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Remarkable improvement relative to traditional approaches in the treatment of hematological malignancies by chimeric antigen receptor (CAR) T-cell therapy has promoted sequential approvals of eight commercial CAR T products within last 5 years. Although CAR T cells' productization is now rapidly boosting their extensive clinical application in real-world patients, the limitation of their clinical efficacy and related toxicities inspire further optimization of CAR structure and substantial development of innovative trials in various scenarios. Herein, we first summarized the current status and major progress in CAR T therapy for hematological malignancies, then described crucial factors which possibly compromise the clinical efficacies of CAR T cells, such as CAR T cell exhaustion and loss of antigen, and finally, we discussed the potential optimization strategies to tackle the challenges in the field of CAR T therapy.
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Humans , Receptors, Chimeric Antigen/therapeutic use , Immunotherapy, Adoptive , Hematologic Neoplasms/therapy , Treatment OutcomeABSTRACT
Objective:To investigate the clinical, imaging, etiological and prognostic features of patients with infarctions in different locations of the medulla oblongata.Methods:Patients with acute medullary infarction hospitalized at Tianjin Huanhu Hospital from July 2017 to July 2022 were included. The risk factors, clinical manifestation, stroke mechanism and 90-day prognosis of these patients were analyzed retrospectively.Results:Among the 256 patients enrolled, 150 (58.6%) had lateral medullary infarction (LMI), 106 (41.4%) had medial medullary infarction (MMI). The most frequent clinical manifestation of patients with LMI was dizziness (84.7%,127/150). And motor disorders (83.0%,88/106) was the most frequent clinical manifestation of patients with MMI. LMI lesions were mostly located in the middle (42.7%,64/150) and MMI lesions were mostly located in the upper (60.4%,64/106) medulla oblongata, with statistically significant difference (χ 2=47.53, P<0.001). Large artery atherosclerosis (LAA) was the main stroke mechanism in LMI and MMI [57.3%(86/150) vs 56.6%(60/106)]. Early neurological deterioration was more common in MMI (25.5%,27/106) and less common in LMI (7.3%,11/150), with statistically significant difference (χ 2=16.17, P<0.001). At discharge, more patients with MMI showed poor prognosis in short term [45.3% (48/106) vs 24.0% (36/150), with statistically significant difference (χ 2=12.76, P<0.001)] and even long term at 90-day follow-up [33.0% (35/106) vs 12.7% (19/150), also with statistically significant difference (χ 2=15.48, P<0.001)] than those with LMI. A total of 10 patients (4.0%, 10/256) developed respiratory failure during hospitalization, including 7 patients with LMI (4.7%, 7/150) and 3 patients with bilateral MMI (2.8%,3/106). Early neurological deterioration ( OR=3.38, 95% CI 1.25-9.10, P=0.016) and LAA (compared with small artery occlusion) ( OR=3.08, 95% CI 1.13-8.37, P=0.028) were independent risk factors for poor prognosis in MMI. Age ( OR=1.01, 95% CI 1.01-1.17, P=0.026) and early neurological deterioration ( OR=20.19, 95% CI=2.63-155.06, P=0.004) were independently correlated with poor outcome in LMI. Conclusions:LMI and MMI had similar etiology and significant differences in clinical manifestations, early neurological deterioration and prognosis. Further classification of medullary infarction was of great significance for diagnosis, treatment and prognosis evaluation.
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Background Female office workers are prone to fatigue due to work and life stress. The natural environment has a positive effect on health, but little research has focused on the effects of forest therapy on physical and mental health of female office workers. Objective To explore the effect of forest therapy on the mental health of fatigued female office workers. Methods In this study, two environments, urban and forest, were selected. A total of 12 subjects with fatigue were recruited and randomly divided into two groups, urban and forest, six subjects in each group, with mean ages of 24.7 and 28.4 years, respectively, all of whom were company employees. The Brief Mood Scale, the Chinese version of Stress Self-Rating Scale, and the Fatigue Self-Rating Scale were distributed to assess baseline psychological indexes of mood, fatigue, and stress status. Higher scores indicate higher levels of negative mood, fatigue, and stress, respectively. The forest group participated in an on-site experiment using forest therapy (forest walks and sits in a forest environment), and the urban group followed the same schedule as the forest group conducting walks and sits in an urban environment. Salivary cortisol was used as the physiological index. Baseline physiological indices were collected on the first day of the experiment, and the on-site forest therapy experiment and collecting physiological and psychological indices were conducted on the second day; physiological indices were collected in the morning before the walk and physiological and psychological indices were collected after the walk, physiological indices were collected in the afternoon before and during the sitting, and psychological indices were collected after the sitting. Subjects' mood and fatigue status were followed up one week after the activity. Mann-Whitney U test and Wilcoxon signed rank test were used to assess the changes of the indicators. Results As to the physiological indicator, the salivary cortisol concentrations before and after the morning walk in the forest group were lower than the corresponding baseline values (both P=0.043); and the decreases were 2.21 and 1.86 nmol·L−1 respectively. Differences between groups showed a trend towards a greater decrease in salivary cortisol concentrations in the forest group than in the urban group after walking and at the 15 th min of sitting (both P=0.068). Among the mood indicators, the forest group showed a greater decrease than the urban group in fatigue dimension after walking (P=0.065) and after sitting (P=0.024); the forest group showed a greater decrease than the urban group in vitality dimension after walking (P=0.054) and after sitting (P=0.045); and the forest group showed a greater decrease than the urban group in "total mood disorder" after sitting (P=0.054). Among the fatigue indicators, the forest group showed a greater decrease in "physical fatigue", "mental fatigue", "consequences of fatigue", and "general fatigue" after walking and sitting than the urban group (all P<0.05). Among the stress indicators, there were not statistically significance of "tension", "loss of control", and "total stress score" between the two groups after sitting (both P>0.05). After one week after the activity, there were not statistically significant differences of mood and fatigue between the two groups (both P>0.05). Conclusion Forest therapy has a regulating effect on symptoms of negative mood, and fatigue in fatigued female office workers, but the effects of a short-term forest therapy last for a limited duration.
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Objective:To explore the significance of 99Tc m-sulfur colloid lymphoscintigraphy in the diagnosis of lower limb lymphedema after gynecological tumor surgery. Methods:The clinical data of patients with lower limb lymphedema after gynecological tumor surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2015 to October 2019 were retrospectively analyzed. 99Tc m-sulfur colloid lymphoscintigraphy was performed in all patients. The results of lymphatic vessel imaging, lymph node imaging and their combination in the diagnosis of lower limb lymphedema were analyzed. The diagnostic efficacy of lymphatic vessel imaging alone, lymph node imaging alone and their combination was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC), and the Youden index, sensitivity and specificity were calculated. Results:Among the 100 lower limbs of 50 patients, 56 limbs had lymphedema and 44 limbs had no obvious edema. When diagnosis was based on abnormal lymphatic vessel imaging alone, among 56 lower limbs with lymphedema, lower limbs lymphatic vessel imaging was positive in 38 (67.9%) and negative in 18 (32.1%); among 44 lower limbs without obvious edema, lower limbs lymphatic vessel imaging was positive in 6 (13.6%) and negative in 38 (86.4%); the sensitivity was 67.9%, the specificity was 86.4%, and the Youden index was 0.543. When diagnosis was based on abnormal lymph node imaging alone, among 56 lower limbs with lymphedema, lower limbs lymph node imaging was positive in 42 (75.0%) and negative in 14 (25.0%); among 44 lower limbs without obvious edema, lower limbs lymph node imaging was positive in 13 (29.5%) and negative in 31 (70.5%); the sensitivity was 75.0%, the specificity was 70.5%, and the Youden index was 0.455. When diagnosis was based on the combination of lymphatic vessel imaging and lymph node imaging, among 56 lower limbs with lymphedema, lymphatic vessel imaging and lymph node imaging were positive in 48 (85.7%) and negative in 8 (14.3%); among 44 lower limbs without obvious edema, lymphatic vessel imaging and lymph node imaging were positive in 14 (31.8%) and negative in 30 (68.2%); the sensitivity was 85.7%, the specificity was 68.2%, and the Youden index was 0.539. The AUC for the combined diagnosis of lymphatic vessel imaging and lymph node imaging was 0.781, the AUC for the diagnosis of abnormal lymphatic vessel imaging was 0.771, and the AUC for the diagnosis of abnormal lymph node imaging was 0.739 (all P < 0.01). Conclusions:99Tc m-sulfur colloid lymphoscintigraphy is of great help in the diagnosis of lower limb lymphedema after operation of gynecological tumors. The combination of lymph node imaging and lymphatic vessel imaging is more effective in the diagnosis of lower limb lymphedema.
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Objective:To explore the clinical pathological characteristics and initial 131I curative responses of familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC). Methods:A total of 66 FDTC patients (19 males, 47 females, age (39.8±11.7) years) and 1 701 SDTC patients (442 males, 1 259 females, age (40.9±11.3) years) who underwent 131I therapy in Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2010 and August 2018 were retrospectively enrolled. The clinical pathological characteristics, preablative stimulated thyroglobulin (ps-Tg), preablative stimulated thyroglobulin antibody (ps-TgAb) and response to initial therapy (excellent response, indeterminate response, biochemical incomplete response, structural incomplete response) of two groups were analyzed and compared. The clinical pathological parameters included age, gender, pathological type, tumour maximum diameter, bilateral, multifoci, nodules goiter, thyroiditis, thyroid membrane invasion, lymph node metastasis (LNM), invasion of the surrounding soft tissues, distant metastasis, TNM staging and American Thyroid Association (ATA) risk stratification (low-risk, intermediate-risk, high-risk). χ2 test or Fisher exact test and independent-sample t test were used to compare the data between two groups. Results:Comparing with SDTC group, FDTC group showed higher proportion of bilateral foci (45.5%(30/66) vs 31.2%(530/1 701); χ2=5.999, P=0.010), thyroid membrane invasion (43.9%(29/66) vs 26.6%(452/1 701); χ2=9.672, P=0.002) and distant metastasis (15.2%(10/66) vs 6.2%(105/1 701); χ2=8.418, P=0.004). There was a statistical difference in risk stratification between two groups (high-risk: 18.2%(12/66) vs 9.2%(156/1 701); intermediate-risk: 68.2%(45/66) vs 72.7%(1 237/1 701); low-risk: 13.6%(9/66) vs 18.1%(308/1 701); χ2=6.898, P=0.030). But the tumor maximum diameter of FDTC group was smaller than that of SDTC group ((1.24±0.74) vs (1.50±0.92) cm; t=-2.275, P=0.020). There were no significant differences in other clinical pathological parameters between FDTC group and SDTC group ( t=-0.804, χ2 values: 0.101-5.359, all P>0.05). There were no significant differences between two groups in the postoperation ps-Tg, ps-TgAb levels and the response to initial therapy after 131I treatment ( χ2 values: 0.059-1.915, all P>0.05). Conclusions:The FDTC group displays distinct characteristics as increased aggressiveness at diagnosis. But after accurately treatment, there is no significant difference in the response to therapy between two groups.
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Objective@#To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy.@*Methods@#Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis.@*Results@#Exploratory factor analysis identified four principal factors which explained 52.584%, and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926.@*Conclusion@#The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
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Objective To development a comfort scale for the patients after enterostomy,test its reliability and validity and to provide a tool for nursing staff to measure the comfort level of patients with enterostomy. Methods Pre-test scales were formed based on literature research methods, group meetings and expert consultation. A total of 310 patients after enterostomy were investigated in a top three hospital in Tianjin Union Medical Center, and the scale was tested by project analysis, validity analysis and reliability analysis. Results Exploratory factor analysis identified four principal factors which explained 52.584% , and the scale determined 4 dimensions, including 35 items. The Cronbach′s α coefficient of the scale was 0.937, the test-retest reliability was 0.846, and the half-fold reliability was 0.926. Conclusion The comfort scale for patients after enterostomy in this study has good reliability and validity. It can be used to evaluate the comfort of patients after enterostomy.
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Objective To explore the relationship and influencing factors between pre‐diabetes mellitus (pre‐DM) and hypertension, providing evidence for formulating strategies for cardiovascular disease prevention and control. Methods We conducted this study from June 2013 to September 2014. Using stratified multistage random sampling, participants were administered a questionnaire survey, their height, weight, waist circumference, hip circumference, other physical attributes, blood pressure and blood lipids were measured. They also underwent the 75‐g glucose tolerance test and other laboratory examinations. A logistic regression model was used to analyze the relationship between pre‐DM and hypertension and its influencing factors. Results A total of 4 002 participants completed the survey. Participants'mean age was 50.3 ± 11.8 years. Of the total participants, 1 962 (49.0%) were males, while 2 039 (51.0%) were females; 1 participant had missing gender data. Further, 2 188 participants had normal glucose metabolism, 1 066 had pre‐DM, and 748 had diabetes. The prevalence of hypertension in participants with normal glucose metabolism, impaired fasting glucose, impaired glucose tolerance, both impaired fasting glucose and impaired glucose tolerance, and DM was 28.3%, 46.5%, 46.3%, 62.0%, and 61.2%, respectively. The prevalence of hypertension varied among people with different glucose metabolism (χ2=306.672, P<0.001). The prevalence of hypertension in the pre‐DM population increased with the aggravation of abnormal glucose metabolism compared to the normal glucose metabolism population, with a linear trend (χ2=299.009, P<0.001). Among those with abnormal glucose metabolism, there were differences in age, cholesterol, triglycerides, low‐density lipoproteins, body mass index, and waist circumference compared to those without hypertension (P<0.05). The risk of hypertension in the pre‐diabetic population was 1.5 times higher than that in the normal glucose metabolism population (OR=2.510, 95% CI: 2.156-2.922, P<0.001). There was no difference in the correlation intensity between pre‐DM and hypertension when gender was taken into account. Age and lipid abnormalities slightly decreased the correlation intensity between abnormal glucose metabolism and hypertension. Considering body mass index and centripetal obesity, the correlation intensity between abnormal glucose metabolism and hypertension could be reduced by controlling these factors. Conclusion The prevalence of hypertension is high in people with pre‐DM. There is a correlation between pre‐DM and hypertension, even when considering factors such as age, dyslipidemia, body mass index, and centripetal obesity. Therefore, it is necessary to strengthen the management of blood pressure in the pre‐diabetic population; improve early intervention for risk factors such as dyslipidemia, body mass index, and centripetal obesity; and reduce the occurrence of hypertension.
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Objective@#To investigate the impact of blood pressure and age on arterial stiffness in general population.@*Methods@#Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups.@*Results@#(1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group.@*Conclusion@#SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.
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Objective To translate the English version of Type 2 Diabetes Stigma Assessment Scale(DSAS-2) into Chinese,and to test the reliability and validity of the Chinese version of DSAS-2. Methods The DSAS-2 was translated and adapted according to Chinese culture following the translation and back-retranslation procedure.The reliability and validity of the Chinese version of DSAS-2 was tested among 294 patients with type 2 diabetes. Results The Chinese version of DSAS-2 included three subscales: Treated Differently (6 items), Blame and Judgment (7 items), and Self-stigma (6 items) and contained a total of 19 items.The Cronbach α coefficient of the Chinese version of DSAS-2 was 0.879,the Cronbach α coefficient of three factors was 0.832,0.815 and 0.844,respectively;the test-retest reliability was 0.835. The content validity index was 0.916. The scores of DSAS-2 correlated with the scores of Rosenberg Self-esteem Scale, Patient Health Questionnaire 8- Item Scale and Generalized Anxiety Disorder 7-Item Scale (r =-0.452, 0.443, 0.412, P<0.01). Three factors were extracted by exploratory factor analysis and could explain 55.75% of the total variance. Conclusions The Chinese version of DSAS-2 has acceptable reliability and validity,which can be used to evaluate stigma among patients with type 2 diabetes in China.
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Objective To investigate the role of resilience on cognitive function in older adults.MethodsBy random sampling,a total of 321 older adults participated the present study and were investigated by Connor-Davidson Resilience Scale,Mini Mental State Examination and self-designed general questionnaire.ResultsThe score of resilience in older adults (82.75±15.13) was significantly higher than that of Chinese community people (65.40±13.90) (t=20.68,P<0.01).Older adults with poor resilience performed significantly lower on all dimensions of cognitive abilities than the other two groups (middle & higher resilience group) (all P<0.05).With both age and educational level controlled,tenacity and strength were of positive prediction for the cognitive abilities of older adults (β=0.25,0.17,P<0.05).ConclusionThere is a close relationship between resilience and cognitive function of older adults.The training of tenacity,strength and optimism will help delay the decline of cognitive function.
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Objective To translate the English version of the Nursing Profession Self-Efficacy Scale into Chinese,and to test the reliability and validity of the Chinese version. Methods The reliability and validity of the Chinese version of scale was tested among 480 nurses from Tianjin First Central Hospital. Results The revised Chinese version of the Nursing Professional Self-Efficacy Scale contained 19 entries, the Cronbach′s α coefficient was 0.95, the test-retest reliability was 0.91. Conclusions The revised Chinese version of the Nursing Profession Self-Efficacy Scale has acceptable reliability and validity. It can be used to measure the Nursing Profession Self-Efficacy among nurses in China.
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To explore the relationship between brachial ankle artery pulse wave velocity of the (baPWV) in different estimation GFR (eGFR) groups and atherosclerosis.In 2010,2012 and 2014,eGFR and baPWV were detected in 1 427 healthy persons.As eGFR level decreased,baPWV increased accordingly with higher proportion of baPWV ≥1 400 cm/s.The percentage of eGFR lower than 60 ml · min-1 · 1.73 m-2 was similar in subgroups with different baPWV.However,the proportion of eGFR reduction ≥ 30％ decreased according to the elevation of baPWV.Multivariate logistic regression analysis indicated the lower the eGFR,the higher the risk of atherosclerosis.Low eGFR is an independent risk factor for atherosclerosis.
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Objective To determine the impact of emotional intelligence, resilience and psychological empowerment of clinical nurses on self-directed learning competence. Methods Totally 270 clinical nurses from six tertiary first-class hospitals in Tianjin City were investigated with Nursing Staff Self-directed Learning Competence Scale, Emotional Intelligence Scale, the Conner-Davidson Resilience Scale and Psychological Empowerment Questionnaire, and then, the datum was analyzed by professional statistical software. Results The total score of self-directed learning competence was (124.96 ± 21.73) points, the total mean score was (3.68 ± 0.64) points, while the mean score of different dimension from high to low was self-motivational belief (3.78±0.67) points, self-monitoring and regulation (3.65 ± 0.69) points, task analysis (3.61 ± 0.76) points, self-evaluation (3.47 ± 0.72) points. The total mean score of emotional intelligence was (3.87±0.53) points, the total mean score of resilience was (2.74±0.54) points, the total mean score of psychological empowerment was (3.74±0.57) points. The total score and score of all dimensions of emotional intelligence, resilience as well as psychological empowerment were positively correlated to self-directed learning competence(r=0.269-0.650, P 0.05. Self-reliance, self-determination, emotional use, self-efficacy, perseverance were indicated as predictive factors of self-directed learning competence among clinical nurses, which explained 58.5 percent of the variance. Conclusions The self-directed learning competence of clinical nurses was at moderate level. The self-directed learning competence can be influenced by emotional intelligence, resilience and psychological empowerment. So we can enhance their self-directed learning competence by improving emotional intelligence,resilience and psychological empowerment.
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Objective To systematically evaluate the effects of prone position ventilation on newborn with respiratory distress syndrome.Methods We searched databases including PubMed,EMBASE,Cochrane Library,Web of Science,CBM,CNKI,Wanfang and VIP.We included all randomized controlled trials and randomized crossover trials of neonatal respiratory distress syndrome.Studies were selected according to inclusion and exclusion criteria,extracting data and assessing quality.Then RevMan 5.3 software was used to analyze the data.Results Ten studies included seven randomized controlled trials and three randomized crossover trials,and 500 patients were included.The results of meta-analysis showed that in prone position ventilation group SaO2[MD=2.41,95％CI(0.87,3.95),P=0.002],PaO2[MD=5.20,95％CI(3.04,7.36),P＜0.001],Pa2//FiO2[MD=24.40,95％CI(8.35,40.44),P=0.003],the risk of pneumothorax [RR =0.10,95％ CI (0.01,0.76),P=0.03] and intracranial hemorrhage [RR =0.41,95％ CI (0.20,0.83),P=0.01]and duration of mechanical ventilation [MD=-23.22,95％CI(-38.30,-8.14),P=0.003] compared with supine positiongroup had significantly statistical difference;however there was no significant difference in ventilator-associated pneumonia[RR=0.72,95％CI(0.48,1.09),P=0.12] between two groups.Conclusion Prone position ventilation is effective to improve SaO2,PaO2 and PaO2/FiO2,shorten duration of mechanical ventilation and reduce the risk of pneumothorax and intracranial hemorrhage in newborn with respiratory distress syndrome.While it could not effectively reduce incidence of ventilator-associated pneumonia.Due to the limitations of the quality of studies included,multi-centered randomized controlled trials with large sample size are needed in the future to evaluate the effects of prone position ventilation on neonatal respiratory distress syndrome.
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Objective To explore the mediating effect of self-efficacy in family environment and mental health.Methods Using family environment scale (FES),general self-efficacy scale (GSES)and mental health scale (MHT)to investigate 360 junior high school students in a middle school by cluster random sampling.Results (1)There was a negative correlation between the family environment intimacy(6.60 ±2.12) and total score of knowledge (3.98±l.85)and mental health(44.56±12.93)(r=-0.170,P＜0.01;r =-0.116,P＜0.05),and a positively correlation on contradictions between the family environment(3.55±2.21) and mental health (44.56± 12.93) (r=0.183,P＜0.05).There was a positively correlation among family environment intimacy(6.60±2.12),the knowledge(3.98± 1.85) and general self-efficacy(2.51 ±0.50) (r =0.148,P＜0.05;r=0.222,P＜0.05).There was a negative correlation between general self-efficacy(2.51± 0.50) and mental health (44.56± 12.93) (r=-0.275,P＜0.05).(2)In the relationship between intimacy and mental health in the family environment,the general self efficacy played partial of intermediary effect,and the mediating effect was 30.83％.In the relationship between family environment and mental health,general self efficacy played intermediary effect.Conclusion The general self efficacy plays an intermediary role in the relationship between family environment intimacy and knowledge and mental health.
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Objective To evaluate the curative effect ofXuebijing injection combined with routine western medicine therapy in the treatment of hypertensive renal damage.Methods A total of 114 patients with hypertension were randomly divided into 2 groups according to the random number table method, 57 patients in each group. The control group was given conventional treatment (maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium), and the treatment group were givenXuebijing injection based on the conventional treatment. The two groups were treated for 6 months. The changes of blood pressure, renal function and serum inflammatory cytokine levels were evaluated.Results After treatment, the mean value of 24 h systolic blood pressure, mean value of 24 h diastolic blood pressure, systolic blood pressure variability and diastolic blood pressure variability in the treatment group were significantly lower than those in the control group (2 months after treatment:t values were 5.256, 5.595, 5.265, 2.564,P<0.05; 6 months after treatment:t values were 6.251, 5.267, 4.466, 5.264,P<0.05); the urinary mAlb, beta 2-MG, and urine albumin to creatinine ratio in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 5.566, 5.282, 2.862,P<0.05; 6 months after treatment:t value were 5.263, 6.565, 3.642,P<0.05);two plasma D-dimer, IL-6, TNF-α and fibrinogen levels in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 3.565, 5.652, 3.985, 5.251,P<0.05; 6 months after treatment:t value were 5.268, 4.836, 3.622, 4.265,P<0.05).ConclusionsXuebijing injection combined with routine western medicine therapy on hypertensive renal damage may have protective effect, and its curative effect was superior to simple maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium therapy.
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A highly stable multilayer film modified glassy carbon electrode (GCE) containing polydopamine (PDA) and Cu microparticles was fabricated by layer-by-layer self-assembly technique. The fabrication process was based on the self-polymerization of dopamine and electroless deposition of Cu microparticles on PDA coating. The fabrication process of multilayer films was characterized by UV-Vis spectra. The electrochemical performance of GCE / (PDA/ Cu) n modified electrode for glucose detection was investigated by cyclic voltammetry and amperometric current-time curve under alkaline conditions. At detection potential of 0. 35 V, the GCE / ( PDA/ Cu) 4 modified electrode presented a linear range of 0. 5 - 9. 0 mmol/ L with a detection limit of 5. 8 μmol/ L (S / N=3). Moreover, the sensitivity of the modified electrode was tunable by controlling the number of bilayers of the multilayer films. The modified electrode showed highly selective, stable and fast amperometric sensing of glucose. It was applied to determine glucose in human blood serum with satisfactory results.
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To explore advances in diagnosis and treatment of neonatal diffuse intravascular coagula-tion.Of the present situation of progress in the diagnosis and treatment of neonatal diffuse intravascular co-agulation were analysis and discussion,and summary of the performance.In the process of diagnosis and treatment of neonatal diffuse intravascular coagulation,has made the progress many,but there are still many problems to be solved.
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To evaluate the clinical effect and safety of western medicine plus Traditional Chinese medicine for sepsis with gastrointestinal dysfunction. We searched CNKI [January 1979 to June 2014], VIP [January 1989 to June 2014], CBM [1978 to 2014], Wan Fang DATA [January 1990 to June 2014], PubMed [1978 to June 2014], The Cochrane Library [Issue 5, 2014], Embase [1974 to June 2014], and other relevant databases and journals to identify randomized controlled trials [RCTs] on western medicine plus Traditional Chinese medicine versus western medicine only for sepsis with gastrointestinal dysfunction. The methodological quality was assessed and the data was extracted according to the Cochrane Reviewer's Handbook and related methods. Meta-analyses were performed by RevMan 5.1.0 software. Five eligible studies included 278 patients. The results of meta-analyses showed that western medicine plus Traditional Chinese medicine therapy can improve the APACHEII score, the peristaltic sound score and SIRS score, improve abdominal distension, decreased white blood cell count, reduce DAO in sepsis patients with gastrointestinal dysfunction. 3 studies reported adverse reactions, there was no significant difference between two groups. Western medicine plus Traditional Chinese medicine can improve gastrointestinal dysfunction in sepsis