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Objective:To formulate a ladder type early activity program in order to provide a theoretical and practical basis for improving the current activity status of tumor patients with pulmonary embolism.Methods:This research was conducted experimentally. A total of 92 tumor patients diagnosed as pulmonary embolism from January 1, 2021 to March 31, 2022 in Sichuan Cancer Hospital were divided into control group and experimental group with 46 cases each by random number table method. In the control group, a routine activity program was carried out, and the patients were confined to bed for 7 days. The experimental group obtained the best evidence of early pulmonary embolism activity plan through evidence-based nursing, formed a nurse-led ladder type early pulmonary embolism activity team, and finally constructed and implemented the ladder type early activity plan. The mortality rate, new thrombosis in ICU for 3 days and 7 days, length of stay in ICU and patients′ comfort were compared between the two groups.Results:The mortality rates within 30 days after the diagnosis of pulmonary embolism were 4.35% (2/46) and 2.17% (1/46) respectively in the control group and the experimental group, with no significant difference between the two groups ( χ2=0.35, P>0.05). The rates of new thrombosis were 15.22% (7/46) and 26.09% (12/46) in the control group, and 4.35% (2/46) and 4.35% (2/46) in the experimental group, respectively at 3 and 7 days after ICU admission, with a significant difference between the two groups at 7 days after ICU admission ( χ2=8.43, P<0.05). The length of stay in ICU and the score of General Comfort Questionnaire (GCQ) were (15.74 ± 11.11) days and (64.30 ± 15.54) points in the experimental group, respectively, while those in the control group were (11.07 ± 5.63)days and (73.84 ± 11.73) points, respectively. The difference between the two groups was statistically significant ( t=-2.55, -3.32, both P<0.05). Conclusions:The evidence-based ladder type early activity program for patients with pulmonary embolism caused by tumor will not increase the mortality of patients, but can ensure the safety of patients, reduce the incidence of new thrombosis and the length of ICU stay, improve the comfort of patients during the treatment of pulmonary embolism. It is worthy of clinical application.
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Objective@#To investigate the satisfaction and well-being of Chinese women with breast deficiency, and to analyze the relevant influencing factors.@*Methods@#A cross-sectional study was conducted using a self-designed questionnaire to investigate the women with breast deficiency, visiting the Plastic Surgery Hospital of Chinese Academy of Medical Sciences from November 2013 to August 2018. The BREAST-Q BR (breast reconstruction) pre-operation and post-operation modules were used to assess the quality of life.@*Results@#A total of 139 effective questionnaires were collected, including 83 patients before BR surgery and 56 post. There was no difference in quality of life in different ages, marital status, education levels, working status, and causes of breast deficiency. Mean scores of satisfaction with breasts, psychosocial well-being and sexual well-being of patients after breast reconstruction were significantly higher than those of patients without reconstruction (P=0.000), but there was no statistical difference in physical well-being-chest score. The physical well-being abdomen scores of patients with abdominal flap reconstruction was lower than that of the patients without reconstruction (P=0.007). With regard to analysis of specific items, compared with preoperative patients, patients with abdominal flap reconstruction reported lower scores in the items related to abdominal muscle weakness (P<0.05).@*Conclusions@#The breast deficiency resulting from Poland syndrome, breast cancer and other causes, can lead to a significant decrease in quality of life. Breast reconstruction can improve satisfaction with breast, psychosocial and sexual well-being in women with breast deficiency. The abdomen well-being of patients with abdominal flap reconstruction is decreased. Therefore, more attention should be paid to retain abdominal muscles to maintain abdominal shape and motor function during operation.
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Objective@#Using Meta-analysis to evaluate the association between the short-term exposure to fine particular matter (PM2.5) and the morbidity of ischemic heart disease (IHD). @*Methods@#In this paper, "particulate matter" , "PM2.5" , "ischemic heart disease" , "coronary heart disease" , "coronary artery disease" , "atherosclerotic heart disease" , and "atherosclerotic cardiovascular disease" were used to systematically search for the literature on the association between the short-term exposure to PM2.5 and the ischemic heart disease through China Biology Medicine disc (CBMdisc), China National Knowledge Infrastructure (CNKI), Wanfang, Vip as well as Pubmed and Web of Science. The time was up to January 31st 2019. The quality of literature was evaluated by the Newcastle-Ottawa Scale. Meta-analysis method was performed by using R3.5.0 software and was used to perform heterogeneity test, calculate combined risk of IHD with short-term exposure to PM2.5 and carry out publication bias test. @*Results@#A total of 1 424 literatures were retrieved. Of the 23 literatures included studies (2 literatures in Chinese and 21 literatures in English) according to the inclusion and exclusion criteria, 14 used a time-series design and 9 used a case-crossover design. The heterogeneity existed across all identified studies (I2=81%, P<0.05). The Random effect model showed that a 10 μg/m3 increase in PM2.5 was associated with estimated relative risk of IHD morbidity at 1.007 (95%CI: 1.005-1.009); Publication bias was noted in the analysis (t=2.76, P<0.05), and the combined effect values of IHD morbidity was reduced to 1.005(95%CI: 1.004-1.007) after adjusting for asymmetry. @*Conclusion@#Short-term exposure to PM2.5 may lead to the increase of ischemic heart disease morbidity.
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Objective To explore the value of simple exercise provocation test ( 6?minute running test) combined with small airway function test in early diagnosis of cough variant asthma ( CVA ) in children.Methods Ninety?four children with chronic cough from September 2017 to September 2018 in the pediatric clinic of the Affiliated Hospital of Xuzhou Medical University were selected for routine pulmonary ventilation function examination,simple exercise stimulation test and questionnaire survey.The differences of pulmonary function,clinical manifestations and allergens between positive and negative children with simple exercise stimulation test were compared and analyzed.Results The forced expiratory volume in one second (FEV1) of 94 children with chronic cough were all more than 70% by routine pulmonary function test,and the exercise provocation test was successfully completed.Among them,32 (34.04%) were positive in simple exercise provocation test.Among the positive patients,30 cases ( 93.75%) were diagnosed as CVA after further examination,clinical treatment and follow?up.In CVA group, FEV1 ( 81.52 ± 14.22)%,forced vital capacity (FVC) (89.00 ± 14.31)%, peak expiratory flow ( PEF) ( 65.05 ± 15.10)%, one?second rate (FEV1／FVC) (92.18±13.59)%,and instantaneous flow at 50% forced expiratory flow were observed after exercise.The vital capacity ( FEF50 ) ( 57.57 ± 22.49 )%, forced expiratory flow at 75% vital capacity (FEF75) (41.15±18.28)%,maximum expiratory flow ( MMEF75／25) (53.14±22.53)% were significantly lower than those before exercise ((94.07±9.69)%,( 92.30± 13.60)%,(80.73± 17.85)%,(101.07± 13.79)%,(66.71±19.29)%,(51.32±18.38)%,(63.75±19.43)%),(t values were 8.592 ,2.617 , 10.246 ,5.428,3.590 ,3.646 ,3.687 ,respectively,all P＜0.05)) In routine examination of pulmonary ventilation function,FEF50 (66.71 ± 19.29)% and FEF75 ( 51.32 ± 18.38)% in the positive group were significantly lower than those in the negative group (( 79.75 ± 21.94)%、( 69.08 ± 29.28)%),( t values were －2.841,－3.123,all P＜0.01).The proportion of night cough,morning cough and severe dry cough in positive group was significantly higher than that in negative group,while the proportion of day cough and wet cough was significantly lower than that in negative group ( P＜0.01).The proportion of eczema history in positive group was significantly higher than that in negative group ( P＜0.01).Conclusion Patients with CVA have high airway responsiveness and small airway dysfunction.Combination of simple motor stimulation test and small airway function test has important clinical value in the early diagnosis of CVA.
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Objective To understand the status of fluoride content in brick tea (pressed tea) in China,and conduct health risk assessment according to the situation of drinking brick tea in fluorosis areas.Methods Twenty national designated brick tea manufacturers were selected to collect 1-5 varieties of brick tea samples of mainstream varieties with large production volume and large sales volume.If low-fluoride brick tea was produced,an additional sample would be collected to determine the fluoride content of tea.The retrospective analysis method was used to collect the monitoring data of brick tea-type fluorosis in the whole country in 2017,and analyze the use of brick tea in the residents of the brick tea-type fluorosis areas in six provinces (regions) of Inner Mongolia,Sichuan,Gansu,Ningxia,Xinjiang and Qinghai.According to the fluoride content of brick tea,combined with daily average consumption data of brick tea in the brick tea-type fluorosis areas,daily average brick tea intake,and hazard quotient of the daily average brick tea fluoride and the standard recommended fluoride intake were calculated.A health risk assessment was conducted based on the hazard quotient (hazard quotient ＞ 1 indicated a health risk).Through the total fluoride intake standard of the Chinese population,the safe consumption of brick tea with different fluoride content was simulated by using the value of the hazard quotient.The tea fluoride was measured by an ion selective electrode method.Results A total of 54 samples were collected,of which 49 were brick tea samples and 5 were low-fluoride brick tea samples.The geometric mean of the fluoride content of 49 brick tea samples was 460 mg/kg,the median was 430 mg/kg,and the range was 102-1 797 mg/kg.There were 14 samples with a fluoride content ＜ 300 mg/kg,accounting for 28.6％.The average fluoride content of 5 low-fluoride brick teasampleswas 193 mg/kg,ranging from 102 to 290 mg/kg.Forty-nine brick tea samples were distributed in 5 provinces,the fluoride content of brick tea was the lowest in Yunnan,128 mg/kg;the highest in Hubei,712 mg/kg.The lowest fluoride content of brick tea in different varieties was Tuo tea,130 mg/kg,and the highest was Jinjian tea,745 mg/kg.There were 1 000 households drinking brick tea in the brick tea-type fluorosis areas in 6 provinces,73.9％ (739/1 000) of households drinking the products of the national assigned brick tea manufacturers;a total of 1 000 brick tea samples were collected,and the geometric mean of brick tea fluoride content was 551 mg/kg,and only 17.5％ (175/1 000) of brick tea had a fluoride content ＜ 300 mg/kg.Compared with the national standards and the standards of World Health Organization,hazard quotient of agriculture,animal husbandry,semi-pastoral industry,urban residents through the brick tea fluoride was 0.34,1.38,0.75,and 0.21,respectively;0.29,1.21,0.66,and 0.19,respectively.Animal husbandry hada health risk through drinking brick tea among them.According to the health standard of total fluoride intake in China,when drinking brick tea with fluoride contents of 300,430,460 and 500 mg/kg,the safe consumption of brick tea for school-age children was 2.9,2.0,1.9 and 1.8 kg,respectively,and for adult was 4.3,3.0,2.8 and 2.6 kg,respectively.Conclusions Brick tea has high fluoride content,and percent of qualified brick tea is low and few of low-fluoride brick tea are consumed.There is a health risk in the animal husbandry who has a large amount of brick tea.
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Objective@#To evaluate the intervention effects of response to heatwave in communities of four cities, China.@*Methods@#Baseline survey on heatwave and climate change related knowledge, attitude and practice (KAP) was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model.@*Results@#The age of the residents interviewed before and after intervention was (46.4 ± 15.5) years and (45.0 ± 15.9) years, respectively. Overall, the residents' awareness rates of heatwave before and after intervention were 70.5% (1 131/1 604) and 82.9% (1 359/1 640) (χ2=69.40, P<0.001). The rate of residents who had wished to receive early warning information increased 6.3% (χ2=41.11, P<0.001), which reached 94.6% (1 551/1 604) after intervention from 88.3% (1 416/1 604) in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% (1 105 residents) among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% (1 231 residents) among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made active role in protecting health from heatwaves. After a series of intervention, male had a effect on attitude about hot wave than female in Nanjing and Chongqing, OR (95%CI) were 1.48(1.02-2.16) and 1.45 (1.18-2.05) , respectively; compared with subjects below primary school education, people with college degree or above had higer KAP in all cities (ORs range from 1.18 to 2.05), P<0.05; regular physical exercise (ORs range from 1.39 to 2.70) also had profound impacts on KAP in all cities (P<0.05).@*Conclusion@#s Early warning and health education were effective measures to enhance residents' response capacity to climate change.
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Objective To study the hematopoietic stem cell injury(HSC)induced by busulfan. Methods C57BL/6 mice were treated with i.p. injection of 20 mg/kg or 40 mg/kg busulfan. All mice were euthanized at 15 days and 30 days after busulfan treatment for analysis of the peripheral blood cell counts, bone marrow cellularity and HPC (LKS-, lineage-sca1 -c-kit+), HSC(LSK, lineage-sca1 +c-kit+)and long-term HSC(CD34 - LSK, CD34 - lineage-sca1 +c-kit+)frequency. The colony-forming unit-granulocyte and macrophage(CFU-GM)ability of HPC was measured by colony-forming cell(CFC)assay,and the HSC self-renewal capacity was analyzed by single-cell colony-forming assay. Results The busulfan administration decreased the WBC,RBC and PLT compared with control mice. The HPC function (CFU-GM)was impaired(P < 0.05), and the HSC colony forming ability was decreased at 15 days after busulfan treatment(P < 0.05), whereas the body weight of the mice didn't change significantly after busulfan treatment. Conclusions Our findings suggest that busulfan can induce hematopoietic stem cell injury,and provide a support for the study of hematopoietic stem cell injury mechanism.
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Objective To understand the associations between extremely low and high air temperature and the years of life lost (YLL) due to diabetes deaths in Chongqing and Harbin with different climatic characteristics in China.Methods A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the lag and cumulative effects of extremely low and high air temperature on YLL due to diabetes for lag 0-30 days by using the urban meteorological and diabetes mortality data of Chongqing (2011-2013) and Harbin (2008-2010).The effects were expressed as relative risk (RR).Results In Chongqing,the cold effects on YLL due to diabetes were delayed by four days and lasted for three days (lag4-6) with the highest RR of 1.304 (95％ CI:1.033-1.647) at lag5.The hot effects were delayed by one day (lagl) with RR of 1.321 (95％ CI:1.061-1.646).In Harbin,the extreme cold effects on YLL were delayed by four days and lasted for seven days (lag4-10) with the highest RR of 1.309 (95％CI:1.088-1.575) at lag6.The hot effects were delayed by one day and lasted for four days (lagl-4) with the highest RR of 1.460 (95％ CI:1.114-1.915) at lag2.The unit risk for cold and hot effects was 43.7％ (P=0.005 5) and 18.0％ (P=0.000 2) in Chongqing and 15.0％ (P=0.000 8) and 29.5％(P=0.001 2) in Harbin,respectively.Conclusions Both extremely low air temperature and extremely high air temperature might increase the years of life lost due to diabetes in cities with different climate characteristics.Health education about diabetes prevention should provide information about the effects of extreme weather events.
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Objective To understand the associations between extremely low and high air temperature and the years of life lost (YLL) due to diabetes deaths in Chongqing and Harbin with different climatic characteristics in China.Methods A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the lag and cumulative effects of extremely low and high air temperature on YLL due to diabetes for lag 0-30 days by using the urban meteorological and diabetes mortality data of Chongqing (2011-2013) and Harbin (2008-2010).The effects were expressed as relative risk (RR).Results In Chongqing,the cold effects on YLL due to diabetes were delayed by four days and lasted for three days (lag4-6) with the highest RR of 1.304 (95％ CI:1.033-1.647) at lag5.The hot effects were delayed by one day (lagl) with RR of 1.321 (95％ CI:1.061-1.646).In Harbin,the extreme cold effects on YLL were delayed by four days and lasted for seven days (lag4-10) with the highest RR of 1.309 (95％CI:1.088-1.575) at lag6.The hot effects were delayed by one day and lasted for four days (lagl-4) with the highest RR of 1.460 (95％ CI:1.114-1.915) at lag2.The unit risk for cold and hot effects was 43.7％ (P=0.005 5) and 18.0％ (P=0.000 2) in Chongqing and 15.0％ (P=0.000 8) and 29.5％(P=0.001 2) in Harbin,respectively.Conclusions Both extremely low air temperature and extremely high air temperature might increase the years of life lost due to diabetes in cities with different climate characteristics.Health education about diabetes prevention should provide information about the effects of extreme weather events.
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Objective To investigate the level and influencing factors of subjective well-being of nurses and establish a model of the relationship of job stress, self-efficacy and subjective well-being. Methods Totally 438 nurses from 5 hospitals in Changchun city were investigated with the self-designed demographic questionnaire, General Well-Being Scale, Nurse Job Stressors Scale and Self-Efficacy Scale. Results The total score of subjective well-being was (71.36 ± 18.83) points. Single factor analysis found that age (F=1.759, P<0.01), department (F=1.712, P<0.01), professional title (F=1.364, P<0.05), years of working (F=1.420, P<0.05) and monthly income (F=1.632, P<0.01) were statistically significant. Multiple linear regression analysis showed that sex (t=-2.447, P<0.05), the first factor of job stress (t=-5.033, P<0.01), the second factor (t=-2.478, P<0.05), the third factor (t=-2.315, P<0.05), the fifth factor (t=-5.862, P<0.01) and self-efficacy (t=10.705, P<0.01) were the predictive effectton of subjective well-being. The result of path analysis shows that self-efficacy has a significant effect of adjustment on job stress and subjective well-being (direct effects=-0.62, indirect effects=-0.24, P<0.01). Conclusions The nurse subjective well-being is in the medium level. Hospitals and all related departments should take effective measures to reduce or eliminate unfavorable factors and increase the protective factors, and then improve the level of nurses′subjective well-being and nursing quality.
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The individual variability should be considered in precision medicine-prevention and treatment strategies.Medical research using genomics, proteomics, metabolomics, systems analyses, and other modern tools has made big progress.In 2002, the members of the Complex-Trait Consortium proposed to develop a new mouse genetics resource called the Collaborative Cross (CC).The CC is a genetic reference panel of recombinant inbred lines of mice, designed for the dissection of complex traits and gene networks.It will provide a powerful measure for functional studies of biological networks, which will be essential to understand the intricacies of disease processes.
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<p><b>OBJECTIVE</b>To explore the short-term effects of ambient PM10 pollution on mortality due to circulatory diseases, and to study the modifying effect of season on the association between ambient PM10 concentration and mortality in Nanjing.</p><p><b>METHODS</b>Daily mortality, air pollution, and meteorological data from 1 January 2009 to 31 December 2013 in Nanjing were collected; Time-stratified case-crossover design was used to analyze the associations between daily average concentration of inhalable particle (PM10) and mortality due to circulatory diseases; Odds ratios (OR) and 95% confidence intervals (CI) were calculated; And stratified analysis was conducted to compare the mortality risks of circulatory diseases exposed to outdoor PM10 in warm season (May-October) with that in cool season (November-April).</p><p><b>RESULTS</b>The mean daily average concentrations of PM10, NO2, and SO2 from 2009 to 2013 in Nanjing were 109.1, 51.5, and 35.4 µg/m(3), respectively. During our study period, a total of 78 299 circulatory disease deaths were recorded. On average, there were approximately 43 circulatory disease deaths per day; and deaths due to cardiac diseases, ischemic heart disease and cerebrovascular diseases were 19, 10 and 24 per day, respectively. After adjusting for the meteorological variables such as daily temperature, relative humidity and air pressure, a10 µg/m(3) increment of PM10 was associated with the mortality on values of (OR) 1.002 4 (95% CI: 1.000 1-1.004 8) for total circulatory diseases, 1.004 8 (95% CI: 1.001 3-1.008 3) for cardiac diseases, 1.007 3 (95% CI: 1.002 4-1.012 3) for ischemic heart disease and 1.000 5 (95% CI: 0.998 5-1.002 4) for cerebrovascular diseases, respectively. In summer season, the OR values of daily mortality for total circulatory diseases and cerebrovascular diseases were 1.008 0 (95% CI: 1.003 9-1.012 2) and 1.005 7 (95% CI: 1.002 0-1.009 4), respectively, the corresponding OR values in cool season were 1.001 4 (95% CI: 0.998 5-1.004 2) and 0.998 8 (95% CI: 0.996 4-1.001 2), respectively; The effect estimates in warm season were higher than that in cool season.</p><p><b>CONCLUSION</b>The elevated levels of ambient PM10 were positively associated with the increase of mortality due to circulatory diseases, and season may modify the effects of outdoor PM10 pollution on mortality.</p>
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Humanos , Contaminantes Atmosféricos , Contaminación del Aire , Enfermedades Cardiovasculares , Mortalidad , Trastornos Cerebrovasculares , Mortalidad , China , Estudios Cruzados , Material Particulado , Estaciones del Año , TemperaturaRESUMEN
Objective To observe the effect of ulinastatin on the expression of interleukin 15 (IL-15), connective tissue growth factor (CTGF) and malondialdehyde (MDA) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose. Methods RPMCs were isolated, cultured and passaged by trypsin, then identified. The third generation of cultured RPMCs were used in the experiment. RPMCs were divided into normal control group, high glucose (1.5%, 2.5%, 4.25%) for 6 hours and 12 hours, high glucose (2.5%) for 3, 6, 12, 24 hours or ulinastatin (160, 320, 640U/ml) for 12 hours. IL-15 mRNA was detected by real-time PCR. IL-15 and CTGF protein in supernatants was detected by ELISA. MDA protein was detected by TBAS. Results Compared with the control group, the expression of IL-15, CTGF and MDA was significantly increased in the groups stimulated by high glucose (P＜0.05) in dose- and time-dependent manner. Ulinastatin could significantly decrease the expression of IL-15, CTGF and MDA induced by high glucose in dosedependent manner both in protein and gene levels (P＜0.05). Conclusions High glucose can up-regulate the expression of IL-15, CTGF and MDA in RPMCs. Ulinastatin can reverse these changes.
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Objective:To evaluate the effects and safety of adjuvant chemotherapy for adults with malignant glioma. Method:PubMed,EMBASE,Cochrane Library,CNKI,Chinese Biomedical Database and VIP were reviewed and randomized controlled trials of adjuvant chemotherapy for adults with malignant glioma were identified.The quality of the included trials was evaluated by two reviewers.A meta-analysis was conducted in homogeneous studies.Result:13 controlled trials were involved in 3639 patients.The meta-analysis results showed that compared with radiotherapy alone,the adjuvant chemotherapy might increase 1 year survival,2 years survival,2 years progression free survival,and their OR and 95%CI were 0.61(0.43,0.87),0.52(0.33,0.81),and 0.42(0.19,0.90),respectively,but 1 year progression free survival and 5 years survival had no statistical significance.Their OR and 95%CI were 0.52(0.26,1.04) and 0.75(0.54, 1.04) respectively.5 studies(2418 cases) reported that the toxicity rates increased in patients who received radiotherapy plus adjuvant chemotherapy compared with those in patients who received radiotherapy alone.Conclusion:The adjuvant chemotherapy may increase one year survival and two years survival,and have advandage impact on 2 years and 5 years progression free survival.Owing to the high possibility of attrition bias and measurement bias in the included studies,there must be a negative impact on evidence intensity of our results and therefore,some randomized controlled trials with high quality have to be expected to obtain the best evidence.