RESUMO
Objective:To investigate the status quo and influencing factors of decision-making regret of surrogate decision makers (SDMs) in neurocritically ill patients.Methods:This study was a cross-sectional survey. A total of 110 critically ill patients admitted to Department of Neurosurgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from August 2021 to April 2022 were selected as the research objects by convenient sampling method. Different methods were adopted in the research including general information questionnaire, Chinese Version of Decision-Making Regret Assessment Scale, Disease-Related Knowledge Awareness Questionnaire, General Self-Efficacy Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale to conduct a questionnaire survey on SDMs in neurocritically ill patients. Multiple linear stepwise regression was used to analyze the influencing factors of decision-making regret in SDMs in neurocritically ill patients.Results:Among the 110 patients with severe neurological diseases, 50.0% (55/110) had no regret, 30.9% (34/110) had mild regret, and 19.1 (21/110) had moderate and severe regret. The results of univariate analysis showed that gender had a statistically significant effect on the score of SDMs decision regret in neurocritical patients ( t=6.57, P<0.05). The age, relationship with patients, education level, decision-making style, place of residence, and monthly income of the family had no effect on the score of regret in decision-making ( t=0.09-1.01, all P>0.05). The results of correlation analysis showed that the score of decision-making regret of SDMs in neurocritically ill patients was negatively correlated with the scores of disease-related knowledge and self-efficacy ( r=-0.342, -0.252, both P<0.05), and positively correlated with the scores of anxiety and depression ( r=0.403, 0.360, both P<0.05). The results of multiple linear regression showed that gender, disease-related knowledge, self-efficacy, anxiety and depression were important factors affecting the decision-making regret of SDMs in neurocritically ill patients ( t values were -3.37-4.31, all P<0.05). Conclusions:SDMs in neurocritically ill patients have a higher degree of decision-making regret, and gender, disease-related knowledge, self-efficacy, anxiety, depression are important influencing factors, suggesting that medical staff can alleviate the decision-making regret of SDMs through decision-making assistance interventions.
RESUMO
Objective@#To explore the effects and molecular mechanism of the selective JAK1inhibitor SHR0302 and Ruxolitinib on myeloproliterative neoplasms (MPN) cell line SET2 and primary cells in vitro.@*Methods@#Cell proliferation was detected by CCK8 kit. Colony forming experiment was conducted to evaluate erythroid burst colony formation unit (BFU-E) of primary cells from MPN patients. Multi-factor kits were used to detect six inflammatory cytokines. Phosphorylated proteins of Jak-Stat signaling pathway were tested by Western blot.@*Results@#At different time points after treated with SHR0302 and Ruxolitinib, the inhibition of cell proliferation was dose dependent by both drugs (P<0.01) . The inhibitory rates of 2.5 μmol/L SHR0302 and 0.1 μmol/L Ruxolitinib on SET2 cells for 72 h were comparable, i.e. (59.94±0.60) % and (64.00±0.66) %, respectively, suggesting that the inhibitory effect of SHR0302 was weaker than that of Ruxolitinib. Similarly, both SHR0302 and Ruxolitinib inhibited BFU-E in primary marrow cells from MPN patients in a dose-dependent manner. SHR0302 1.0 μmol/L produced similar degree of inhibition compared to Ruxolitinib 0.2 μmol/L. Except IL-12, the expression of other 5 cytokines (IL-6, TNF-α, IL-1β, IL-2, IL-8) was significantly inhibited by 1.6 μmol/L SHR0302 in SET2 cells at 24 h (P<0.01) , while Ruxolitinib 1.0 μmol/L had the same effect. Several phosphorylated molecules of Jak-Stat signaling pathway were significantly inhibited by SHR0302 in SET2 cells only for 3 h. P-stat1 (Tyr701) , p-stat3 (Tyr705) were down-regulated when treated with SHR0302 1.0 μmol/L (P<0.05) , p-jak1 (tyr1022/1023) and p-stat5 (Tyr694) were inhibited at 5.0 μmol/L (P<0.05) . Ruxolitinib significantly inhibited the downstream STAT protein at 0.1 μmol/L. Again, the inhibitory effect of SHR0302 on protein expression was weaker than that of Ruxolitinib.@*Conclusion@#SHR0302 can effectively inhibit the proliferation of MPN cell line and patients' primary cells, as well as the expression of inflammatory factors. The molecular mechanism is possibly related to the down-regulation of phosphorylated proteins of Jak-Stat signaling pathway. Overall, the anti-proliferative and anti-inflammatory effects of SHR0302 are weaker than those of Ruxolitinib.
RESUMO
Objective To observe the effect of moxibustion and ear acupoint pressing method in treating dry eye syndrome.Methods Will meet the inclusion criteria of 63 patients were randomly divided into a treatment group (n=31) , treated with moxibustion and ear acupoint pressing method, and a control group (n=32) who were given with sodium hyaluronate eye drops. After 4 weeks' treatment, clinic symptom,break-up time of tear film(BUT), fluorescence staining(FL) and tear meniscus height(TMH) were measured and compared respectively.Results After treatment, the BUT (8.28 ± 1.73 svs.5.00 ± 1.51 s,t=11.948) in the treatment group was longer than the control group (P<0.01), FL score (1.00 ± 0.90vs.1.85 ± 1.45,t=4.057) in the treatment group were lower than the control group; TMH(0.28 ± 0.06 mm vs.0.20 ± 0.06 mm,t=6.768) in the treatment group were higher than the control group (P<0.01). After treatment, dry sense (1.61 ± 0.67 vs.2.60 ± 0.89,t=6.053), foreign body(1.00 ± 0.45 vs.1.85 ± 1.45,t=10.460), burning(0. 39 ± 0.67 vs.1.59 ± 0.87, t=6.142), visual fatigue (0.61 ± 0.67 vs.1.50 ± 1.16,t=3.725), eye expansion (0.29 ± 0.46 vs.1.28 ± 1.02, t=4.980), Photophobia (0.77 ± 0.76 vs.1.67 ± 0.90,t=4.092), cry (0.29 ± 0.46 vs.0.59 ± 0.91,t=2.038) integral in the treatment group were lower than those in the control group (P<0.05,P<0.01).Conclusion The effect of moxibustion and ear acupoint pressing method in treating dry eye syndrome is more effective than sodium hyaluronate eye drops.