of trial group. This research showed that,conventional Western medicine treatment,combined with modified Sanzi Yangqin Decoction in treating acute exacerbation patients with chronic obstructive pulmonary disease could improve the clinical efficiency and pulmonary functions,improve the PaO_2,decrease the PaCO_2,with a high safety. However,the quality of existing research is low,requiring more high quality clinical trials for further validation.
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Humans , Drugs, Chinese Herbal , Therapeutic Uses , Forced Expiratory Volume , Lung , Pulmonary Disease, Chronic Obstructive , Drug Therapy , Randomized Controlled Trials as TopicABSTRACT
The study aims to explore the effects of N-p-chlorobenzenesulfonyl-4-amino salicylic acid on the dextran sodium sulfate (DSS)-induced ulcerative colitis in mouse. A total of 60 BALB/c mice were randomly divided into 6 groups (n=10):control group, DSS model group, 5-amino salicylic acid (5-ASA) group, and administration groups (N-p-chlorobenzenesulfonyl-4-aminosalicylic acid) 10, 20, 40 mg·kg-1. Model group were induced by drinking 4% (w/v) DSS solution for 7 days and normal water for the next 3 days. The positive group and drug group mouse were given 5-ASA (40 mg·kg-1) and N-p-chlorobenzene sulfonyl-4-amino salicylic acid (10, 20, 40 mg·kg-1) by gavage respectively. During the experiment, changes in body weight, bloody stool, fecal character and mental status were observed daily. Damage and repair of the colon mucosa and the pathological changes of important organs were observed by hematoxylin and eosin (HE) staining. Expression of inflammatory factors such as tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6), macrophage inflammatory protein 2 (MIP-2), myeloperoxidase (MPO) in serum were detected by ELISA. The results showed that bloody stools and diarrhea emerged on the 4th day after model establishment in model mice. The number of bloody mice rose to ten, and blood and diarrhea began to appear in the administration group on the 7th day. Mental status was poor and body weight decreased significantly in model group since the 4th day, and the situation was improved in the administration group and 5-ASA group. Colons in the administration groups (10, 20, 40 mg·kg-1) were longer than those in the DSS model group. In the DSS model group, the colonic mucosa and submucosa of mice exhibited severe inflammatory cell infiltration, various degrees of necrosis, proliferation. In the middle dose group (20 mg·kg-1), the situation has improved slightly and the colonic mucosa showed mildly chronic inflammation and a small amount of inflammatory cells infiltration. The high dose group (40 mg·kg-1) showed normal colon mucosal, relatively complete epithelial structure and few inflammatory cell infiltration. The levels of IL-1β, IL-6, TNF-α, MIP-2 and MPO in the serum of mice were lower in the administration group (40 mg·kg-1) than in model group. Therefore, N-p-chlorobenzenesulfonyl-4-amino salicylic acid might be a feasible treatment for DSS-induced UC.
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Objective To investigate the serum levels of miR-661 in type 2 diabetes(T2DM)patients and type 2 diabetes with microvascular complications(T2DMC),and to further evaluate its clinical auxiliary diagnosis significance.Methods The serum levels of miR-661 were examined in 60 T2DM patients,60 T2DMC patients and 60 healthy controls using quantitative real-time PCR (qRTPCR).The sera levels of biochemical parameters including fasting plasma glucose (FPG),cholesterol (TC),triglycerides (TG),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C) and haemoglobinA1C (HbA1 c) were determined by biochemical analyzer.The ROC curve analysis,correlation analyses and logistic regression analyses were performed to evaluate the clinical auxiliary diagnosis value of serum miR-661,respectively.Results The qRT-PCR results showed that the concentrations of miR-661 was 118 (63.6,192.4) fmol/L in healthy controls,which were significant lower than those of T2DM patients [230.1 (83.6,426.2) fmol/L,(U =1 207,P ＜ 0.01)] and T2DMC patients [441.3 (212.9,1 021) fmol/L,(U =435,P ＜ 0.01)].ROC curve (AUCROc) of miR-661 was 0.665(95％CI:0.585 ～0.765,P ＜0.01)for T2DM patients and 0.879(95％CI:0.821 ～ 0.938,P＜0.01)for T2DMC patients.The AUCROc between T2DM and T2DMC patients was 0.694 (95 ％ CI:0.600 ～ 0.788,P ＜ 0.01).The correlation analyses revealed that the levels of miR-661 was positively correlated with concentrations of FPG(r =0.291,P ＜ 0.05)and LDL-C(r =0.149,P ＜ 0.05),and negatively correlated with concentrations of HDL-C (r =-0.243,P ＜ 0.01).Logistic regression analysis revealed that serum miR-661 was an independent risk factor in T2DM and T2DMC(P ＜ 0.01).Conclusion Serum miR-661 was potential biomarker and risk factor for T2DM and T2DMC.
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AIM@#To observe the effect of modified Si-Miao-San (mSMS) on advanced glycation end products (AGEs)-induced pancreatic B cell dysfunction, as well as examining the underlying mechanisms.@*METHOD@#Pancreatic B cells (INS-1) were stimulated with advanced glycation end products (AGEs, 200 μg·mL(-1)) for 24 h to produce dysfunction in pancreatic B cells and the effects of mSMS observed on insulin secretion, NF-κB (p65) phosphorylation, reactive oxygen species (ROS) production, mitochondria membrane potential (Δψm), cell apoptosis, phosphorylation of AMP-kinase (AMPK), and caspase 3 activity.@*RESULTS@#The AGEs challenge resulted in increased basal insulin secretion, but decreased insulin secretion in response to high glucose, whereas this situation was reversed by mSMS treatment. AGEs stimulation induced NF-κB (p65) phosphorylation and reactive oxygen species (ROS) production, as well as Δψm collapse and cell apoptosis. mSMS inhibited ROS production and inhibited NF-κB activation by attenuating p65 phosphorylation. Meanwhile, AGEs-induced Δψm collapse and cell apoptosis were also reversed by mSMS treatment. Compound C, an inhibitor of AMP-Kinase (AMPK), abolished the beneficial effects of mSMS on the regulation of B cell function, indicating the involvement of AMPK.@*CONCLUSION@#mSMS ameliorated AGEs-induced B cell dysfunction by suppressing ROS-associated inflammation, and this action was related to its beneficial regulation of AMPK activity.
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Animals , Humans , Rats , AMP-Activated Protein Kinases , Genetics , Metabolism , Apoptosis , Cell Line, Tumor , Drugs, Chinese Herbal , Pharmacology , Glucose , Metabolism , Glycation End Products, Advanced , Metabolism , Inflammation , Drug Therapy , Genetics , Metabolism , Insulin-Secreting Cells , Cell Biology , Metabolism , Phosphorylation , Reactive Oxygen Species , MetabolismABSTRACT
PURPOSE: To describe the therapeutic effect and possibility of the ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage (Hunt-Hess grades IV - V). MATERIALS AND METHODS: Nine cases with intracranial aneurysms, demonstrated by computed tomographic angiography (CTA), were treated by ultra-early surgery under general anesthesia within 24 hours from subarachnoid hemorrhage (SAH), 5 cases were treated within 6 hours and 4 cases in 6 - 24 hours. Preoperative Hunt-Hess grade: 6 cases were IV and 3 cases were V. The clinical outcome was evaluated by Glasgow Outcome Scores (GOS). RESULTS: In operation, difficult dissection occurred in 5 cases (55.6%), and rupture of aneurysm occurred and temporary obstructions were performed in 4 cases (44.4%). After clipping of aneurysm, 2 cases underwent V-P shunt because of hydrocephalus, pulmonary infection occurred in 3 cases, hypothalamus reaction accompanied with upper gastrointestinal hemorrhage in 2 cases. The clinical outcome were favorable (GOS 4 - 5) in 4 cases (44.4%), dissatisfied (GOS 2 - 3) in 3 cases (33.3%), and dead (GOS 1) in 2 cases (22.2%) when patients departed from our hospital. CONCLUSION: The ultra-early surgery can avoid early rebleeding of intracranial aneurysm, therefore, should be considered in the treatment of Hunt-Hess grade IV-V intracranial aneurysms. The appliance of CTA can make it possible to use of ultra-early surgery and improve the therapeutic effect.
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Adult , Aged , Female , Humans , Male , Middle Aged , Cerebral Angiography , Intracranial Aneurysm/pathology , Subarachnoid Hemorrhage/pathologyABSTRACT
Growing evidence indicates that hyperhomocysteinemia is not only a high risk factor for cerebrovascular diseases,but also closely correlated with neurodegenerative diseases and mental diseases,such as Alzheimer's disease,Parkinson's disease,dementia,cognitive impair- ment,depression and schizophrenia,The mechanisms of homocysteine neurotoxicity remains unclear,and it may include activating extracellular signal-regulated kinases,excessively activating glutamate receptors,participating in oxidative stress response,affecting methylation process and damaging DNA.
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OBJECTIVE To approach whole environment dynamic monitoring of the cross infection in operation department.METHODS To learn the experience of planning,construction and infection′s monitoring and managing of domestic and abroad operation departments,in combination with own work practice of reforming and infection management.RESULTS There were straight relations between planning,plane disposition,flow-sheet,construction quality,managing way and cross infection.CONCLUSIONS The whole environment dynamic monitoring of cross infection in operation department is very important.Of the total,the monitoring of planning design,the efficiency,rationality and safety of disposition,and flow-sheet of operation department at the beginning stage of construction is the premise of preventing and controlling cross infection there.The monitoring of construction quality at intermediate stage is the foundation of monitoring cross infection.The dynamic monitoring of alive human flow(patients,staff),logistic flow(articles during pre-operation,in-operation,and post-operation) and air current at later stage is the key point of preventing and controlling cross infection.