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Objective:By analyzing the cost change trend,internal structure change and main influencing factors of diabetes inpatients'hospitalization expenses,it provides empirical basis for promoting the reform of medical service prices,optimizing the internal structure of hospitalization expenses,effectively controlling hospitalization expenses,and reducing the economic burden of diabetes inpatients.Methods:Using the first page data of medical records of 13 426 diabetes inpatients in the target hospital from 2017 to 2021,it analyzes the structural change of diabetes inpatients'hospitalization expenses by using structural change degree and grey correlation degree methods,and analyzes the influencing factors of hospitalization expenses by using linear regression and BP neural network model.Results:Drug expenses and medical technology expenses are the top two in the proportion of total hospitalization expenses of discharged patients with diabetes,and they account for a large proportion in the total hospitalization expenses.The results of structural change and grey correlation show that drug expenses and medical technology expenses are these two factors that cause changes in the total hospitalization cost structure and have a high correlation with the total hospitalization cost,with a cumulative contribution rate of 90.50％.According to the results of linear regression and neural network model,the length of stay is the most important factor affecting the total cost of hospitalization of diabetes patients,followed by the number of operations/procedures and diagnoses.Conclusion:The internal composition of hospitalization expenses for diabetes patients is unreasonable.The proportion of drug expenses and medical technology expenses is too high.The proportion of medical and nursing expenses reflecting the technical labor value of medical personnel is relatively low.The structure of medical income needs to be further optimized.The length of stay is the most critical factor affecting the hospitalization expenses of diabetes patients.Reasonable control of the length of stay can effectively control the unreasonable growth of medical expenses and reduce the economic burden of diabetes patients.
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Objective:To conduct a scope review on the application of ICU diaries in critically ill patients, laying the foundation for further exploration and construction of ICU diary patterns and frameworks that were in line with the national conditions and tailored to different regions and cultural backgrounds.Methods:The Joanna Briggs Institute Reviewer′s Manual was used as the methodological framework, and a computer search was conducted in nine domestic and international databases, including China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, Cochrane Library, PubMed, and Embase, etc. The search period was from the inception of the databases until March 13, 2023. The included literature was screened, summarized, and analyzed.Results:A total of 19 articles were included. ICU diaries were commonly recorded using a combination of text and visuals, with the involvement of both healthcare professionals and family members. Most patients received ICU diaries approximately one month after their transfer from the ICU. Out of the 15 studies, ICU diaries were found to be effective, while 4 studies indicated no significant improvement in patients′ psychological issues. However, ICU diaries were still considered acceptable by patients and their families.Conclusions:The application of ICU diaries has shown positive significance in critically ill patients, but further research and exploration are needed to investigate its impact on issues such as post-traumatic stress disorder, anxiety, depression, and quality of life. In the future, a combination of multiple forms and high-quality research designs with large samples, long periods, and structured approaches should be employed to explore its application effects and long-term outcomes on psychological problems.
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Objective:To analyze the status quo of type D personality, intolerance of uncertainty and family support in first-episode stroke patients, and to explore the mediating role of family support between type D personality and intolerance of uncertainty in first-episode stroke patients, in order to provide reference for formulating relevant clinical intervention measures to promote the physical and mental health of first-episode stroke patients.Methods:This study was a cross-sectional investigation. A total of 300 patients with acute first-episode stroke who met the inclusion and exclusion criteria in the Department of Neurology of the General Hospital of Ningxia Medical University and the First People′s Hospital of Yinchuan from May 2023 to September 2023 were selected as the study objects by convenience sampling method. The general data questionnaire, Type D personality Scale-14, Family Caring Index Scale and the Intolerance of Uncertainty Scale were used to investigate them. Pearson correlation analysis was used to test the correlation between variables, and SPSS plug-in PROCESS 3.5 was used to test the mediation effect.Results:Finally, 300 questionnaires were effectively collected, including 228 males and 72 females. Patients aged ≥ 60 years old were the majority, accounting for 49.3% (148/300). The detection rate of type D personality in the first stroke patients was 37.3% (112/300), and the total score of Type D personality inventory, family support and intolerance of uncertainty of type D personality in the first stroke patients were (22.16 ± 9.95), (6.40 ± 2.23), (27.82 ± 7.93) points. The correlation analysis results showed that the intolerance of uncertainty of type D personality in the first stroke patients was positively correlated with type D personality scores ( r=0.675, P<0.001). There was a negative correlation with family support score ( r=-0.644, P<0.001). The results of mediating effect analysis showed that family support played a partial mediating role in the relationship between type D personality and intolerability of uncertainty in first-stroke patients, and the mediating effect accounted for 34.94% of the total effect. Conclusions:The mediating role of family support between type D personality and intolerability of uncertainty in first-stroke patients is established. In the future, the level of family support of patients can be continuously improved to reduce their intolerability of uncertainty, so as to promote the physical and mental health of patients and improve their quality of life.
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Objective To investigate the expression of lncRNA SNHG8 in placenta accrete(PA)and its effect on trophoblast invasion and migration.Methods qRT-PCR was used to detect the expression of lncRNA SNHG8 in placenta tissue of 30 cases in PA group and 30 cases in control group,and the correlation between lncRNA SNHG8 expression and prenatal ultrasound score of 30 cases in PA group was analyzed.Transwell and scratch assay were used to detect the effect of lncRNA SNHG8 interference on the invasion and migration of human chorionic trophoblast cells(HTR8/SVneo cells),and western blot was used to detect the expression of MMP-2 and MMP-9.The downstream targets of lncRNA SNHG8 were predicted by StarBase software,and the expression of lncRNA SNHG8 was detected in placental tissues of the two groups.Dual luciferase reporter assay was used to detect the targeting relationship between lncRNA SNHG8 and miR-542-3p.Results Compared with that of the control group,the expression of lncRNA SNHG8 was up-regulated in the placenta tissue of the PA group(P<0.05),and it was positively correlated with prenatal ultrasound score.Interference with lncRNA SNHG8 inhibited the invasion and migration of trophoblast cells(P<0.05);the protein expression of MMP-9 and MMP-2 also decreased signifi-cantly(P<0.05).Biological prediction indicates that miR-542-3p had a binding site with lncRNA SNHG8,and miR-542-3p expression was down-regulated in PA placental tissue(P<0.05).Dual luciferase reporter assay confirmed that lncRNA SNHG8 could target miR-542-3p.Compared with si-SNHG8+inhibitor-NC,co-transfection of si-SNHG8 and miR-542-3p inhibitor enhanced the invasion and migration ability of trophoblast cells(P<0.05).Conclusion lncRNA SNHG8 is highly expressed in PA and is related to the severity of PA.LncRNA SNHG8 promotes the invasion and migration of trophoblast by regulating the level of miR-542-3p.The study suggests that lncRNA SNHG8 plays an important role in the invasion and migration of PA trophoblast cells,which is expected to be a clinical diagnostic biomarker and therapeutic target.
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Objective To evaluate the clinical value of free glycoprotein non-metastatic melanoma protein B(GPNMB)as a drug resis-tance and prognostic marker for non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)amplifica-tion accompanied by mutations.Methods Fifty-five cases of NSCLC patients with EGFR amplification associated with mutations who received treatment from March 2018 to September 2019 were included as the observation group.All patients received an EGFR-tyrosine kinase inhibitor(EGFR-TKI)as the first-line treatment;67 blood samples from the physical examination center during the same period were randomly included as healthy control.We compared the expression levels of free GPNMB between the two groups,explored the correlation between GPNMB expression and the clinicopathological information in the observation group;and combined the clinical efficacy to evaluate its value as a drug resistance marker.Through follow-up,the progress free survival(PFS)of patients was statistically analyzed,and through multivariate Cox regression analysis,independent risk factors affecting the survival in the observation group were explored.Results Compared with that in the control group,the expression level of free GPNMB in the observation group was signi-ficantly up-regulated.The expression level of free GPNMB in the observation group is significantly related to the clinical efficacy of EGFR-TKI(P = 0.016).Patients with high GPNMB expression have significantly stronger drug resistance,and patients with high GPNMB expression have significantly shorter PFS duration(P = 0.032).A high free GPNMB expression(HR = 4.029,95%CI:1.942-8.358,P＜0.001)is also an independent risk factor affecting patient survival.Conclusion The expression level of free GPNMB in patients with EGFR amplification accompanied by mutant NSCLC is significantly up-regulated,and its high expression is significantly related to the enhancement of the patient's drug resistance.High GPNMB expression is significantly related to the poor prognosis of patients and is an independent risk factor affecting patient survival.
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Objective To summarize the clinical features,diagnosis and treatment and prognosis of trocar site hernia(TSH).Methods Clinical data of 12 patients with TSH receiving laparoscopic surgery from January 2019 to January 2023 were retrospectively analyzed.The clinical manifestations included intestinal obstruction in 8 cases,trocar incision prolongation with fluid seepage in 1 case,and no obvious symptoms in 3 cases.The patients were diagnosed by abdominal CT in 9 cases,by small intestine contrast imaging in 1 case,by abdominal MRI in 1 case,and by abdominal plain film combined with abdominal color ultrasound in 1 case.The hernia was located in the right lower abdomen in 5 cases,the left lower abdomen in 4 cases,and the right upper abdomen in 3 cases.The trocar diameter was 12 mm in 6 cases,10 mm in 5 cases,and 5 mm in 1 case.A drainage tube was placed at trocar site in 5 cases.Open operations were performed in 11 cases,including small intestine reduction and abdominal wall layer-by-layer suture in 4 cases,partial small intestine resection and anastomosis in 3 cases,Onlay repair in 3 cases,and partial omentectomy,transverse colon reduction and Onlay repair in 1 case.Another case developed trocar site refractoriness which did not heal,and the patient refused surgery,who was given dynamic observation.Results The operation was successful in the 11 cases.Postoperatively,1 case of inflammatory intestinal obstruction underwent intestinal decompression tube implantation,1 case of incision bleeding underwent emergency operation again to stop bleeding,and the rest recovered smoothly.All the 12 patients were followed up for 5-48 months,with a median of 13 months.The patient without surgery had persistent induration and intermittent exudation at the trocar site.One case died due to tumor metastasis,and none of the others had hernia recurrence.Conclusions The most common manifestation of TSH is intestinal obstruction,which mostly occurs at trocar with diameter≥10 mm.If there are symptoms,it should be treated by surgery as soon as possible.
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AIM: To analyze the abnormal refractive status of infants and young children aged 6 to 48 months, and to provide basis for the correction of ametropia and the early prevention and treatment of amblyopia.METHODS: Infants and young children aged 6 to 48 months were examined for refraction by Spot vision screener for natural optometry. Clinical data of infants and young children with refractive abnormalities were collected, Ciliary muscle paralysis agent was used for retinoscopy and optometry, and the results were statistically analyzed.RESULTS: A total of 168 cases(336 eyes)with abnormal Spot refractive outcomes were collected, with a high proportion of hyperopia and astigmatism abnormalities, 38.4% and 28.6%, respectively, while the proportion of myopia was low(12.2%). There were 90 cases of anisometropia(≥1.00 D), among which 41 cases(45.6%)were astigmatic anisometropia, 33 cases(36.7%)were hyperopic anisometropia, and 16 cases(17.8%)were myopic anisometropia, accounting for the least proportion. A total of 109 infants and young children with Spot refractive abnormalities completed ciliary muscle paralysis retinal optometry. The analysis of the difference and correlation between Spot diopter and post ciliary muscle paralysis optometry results showed that the difference in astigmatism was 0.34±0.64 D(P<0.001), the difference in hyperopia was -2.10±1.27 D(P<0.001), and the difference in myopia was -0.43±0.91 D(P=0.023). Although there was a statistical difference between the two results, astigmatism, hyperopia, and myopia were highly positively correlated, respectively(r=0.694, 0.762, 0.909).CONCLUSION: The main refractive abnormalities in infants and young children aged 6 to 48 months are astigmatism, hyperopia, and anisometropia, with fewer abnormalities in myopia. For screening abnormalities, further ciliary muscle paralysis agent retinoscopy and optometry should be performed, and glasses correction should be given to effectively prevent refractive amblyopia in infants and young children.
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Insulin-like growth factor-1 receptor (IGF-1R) has been made an attractive anticancer target due to its overexpression in cancers. However, targeting it has often produced the disappointing results as the role played by cross talk with numerous downstream signalings. Here, we report a disobliging IGF-1R signaling which promotes growth of cancer through triggering the E3 ubiquitin ligase MEX3A-mediated degradation of RIG-I. The active β-arrestin-2 scaffolds this disobliging signaling to talk with MEX3A. In response to ligands, IGF-1Rβ activated the basal βarr2 into its active state by phosphorylating the interdomain domain on Tyr64 and Tyr250, opening the middle loop (Leu130‒Cys141) to the RING domain of MEX3A through the conformational changes of βarr2. The models of βarr2/IGF-1Rβ and βarr2/MEX3A could interpret the mechanism of the activated-IGF-1R in triggering degradation of RIG-I. The assay of the mutants βarr2Y64A and βarr2Y250A further confirmed the role of these two Tyr residues of the interlobe in mediating the talk between IGF-1Rβ and the RING domain of MEX3A. The truncated-βarr2 and the peptide ATQAIRIF, which mimicked the RING domain of MEX3A could prevent the formation of βarr2/IGF-1Rβ and βarr2/MEX3A complexes, thus blocking the IGF-1R-triggered RIG-I degradation. Degradation of RIG-I resulted in the suppression of the IFN-I-associated immune cells in the TME due to the blockade of the RIG-I-MAVS-IFN-I pathway. Poly(I:C) could reverse anti-PD-L1 insensitivity by recovery of RIG-I. In summary, we revealed a disobliging IGF-1R signaling by which IGF-1Rβ promoted cancer growth through triggering the MEX3A-mediated degradation of RIG-I.
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Objective:To investigate the clinical application status and safety of systemic administration of Levofloxacin.Methods:Hospitalized children treated with Levofloxacin from January 1, 2017 to December 31, 2022 in Beijing Children′s Hospital, Capital Medical University and Baoding Hospital of Beijing Children′s Hospital were retrospectively recruited.Clinical data like the gender, age, weight, discharge diagnosis, drug name, dosage, route of administration, course of treatment, pathogenic microorganisms, and adverse events were collected.Results:A total of 220 children were included.The age of Levofloxacin use ranged from 1 month and 14 days to 16 years, 7 months and 27 days.The use of Levofloxacin in children was mainly distributed in school age (70 cases), preschool age (65 cases), and early childhood (44 cases), accounting for 81.37% of all children.Children treated with Levofloxacin were admitted in a total of 13 departments, mainly included the respiratory department (77 cases), hematology department (49 cases), infectious medicine department (47 cases), pediatric intensive care unit (14 cases), and stem cell transplantation department (9 cases), accounting for 89.08% of all children.The use of Levofloxacin was mainly applied to children with pneumonia (150 cases), systemic disseminated tuberculosis (25 cases), sepsis (20 cases) and blood disease complicated with infection (16 cases). The common pathogens were Mycoplasma pneumoniae (102 cases), Klebsiella pneumoniae (14 cases), Stenotrophomonas maltophilia (14 cases), Acinetobacter baumannii complex (10 cases), Staphylococcus aureus(9 cases), and Pseudomonas aeruginosa (9 cases). The use and dosage of Levofloxacin were concerned, including insufficient single dose(25 cases), overdose(9 cases), incorrect dosing frequency (9 cases). There were 3 cases of adverse drug reaction of Levofloxacin, including 2 cases of gastrointestinal reactions (1 case of diarrhea, a single dose of 15 mg/kg, clinically cured; 1 case of nausea, clinically improved), and 1 case of rash (clinically improved). Serious adverse drug reactions were not reported. Conclusions:Levofloxacin is relatively safe for short- and medium-term use in children.It should be administered according to the correct usage and dosage.During the administration period of Levofloxacin, the gastrointestinal system, rash, liver and kidney functions, blood system, blood sugar, heart system, nervous system and other indicators should be closely concerned.
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Objective:To explore whether BHLHE40 can affect the sensitivity of thyroid cancer (TC) cells to cisplatin by activating oxidative phosphorylation (OXPHOS) pathway by targeting high mobility group A2 (HMGA2) .Methods:The mRNA expression of HMGA2 and its upstream transcription factor BHLHE40 in TC tissues was analyzed by TCGA-THCA and hTFtarget online databases. The si-HMGA2, oe-HMGA2, oe-BHLHE40, negative control si-NC and oe-NC were transfected into TC cells (K1 and SW579) by liposome transfection method. The mRNA expression levels of BHLHE40 and HMGA2 in TC cells (SW579, FTC-133, and K1) and normal thyroid cells (Nthy ori3-1) were detected by real-time quantitative PCR (qRT-PCR). The cell viability was detected by MTT assay, the half inhibitory concentration (IC 50) value of cisplatin was calculated by CCK-8 assay, the apoptosis level was detected by flow cytometry, and the expression of OXPHOS complex was detected by Western blotting. Seahorse XFe 96 was used to analyze the oxygen consumption rate of the TC cells. Dual-luciferase assay and chromatin immunoprecipitation (ChIP) assay were used to analyze the binding relationship between BHLHE40 and HMGA2. Results:TCGA database results showed that the mRNA expression levels of HMGA2 and BHLHE40 in TC tissues (10.57±2.58, 13.89±1.13) were higher than those in normal thyroid tissues (4.82±1.69, 12.28±1.01), with statistically significant differences ( t=16.69, P<0.001; t=10.43, P<0.001). The results of qRT-PCR showed that the relative mRNA expression levels of HMGA2 in normal thyroid cells (Nthy ori3-1) and TC cells (SW579, FTC-133, and K1) were 1.00±0.13, 2.94±0.23, 4.71±0.41 and 6.29±0.49, while those of BHLHE40 were 1.00±0.12, 2.60±0.23, 3.39±0.35 and 6.18±0.51 respectively, both with statistically significant differences ( F=130.50, P<0.001; F=125.20, P<0.001). Further pairwise comparison showed that mRNA expression levels of HMGA2 and BHLHE40 in TC cells were significantly higher than those in normal thyroid cells (all P<0.001). According to MTT experimental results, si-HMGA2 treatment significantly reduced the cell viability of K1 cells compared to the si-NC group (all P<0.05). In addition, compared to the oe-NC group, oe-HMGA2 treatment significantly increased the cell viability of SW579 cells (all P<0.05). Compared to the oe-NC+DMSO group, the oe-HMGA2+DMSO group showed enhanced cell viability of SW579 cells, while the OXPHOS pathway inhibitor Gboxin was able to reverse the effect of overexpressing HMGA2 on cell viability (all P<0.05). The results of flow cytometry and CCK-8 experiments showed that compared to the si-NC group (apoptosis level: 6.19%±0.28%; cisplatin IC 50 value: 17.47 μmol/L), knocking down HMGA2 could increase the apoptosis level (11.96%±0.32%; t=19.17, P<0.001) and cisplatin sensitivity (IC 50 value: 1.49 μmol/L) of K1 cells. In addition, compared to the oe-NC group (apoptosis level: 9.98%±0.32%; cisplatin IC 50 value: 8.17 μmol/L), overexpressing HMGA2 significantly decreased the apoptosis level (4.32%±0.25%; t=19.65, P<0.001) and cisplatin sensitivity (IC 50 value: 34.95 μmol/L) of SW579 cells. The results of dual-luciferase assay showed that compared with the si-NC group, knocking down the expression of BHLHE40 in human kidney epithelial 293T cells significantly reduced the luciferase activity of wild-type HMGA2 (0.31±0.02 vs. 1.00±0.11; t=10.69, P=0.004). However, there was no significant effect on the luciferase activity of mutant-type HMGA2 (1.06±0.11 vs. 1.00±0.07; t=0.80, P=0.470). ChIP results showed that the mRNA expression level of HMGA2 in K1 cells was significantly increased in the anti-BHLHE40 group (6.57±0.62) compared with the IgG group (1.00±0.10; t=15.36, P<0.001). Compared to the oe-NC+DMSO group, the oe-HMGA2+DMSO group showed decreased apoptosis level ( P<0.05) and cisplatin sensitivity of SW579 cells, with a significant increase in the expression of OXPHOS complexes Ⅰ-Ⅴ and cellular oxygen consumption rates (all P<0.05). The effect of overexpressing HMGA2 was reversed by treatment with oe-HMGA2+Gboxin (all P<0.05). The recovery experiment showed that compared to the oe-NC+si-NC group, overexpression of BHLHE40 in SW579 cells increased cell viability and the expression of OXPHOS complexes Ⅰ-Ⅴ, while decreasing apoptosis levels and increasing cellular oxygen consumption rates and cisplatin IC 50 values (all P<0.05). However, simultaneous knockdown of HMGA2 reversed the effect of overexpressing BHLHE40 (all P<0.05) . Conclusion:BHLHE40 can activate the OXPHOS pathway by targeting and regulating the expression of HMGA2, thereby affecting the sensitivity of TC cells to cisplatin.
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Objective:To explore the relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.
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Objective:To explore the potential categories of resourcefulness in primary caregivers of stroke patients and analyze the differences in the characteristics of different types of caregivers, so as to provide basis for clinical construction of effective intervention plans.Methods:The 308 primary caregivers of stroke patients who met the research standards in the Department of Neurology of General Hospital of Ningxia Medical University, People′s Hospital of Ningxia Hui Autonomous Region, the First People′s Hospital of Yinchuan from December 2020 to August 2021 were selected as the research objects by convenient sampling method.The general information questionnaire, Resourcefulness Scale and Social Support Revalued Scale were used for cross-sectional investigation.Results:The resourcefulness of the primary caregivers of stroke patients were divided into 2 potential categories: low resourcefulness group (62.7%, 193/308) and high resourcefulness group (37.3%, 115/308). Uni-variate analysis showed that there were differences between potential categories: age and education level of stroke patients, whether there was long-term medication history, number of other chronic diseases, had there been any complications due to illness, age, education level and occupation of caregivers, average daily care duration, family relations, and social support ( χ2 values were -3.34 - 23.62, all P<0.05). Logistic regression analysis showed that social support and education level of caregivers were the influencing factors of caregiver resourcefulness ( P<0.05). Conclusions:The resourcefulness in the primary caregivers of stroke patients has certain characteristics. Clinically, targeted intervention measures should be formulated according to the different types of caregiver resourcefulness characteristics of caregivers and their influencing factors to improve the caregiver resourcefulness of stroke patients.
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Objective:To construct a conceptual framework of burnout among primary caregivers of stroke patients based on grounded theory.Methods:According to the characteristics of age, gender, relationship with patients, length of care and other characteristics of purpose sampling method, from December 2021 to March 2022, 31 primary caregivers of stroke patients were selected for semi-structured interviews in two second-class hospitals, a first-class hospitals and a community health service station in Wuzhong city and Yinchuan city. The data were analyzed in procedural grounded theory method.Results:A total of 29 primary categories and 9 secondary categories were formed. The conceptual framework of burnout among primary caregivers of stroke patients was finally established, which consisted of four main categories (role burnout, physical burnout, psychological burnout and social burnout) and a core category (burnout of primary caregivers of stroke patients).Conclusions:The conceptual framework of burnout among primary caregivers of stroke patients constructed in this study elaborates the connotation of burnout of primary caregivers of stroke patients from four aspects, which can provide a basis for the development of assessment tools and the formulation of intervention measures in the future.
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Objective:To know whether the implementation of "Five Love" values education in the teaching of nursing introduction can improve students′ learning effect and professional identity.Methods:A quasi experimental study was conducted. The convenient cluster sampling method was used to select 118 freshmen from the Chinese foreign cooperation undergraduate class of the Nursing School of Henan University of Chinese Medicine as the ideological and political group from March to July 2022, and implement the teaching integrated with the "Five Love" values ideological and political program. From March to July 2021, 120 freshmen from the Chinese foreign cooperation undergraduate class were set as the control group, and the routine teaching were implemented. The test scores and college students′professional identity were compared between the two groups.Results:The total score of the process assessment in the ideological and political group was (92.78 ± 6.54) points, higher than that of the control group (85.64 ± 10.21) points, the difference was statistically significant ( t=-3.09, P<0.05). The scores of ideological and political group students in Professional Identity Questionnaire before education were (2.60 ± 0.72) points and after education were (3.50 ± 0.24) points, and the difference was statistically significant ( t=-4.80, P<0.05). Three themes can be extracted from the group focus interview and reflection homework: "promoting the formation of students 'Five Loves' values, increasing the sense of learning benefits and enhancing the relationship between teachers and students". Conclusions:Carrying out "Five Loves" value education in the teaching of nursing introduction course can improve the teaching effect and students' professional identity, increase students' sense of learning benefit, and enhance the relationship between teachers and students.
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【Objective】 To investigate the clinical manifestations, diagnosis, differential diagnosis and management strategies of thrombocytopenia caused by tirofiban. 【Methods】 The basic clinical data, platelet count changes and treatment course of 7 patients with acute coronary syndrome who used tirofiban resulting in severe thrombocytopenia during their hospitalization in our hospital from December 2021 to March 2023 were collected, and their individual and common characteristics were analyzed. 【Results】 Platelet counts were in the normal range in all 7 patients on admission. Six of the patients had thrombocytopenia occurring from 3 to 16 hours after tirofiban use, and one patient was detected at 34 h of tirofiban use. Their minimum platelet count ranged from (1-11)×109/L. All 7 cases discontinued tirofiban and other antithrombotic drugs, and the platelet count increased to 50×109/L in 6 patients in 2 to 4 days after stopping the drug and gradually returned to the normal range. During this period, there were no bleeding or acute thrombotic events, and no platelet transfusion was conducted. Five patients resumed antithrombotic therapy when the platelet count returned to (20-50)×109/L, 1 patient underwent elective coronary artery bypass grafting (CABG) surgery when the count rose above 50×109/L. One patient had bleeding manifestations after thrombocytopenia and required limited-duration CABG surgery, so 3 U platelet transfusion and immunoglobulin treatment were performed consecutively. CABG surgery was performed when the platelet count increased to 76×109/L. The differential diagnosis of the cause of thrombocytopenia was performed in all seven patients, and other causes of thrombocytopenia, such as heparin, were excluded. 【Conclusion】 Tirofiban can cause acute severe or extremely severe thrombocytopenia. Routine platelet count testing at 6 hours after medication can prevent serious adverse events by discontinuing tirofiban promptly after thrombocytopenia occurs. At the same time, it is determined whether to perform platelet transfusion based on whether the patient has bleeding and the risk of bleeding, and the timing of resuming antithrombotic treatment is determined based on the recovery of platelet count and the risk of thrombosis.
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The well-known insulin-like growth factor 1 (IGF1)/IGF-1 receptor (IGF-1R) signaling pathway is overexpressed in many tumors, and is thus an attractive target for cancer treatment. However, results have often been disappointing due to crosstalk with other signals. Here, we report that IGF-1R signaling stimulates the growth of hepatocellular carcinoma (HCC) cells through the translocation of IGF-1R into the ER to enhance sarco-endoplasmic reticulum calcium ATPase 2 (SERCA2) activity. In response to ligand binding, IGF-1Rβ is translocated into the ER by β-arrestin2 (β-arr2). Mass spectrometry analysis identified SERCA2 as a target of ER IGF-1Rβ. SERCA2 activity is heavily dependent on the increase in ER IGF-1Rβ levels. ER IGF-1Rβ phosphorylates SERCA2 on Tyr990 to enhance its activity. Mutation of SERCA2-Tyr990 disrupted the interaction of ER IGF-1Rβ with SERCA2, and therefore ER IGF-1Rβ failed to promote SERCA2 activity. The enhancement of SERCA2 activity triggered Ca2+ER perturbation, leading to an increase in autophagy. Thapsigargin blocked the interaction between SERCA2 and ER IGF-1Rβ and therefore SERCA2 activity, resulting in inhibition of HCC growth. In conclusion, the translocation of IGF-1R into the ER triggers Ca2+ER perturbation by enhancing SERCA2 activity through phosphorylating Tyr990 in HCC.
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Objective:To compare the efficacy of stereotactic body radiotherapy(SBRT) and surgery in treating intrapulmonary recurrence of non-small cell lung cancer (NSCLC) after radical surgery.Methods:A retrospective analysis was conducted on NSCLC patients, who underwent radical surgery at the Cancer Hospital Affiliated to University of Chinese Academy of Sciences from November 2012 to December 2018 and then received SBRT or secondary surgery because of postoperative intrapulmonary recurrence. The survival rates of these patients were calculated using the Kaplan-Meier method. The comparison between the two groups was made using the Log-rank method, and the univariate and multivariate analysis was made using the Cox regression method.Results:Among 62 eligible patients, 33 received SBRT and 29 received secondary surgery, and they were divided into the SBRT group and the surgery group accordingly. For the SBRT and surgery groups, the median follow-up time was 45.8 months and 37.4 months, the 3-year locoregional control rate (LRCR) 79.8% and 90.2%, respectively ( P > 0.05), the progression-free-survival (PFS) 58.5% and 42.3%, respectively ( P >0.05), and the overall survival (OS) 78.0% and 85.5%, respectively ( P >0.05). The multivariate analysis suggested that treatment method, Charlson comorbidity index (CCI), and adjuvant drug therapy were independent prognostic factors for PFS ( P = 0.027, 0.013, 0.001). Conclusions:The efficacy of SBRT and surgery is comparable for patients with intrapulmonary recurrence of NSCLC after radical surgery.
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SARS-CoV-2 vaccines are effective in preventing COVID-19, but their efficacy in blocking virus transmission is controversial. Although SARS-CoV-2 vaccines can reduce the sources of infection and the possibility of secondary transmission from breakthrough infection cases, their effectiveness wanes over time. Moreover, the emergence of variants with stronger transmissibility and immune escape ability also poses huge challenges to the effectiveness of SARS-CoV-2 vaccines in blocking virus transmission. Therefore, ending the COVID-19 pandemic still requires the continuous research and development of new vaccines as well as the adoption of effective prevention and control measures.
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Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
Résumé
Objective To investigate the population differences of the newly named "metabolic associated fatty liver disease" (MAFLD) and the former name "nonalcoholic fatty liver disease" (NAFLD). Methods From November 2020 to January 2021, a cross-sectional survey was conducted among 624 elderly individuals aged above 65 years in a community in Beijing, China, and related data were collected, including demographic data, past history, laboratory markers, liver ultrasound, and liver elasticity. According to the presence or absence of fatty liver based on ultrasonic diagnosis, the individuals were divided into fatty liver group with 389 individuals and non-fatty liver group with 235 individuals. The independent samples t -test was used for comparison of normally distributed continuous data between the two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between the two groups; the chi-square test was used for comparison of categorical data between the two groups. Results Among the 389 patients with fatty liver, 387(99.5%) were diagnosed with MAFLD and 368(94.6%) were diagnosed with NAFLD, and there were 19 patients with a history of heavy alcohol consumption and 2 with positive surface antigen. A total of 366 patients met the diagnostic criteria for both MAFLD and NAFLD, accounting for 94.6% of the MAFLD patients and 99.5% of the NAFLD patients. Compared with the non-fatty liver group, the MAFLD group had significant increases in body mass index (BMI) ( t =-11.228, P < 0.05), waist circumference ( Z =-8.532, P < 0.05), hip circumference ( Z =-6.449, P < 0.05), waist-hip ratio ( Z =-5.708, P < 0.05), alanine aminotransferase ( Z =-5.027, P < 0.05), aspartate aminotransferase ( Z =-2.880, P < 0.05), platelet count ( t =-3.623, P < 0.05), triglyceride ( Z =-8.489, P < 0.05), fasting blood glucose ( Z =-3.516, P < 0.05), HbA1c ( Z =-2.884, P < 0.05), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) ( Z =-0.394, P < 0.05), high-sensitivity C-reactive protein ( Z =-4.912, P < 0.05), controlled attenuation parameter (CAP) ( t =13.744, P < 0.05), and liver stiffness measurement (LSM) ( Z =-7.69, P < 0.05), as well as a significant reduction in high-density lipoprotein cholesterol (HDL-C) ( t =6.348, P < 0.001). Meanwhile, MAFLD patients had more metabolic associated diseases, such as overweight, obesity, central obesity, dyslipidemia, and hypertension ( χ 2 =9.978, 65.472, 36.571, 9.797, and 5.128, all P < 0.05). In the MAFLD group, 30.7% of the patients had non-obese fatty liver disease (BMI < 25 kg/m 2 ), and 11.1% had lean fatty liver disease (BMI < 23 kg/m 2 ); compared with the obese MAFLD patients, the non-obese MAFLD patients had significantly lower age ( Z =-3.042, P < 0.05), BMI ( Z =-15.705, P < 0.05), waist circumference ( Z =-9.589, P < 0.05), hip circumference ( Z =-10.275, P < 0.05), HOMA-IR ( Z =-2.081, P < 0.05), CAP ( t =-3.468, P < 0.05), LSM ( Z =-3.630, P < 0.05), and NAFLD fibrosis score ( t =-4.433, P < 0.05). According to LSM value, advanced liver fibrosis accounted for 3.6% of the MAFLD population, and 10% of the MAFLD population could not be excluded for advanced liver fibrosis. Conclusion The diagnosis of MAFLD can basically cover the NAFLD population in the elderly people, and it is supposed that MAFLD can almost directly replace the concept of NAFLD in similar populations. However, further studies are needed to investigate its application in other populations.