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Objective:To explore the employment experiences of coordinators of In-Hospital Organ Procurement Organization (OPO).Methods:Based on purpose sampling, 12 full-time In-Hospital OPO coordinators in Chongqing City were recruited from July to December 2020. A semi-structured and in-depth interview was performed and the data was analyzed by Colaizzi.Results:4 first-level themes were extracted, including professional identity process, negative emotional experience, improvement of professional practice competence and job expectancy. 12 second-level themes were identified including career expectations and identity confusion, professional values, shortage of respect and ratification, huge workloads, great psychological pressure, influence of the bereaved families, enhancement of the ability to communicate, improvement of problem-solving ability, improvement of team-work ability, optimization of scenario simulation, a perfection of the assessment system, a clear career path.Conclusions:In-Hospital OPO coordinators are lack of professional awareness in an initial stage. While feeling a sense of professional value, they also experience some negative emotions. Furthermore, their competences are improved in practice and they, meanwhile, express a strong desire for career development. It is suggested that the administrators could explore establishment of academic education, enhancement of psychological and social support, creation of pretty working environments and improvement of training, assessment and promotion systems to facilitate the career development of coordinators.
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Effective response to the aging of China′s population bears on the overall development of the country and the well-being of hundreds of millions of people. From the elderly social participation, intelligent media use and calm better death as the entry point actively promote healthy aging, happy aging through the community nursing, information nursing, hospice care and other perspectives. Nursing has always adhered to the people-centered, social reality needs as the guidance. It is expected to provide reference for improving the welfare construction of the broad masses of people represented by the elderly and facilitating the all-round promotion of the Healthy China strategy.
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Henoch-Schonlein purpura (HSP) is a type of systemic leucocytoclastic vasculitis mediated by IgA immune complex deposition, which mainly affects the skin, joints, gastrointestinal tract and small blood vessels in the glomeruli.It is a common systemic vasculitis in children.Due to severe complications of HSP, conventional clinical medicine has limited efficacy in some serious, even life-threatening or organ dysfunction cases, such as advanced renal insufficiency, fatal gastrointestinal bleeding, nervous vasculitis, pulmonal bleeding, etc.As an adjunctive therapy, plasma exchange has led to significant results for this type of HSP.In this paper, the status of plasma exchange in HSP treatment was reviewed.
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Objective To investigate the role of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC1α) in high-fat diet-induced insulin resistance (IR) and mitochondrial degeneration in skeletal muscle.Methods Wistar rats were randomly divided into a normal chow (NC)group (n =10) and a high-fat diet(HFD)group (n =10).After eight weeks,fasting plasma glucose(FBG) levels,fasting insulin(FINS) levels and glucose infusion rates (GIR) in each group were measured (n=3).Samples of rat skeletal muscle were harvested.L6 myoblasts were divided into a control group,a PA group (cells were cultured in palmitic acid),a pcDNA3 group (cells were transfected by the plasmid pcDNA3)and a pcDNA3-PGC1α group (cells were transfected by the PGC1α-overexpressiorn plasmid).Expression levels of PGC1α,nuclear respiratory factor 1 (NRF1),uncoupling protein 3 (UCP3),and cytochrome C oxidase 1 (COX1) in skeletal muscle and L6 myoblasts were measured by real-time PCR and Western blotting.Results Levels of FBG and insulin were higher and those of GIR were lower in the HFD group than in the NC group,(6.0±0.7)mmol/L vs.(5.0±0.4)mmol/L、(23.3±3.0)mU/L vs.(12.9±1.8)mU/L、(14.2±1.8)％ vs.(22.6±2.4)％ (t =-3.578,-6.679,6.265,respectively,P ＜ 0.05).Expression levels of PGC1α,NRF1,UCP3,and COX1 were down in skeletal muscle in the HFD group compared with those in the NC group(P ＜0.05).In L6 myoblasts cultured with palmitic acid,the expression of PGC1 α,NRF1,UCP3,and COX1 were down compared with their expression in the NC group (P ＜ 0.05).However,the altered expression of PGC1α,NRF1,UCP3,and COX1 was reversed by transfecting with PGC1α-overexpression plasmids (F =30.079,96.883,226.772,respectively,P ＜ 0.001).Conclusions High-fat diets can lead to insulin resistance and decreased expression of mitochondrial energy metabolism-related genes,which can be reversed by PGC1α.The decreased expression of PGC1α may mediate the high-fat diet-induced mitochondrial dysfunction and IR.
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Objective To investigate the effects of activated protein kinase(AMPK)agonists on the expression of peroxisome proliferator-activated receptor γ coactivator 1α(PGC1a),mitofusin 2 (Mfn2) and nuclear respiratory factor1 (NRF1)in the process of lipid-induced mitochondrial dysfunction of skeletal muscles.Methods The expression of PGC1α,Mfn2 and NRF1 in C2C12 skeletal muscle cells after intervention with palmitic acid was detected using reverse transcription-polymerase chain reaction(RT-PCR)and Western blotting.The effect of 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) on Mfn2 and NRF1 and,the expression of Mfn2 and NRF1 in C2C12 cells induced by a PGC1α activator and PGC1α-siRNA were assessed by Western blotting.Results Palmitic acid decreased the mRNA and protein expression of PGC1α,Mfn2 and NRF1 in C2C12 cells (P＜0.05).Additionally,AICAR,rosiglitazone and metformin up-regulated PGC1α expression,regardless of the presence of palmitic acid and,AICAR reversed lipid-induced PGC1α,Mfn2 and NRF1 attenuation in C2C12 cells.Furthermore,Mfn2 and NRF1 protein expression increased with PGC1α over-expression,and decreased with down-regulated PGC1α expression.Conclusions AICAR can relieve the adverse effects of palmitic acid on PGC1α,Mfn2 and NRF1 in skeletal muscle cells.Moreover,it appears that AICAR can up-regulate Mfn2 and NRF1 expression through activating PGC1α.
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Objective To investigate whether there are changes in the ability of intertemporal choices in migraine sufferers. Method Thirty migraine sufferers and thirty healthy controls were investigated by Delay?discount Test. Results (1)The ratio of later?large (LL) choice in migraine suffers((18.15± 17.53)%) was significantly lower than that in the healthy controls((35.37±20.70)%),and the difference was statistically significant(t=3.31, P<0.05).Under the immediate option for now selection conditions and no immediate option for not?now selection conditions,the ratio of later?large (LL) choice in migraine suffers ((18.33±21.00)% ,(17.96±18.09)%) was also significantly lower than that in the healthy controls ((35.56±21.52)%,(35.19±22.05)%),and the difference was statistically significant(t=3.31, P<0.05;t=3.14, P<0.05).(2) Pearson correlation analysis showed that the Stroop Test of migraineurs was positively correlated with LL selection ratio under now conditions (r=0.49, P=0.006) and total LL selection (r=0.42, P=0.021) . Conclusion The ability of intertemporal choices in migraine sufferers has been impaired,which is correlated with executive function.
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Objective To explore the decision-making impulsivity in patients with idiopathic generalized epilepsy.Methods 39 patients with idiopathic generalized epilepsy and 40 healthy controls completed delay discounting task.The participants were demanded to make a series of choices between two different rewards after a delayed period (a smaller sooner reward or a larger longer reward).Results The delay discount rate k was transformed to common logarithm lg (k),and lg (k)=-1.75±0.86 in IGE group was more larger than that in HC group lg (k)=-2.21±0.72(t=2.58,P=0.01).IGE group performed worse than HC group in verbal fluency test-semantic (M (P25,P75):16.00 (14.00,19.00) vs 18.00 (16.00,22.75),Z =-2.86,P＜0.01),verbal fluency test-voice (M (P25,P75):4.00 (3.00,6.00) vs 7.00 (6.00,10.00),Z =-4.26,P＜0.01) and digital span backward test (M(P25,P75):5.00(5.00,7.00) vs 6.00 (5.00,8.00),Z=-2.48,P=0.01).In addition,lg (k) had significant correlation with verbal fluency test-semantic (r=0.32,P=0.048).Conclusion IGE group prefer immediate rewards and show more impulsive than HC group in delay discounting task.IGE group has cognitive deficit in frontal lobe language function and attention function.In addition,impulsivity is correlated with frontal lobe function.
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Objective To investigate the impairment of intertemporal choices in adolescents with positive and negative schizophrenic symptoms.Methods 30 adolescent schizophrenia patients with positive symptoms (positive symptoms group),30 adolescent schizophrenia patients with negative symptoms (negative symptoms group)and 30 healthy controls were selected.All the subjects were investigated with intertemporalchoice Test.Results (1) Under now conditions ((37.22±30.92)％,(19.67±16.35)％,P＜0.05)),notnow conditions ((35.74±31.69)％,(19.33± 18.07)％,P＜0.05)) and overall condition ((36.48±30.44) ％,(19.50± 13.82)％,P＜0.05)),the ratio of later-large (LL) choice in negative symptoms group were significantly higher than those in the healthy controls.Under now conditions ((37.22±30.92) ％,(20.37±22.33) ％,P＜0.05)),not-now conditions ((35.74± 31.69) ％,(22.04±22.05) ％,P＜ 0.05)) and overall condition ((36.48±30.44) ％,(21.20±21.57) ％,P＜0.05)),the ratio of LL choice in negative symptoms group were significantly higher than those in positive symptoms group.There were no differences in the ratio of LL choice between positive symptoms group and healthy controls (P＞ 0.05).(2)Pearson correlation analysis showed that the Vocabulary Fluency Test of negative symptoms group was positively correlated with LL selection ratio under now conditions (r=0.411,P=0.024).Conclusion The ability of intertemporal choices in adolescents schizophrenia patients with negative symptoms is impaired remarkably,while this kind of ability is impaired unremarkable in adolescence with negative symptoms.The ability of intertemporal choices in adolescents schizophrenic patients with negative symptoms is correlated with cognitive executive function.
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Objective To explore whether the ability of intertemporal choice is impaired in schizophrenic patients and in their unaffected siblings.Methods Twenty-five schizophrenia patients,twenty-five unaffected siblings of patients and thirty healthy controls were recruited in the study."Delay-discounting" task and a battery of cognitive neuropsychological assessment were used to examine the intertemporal decision-making.Results (1) the value of k was ((0.005±0.009 in schizophrenia,0.011±0.014 in unaffected siblings and 0.024±0.029 in healthy controls,respectively.There was significant difference in k value among these three groups (F=9.487,P＜0.001).There were significant differences in k value between patients group and healthy controls,and between unaffected siblings and healthy controls (P＜0.05).There was no significant difference between schizophrenia and their unaffected siblings (P＜0.05).(2) Pearson correlation analysis not showed any relationship between neuropsychological test and the value of k.Conclusion The ability of intertemporal choices is impaired in schizophrenia and their unaffected siblings to a great degree.
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Objective To explore whether the ability of intertemporal choice is impaired in schizophrenic patients and in their unaffected siblings.Methods Twenty-five schizophrenia patients,twenty-five unaffected siblings of patients and thirty healthy controls were recruited in the study."Delay-discounting" task and a battery of cognitive neuropsychological assessment were used to examine the intertemporal decision-making.Results (1) the value of k was ((0.005±0.009 in schizophrenia,0.011±0.014 in unaffected siblings and 0.024±0.029 in healthy controls,respectively.There was significant difference in k value among these three groups (F=9.487,P＜0.001).There were significant differences in k value between patients group and healthy controls,and between unaffected siblings and healthy controls (P＜0.05).There was no significant difference between schizophrenia and their unaffected siblings (P＜0.05).(2) Pearson correlation analysis not showed any relationship between neuropsychological test and the value of k.Conclusion The ability of intertemporal choices is impaired in schizophrenia and their unaffected siblings to a great degree.
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OBJECTIVE@#To investigate the expression of MIF, NF-κB p65 and IL-1β in the tissue of nasal polyps and normal inferior turbinate, to analyze their relevance, and to explore their role in nasal polyps.@*METHOD@#The infiltrating results of EOS and others inflammatory cells in 48 cases diagnosed as nasal polyps (nasal polyps group) were detected by HE staining, and the expression of MIF, NF-κB p65 and IL-1β were investigated by immunohistochemistry. Twenty-one patients who were performed septoplasty orthotics were included as the control group; the VAS and Lund-Kennedy score were used to evaluate the degree of nasal polyps in patients and the correlation analysis was conducted between the disease severity and the expression levels of this three factors.@*RESULT@#(1) The infiltrating results of EOS and the expression level of MIF, NF-κB p65, IL-1β in nasal polyps group are obviously higher than these in the control group (P 0.05).@*CONCLUSION@#MIF, NF-κB p65 and IL-1β may promote the development of the nasal polyps, and there may exist the IL-1β--NF-κB--MIF approach in nasal polyps; MIF and NF-κB may participate in maintaining physiological function of inferior turbinate and have relations with the lightest sustained inflammation of inferior turbinate. The MIF and NF-κB p65 nuclear activation rate can be used as a standard of the nasal polyp severity and the judgement prognosis.
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Humanos , Inflamación , Metabolismo , Interleucina-1beta , Metabolismo , Oxidorreductasas Intramoleculares , Metabolismo , Factores Inhibidores de la Migración de Macrófagos , Metabolismo , Pólipos Nasales , Metabolismo , Factor de Transcripción ReIA , MetabolismoRESUMEN
Objectives To analyze a rare autosomal recessive disease, aggrecan type spondylometaphyseal dysplasia (SEMD), which was caused by ACAN gene mutations. Methods A 7 years old girl was diagnosed with short stature after excluding growth hormone deficiency, idiopathic short stature, and hypothyroidism. Combining family history and clinical features, SEMD were suspected and genetic tests were performed. Results The patient was found with homozygous mutations of c.512C > T inACAN gene, and was diagnosed with aggrecan type SEMD. Her parents were found to be heterozygous mutation carrier. Conclusions In patients with high suspection of a special type of short stature, early genetic tests should be carried out for a clear diagnosis.
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Objective To investigate the effects of dopaminergic medication on decision-making un-der ambiguity in patients with early Parkinson's disease( PD) . Methods Using Iowa Gambling Task ( IGT) for 24 early non-medication idiopathic PD patients( Hoehn and Yahr Scale≤Ⅱlevel) ,24 early idiopathic PD patients with regular dopaminergic medication and also for 24 healthy controls( HC) whose age,gender,and education match to PD patients to test their ability of decision-making under ambiguity. Results The results showed non-medication PD group showed impairments on digtal span and verbal fluency and decision-making task. There was significant difference in IGT task scores among the three groups(F=6.024, P=0.004) . The total net scores of advantageous choices in IGT were significantly lower in non-medication PD group( (-4.50 ±22.19) scores) than medication PD group((8.83±23.24)scores) and healthy group((15.92±15.77) scores) . The difference of net scores in block1 to block5 between non-medication PD group and medication PD group was gradually increased,and the difference of net scores in block5 was significant(P0.05) . As the game processing,medication PD group gradually shifted their se-lections toward the advantageous choices. But non-medication group did not exhibit this shift pattern and the performance was much poorer. Meanwhile, the study also indicated the total net scores of advantageous choices for non-medication PD group was positive correlation to the MoCA scores ( r=0.614, P=0.001). Conclusion The present study has shown that non-medication PD group has impairment in decision-making under ambiguity risk condition and prefer to choose risky options. when exogenous complement dopaminergic medication,the risk decision-making ability of medication PD group has been improved.
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Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing thyroid nodules of thyroid imaging reporting and data system (TI-RADS) 4. Methods From November 2011 to August 2016, 159 TI-RADS 4 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery. Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose thyroid malignancy. The diagnostic performances of CEUS, elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value and omission diagnostic rate of CEUS, elastography and their combined use were compared by Chi-square test. Results The CEUS features significantly predicting malignancy were heterogeneous enhancement, hypoenhancement, without or incomplete ring-enhancement and later time to peak than the surrounding parenchyma (χ2=24.378, 69.194,29.434 and 7.375, all P 0.05). Conclusion The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of TI-RADS 4 nodules.
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Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.
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Objective To identify the risk factors associated with cardiovascular and cerebrovascular disease (CCVD) in maintenance hemodialysis (MHD) patients. Methods We analyzed all of the patients undergoing maintenance hemodialysis in the dialysis center of the 3rd Affiliated Hospital of Sun Yat-sen University for at least 3 months from Jan 1st, 2009 to Dec 31st, 2014. Baseline and yearly interval clinical data were recorded and patients were followed up until morbidity or death of CCVD. Cox proportional hazard regression and time-dependent Cox regression were used to estimate the relative risk of outcomes associated with clinical measurements. Results There were 243 patients enrolled in the study, with a mean age of (53.2 ± 16.4) years old, and 138 of them were male (56.8%). The multivariate Cox proportional model revealed that age (HR=1.040, 95%CI:1.015-1.065, P=0.002), Erythropoietin (EPO) dose (HR=0.914, 95%CI: 0.846-0.987, P=0.022) and history of cardiovascular and cerebrovascular disease (HR=4.045, 95%CI: 2.074-7.890, P<0.001) were independent predictors of CCVD in MHD patients. After adjusting for baseline predictors, time-dependent serum phosphorus level (HR=1.722, 95%CI: 1.034-2.866, P=0.037) was significantly associated with CCVD. Conclusion Older age, decreases in EPO dose and history of cardiovascular and cerebrovascular disease were associated with increased risks of CCVD in MHD patients. Increase in serum phosphorus level was associated with increased risks of CCVD in a time-dependent manner.
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Objective To explore the effect of dietary fat acids on incretin and islet function in healthy adults .Methods Before each test, healthy subjects received a 1-week pre-experiment eucaloric diet .Fifteen subjects consumed two meals containing different fat acids , including high saturated fat acid ( HSF) and high monounsaturated fat acid ( HMF) .On two separate occasions,they underwent a minimum of 1-week washout between meals .At 0,30,60,120,180 and 240 min following meal intake, the plasma concentrations of gastric inhibitory polypeptide (GIP), glucagon-like peptide-1(GLP-1) and serum concentrations of glucose, insulin, triglycerides ( TG) and free fatty acid ( FFA) were measured.Results Postprandial glucose did not increase significantly following HSF and HMF meals (P>0.05).Compared with HMF meal, significant increase in AUCins240min,AUCTG240min and AUCFFA240minwas observed following HSF meal (P0.05). AUCI/AUCG was significantly lower following HMF meal as compared with HSF meal (P<0.05).Conclusion This study demonstrates that the function of GIP ,GLP-1 andβcell is affected by the dietary fat acids in healthy adults .The HMF meal may stimulate GIP and GLP-1 secretion to a greater extent than HSF meal .
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To report a case of an adult male with a huge cavernous hemangioma arising from the nasal septum, and the lesion was widely spread to hard palate, sphenoid sinus, ethmoid sinus and right maxillary sinus. After giving embolization, it was completely excised via transnasal endoscopic approach and lateral rhinotomy, histologic examination reported cavernous hemangioma. There was no recurrence at 1 year's follow-up.
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Humanos , Masculino , Persona de Mediana Edad , Hemangioma Cavernoso , Tabique Nasal , Neoplasias NasalesRESUMEN
OBJECTIVE@#Aimed to discuss the perioperative treatment of the patient with asthma under endoscopic sinus surgery, to reduce the complications, adverse events and improve cure rate.@*METHOD@#One hundred and fifty-two patients with asthma under nasal endoscopic surgery were analyzed retrospectively.@*RESULT@#After specification of perioperative treatment, all patients with good control of asthma were in good condition before surgery. One hundred and sixteen patients were safely backed to ward after surgery. There were 13 cases had asthma attack of different degrees. The other 35 patients were send to ICU for observation of 24 to 48 h. One case had an acute attack after returned from ICU. One patient had instantly attacks of asthma after extubation. All patients improved after treatment,and recovered well after 1 year's follow-up.@*CONCLUSION@#We should pay more attention to the close relationship of CRS and asthma, standardize the perioperative treatment, master the principles of management of acute attack of asthma. As long as to make sufficient perioperative preparation, the nasal endoscopic surgery with asthma is safe, and it can have good efficacy.
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Asma , Enfermedad Crónica , Endoscopía , Estudios de Seguimiento , Estudios Retrospectivos , Rinitis , Cirugía General , Sinusitis , Cirugía General , Resultado del TratamientoRESUMEN
Objective To investigate the memory monitoring ability in patients with hepatolenticular degeneration(HLD) and explore the mechanism of their memory impairment.Methods The feeling-of-knowing (FOK) paradigm of episodic memory(EM) and semantic memory(SM)were established and subsequently applied to 30 HLD patients and 30 healthy control(HC) participants who were matched in age and educational level.Results Compared with healthy control group (FOK-EM recall (64.17 ± 29.21) ％ ; FOK-SM recall (84.72 ± 11.44)％),the FOK-EM recall((26.55±20.92)％) and FOK-SM recall((53.93±28.42)％) in HLD patients were significantly lower(t=-5.140,P＜0.01 ; t=-5.123,P＜0.01).The positive judgment and correct recognition of FOK-EM ((50.64±29.43) ％) and the negative judgment and correct recognition of FOK-EM((12.80± 18.32) ％) in the HLD group were significantly different from the HC group (the positive judgment and correct recognition of FOK-EM:(75.15±31.73)％ and the false judgment and correct recognition of FOK-EM:(1.81±5.41)％; t=-2.693,P＜0.05 ; t=3.026,P＜0.01).Most importantly,the stroop effect was positively correlated with the negative judgment and correct recognition of FOK-EM in HLD group(r=0.601,P＜0.01).Conclusion The results show that the HLD group underestimate their memory performance on episodic FOK,and the impairment of memory monitoring is positively correlated with the deficit of executive function,indicating that the prefrontal impairment can be an influential factor of memory disorder in HLD,whereas the unimpaired semantic metamemory FOK indicates the episodic and semantic metamemory monitoring may depend on different neural network.