Soft skills of nursing teachers in the department of gastroenterology and their impact on teaching behaviors / 中华医学教育探索杂志

Objective:To investigate the soft skills of nursing teachers in the department of gastroenterology and their impact on teaching behaviors.Methods:A total of 438 nursing teachers from the Department of Gastroenterology of 12 grade A tertiary hospitals in our province were selected as the subjects by cluster sampling. The general information questionnaire, nursing soft skill assessment scale, and clinical nursing mentors' behavior scale were used for a questionnaire survey. The scores for soft skills and teaching behaviors of nursing teachers were evaluated. A Pearson correlation analysis was conducted to discuss the correlation between soft skills and teaching behaviors. The independent sample t test and variance analysis were performed for univariate analysis of teaching behaviors. A multivariate analysis of teaching behaviors was performed by multiple linear regression analysis. Results:The total score of the nursing soft skill assessment scale was (164.75±18.49), and the average score of items was (3.43±0.49). The total score of the clinical nursing mentors' behavior scale was (94.26±8.48), and the average score of items was (4.10±0.46). The total score of nursing soft skills was positively correlated with the total score of teaching behaviors ( r=0.31, P<0.05). The total score of the behavior scale of nursing teachers varied significantly across different education backgrounds, professional titles, nursing ages, and teaching years ( P<0.05). The multiple linear regression analysis found that professional title, teaching years, and nursing soft skills were important factors affecting the teaching behavior level of nursing teachers, which could explain 39.50% of the teaching behavior level. Conclusion:Soft skills of nursing teachers in the Department of Gastroenterology are at a middle level. Professional title, teaching years, and soft skills are important factors affecting teaching behaviors. Improving soft skills of nursing teachers may help improve teaching behaviors.

Study of the effects of long-term outcomes of autologous peripheral blood stem cell reinfusion in patients with decompensated cirrhosis / 中华肝脏病杂志

Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.

An investigation of quality of life and treatment of patients with primary biliary cholangitis / 临床肝胆病杂志

ObjectiveTo evaluate the quality of life and treatment of patients with primary biliary cholangitis (PBC) using the PBC-40 scale. MethodsThe PBC-40 scale was used to perform an investigation of 37 patients who were diagnosed with PBC and received continuous treatment in Department of Gastroenterology, The First Affiliated Hospital of Air Force Medical University, from January 2017 to December 2018. With reference to patients’ baseline biochemical parameters and pathological staging, the scores of the six domains of the PBC-40 scale, i.e., “symptom”, “pruritus”, “weakness”, “cognitive function”, “social function”, and “emotional function”, were analyzed. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between multiple groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. The paired-samples Wilcoxon signed rank sum test was used for comparison of pruritus score before and after treatment, and the paired samples t-test was used for comparison of weakness score before and after treatment. A Spearman analysis was used to investigate correlation. ResultsIn the PBC-40 scale, the scores of symptom, pruritus, weakness, cognitive function, social function, and emotional function were 16.5±4.3, 5.2±3.3, 26.4±8.3, 15.3±5.1, 25.4±8.4, and 8.1±2.7, respectively. A stratified analysis was performed for the patients aged ＜50 years, 50-60 years, and ＞60 years, and the results showed that there was a significant difference in the score of pruritus between the different age groups (χ2=8.290, P=0.016). The PBC patients with a body mass index of ≥24 kg/m2 had significantly lower scores of symptom and cognitive function than those with a body mass index of ＜24 kg/m2 (symptom: Z=-2.222, P=0025; cognitive function: t=2.255, P=0.030). The patients with positive anticentromere antibody had a significantly higher score of weakness than those with negative anticentromere antibody (t=3.453, P=0.001). The score of pruritus was positively correlated with alkaline phosphatase (ALP) (R2=0.325, P=0.049) and gamma-glutamyl transpeptidase (GGT) (R2=0.402, P=0.014). ConclusionThe PBC-40 scale can be used to evaluate the quality of life of Chinese patients with PBC. High levels of ALP and GGT may predict low quality of life.

Research progress on risk factors for poor response of ursodeoxycholic acid in primary biliary cholangitis / 中华肝脏病杂志

Primary biliary cholangitis (PBC) is an autoimmune-mediated chronic cholestatic liver disease. Ursodeoxycholic acid (UDCA) is a first-line drug approved by the Food and Drug Administration for the treatment of PBC. It can effectively improve serum biochemical indicators, delay histological progress, and prolong the survival of non-transplant patients. However, around 40% of patients with PBC have a poor response to UDCA with a poor outcome. Early identification of patients with poor biochemical responses and timely second-line treatment may alter the course of the disease. This article summarizes the risk factors for the poor response of UDCA in the PBC.

Analysis of related factors for primary hepatic carcinoma caused by chronic hepatitis B and hepatitis C / 中华预防医学杂志

Objective@#To explore the related factors for primary hepatic carcinoma (PHC) caused by chronic hepatitis B (CHB) and hepatitis C (CHC).@*Methods@#According to the principle of cross-sectional study, a cluster random sample method was used, a total of 366 chronic hepatitis patients in hospitals were recruited from three provincial tertiary hospitals in Shanxi, Henan and Jilin between July 2016 and October 2016, respectively. Using a self-designed unified questionnaire, face-to-face interviews was conducted on subjects, including sex, age, alcohol consumption, coffee consumption, green tea consumption, fish consumption, smoking, HBV/HCV diagnosis and treatment, diabetes mellitus, family history of PHC (whether PHC in first-degree relatives), etc. Multivariate unconditional logistic regression were performed to identify the related factors for PHC with CHB and CHC. According to the clinical diagnosis the patients were divided into a chronic hepatitis group (not developing to PHC) and a PHC group.@*Results@#Among 366 cases patients, 287 (78.4%) cases were male, 79 cases were female (21.6%), average age was (52.7±9.3) years. 202 cases were chronic hepatitis group, 164 cases were PHC group. Multivariate unconditional logistics regression analysis indicated that alcohol consumption (odds ratio (OR)=2.11, 95%CI: 1.18-3.75), family history of PHC (OR=5.12, 95%CI: 2.60-10.08) were positively correlated with the development of PHC in chronic b, green tea consumption (OR=0.45, 95%CI: 0.23-0.88), antiviral treatment (OR=0.19, 95%CI: 0.11-0.32) were negatively correlated. Alcohol consumption (OR=3.98, 95%CI: 1.14-13.85) was positively correlated with the development of PHC in chronic c, antiviral treatment (OR=0.14, 95%CI: 0.04-0.50) was negatively correlated.@*Conclusion@#Alcohol consumption, family history of PHC, green tea consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis b. Alcohol consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis c.

Effect of genistein on ammonia-induced NF-κB activation in astrocytes / 中国病理生理杂志

AIM:To explore the effect of genistein on ammonia-induced nuclear factor-κB (NF-κB) activation and the underlying mechanism.METHODS:Primary astrocyte cultures were prepared and challenged with NH4Cl to establish a hyperammonemic model.The activation of ERK,Akt and NF-κB was examined by Western blot.RESULTS:AG1478 and genistein significantly inhibited ammonia-induced activation of ERK and Akt.Ammonia-induced NF-κB nuclear translocation was significantly inhibited by the pretreatment of LY294002,genistein and AG1478.CONCLUSION:Genistein significantly inhibited ammonia-induced ERK activation and Akt-mediated NF-κB activation,which might represent the important mechanism by which this naturally occurring substance exerts its swelling-inhibiting effect.

Effect of genistein on ammonia-induced NF-κB activation in astrocytes / 中国病理生理杂志

AIM:To explore the effect of genistein on ammonia-induced nuclear factor-κB (NF-κB) activation and the underlying mechanism.METHODS:Primary astrocyte cultures were prepared and challenged with NH4Cl to establish a hyperammonemic model.The activation of ERK,Akt and NF-κB was examined by Western blot.RESULTS:AG1478 and genistein significantly inhibited ammonia-induced activation of ERK and Akt.Ammonia-induced NF-κB nuclear translocation was significantly inhibited by the pretreatment of LY294002,genistein and AG1478.CONCLUSION:Genistein significantly inhibited ammonia-induced ERK activation and Akt-mediated NF-κB activation,which might represent the important mechanism by which this naturally occurring substance exerts its swelling-inhibiting effect.

Observation on therapeutic alliance with UDCA and glucocorticoids in AIH-PBC overlap syndrome / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the efficacy of ursodeoxycholic acid (UDCA) combined with glucocorticoids in the treatment of autoimmune hepatitis-primary biliary cirrhosis (AIH-PBC) overlap syndrome.</p><p><b>METHODS</b>19 patients with AIH-PBC overlap syndrome were divided randomly into two groups: initiate combined group and initiate UDCA-monotherapy group. Biochemical responses and pathological features before and after treatment were analyzed retrospectively with student's t test, Wilcoxon rank sum test and Fisher's exact method.</p><p><b>RESULTS</b>In the initiate combination group, biochemical responses in terms of AIH features (ALT decline to normal, IgG is less than or equal to 16 g/L) and PBC features (ALP decline ≥ 40% or to normal) were achieved. In UDCA-monotherapy group, no statistical difference existed in biochemical responses before adding glucocorticoids, whereas the levels of ALT, AST, GLB and IgG decreased significantly when combined with glucocorticoids. No statistical difference of rates of biochemical responses eixted between the two groups, whereas variance could be seen in different pathological stages. Alleviation of inflammatory infiltration after therapy appeared in 3 patients.</p><p><b>CONCLUSION</b>Combination therapy of UDCA with glucocorticoids could be suitable for AIH-PBC overlap syndrome. Early treatment is of benefit for achieving better biochemical response and pathological improvement.</p>