The Lived Experience of Frailty in Patients Aged 60 Years and Older with Heart Failure: A Qualitative Study

Purpose@#The prevalence of frailty among patients with heart failure is about 45%. Frailty may result in patients' functional decline, falls, disability, and decreased quality of life. Qualitative studies can explore older patients' perceptions of frailty and help patients cope with it. However, a qualitative approach that explores the experience of frailty in older patients living with heart failure is lacking. This study aimed to explore the lived experience of frailty in older patients with heart failure. @*Methods@#This qualitative study applies Giorgi's phenomenological method. Data were collected from October 2019 to August 2020. Thirteen older patients with heart failure aged at least 60 years were recruited using purposive sampling from a medical center in Taiwan. The participants participated in an in-depth interview using a semistructured interview guide. @*Results@#Seven themes were identified: “being reborn at the end of the road but having difficulty recovering”, “living with a disease with an ineffable feeling”, “feeling like being drained: physical weakness and a dysfunctional body”, “struggling with impaired physical mobility and facing unexpected events”, “suffering from mental exhaustion”, “receiving care from loved ones”, and “turning over a new leaf”. @*Conclusions@#Frailty in older patients with heart failure was obscure and difficult to describe. Frailty could be improved by medical intervention, self-management, and social support but was difficult to reverse. Patients with heart failure should be evaluated for frailty using multidimensional assessment tools at first diagnosis and provided frailty-related information so that patients have proper insight into their disease as early as possible.

Application effect of walking stability training guided by mirror neuron theory in stroke patients with hemiplegia / 中国实用护理杂志

Objective:To study effects of balance and motor function of walking stability training guided by mirror neuron theory for stroke patients with hemiplegia.Methods:A total of 67 stroke with hemiplegia from January 2019 to June 2020 in Heze Municipal Hospital were divided into experimental group (34 cases) and control group (33 cases). All patients were given conventional rehabilitation training, the control group was given body weight support treadmill training, the experimental group was given mirror visual feedback therapy combined with body weight support treadmill training. The training time was 8 weeks. The body balance function, body motor function and life quality were evaluated by Fugl-Meyer Balance scale(FM-B), Berg Balance Scale(BBS), Tinetti Gait Analysis(TGA), Functional Ambulation Category scale(FAC), Stroke-Specific Quality of Life scale (SS-QOL) and compared before and after training between the two groups.Results:There was no significant difference in the score (classification) of FM-B, BBS, TGA, SS-QOL, FAC before training between the two groups( P>0.05). The score (classification) of FM-B, BBS, TGA, FAC after training were (11.35±1.32), (47.33±6.20), (9.32±1.12) points and (3.54±0.61)grades in the experimental group and (9.86±1.25), (42.14±6.35), (8.25±1.32) points and (3.15±0.54) grades in the control group. There were statistically significant of differences( t values were 2.768-4.741, P<0.05). The score of energy, activity ability, emotion, self-care ability, thinking, upper limb function and life quality total score of SS-QOL were (10.31±1.43), (21.46±4.45), (17.64±3.36), (17.32±3.15), (16.23±2.21), (159.11±16.34) points in the experimental group and (8.46±1.21), (17.32±3.24), (15.35±3.11), (14.78±2.32), (8.45±1.25), (13.45±1.54), (141.65±17.24) points in the control group. There were statistically significant of differences( t values were 2.893-7.096, P<0.05). Conclusions:Walking stability training based on mirror neuron theory help to restore limb balance and motor function, and improve life quality in stroke patients with Hemiplegia.

Ferulic acid protects palmitic acid-induced lipotoxicity in hepatocytes via inhibiting p38 MAPK / 中国临床药理学与治疗学

AIM: To investigate the protective effect of ferulic acid on palmitic acid-induced lipotoxicity in HepG2 cells and to explore its potential molecular mechanisms. METHODS: HepG2 cells were induced by palmitic acid to establish a lipotoxicity model, while ferulic acid was added prior to palmitic acid treatment. Lactate dehydrogenase (LDH) was used to detect cell damage. Methyl azozole trace enzyme reaction is used for 3-(4, 5)-dimethylthiahiazo (-z-y1)-3, 5-di-phenytetrazoliumromide (MTT) was employed to detect cell viability. The molecular mechanisms of the protective effect of ferulic acid was analyzed by Western Blotting. RESULTS: There was no cytotoxic effect of different concentrations of ferulic acid (25, 50, 100, 200 μmol/L) treatment on HepG2 cells (P>0.05). Ferulic acid intervention significantly inhibited palmitic acid-induced cell death and improved palmitic acid-induced reduction of cell mitochondrial membrane potential (P<0.05). The activation of p38 significantly enhanced palmitic acid-induced hepatocellular lipotoxicity (P<0.05), while inhibition of p38 significantly improved palmitic acid-induced cell damage (P<0.05). In addition, ferulic acid significantly inhibited the upregulation of p38 phosphorylation by palmitic acid treatment (P<0.05). p38 activator exposure blocked the protective effect of ferulic acid on lipotoxicity (P<0.05). CONCLUSION: Ferulic acid effectively improves hepatocellular injury induced by lipotoxicity.The inhibition of p38 signaling pathway is potentially involved in its protective effect. Ferulic acid may be an effective factor in the prevention and treatment of liver disease with lipotoxicity as a major pathological characteristic.

The effectiveness of nutritional risk assessment and interventions in patients with oral cancer / 中国实用护理杂志

Objective To evaluate the effect of nutritional risk screening and interventions on postoperative nutritional status in patients with oral cancer. Methods A total of 83 oral cancer patients with mild or moderate nutritional risk rated by patient-generated subjective global assessment(PG-SGA) from January 2015 to June 2017 were randomized into an experimental group(43 cases) and a control group (40 cases). The patients in the experimental group received 2-week nutritional intervention before the operation,while the patients in the control group received routine preoperative treatment and diet guidance. The biochemical measurements of postoperative nutritional indicators, peripheral blood immunoglobulin indicators, postoperative complications and hospital stays were compared between the two groups. Results The levels of prealbumin, retinol- binding protein, total lymphocyte count and transferrin were (218.5±34.6) mg/L, (23.5±4.3)μg/L, (1.82±0.45)×109/L, (2.07±0.63 )μg/L on the day of admission in the experimental group, and at 1 day before the operation were (237.3±36.5) mg/L, (27.7±4.8)μg/L, (2.02±0.39)×109/L, (2.43±0.54)μg/L, there was no significant difference(P<0.05). IgM, IgG, IgA at 1 day before the operation were significantly higher than those on the day of admission in the experimental group(P<0.05), and the levels of prealbumin, retinol-binding protein, total lymphocyte count,transferrin, IgM, IgG, IgA and body mass index at 8 days after the operation in the experimental group were significantly higher than those in the control group(t=1.574-3.418, P<0.05). The total rate of postoperative complications was 11.6％(5/43) in the experimental group, 30.0％(12/40) in the control group, and there was significant difference between the two groups (χ2=6.840, P<0.01). The incidence of infection-associated complications such as pneumonia and incision infection was 7.0％(3/43) in the experimental group, 20.0％(8/40) in the control group, and there was significant difference between the two groups (χ2=5.096, P<0.05). Conclusions Preoperative nutritional support can effectively improve the perioperative nutritional status,decrease postoperative complications and operative risk in esophageal cancer patients with mild or moderate nutritional risk.

Role of cytoplasmic lncRNAs in regulating cancer signaling pathways / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Cancer remains a serious healthcare problem despite significant improvements in early detection and treatment approaches in the past few decades. Novel biomarkers for diagnosis and therapeutic strategies are urgently needed. In recent years, long noncoding RNAs (lncRNAs) have been reported to be aberrantly expressed in tumors and show crosstalk with key cancer-related signaling pathways. In this review, we summarized the current progress of research on cytoplasmic lncRNAs and their roles in regulating cancer signaling and tumor progression, further characterization of which may lead to effective approaches for cancer prevention and therapy.

Exosomal long non-coding RNAs: biological properties and therapeutic potential in cancer treatment / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Exosomes and long non-coding RNAs (lncRNAs) are emerging as important elements contributing to a more comprehensive understanding of cancer development and progression. The discovery of lncRNAs in exosomes further indicates their bona fide biological functional roles in cancer development and drug resistance. In this review, we describe the biogenesis of exosomes and summarize the function of exosomal lncRNAs in the field of cancer research. These findings strikingly advance current knowledge of exosomal lncRNAs and suggest that they may be promising diagnostic biomarkers and therapeutic targets for cancer.

The development and evaluation of individualized templates to assist transoral C2 articular mass or transpedicular screw placement in TARP-IV procedures: adult cadaver specimen study

OBJECTIVES: The transoral atlantoaxial reduction plate system treats irreducible atlantoaxial dislocation from transoral atlantoaxial reduction plate-I to transoral atlantoaxial reduction plate-III. However, this system has demonstrated problems associated with screw loosening, atlantoaxial fixation and concealed or manifest neurovascular injuries. This study sought to design a set of individualized templates to improve the accuracy of anterior C2 screw placement in the transoral atlantoaxial reduction plate-IV procedure. METHODS: A set of individualized templates was designed according to thin-slice computed tomography data obtained from 10 human cadavers. The templates contained cubic modules and drill guides to facilitate transoral atlantoaxial reduction plate positioning and anterior C2 screw placement. We performed 2 stages of cadaveric experiments with 2 cadavers in stage one and 8 in stage two. Finally, guided C2 screw placement was evaluated by reading postoperative computed tomography images and comparing the planned and inserted screw trajectories. RESULTS: There were two cortical breaching screws in stage one and three in stage two, but only the cortical breaching screws in stage one were ranked critical. In stage two, the planned entry points and the transverse angles of the anterior C2 screws could be simulated, whereas the declination angles could not be simulated due to intraoperative blockage of the drill bit and screwdriver by the upper teeth. CONCLUSIONS: It was feasible to use individualized templates to guide transoral C2 screw placement. Thus, these drill templates combined with transoral atlantoaxial reduction plate-IV, may improve the accuracy of transoral C2 screw placement and reduce related neurovascular complications. .