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Objective:To deeply explore the pain experience of patients with rheumatoid arthritis, so as to provide a basis for the practical interventions in the next step.Methods:Using the phenomenological research method, 18 patients with rheumatoid arthritis who experienced pain in the First Hospital of Soochow University from September 2020 to January 2021 were selected for semi-structured interviews, and the Colaizzi 7-step analysis method was used for data analysis.Results:The pain experience of patients with rheumatoid arthritis were summarized into six themes. Pain was complex and erratic, pain relief strategies were ineffective, pain negatively affected daily life, expected more pain relief, seeking help selectively when pain occurs, and experienced pain brings positive change.Conclusions:Medical staff must pay attention to the real experiences and demands of pain in rheumatoid arthritis patients, use information technology and multidisciplinary collaboration to provide patients with effective pain management strategies and encourage patients to make more positive changes to relieve pain symptoms.
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Objective@#To evaluate the expression of cytokeratin (CK)7, CK8/18, CK19 and p40 in esophageal squamous cell carcinoma (ESCC) and its significances. @*Methods@#One hundred and ninety cases of surgically resected ESCCs and 154 normal esophageal tissues as control were collected at the First Affiliated Hospital of Zhengzhou University in 2012.Of the 190 ESCC cases including 116 male and 74 female, aged 28-82 (60.3±8.6) years, 88 cases <60 years old and 102 cases ≥60 years old. Tissue sections were immunostained for CK7, CK8/18, CK19 and p40, and the expression was evaluated and correlated with the clinicopathologic findings and outcome. @*Results@#CK19 and p40 were expressed in 190 cases of ESCCs; with 147 cases (77.4%) and 151 cases (79.5%) showing high p40 and CK19 expression, respectively; while 43 cases (22.6%) and 39 cases (20.5%) showed low p40 and CK19 expression, respectively. The low expression groups showed more lymph node metastases and higher pTNM stages compared to the high expression groups. The high CK19 expression group showed better prognosis than the low expression group (P<0.01); p40 expression was not correlated with prognosis(P>0.05). In contrast, CK7 and CK8/18 expression was only seen in 29 cases (15.3%) and 59 cases (31.1%) of ESCCs, respectively, and their expression correlated significantly with the degree of tumor differentiation and lymph node metastasis (P<0.05). The prognosis in the CK7 negative group was better than that in the CK7 positive group. Similar results were found in CK8/18 expression. Multivariate analysis revealed that pTNM stages, low CK19 expression and CK8/18 expression were independent prognostic factors. @*Conclusions@#Low p40 expression and the expression of CK7 and CK8/18 cannot exclude poorly-differentiated ESCCs.CK7 and CK8/18 expression and low CK19 and p40 expression in the ESCCs are associated with lymph node metastasis and poor prognosis. Decreased expression of CK19 and positive expression of CK8/18 in ESCCs are independent prognostic markers.
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Objective To observe the short-term intraocular pressure after 25G+ pars plana vitrectomy (PPV) and analyze the possible influencing factors in rhegmatogenous retinal detachment (RRD) and proliferative diabetic retinopathy (PDR) eyes.Methods This is a retrospective case-control study.A total of 160 patients (163 eyes) of RRD and PDR who underwent 25G+ PPV were enrolled in this study.There were 88 males (89 eyes) and 72 females (74 eyes),with the mean age of(50.37± 13.24) years.There were 90 patients (92 eyes) with RRD (the RRD group) and 70 patients (74 eyes) with PDR (the PDR group).Best corrected visual acuity (BCVA) and intraocular pressure (IOP) were performed on all the patients.The BCVA was ranged from hand motion to 0.6.The average IOP was (12.61 ± 4.91) mmHg (1 mmHg=0.133 kPa).There were significant differences in crystalline state (x2=9.285,P=0.009),IOP (x2=58.45,P=0.000),history of PPV (x2=4.915,P=0.027) and hypertension (x2=24.018,P=0.000),but no significant difference in sex (x2=0.314,P=0.635) and age (x2=5.682,P=0.056) between the two groups.A non-contact tonometer has been used to measure IOP on postoperative day 1 and 3.The postoperative IOP distribution has been divided into five groups:severe ocular hypotension (≤5 mmHg),mild ocular hypotension (6-9 mmHg),normal (10-21 mmHg),mild ocular hypertension (22-29 mmHg),severe ocular hypertension (≥ 30 mmHg).Logistic regression analysis has been used to analyze the risk and protective factors.Results On the first day after surgery,there were 21 eyes (12.9％) in mild ocular hypotension,96 eyes (58.9％) in normal,22 eyes (13.4％) in mild ocular hypertension and 24 eyes (14.7％) in severe ocular hypertension.On the first day after surgery,there were 18 eyes (11.0％) in mild ocular hypotension,117 eyes (71.7％) in normal,23 eyes (14.1％) in mild ocular hypertension and 5 eyes (3.1％) in severe ocular hypertension.There was no significant difference of IOP distribution between the two groups (Z=-1.235,-1.642;P=0.217,0.101).The results of logistic regression analysis showed that silicone tamponade was a risk factor for ocular hypertension in PDR eyes on the first day after surgery [odds ratio (OR)=15.400,95％ confidence interval (CI) 3.670-64.590;P＜0.001],while intraocular lens was the risk factor for ocular hypotension in PDR eyes on third day after surgery (OR=19.000,95％CI 1.450-248.2;P=0.025).As for RRD eyes,the ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=3.755,95％CI 1.088-12.955;P=0.036).For all eyes,silicone tamponade (OR=0.236,95％CI 0.070-0.797),air tamponade (OR=0.214,95％CI 0.050-0.911) and inert gas tamponade (OR=0.092,95％CI 0.010-0.877) were protective factors for ocular hypotension on the first day after surgery (P=0.020,0.037,0.038);silicone tamponade was protective factor for ocular hypotension on the third day after surgery (OR=0.249,95％ CI 0.066-0.94,P=0.040);while aphakic eyes was the risk factor for ocular hypotension on third day after surgery (OR=7.765,95％ CI 1.377-43.794,P=0.020).The ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=4.034,95％ CI 1.475-11.033,P=0.007).Conclusions The abnormal IOP is common after 25G+ PPV with a rate from 28.3％ to 31.1％.Silicone tamponade,air tamponade and inert gases tamponade are protective factors for postoperative ocular hypotension,aphakic eye is risk factor for postoperative ocular hypotension.Ocular hypotension before surgery and silicone oil tamponade are risk factors for postoperative ocular hypertension.
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Objective To study the influence of precision medicine-based health education on cognitive level of disease knowledge,anxiety and depression in patients with gestational diabetes.Methods Toally 84 cases of gestational diabetes patients in our hospital from September 2014 to December 2015 were divided into a study group and a control group according to the random number table,42 cases in each group.While the routine nursing intervention was done in the control group,the precision medicinebased health education program was carried out in the study group.The two groups were assessed using the cognitive questionnaire designed by our hospital.The self rating anxiety scale (SAS) and self rating depression scale (SDS) prepared by Zung were used to assess the levels of anxiety and depression in the two groups before the intervention and two weeks after the intervention.Results The cognitive level of disease knowledge in the study group after the intervention was statistically significantly higher than that of the control group (P＜0.05).Before the intervention,there were statistically insignificant differences in anxiety and depression between the two groups (P＞0.05),but after the intervention,the levels of anxiety and depression in the study group were significantly lower than those of the control group (P＜0.05).Conclusion The precision medicine-based health education is helpful for the patients with gestational diabetes to improve their diabetes-related knowledge and meanwhile it can relieve their anxiety and depression.
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The exact pathophysiological mechanisms of diabetic retinopathy (DR) remain elusive.The inflammatory reaction,retinal vascular leakage and retinal neovascularization are main features of DR.Adiponectin (APN) is an endogenous biological active protein secreted by adipocytes.It can increase insulin sensitivity,regulate blood glucose and lipid metabolism,and has anti-inflammation and anti-neovascularization functions.It may be involved in the development of DR.This review summarized the studies on the association between APN and DR in recent years.
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Objective To investigate the experience of family caregivers in nursing perioperative patients undergoing permanent cardiac pacemaker. Methods Twenty-five family caregivers taking care of the patients undergoing permanent cardiac pacemaker participated in the non-structural study. Data were analyzed by phenomenological procedure. Result The factors by category analysis includes fear, anxiety and uneasiness due to preoperative lack of relevant knowledge and postoperative lack of caring experience, lowered health level of the caregivers, strong demand for health education and lack of confidence in home care. Conclusions The family caregivers′ experience varies with different phases in perioperative period. Nurses should provide personalized services to enhance the continuity of home care so as to enhance the care quality.
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Background and purpose: Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) gene is a kind of tumor suppressors, which has been reported to be underexpressed in endometrial carcinoma (EC) tissues by several reports. However, the biological effects and possible mechanisms of PTEN on EC have been known less. In this study, we tried to investigate the effects and possible mechanisms of PTEN on the invasion and migration of endometrial carcinoma cells and to provide a potential target for endometrial carcinoma therapy. Methods:The recombinant plasmid pIRES2-ZsGreen1-PTEN was rebuilt by gene recombination technology;The plasmid was transferred into HEC-1B cells and the cells transfected with pIRES2-ZsGreen1 plasmid were used as control;The expression of PTEN was observed by fluorescence microscope and Western blot assay;Cell migration and invasion was determined by the wound healing assay, transwell migration and invasion assays respectively;The Western blot analysis was performed to detect the expression of ATP-dependent tyrosine kinase (AKT), phosphorylated-AKT (p-AKT) and matrix metalloproteinase-2 (MMP-2). Results:The agarose gel electrophoresis showed a stripe of 1.2 kb which was same to PTEN cDNA;The sequence analysis showed the PCR products owned the same sequence with the coding region of PTEN cDNA in GenBank, suggesting the recombinant plasmid was constructed successfully;The green light of cells observed by fluorescence microscope and the Western blot analysis showed the expression of PTEN was upregulated in the cells transfected with the recombinant plasmid, suggesting the plasmid expressed successfully in HEC-1B cells;The wound healing assay as well as transwell migration assay showed ectopic expression of PTEN suppressed cell migration;The invasive capacity of HEC-1B cells was significantly decreased upon transfection with PTEN plasmid compared to control and untreated groups;Moreover, compared with the control groups, the expression of p-AKT and MMP-2 was downregulated, while there was no significant alteration of the expression of AKT. Conclusion:PTEN could suppress cell migratory and invasive ability of endometrial carcinoma cells by suppressing the phosphorylation of AKT followed by the decrease of MMP-2.