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ABSTRACT Objective: To investigate the effect of the FOCUS-PDCA procedure on the self-care ability of patients undergoing colostomy for rectal cancer. Method: A nonrandomized controlled trial of 160 patients with rectal cancer undergoing colostomy. The control group received routine nursing intervention, and the observation group received the FOCUS-PDCA procedure. The self-care ability of the two groups was investigated 1 week and 1 month after surgery, and a comparative analysis was made between the groups. Results: One week after surgery, the self-care ability of rectal cancer patients with colostomy increased from 39.09 points before implementation of the FOCUS-PDCA procedure to 60.15 points after implementation; an increase of 21.06%. One month after surgery, the self-care ability increased from 61.50 points to 83.13 points after implementation of the FOCUS-PDCA procedure; an increase of 21.63%. Conclusion: Application of the FOCUS-PDCA procedure improved the self-care ability of rectal cancer patients undergoing colostomy, improved their physical and mental health, reduced colostomy complications, and improved their quality of life. The results suggest that it is worth applying FOCUS-PDCA more widely.
RESUMO Objetivo: Investigar o efeito do procedimento FOCUS-PDCA na habilidade de autocuidado de pacientes submetidos a colostomia por câncer retal. Método: Um ensaio clínico não randomizado com 160 pacientes com câncer retal submetidos a colostomia. O grupo controle recebeu intervenção de enfermagem de rotina, e o grupo observação recebeu o procedimento FOCUS-PDCA. A capacidade de autocuidado dos dois grupos foi investigada por 1 semana e 1 mês após a cirurgia, e foi feita uma análise comparativa entre os grupos. Resultados: Em uma semana após a cirurgia a capacidade de autocuidado de pacientes com câncer retal com colostomia aumentou de 39,09 pontos antes da implementação do procedimento FOCUS-PDCA para 60,15 pontos após a implementação; um aumento de 21,06%. Em um mês após a cirurgia, a capacidade de autocuidado aumentou de 61,50 pontos para 83,13 pontos após a implantação do procedimento FOCUS-PDCA; um aumento de 21,63%. Conclusão: A aplicação do procedimento FOCUS-PDCA melhorou a capacidade de autocuidado de pacientes com câncer retal submetidos a colostomia, melhorou sua saúde física e mental, reduziu as complicações da colostomia e melhorou sua qualidade de vida. Os resultados sugerem que vale a pena aplicar o FOCUS-PDCA de forma mais ampla.
RESUMEN Objetivo: Investigar el efecto del procedimiento FOCUS-PDCA sobre la capacidad de autocuidado de pacientes sometidos a colostomia por cáncer de recto. Método: Un ensayo controlado no aleatorizado de 160 pacientes con cáncer de recto sometidos a colostomia. El grupo de control recibió una intervención de enfermería de rutina y el grupo de observación recibió el procedimiento FOCUS-PDCA. La capacidad de autocuidado de los dos grupos se investigó 1 semana y 1 mes después de la cirugía, y se realizó un análisis comparativo entre los grupos. Resultados: En una semana después de la cirugía la capacidad de autocuidado de los pacientes con cáncer de recto con colostomía aumentó de 39,09 puntos antes de la implementación del procedimiento FOCUS-PDCA a 60,15 puntos después de la implementación; un aumento del 21,06%. En un mes después de la cirugía, la capacidad de autocuidado aumentó de 61,50 puntos a 83,13 puntos después de la implementación del procedimiento FOCUS-PDCA; un aumento del 21,63%. Conclusión: La aplicación del procedimiento FOCUS-PDCA mejoró la capacidad de autocuidado de los pacientes con cáncer de recto sometidos a colostomía, mejoró su salud física y mental, redujo las complicaciones de la colostomía y mejoró su calidad de vida. Los resultados sugieren que vale la pena aplicar FOCUS-PDCA de manera más amplia.
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Rectal Neoplasms , Self Care , Oncology Nursing , Aptitude , Colostomy , Total Quality ManagementABSTRACT
Abstract Purpose: To investigate the therapeutic benefits of Hydroxysafflor yellow A (HSYA) on blood-brain barrier (BBB) vulnerability after traumatic brain injury (TBI) and identify its potential action of mechanisms on TBIinduced injuries. Methods: The rat TBI model was performed by using a controlled cortical impact device. The BBB permeability induced by TBI was measured through Evans Blue dye superflux and western blotting or polymerase chain reaction (PCR) for tight junctional proteins (TJPs). The post-TBI changes in oxidative stress markers, inflammatory response and neuron apoptosis in brain tissue were also tested. Results: Herein, the results showed that HSYA acutely attenuated BBB permeability via increasing the production of the TJPs, including occludin, claudin-1 and zonula occludens protein 24 h after TBI. Additionally, HSYA could suppress the secretion of proinflammatory factors, such as interleukin-1β, interleukin-6, and tumor necrosis factor-α (IL-1β, IL-6, and TNF-α), and also concurrently down-regulate the expression of inflammation-related Toll-like receptor 4/nuclear factor kappa-B (TLR4/NF-kB) protein. These HSYA challenged changes were accompanied by the decreased TBI induced oxidative stress markers and inhibited the expression of apoptosis proteins Bax, caspase-3 and caspase-9. Conclusions: Taken together, all findings suggested that HSYA (30 mg/kg) are against TBI through improving the integrity in BBB, which are associated with the antioxidant, anti-inflammation and antiapoptosis via the probable mechanism of down-regulation of the TLR4/NF-kB pathway, and its in-detail protective mechanisms are under study.
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Animals , Rats , Blood-Brain Barrier , Brain Injuries, Traumatic/drug therapy , Permeability , Quinones , Chalcone/analogs & derivatives , Apoptosis , Oxidative Stress , Inflammation/drug therapyABSTRACT
Aims: The aim of the study was to prospectively explore the prognostic factor for gastric cancer with liver metastasis (GCLM), since no prognostic factor was reported to be consistently significant across studies. Patients and Methods: One hundred and five patients with GCLM treated at our center between January 1, 2010, and March 31, 2016, were included and their clinical data were retrospectively analyzed. The univariate analyses were first applied for identify the potential independent prognostic and predictive factors for liver metastasis. These factors were further evaluated with Cox proportional-hazard regression model testing. Finally, survival curves were estimated. Results: The Eastern Cooperative Oncology Group (ECOG) score, number of other distant metastases, levels of cancer antigen (CA), and carcinoembryonic antigen (CEA) were independent prognostic factors (adjusted relative risk [RR]: 1.362–2.887; P = 0.000–0.027). The survival of patients who received radical gastrectomy would be associated with the ECOG score, staging (T stage and N stage), CA 19-9, and CEA levels (RR: 2.169–3.787; P = 0.000–0.027). Patients with following indicators 1 month postoperatively were prone to liver metastasis after radical gastrectomy (median, 6.9–12.03 months; P = 0.007–0.042): Venous/lymphatic invasion, pathological Stage IV (especially combined with T4 stage), intestinal Lauren type, and combined elevation of CEA and CA 19-9 levels. Conclusions: The therapy design for patients with GCLM should consider the general conditions and personal clinicopathological characters of patients. After balancing the benefit and risk factors, multidisciplinary treatment and individual treatment should be developed based on evidence-based medicine model for each patient
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Objective To evaluate the homogeneity of the proficiency test samples to verify whether it meets the requirements of the comparison in international reference laboratory.Methods According to the Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing (CNAS-GL03),14 biochemical indexes including ALT,AST,ALP,GGT,CK,LDH,TP,T-Bil,Urea,Cr,UA,Glu,TG and TC in the past three years (from 2014 to 2016)were tested by the Roche detection system Modular P800 Biochemical analyzer.The mean ((x)),standard deviation (s)and coefficient of variation (CV)of the samples were calculated.One-way analysis of variance (ANOVA)was performed and the guideline of Ss ≤0.3σ was used to evaluate the between-bottle differences.Results The results showed that the CVs of AST in RELA 2014A and B were higher than 2.0％.The CVs of CK were over 2％ in all tests except for RELA 2016B.The results of ANOVA for RELA samples demonstrated that the F value of CK was over the critical value 4.39,which was statistically significant (P ＜ 0.05).The F values of the ALT and T-Bil in 2015B and the Cr in 2014A were also over 4.39 (P ＜ 0.05) respectively,while the F values of other measurements were less than the critical value of F,indicating there was no statistical significance (P ＞ 0.05).The CK measurement data Ss ＞ 0.3σ in all the samples by the guideline of Ss ≤ 0.3σ,suggesting that there was a between-bottle difference in CK.The other indexes were Ss ≤ 0.3σ,showing no between-bottle difference in those items.Conclusion There were significant differences between the bottles of the CK item in the past three years,and the homogeneity of all the other items in the samples could meet the requirements of Proficiency Testing for the international reference laboratory.
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OBJECTIVE To investigated the regulatory effect of paeoniflorin-6'-O-benzene sulfonate (CP-25) on B cell activating factor (BAFF)/BAFF receptor-nuclear factor of kappa B (NF-κB) signaling in B cell of collagen induced-arthritis (CIA) mice. METHODS Mice CIA was induced by injection of typeⅡcollagen (CⅡ). The arthritis index (AI) and swollen joint count (SJC) were assessed, and histopathology of spleen and joints were observed. The percentage of B cells subsets, BAFF receptor expressions were analyzed by flow cytometry. BAFF and immunoglobulin (Ig) levels were measured by protein antibody array. The expressions of TRAF2, MKK3, MKK6, p-P38, and p-NF-κB65 in NF-κB signaling mediated by BAFF were analyzed by western blot. RESULTS CP-25 decreased AI and SJC, restored abnormal weights, reduced thymus index and spleen index, inhibited T/B cells proliferation, alleviated the histopathology of spleen and joints in CIA mice. CP-25 also reduced high levels of serum BAFF and immunoglobulin, decreased CD19+B cells, CD19+CD27+B cells, and CD19-CD27+CD138+ plasma cells, inhibited BAFFR and TACI expressions, decreased the expressions of TRAF2, MKK3, MKK6, p-P38, and p-NF-κB65. Compared with biological agents etanercept and rituximab, CP-25 restored high T cells proliferation and percentages of B subsets to normal level, and recovered the high levels of IgA, IgD, IgG1, IgG2a and high expressions molecules in NF- κB signaling to normal levels. The action intensity of rituximab and etanercept was more strong than CP- 25. The inhibitor effects of rituximab and etanercept on AI and SJC, thymus index, proliferation of T cells and B cells subsets were strong, and down-regulated the indexes to under normal levels. CONCLUSION CP-25 might be a promising anti- inflammatory immune and regulation drug, which alleviated CIA and regulated the functions of B cells through BAFF/BAFF receptor-NF-κB signaling.
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OBJECTIVE This study was to investigate the effects of CP- 25 on the functions of activated human B cells through regulating BAFF and TNF-alpha signaling. METHODS B cells from peripheral blood mononuclear cells (PBMCs) of normal human were isolated using magnetic cell separation (MACS) by a positive selection. B cells (107 cells·mL-1) were stimulated by BAFF (100 ng·mL-1) or TNF-alpha (100 ng·mL-1) for two hours, and then were treated with CP-25 (10-5 mol·L-1) or Rituximab (5 μg·mL-1) or Etanercept (10 μg·mL-1). B cell proliferation was detected by CCK-8. B cell subsets and BAFF receptors (BAFFR, BCMA and TACI) were analyzed by flow cytometry. The expression of TNFR1 and TNFR2 on B cells was analyzed by flow cytometry. The expression of MKK3, MKK6, P-p38, P-p65, TRAF2 and p100/52 was analyzed by Western blotting. RESULTS CP-25 inhibited B cells proliferation stimulated by BAFF or TNF- alpha. CP- 25, Rituximab and Etanercept reduced the percentage and numbers of CD19+ B cells, CD19+CD20+ B cells, CD19+CD27+ B cells and CD19+CD20+CD27+ B cells induced by BAFF or TNF-alpha. CP-25 down-regulated the high expression of BAFFR, BCMA and TACI stimulated by BAFF or TNF-alpha. CP-25, Rituximab and Etanercept down-regulated significantly the expression of TNFR1 and TNFR2 on B cell stimulated by BAFF or TNF-alpha. CP-25, Rituximab and Etanercept down-regulated the expression of MKK3, P-p38, P-p65, TRAF2 and p52 in B cells stimulated by BAFF and the expression of TRAF2 and P- p65 in B cells stimulated by TNF-alpha. CONCLUSION CP- 25 regulated moderately activated B cells function by by regulating the classical and alternative NF-κB signaling pathway mediated by BAFF and TNF-alpha-TRAF2-NF-κB signaling pathway. This study suggests that CP-25 may be a promising anti-inflammatory immune and soft regulation drug.
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Rational nutritional support shall be based on nutritional screening and nutritional assessment.This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area.It is helpful for the early detection of problems in nutritional supports,nutrition management and the implementation of intervention measures,which will contribute a lot to improving the patient's poor clinical outcome.A total of three tertiary medical institutions were enrolled in this study.From October 2015 to June 2016,1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening,including 8 cases who refused to participate,5 cases of same-day surgery and 5 cases of coma.A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk.Logistic regression analysis was performed with univariate analysis (P＜0.05),to investigate the incidence of nutritional risk and influencing factors.The incidence of nutritional risk was 26.35％ in the inpatients,25.90％ in male and 26.84％ in female,respectively.The single-factor analysis showed that the age ≥60,sleeping disorder,fasting,intraoperative bleeding,the surgery in recent month,digestive diseases,metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P＜0.05).Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1,N=0)as dependent variable,logistic regression analysis revealed that the age ≥60,fasting,sleeping disorders,the surgery in recent month and digestive diseases are hazardous factors for nutritional risk.Nutritional risk exists in hospitalized patients in central urban areas.Nutritional risk screening should be conducted for inpatients.Nutritional intervention programs should be formulated in consideration of those influencing factors,which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.
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Background: 3-Ketosteroid-∆¹-dehydrogenase (KSDD), a flavoprotein enzyme, catalyzes the bioconversion of 4-androstene-3,17-dione (AD) to androst-1,4-diene-3,17-dione (ADD). To date, there has been no report about characterization of KSDD from Mycobacterium neoaurum strains, which were usually employed to produce AD or ADD by fermentation. Results: In this work, Corynebacterium crenatum was chosen asa new host for heterologous expression of KSDD from M. neoaurum JC-12 after codon optimization of the KSDD gene. SDS-PAGE and western blotting results indicated that the recombinant C. crenatum harboring the optimized ksdd (ksdd n) gene showed significantly improved ability to express KSDD. The expression level of KSDD was about 1.6-fold increased C. crenatum after codon optimization. After purification of the protein, we first characterized KSDD from M. neoaurum JC-12, and the results showed that the optimum temperature and pH for KSDD activity were 30°C and pH 7.0, respectively. The Km and Vmax values of purified KSDD were 8.91 µM and 6.43 mM/min. In this work, C. crenatum as a novel whole-cell catalyst was also employed and validated for bioconversion of AD to ADD. The highest transformation rate of AD to ADD by recombinant C. crenatum was about 83.87% after 10 h reaction time, which was more efficient than M. neoaurum JC-12 (only 3.56% at 10 h). Conclusions: In this work, basing on the codon optimization, overexpression, purification and characterization of KSDD, we constructed a novel system, the recombinant C. crenatum SYPA 5-5 expressing KSDD, to accumulate ADDfromADefficiently. This work provided new insights into strengthening sterol catabolism by overexpressing the key enzyme KSDD, for efficient ADD production.
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Androstadienes/metabolism , Corynebacterium/enzymology , Mycobacterium/enzymology , Oxidoreductases/metabolism , Codon , Recombinant ProteinsABSTRACT
Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.
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Objective To investigate midwives' role cognition and their working experience.Methods It was a qualitative study using the phenomenological method.10 midwives were interviewed and all the data were analyzed using the categorization method.Results Three main categories were identified:diversified midwife roles; capacities and qualities required to fulfill midwifery roles; positive and negative experiences coexisted.Conclusions Managers should develop humanized management approaches to facilitate the fulfillment of midwives' roles and improve their working experience.The research also revealed the need to improve Chinese midwifery education and the midwifery regulation systems.
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The interactions between plant secondary metabolites (tannic acid, rutin, cinnamic acid and catechin) and glutathione transferase (GST) were investigated by fluorescence and UV-Vis absorption spectroscopy. Intrinsic fluorescence of GST was measured by selectively exciting their tryptophan (Trp) residues and quenching constants were determined using the Stern-Volmer equation. The binding affinity was found to be strongest for tannic acid and ranked in the order tannic acid>rutin>cinnamic acid>catechin. The pH values in the range of 6.7-7.9, except for tannic acid, did not affect significantly the affinity of rutin, cinnamic acid and catechin with GST. Results showed that the fluorescence quenching of GST was a static_quenching. Fluorescence quenching and UV-Vis absorption spectroscopy suggested that only the tannic acid changed the microenvironment of the Trp residues. Furthermore, the number of binding sites and binding constants at different pH values showed that tannic acid had strongest affinity towards GST and hydrogen bonding played an important role in the affinity between GST and the metabolites.