Effects of patient participation decision aid on decision conflict and risk perception of patients undergoing cardiac valve replacement / 中国实用护理杂志

Objective:To explore the effects of application of the patient participation decision aid in patients undergoing cardiac valve replacement.Methods:A total of 38 patients hospitalized for cardiac valve replacement from June to November, 2020 in the First Affiliated Hospital of Nanjing Medical University, were enrolled as the control group, and 38 patients admitted from January to May, 2020, were recruited as the experimental group by convenient sampling method. The control group was given routine nursing intervention, while the experimental group was carried out patient participation decision aid assistant program on the basis of routine nursing. The effects of intervention were assessed by Decision Conflict Sale (DCS), Preparation for Decision Making (PrepDM) and Risk Perception Questionnaire for patients with chronic diseases at admission and one day before operation.Results:There was no significant difference in the scores of DCS, PrepDM and Risk Perception Questionnaire for patients with chronic diseases at admission between the two groups( P>0.05). At one day before operation, the information& values scores dimension, support and valid decision dimension scores, decision uncertainty dimension scores and total scores of DCS were (12.37 ± 4.11) , (12.50 ± 4.65) , (3.74 ± 1.17), (28.61 ± 7.07) points in the experimental group, lower than those in the control group (15.11 ± 3.62) , (17.84 ± 4.25), (4.37 ± 1.30), (37.32 ± 6.57) points, the differences were statistically significant between the two groups( t values were 2.22-5.56, all P<0.05). At one day before operation, the score of PrepDM was (73.58 ± 5.32) points in the experimental group, higher than that in the control group (67.82 ± 4.89) points, the difference was statistically significant ( t=4.92, P<0.05). At one day before operation, the scores of economic risk dimension, physical and medical risk dimension, psychosocial risk dimension scores and total scores of Risk Perception Questionnaire for patients with chronic diseases were (11.45 ± 3.94), (12.39 ± 3.64), (7.21 ± 4.09), (31.05 ± 6.11) points in the experimental group, lower than those in the control group (13.50 ± 3.73), (15.82 ± 5.18), (9.32 ± 3.59), (38.63 ± 7.27) points, the differences were statistically significant ( t values were 2.33-4.92, all P<0.05). Conclusions:Patient participation decision aid program can effectively decrease decision conflict, promote preparation for decision making and alleviate risk perception of patients undergoing cardiac valve replacement.

Proliferation kinetics of immune cells during early phase of bone marrow transplantation in mouse model based on chemotherapy conditioning / 中南大学学报(医学版)

OBJECTIVES@#To establish mouse bone marrow transplantation by pretreatment with chemotherapy, and to explore the dynamic changes of immune cells in the early stage of allogeneic transplantation in the spleen of mice.@*METHODS@#Mice were divided into 4 groups (80 mg/kg group, 100 mg/kg group, 120 mg/kg group, and 150 mg/kg group) according to the difference in dose of busulfan. The mice were treated with busulfan and cyclophosphamide combined chemotherapy, and the appropriate dosage was determined by evaluating the myeloablative effect and drug toxicity. According to the type of the genetic transplantation, the mice were also divided into 4 groups: An allogeneic transplantation group, a homogenic transplantation group, a chemotherapy alone group, and a normal control group. The mice were pretreated with busulfan and cyclophosphamide before bone marrow transplantation. In the allogeneic transplantation group, the suspension of splenocytes was prepared at the first day, the 3rd day, the 5th day, and the 8th day after transplantation for flow cytometry detection, and the dynamic changes of splenic immune cells were analyzed. The homogeneic transplantation group served as the concurrent control, the normal control group served as the control of basic value of spleen immune cells, and the chemotherapy alone group was used to evaluate the myeloablative effect.@*RESULTS@#1) The optimal dose of busulfan was 100 mg/kg. The combination of busulfan and cyclophosphamide can restore the hematopoiesis of transplanted mice, and the toxicity associated with pretreatment is small. 2) In the allogeneic transplantation group: The hematopoietic reconstitution and high donor chimerism rate were achieved after transplantation. In the early phase of bone marrow transplantation, the T lymphocytes were the main cell group, while the recovery of B lymphocytes was relatively delayed. The dendritic cells and natural killer cells from donors were the earliest cells to recover and achieve high chimerism rate compared with T cells and B cells. Most T cells were in the initial T cell state within 5 days after allogeneic transplantation. However, in the 5th day after transplantation, these cells were mainly in the effective memory phenotype. The reconstruction of donor-derived naive T cells was slow, but the reconstruction of donor-derived effective memory T cells and regulatory T cells was relatively fast. 3) In the homogeneic transplantation group: The mice could recover hematopoiesis and the recovery of B lymphocytes was delayed. 4) In the chemotherapy alone group: All mice died in 12-15 days after chemotherapy, and the peripheral blood routine showed pancytopenia before death.@*CONCLUSIONS@#Pretreatment with chemotherapy can successfully establish the mouse model of bone marrow transplantation. There are difference in the proportion of T cells, B cells, natural killer cells, dendritic cells, effector memory T cells, initial T cells, and regulatory T cells after transplantation, and the relationship between donor and recipient is also changed.

Clinical significance of standardized screening of early gastric cancer in Qinghai Province / 中华消化内镜杂志

Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.

Extracellular signal regulated kinase 5 promotes cell migration, invasion and lung metastasis in a FAK-dependent manner

This study was designed to evaluate ERK5 expression in lung cancer and malignant melanoma progression and to ascertain the involvement of ERK5 signaling in lung cancer and melanoma. We show that ERK5 expression is abundant in human lung cancer samples, and elevated ERK5 expression in lung cancer was linked to the acquisition of increased metastatic and invasive potential. Importantly, we observed a significant correlation between ERK5 activity and FAK expression and its phosphorylation at the Ser

A qualitative research of the status-quo of service in primary health care for dementia who stay in home in the supply-side perspective / 中国实用护理杂志

Objective:To understand the status quo of primary medical and health services for home aged dementia patients in Weifang from the perspective of medical service providers. And to provide suggestions for improving the primary medical services and community care for home aged dementia patients.Methods:A semi-structured in-depth interview was conducted with 26 primary medical and health care workers in the primary medical and health services of home patients with senile dementia, and the interview data were summarized and extracted by content analysis method.Results:Four themes were extracted according to the primary medical and health services for home aged dementia patients. Theme 1: less chance to contact with dementia patients, and the understanding of the disease is biased. Theme 2: limited medical services and no targeted services. Theme 3: receive less relevant training and need professional technical support. Theme 4: there is no system of medical support, and an effective model needs to be established.Conclusion:There are few primary medical and health services for home patients with senile dementia, and there are regional differences. It is necessary to increase the understanding of home patients with senile dementia by various means and increase the primary medical services for home patients.

Application of flipped classroom based on Moodle in the teaching of gynecology and obstetrics nursing / 中华医学教育探索杂志

The traditional teaching method of the medical curricculum, gynecology and obstetrics nursing has many problem. The flipped classroom subvetted the traditional teaching structure, and realizes the advance of knowledge transfer and optimization of knowledge internalization. The research group made design, recorded micro-course video and used the free and open source of Moodle course management platform to implement flipped classroom. The interactive function of the platform released learning tasks before class, had discussion in class and answered after-class quesstions. The subjectivity of students was highly emphasized. The results showed that the flipped classroom can improve students' academic performance, develop students' good study habits and learning interest, and also bears significance for the cultivation of autonomic learning ability and critical thinking.

Application of flipped classroom based on Moodle in the teaching of gynecology and obstetrics nursing / 中华医学教育探索杂志

The traditional teaching method of the medical curricculum, gynecology and obstetrics nursing has many problem. The flipped classroom subvetted the traditional teaching structure, and realizes the advance of knowledge transfer and optimization of knowledge internalization. The research group made design , recorded micro-course video and used the free and open source of Moodle course management platform to implement flipped classroom. The interactive function of the platform released learning tasks before class, had discussion in class and answered after-class quesstions. The subjectivity of students was highly emphasized . The results showed that the flipped classroom can improve students' academic performance, develop students' good study habits and learning interest, and also bears significance for the cultivation of autonomic learning ability and critical thinking.

Ion Chromatography Method of Four Carboxylic Acids in Workplace Air / 中华劳动卫生职业病杂志

Objective@#To assess psychological acceptance and occupational stress of medical staff, analyze the relationship among personality, psychological acceptance and occupational stress and discuss the direct or indirect effects of personality to occupational stress.@*Methods@#The gaseous four kinds of carboxylic acids in the workplace air were simultaneously collected by silica gel tube, and then desorbed by deionized water and eluted by ion chromatograph. The the content was detected by conductivity detector.@*Results@#The linear relationship was good in the concentration range of about 0~140 mg/L. The correlation coefficient r>0.999, and the maximum detection limit was 4.5 μg/mL. The sampling efficiency of the four carboxylic acids ranges from 96.10%~100.27%. Through the sample added recovery experiments, the low and high content of the silicone tube samples were detected; and the range of desorption efficiency was 82.18%~100.12%; the range of precision was 0.70%~3.71%.@*Conclusion@#This method adopts deionized water to desorb samples, and the application of ion chromatography detection have reached the requirements of《Guidelines for the establishment of occupational health standards, Part 4: Determination of chemical substances in workplace air》, which can be used in four kinds of workplace air detection of carboxylic acid compounds.

Analysis of influencing factors of maternal and neonatal outcomes in preterm premature rupture of mem-branes / 实用医学杂志

Objective To investigate the influencing factors of preterm premature rupture of membranes and maternal outcomes. Methods 326 cases with PPRM singleton were selected as the study group in our hospital,and 300 singleton cases with preterm premature rupture of membranes as the control group. Retrospective investigation of the pregnant women and neonatal was performed. Results By single factor analysis,there was no significant difference between the two groups of gestational hypertension,gestational diabetes,uterine dysplasia, uterine scar incidence(P > 0.05);The incidence of reproductive tract infection and fetal abnormalities in study group was higher than that in the control group(P<0.05). The single factor analysis in multivariate logistic regres-sion with statistical difference analysis of reproductive tract infection and abnormal fetal position for preterm prema-ture rupture of the placenta affect independent risk factors. The incidence of neonatal asphyxia and neonatal pneu-monia in the study group was higher than that in control group,and the neonatal weight was lower than the control group,Apgar score was lower than that in the control group(P<0.05). Conclusion the reproductive tract infec-tion and abnormal fetal position of preterm premature rupture of the placenta membranes affect the independent risk factors for preterm premature rupture of membranes ,adverse neonatal outcomes,neonatal asphyxia and the incidence of pneumonia,and light weight need further research.

A study on oral health-related quality of life in end-stage renal disease patients undergoing hemodialysis / 中国实用护理杂志

Objective To investigate oral health-related quality of Life(OHRQoL)in end-stage renal disease Patients undergoing hemodialysis(HD) and its influencing factors. Methods Through convenient sampling, totally 185 HD patients in two first-class tertiary hospitals in Changchun were investigated with the Oral Health Impact Profile-14(OHIP-14) . Influencing factors of oral health-related quality of life of patients were extracted from patients'general information and oral health behavior questionnaire. Single factor analysis and multivariate linear stepwise regression analysis were used for statistical analysis. Results The scores of oral health-related quality of life in hemodialysis patients were Significantly higher than those of the normal population in China(P<0.05)and age, duration of hemodialysis, status of smoking, frequency of brushing, brush teeth time, status of using mouth wash, and frequency of oral examination were influencing factors for oral health-related quality of life of HD patients, (β=-0.156-0.164, all P<0.05). Conclusions Oral health-related quality of life in HD patients is poor. Medical workers should pay attention to older patients with longer duration of hemodialysis and poor oral health behavior, take effective interventions to improve oral health-related quality of life of HD patients.

Research the progress of communication tools for conscious patients with mechanical ventilation in ICU / 中国实用护理杂志

The language communication barrier of conscious mechanical ventilation in an intensive care unit (ICU) has brought physiological and psychological discomfort to patients and using communication tools can improve efficiency of communication and patients′ satisfaction, it is also a key factor affecting nursing quality and patients′ safety. This article reviewed the application progress of communication tools for conscious patients with mechanical ventilation in ICU, and analyzed the effects and barriers about different types of communication tools, aimed to provide reference for better communication between nurses and patients in ICU.

The Effect of TNF-αon the Cytokines Expression in mice with Different Tidal Volume Ventilation / 实用医学杂志

Objective To investigate the effect of tumor necrosis factor-α(TNF-α)on cytokines expression in mice with different tidal volume(VT). Methods Thirty six SPF male BALB/c mice were randomly divided into three groups:A group(spontaneously breathed 4 h),S and L group(mechanically ventilated 4 h,VT=6 mL/kg and VT=20 mL/kg). The three groups were then randomly divided into two subgroups(C and T group,n=6). Mice in C group were injected with NS,while that of T groups were injected with TNF-α at 20 μg/kg from tail intravenous. Morphological manifestation was observed by hematoxylin and eosin staining. Ultrastructure of macrophages were examined by transmission electron microscopy. The expression of TNF-α,interleukin(IL)-1β,IL-6,IL-10 in serum and BALF were measured by ELISA. The expression of NF-κB mRNA and protein were detected by RT-PCR and WB,respectively. Results Compared with A and S group,following could be observed under light microscope in L group:the pulmonary interstitial edema,consolidation of part of the lung tissue,alveolar space fusion and a number of inflammatory cells infiltration. The expression of TNF-α,IL-1β,IL-6,IL-10 in serum and BALF,the expression of NF-κB mRNA and protein in macrophages of L group were significantly higher than those of A and S group(both P<0.05). The expression of these cytokines and NF-κB mRNA and protein were increased in T group (P < 0.05). The expression NF-κB is positively correlated with the expression of TNF-α,IL-1β and IL-6. Conclusion TNF-α is a key factor in inflammation of ventilation induced lung injury,which may provide a new method for prevention of VILI in clinical practice.

Fusobacterium nucleatum Prompts Colonic Tumorigenesis in Mice and its Potential Mechanism / 胃肠病学

Background:Accumulating evidence links colorectal cancer (CRC) with the gut microbiota.Fusobacterium nucleatum (F.nucleatum) has been revealed to be involved in the development of CRC, however, the mechanism of F.nucleatum in mediating colorectal tumorigenesis is still poorly understood.Aims:To investigate the effect and potential mechanism of F.nucleatum on CRC.Methods:Wild type C57BL/6 mice and APC(Min/+) mice characterized by multiple intestinal neoplasia were used in this animal study.After administered with F.nucleatum intragastrically and/or 1,2-dimethylhydrazine (DMH, a carcinogen) subcutaneously, the aberrant crypt foci (ACF) and colonic tumor were counted at 8th and 20th week, respectively.Structural alteration of intestinal microbiota and mucosal immune factors were detected in wild type C57BL/6 mice receiving different interventions by using Roche 454 GS FLX pyrosequencing and Bio-Plex ProTM cytokine assay, respectively.Results:In DMH-treated wild type C57BL/6 mice or APC(Min/+) mice, number of ACF and colonic tumor in those administered with F.nucleatum were significantly higher than those without (P<0.05).F.nucleatum colonization significantly altered the lumen microbial structure, with decreased Cyanobacterium and increased Tenericutes and Verrucomicrobia (P all <0.05).Furthermore, F.nucleatum up-regulated expressions of tumor-related immune factors in colonic mucosa, such as IL-21, IL-22, IL-31 and CD40L (P<0.05).Conclusions:F.nucleatum colonization in intestine may prompt colonic tumorigenesis in mice via inducing intestinal dysbiosis and modulating tumor-related immune factors expression.

Construction and Identification of the Bait Vector Containing Duck Circovirus Cap Gene for the Yeast Two-hybrid System / 病毒学报

To construct a bait expression vector containing the duck circovirus Cap gene for use in the yeast two-hybrid system, the whole cap codon-optimized gene was inserted into pGBKT7 vector and confirmed by PCR, restriction enzyme digestion, and sequence analysis. After transformation into a Y2HGold yeast strain, the expression of Cap protein was analyzed by Western blotting. Toxicity and self-activation of the bait protein were detected using different dropout minimal base. PCR reaction, restriction enzyme digestion, and sequencing analyses indicated that the duck circovirus Cap gene was correctly inserted into pG- BKT7. Western blotting showed that the whole Cap protein was expressed. The recombinant bait protein had no toxicity and self-activation. Therefore, the bait vector with the Cap gene was constructed successfully, providing a foundation for future screening for interacting proteins in the yeast two-hybrid system.

CD133+ ovarian cancer stem-like cells differentiate into vascular endothelial cells / 中国组织工程研究

BACKGROUND:Numerous studies have confirmed that neovascularization plays an important role in the growth, invasion and metastasis of tumors. OBJECTIVE:To investigate the features of CD133+ ovarian cancer stem-like cels differentiating into vascular endothelial cels. METHODS:CD133+ ovarian cancer stem-like cels were successfuly harvested from A2780 ovarian cancer cel lines using serum-free culture method, and incubatedin vitro onto 96-wel plates with or without Matrigel. Then, we observed the capacity of CD133+ ovarian cancer stem-like cels and human umbilical vein endothelial cels to form tube-like structures at different time points. Through xenograft experiments, the role of CD133+ ovarian cancer stem-like cels in the angiogenesis of ovarian cancer was observed using immunofluorescence staining. RESULTS AND CONCLUSION:CD133+ovarian cancer stem-like cels and human umbilical vein endothelial cels cultured with no Matrigel had no corresponding lumen formation, and could not express CD31. But those cultured with Matrigel had lumen formation and expressed CD31 significantly. After tumor formation, human-derived CD31 expression was observed in the tumors. These findings indicate that CD133+ ovarian cancer stem-like cels can differentiate into vascular endothelial cels, and be involved in tumor revascularization.

Effect of Cluster Needling at Scalp Acupoints on Cognitive Function in Alzheimer Disease / 上海针灸杂志

Objective To observe the effect of cluster needling at scalp acupoints on cognitive function in Alzheimer disease (AD), and to elucidate its mechanism. Method Seventy eligible patients with cognitive impairment were randomized into two groups by their admission number. The treatment group was intervened by cluster needling at scalp acupoints plus oral administration of Fluoxetine hydrochloride, while the control group was by ordinary acupuncture. Two treatment courses later, the two groups were observed and compared in therapeutic efficacy and Activities of Daily living (ADL). Result There was a significant difference in comparing the total effective rate between the two groups (P＜0.05), the ADL scores dropped significantly in both groups after intervention (P＜0.01), and the decrease in the treatment group was statistically more significant (P＜0.01). Conclusion Cluster needling at scalp acupoints can effectively improve cognitive impairment in AD patients, and can promote the quality of life.

Relationship between the levels of serum cortisol and alexithymia in depressive patients with somatic symptoms / 中华行为医学与脑科学杂志

Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.

Clinical significance of serum IGF-2 and IGFBP-3 in perioperative period patients with ovarian cancer / 中国医师杂志

Objective To investigate the changes of serum insulin-like growth factor-2 (IGF-2) and insulin-link growth factor binding protein-3(IGFBP-3) in the patients with ovarian cancer before and after operation,and evaluate their clinical significance.MethodsThe contents of serum IGF-2 and IGFBP-3 in 82 patients with ovarian cancer were detected by ELISA before and after operation and compared with that in health controls.ResultsThe contents of IGF-2 in the patients before operation were significantly higher than that in control group[(101.5±22.2)ng/ml,(49.3±15.6)ng/ml vs (69.6±17.7)ng/ml,(23.9±11.3)ng/ml,t＝3.74,2.85,P＜0.05].The contents of IGFBP-3[(39.8±11.1)ng/ml]in the patients before operation were significantly lower than that in control group[(55.8±19.2)ng/ml](t′＝4.49,P＜0.05).There was significant correlation between the contents with lymph node metastasis and clinical stage[(107.5±24.0)ng/ml,(41.7±16.9)ng/ml vs (91.6±17.7)ng/ml,(56.9±19.1)ng/ml;(103.4±27.2)ng/ml,(50.2±16.6)ng/ml vs (86.6±12.3)ng/ml,(41.1±17.1)ng/ml,t＝2.83,2.37,2.48,3.32,P＜0.05).The contents of IGF-2 was significantly decreased,and IGFBP-3 was significantly increased in patients after radical operation [(86.6±12.3)ng/ml,(41.1±17.1)ng/ml vs (103.2±26.0)ng/ml,(45.3±14.9)ng/ml,t′＝3.46,t＝2.67,P＜0.05].But there was no significant difference on the level of IGF-2 and IGFBP-3 before and after palliative resection(P＞0.05).ConclusionsThe contents of serum IGF-2 and IGFBP-3 are closely related to tumor invasion,metastasis and clinical stage.Dynamic determination of the contents of serum IGF-2 and IGFBP-3 may be an important index for evaluation of invasion,metastasis,efficacy and prognosis for the patients with ovarian cancer.