Analysis of Ethical Review of Clinical Study on Defecation Function of Patients with Rectal Cancer after sphincter-preserving Surgery / 中国医学伦理学

In order to understand the status quo of ethical review of clinical research on the defecation function of patients with rectal cancer after sphincter-preserving surgery, analyze its causes and put forward corresponding suggestions, to arouse researchers’ attention to ethical review in subsequent relevant clinical studies. The ethical review of literatures related to the defecation function of patients with rectal cancer after sphincter-preserving surgery published on CNKI in recent 10 years was sorted out and summarized. The results showed that the ethical review of clinical research papers on defecation function of patients with rectal cancer after sphincter-preserving surgery was not optimistic. We should strengthen the ethical training of researchers, improve the ethical awareness of researchers, strictly implement the ethical norms of paper publication, strengthen the ethical requirements of manuscript contracts, perfect the ethical review system, and pay attention to the examination and supervision of informed consent, so as to promote the construction of ethical examination and approval norms of clinical research documents.

Qualitative Study of Primary Caregiver Load Experience in Colorectal Stoma Patients / 中国医学伦理学

To deeply explore the load experience of primary caregivers of colorectal stoma patients, analyze their psychological load, understand their load experience when caring for patients, so as to provide theoretical basis for promoting patients’ home rehabilitation and continuous nursing. A semi-structured interview was conducted with the primary caregivers of 10 patients with permanent stoma in a tertiary hospital in Xi’an using a phenomenological research method, and the data were summarized and refined by Colaizzi 7-step analysis. A total of four themes were extracted: complex emotional reactions, lack of knowledge about stoma care, a huge care load on the shoulder, and social and financial support needed. The primary caregivers of colorectal stoma patients have a certain degree of care load in the daily care of the patients. Health care professionals should pay attention to the psycho-emotional changes of these individuals and take targeted interventions to reduce the psychological load of the caregivers and improve the quality of life of the patients and their caregivers.

Research on the Progress of Applying Virtual Reality Technology in Preventing Falls in the Elderly / 中国医疗器械杂志

The primary cause of injury and death in the elderly has been reflected in fall the elderly, so the application of reasonable and effective prevention strategies has great significance in reducing the risk of fall in the elderly. The research progress of virtual reality technology applied in preventing fall in the elderly at home and abroad over the years was systematically reviewed in this study. The mechanism of the technology in preventing fall in the elderly was mainly elaborated from five aspects of improving balance ability, gait disturbance, cognitive impairment, muscle strength and the fear psychology of falling. The purpose of this thesis is to broaden the research ideas of medical personnel on the prevention of fall of the elderly, provide more effective clinical practice plans, reduce the occurrence of fall, and guarantee the safety of the elderly.

Study on the correlation among nurses′ adversity quotient, self-efficacy and positive coping style and work engagement / 中国实用护理杂志

Objective:To explore the chain mediating effect of self-efficacy and positive coping styles between nurses′ adversity quotient on work engagement, so as to provide a theoretical reference for nursing managers to promote work engagement.Methods:A convenience sampling method was used to select 512 nurses from four tertiary hospitals in Shaanxi Province, and a cross-sectional study was conducted on them using the general information questionnaire, Adversity Response Profile, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Utrecht Work Engagement Scale-9.Results:The total scores of nurses' adversity response profile, self-efficacy, positive coping style and work engagement were 132.00(120.00, 139.00), 27.00(23.00, 29.00), 24.00(20.00, 25.00), 27.00(25.00, 35.00) points. Nurses' work engagement was significantly positively correlated with adversity quotient, self-efficacy and positive coping styles( r values were 0.523-0.614, all P<0.01). The independent mediation of self-efficacy or positive coping styles and the chain mediation of both accounted for 23.6%,40.9% and 15.9% of the total effect respectively. Conclusions:Nurses′ adversity quotient not only directly affected work engagemnet, but also indirectly affected work engagement through self-efficacy and positive coping style. The research suggested that managers should pay attention to the improvement of nurses′ self-efficacy and positive coping style, so as to promote nurses′ work engagement.

Analysis of trends and hot spots in the research of atrial fibrillation and cognitive impairment / 中华全科医师杂志

Objective:To explore the research trends and hot spots of atrial fibrillation and cognitive impairment.Methods:Research papers and review articles related to atrial fibrillation and cognitive impairment was retrieved from the Web of Science core collection database from inception to November 17, 2021. The bibliometric and visualization analysis on the publishing times,journals and countries,related disciplines and key words was conducted with Excel and VOSviewer software.Results:A total of 1 496 articles were collected,showing a parabolic rise in the number of published articles in recent years. During this period,journal Stroke published more high quality articles in the field than others. The academic areas with the most publications were neurology, cardiovascular research, peripheral vascular disease and geriatrics. "Stroke" and "risk factors" were the keywords with the highest frequency. The research hot spots of atrial fibrillation and cognitive impairment mainly focused on anticoagulant drugs, mechanism research, epidemiology catheter ablation and status quo investigation. Conclusion:Through visualization, the development trend and research hot spots on atrial fibrillation and cognitive dysfunction are displayed intuitively, to provide reference for future studies.

Compliance of oral anticoagulant medication and influencing factors among nonvalvular atrial fibrillation patients with new-onset acute ischemic stroke / 中华全科医师杂志

Objective:To investigate the compliance of oral anticoagulant(OAC) medication and influencing factors among nonvalvular atrial fibrillation(NVAF) patients with new-onset acute ischemic stroke (AIS).Methods:A total of 396 NVAF patients, who initiated OAC therapy after a new-onset AIS from August 2011 to December 2020 were enrolled from China Atrial Fibrillation Registry (China-AF). The demographic characteristics, medical history, comorbid diseases and medication of patients were collected before and after the index stroke, and the influencing factors of compliance of OAC medication were analyzed.Results:Patients were followed up for a mean of 26.9 months. Among 396 patients, 228 (57.6%) had continuous anticoagulant medication (persistent OAC group);while 168 (42.4%) discontinued OAC therapy within 2 years after the index stroke (non-persistent OAC group). Patients on persistence OAC had a higher proportion of atrial fibrillation episodes than patients on non-persistent OAC [83.3% (190/228) vs. 73.8% (126/168); χ 2=5.34, P=0.021], while lower proportion of radiofrequency ablation(RFA)[18.9% (43/228) vs. 32.1% (43/228); χ 2=9.22, P=0.002]. Multivariate Cox regression modelshowed that history of RFA ( HR=1.77, 95% CI: 1.25-2.50; P=0.001) was positively associated with non-persistence of OAC. Conclusion:The study indicates that quite large proportion of NVAD patients with a new-onset of AIS discontinued OAC therapy during 2 years of follow up, and a history of RFA procedure might be an independent factor associated with discontinuing of anticoagulant therapy.

Effects of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma patients after autologous peripheral blood hematopoietic stem cell transplantation / 白血病·淋巴瘤

Objective:To investigate the effect of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma (NHL) patients after autologous peripheral blood hematopoietic stem cell transplantation (APBSCT). Methods:The data of 60 NHL patients who underwent APBSCT from May 2010 to May 2016 in the Affiliated Cancer Hospital of Shanxi Medical University was retrospectively analyzed, including 32 B-NHL patients and 28 T-NHL patients. The patients were grouped according to the receiver operating characteristic curve (ROC) threshold, and the hematopoietic reconstruction after transplantation was analyzed. The relationship between the infused CD34 + cell count and prognosis was analyzed. The prognostic factors were analyzed using univariate and multivariate analyses. Results:The CD34 + cell count threshold was determined to be 4.35×10 6/kg based on ROC. In CD34 + cell count≥ 4.35×10 6/kg group (20 cases) and CD34 + cell count < 4.35×10 6/kg group (40 cases), the granulocyte recovery time was (9.9±1.2) d and (12.5±3.7) d ( P = 0.031), and the platelet recovery time was (9.4±1.7) d and (13.8±2.9) d ( P = 0.012). The 3-year overall survival(OS) rates in CD34 + cell count ≥ 4.35×10 6/kg group and CD34 + cell count < 4.35×10 6/kg group were 85.0% and 55.0% ( P = 0.024), and the 3-year PFS rates were 85.0% and 57.5% ( P = 0.016). In B-NHL patients, the 3-year PFS rates in CD34 + cell count ≥ 4.35×10 6/kg group (11 cases) and CD34 + cell count < 4.35×10 6/kg group (21 cases) were 81.8% and 42.9% ( P = 0.037), respectively. In T-NHL patients, the 3-year OS rates in CD34 + cell count ≥ 4.35×10 6/kg group (9 cases) and CD34 + cell count < 4.35×10 6/kg group (19 cases) were 77.8% and 36.8% ( P = 0.049), respectively. Univariate survival analysis showed that the predictive factors of both OS and PFS included age > 60 years old, Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score > 2 and infused CD34 + cell count < 4.35×10 6/kg (all P < 0.05). Multivariate analysis showed that IPI score and infused CD34 + cell count were both independent predictive factors of PFS ( RR = 0.333, 95% CI 0.112-0.994, P = 0.049; RR = 0.190, 95% CI 0.047-0.773, P = 0.020), and IPI score was an independent predictive factor of OS ( RR = 0.095, 95% CI 0.011-0.837, P = 0.034). Conclusion:The infused CD34 + cell count affects the hematopoietic reconstruction time and component blood transfusion after APBSCT, and has certain predictive value for the prognosis of NHL patients.

Clinical analysis of seven cases of myeloid sarcoma / 中华肿瘤杂志

Objective@#To investigate the clinical manifestations, pathological features, diagnosis and treatment of myeloid sarcoma, and to improve the understanding of myeloid sarcoma.@*Methods@#The clinical data, diagnosis and treatment of 7 patients with myeloid sarcoma were retrospectively analyzed.@*Results@#Of the 7 patients with myeloid sarcoma, 1 was male and 6 were female. In most patients, the local compression symptoms caused by painless local masses or masses were the first manifestations. One patient had lesions involving the cervix and vaginal bleeding was the first symptom. The lesions were extensive with 19 sites involved. The positive proportion of immunohistochemical staining was 6/6 for CD43, 6/7 for MPO, 4/5 for CD117, 4/4 for LCA, 3/5 for CD34 and 2/2 for CD99. Lymphocyte markers CD3 and CD20 were negative in all 7 patients.@*Conclusions@#Myeloid sarcoma is a rare hematological malignancy. Early diagnosis and active treatment are the key to improve prognosis. Current treatments include systemic chemotherapy, surgical resection, radiation therapy, and hematopoietic stem cell transplantation.

Correlation Study Between Synchronic Heart Rate Variability, Blood Pressure Variability and Blood Vessel Damage in Patients With Essential Hypertension / 中国循环杂志

Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.

Effect of lienal polypeptide injection combined with chemotherapy on cell immune function of patients with advanced diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To study the clinical effect of lienal polypeptide injection combined with chemotherapy on patients with advanced diffuse large B-cell lymphoma. Methods Sixty patients with advanced diffuse large B-cell lymphoma were randomly divided into investigative group (30 cases) and control group (30 cases). Patients in the investigative group were administrated with lienal polypeptide injections when undergoing chemotherapy, while patients in the control group were given only chemotherapy. The clinical effect and immune function in the two groups were compared. Results After chemotherapy, the average Karnofsky score and T cell subpopulations in the investigative group were higher than those in the control group (all P<0.05). At the same time, the rate of chemotherapy related hematologictoxicity in the investigative group was significantly lower than that in the control group (P<0.05). The response rates of investigative group and control group were 80 %(24/30) and 73 %(22/30), respectively, with no statistical significance (P=0.897). Conclusion During chemotherapy, the addition of lienal polypeptide injection will improve the immune function of patients with advanced diffuse large B-cell lymphoma, stimulate bone marrow function and improve the quality of life.

Effect of Moxibustion on the Learning and Memory of Rat Models of Alzheimer’s Disease and the Expression of Hippocampal Aβ, IL-1β and IL-2 / 上海针灸杂志

Objective To observe the effect of moxibustion on the learning ability and memory of rat models of Alzheimer’s disease (AD) and the expression of amyloidβ protein (Aβ)-42, interleukin (IL)-1β, and IL-2, for unveiling the function and mechanism of moxibustion in treating AD.Method Forty-eight healthy male Sprague-Dawley rats were randomized into a sham-operation group, a model group, a Western medication group, and a moxibustion group, 12 rats in each group. The AD model rats were established by injection of Streptozotocin (STZ) into bilateral ventricles. From the 10th day after the operation, the moxibustion group started to receive moxibustion at Baihui (GV 20), Mingmen (GV 4), Changqiang (GV 1), and Guanyuan (CV 4); meanwhile, the Western medication group received Donepezil hydrochloride via intragastric administration. After 30-day treatment, the learning and memory ability was tested by using water maze, the hippocampal Aβ-42 was examined by immunohistochemical method, and the expression of hippocampal IL-1β and IL-2 was by double-antibody sandwich ELISA.Result Compared to the model group, moxibustion significantly down-regulated the levels of Aβ-42 (P<0.05) and IL-1β protein (P<0.05), up-regulated the level of IL-2 protein (P<0.05) in hippocampus, and markedly improved the learning and memory of AD rats (P<0.05).Conclusion Moxibustion can enhance the immunity and learning ability, which is plausibly related to the down-regulation of IL-1β, up-regulation of IL-2, and improvement of Aβ-42 in hippocampus.

Reoperations of long bone fractures with interlocking intramedullary nails and limited open reductions / 中国矫形外科杂志

[Objective] To investigate the causes of failures of long bone fractures with internal fixations and to study the treatments and effects of reoperations of long bone fractures with inter-locking intramedullary nail and limited open reduction.[Method]Twenty-four patients of failures of long bone fractures with internal fixations were retreated with inter-locking intramedullary nail and limited open reduction.There were 15 cases of femoral fracture,7 cases of tibial fracture and 2 cases of humerus shaft fracture.Of the femoral fracture,there were 14 cases of fractures of shafts of femurs and 1 case of supracondylar fracture of femur;11 male,4 female;7 left cases,8 right cases;1 case complicated with bending of bone plate and screw,6 cases with breakages of plate;1 case with bending of common intramedullary nail,2 cases with breakages of common intramedullary nails,1 case of screw and wire lock fixation complicated with pseudoarticulation formation,4 cases with nonunion of fracture.Of the cases of tibial shaft fracture,there were 6 male,l female;3 left cases,4 righe cases;3 cases complicated with breakages of bone plate and screw,1 case with failure of external fixator,3 cases with nonunion of fracture.Of the cases of humerus shaft fracture,there were 2 cases of male and left ones;1 case complicated with breakage of bone plate and screw,1 case with breakage of common intramedullary nail.The ages of patients ranged from 18 to 68 years old with mean ages 43.7 years old.All fixation failure cases were retreated with inter-locking intramedullary nails and limited open reductions with autogenous iliac bone grafts or bone allografts.[Result]The average follow-up time was 25 months(12～35 months).All cases were cured with bone unions.Complications with submerge,breakages and bending of intramedullary nails did not occur.In the reoperating cases of femoral and filial fractures,the knee function were excellent in 18 cases,good 2 cases,fair 1 case and poor 1 case according to Karlstrom scale.Among the reoperating cases of humeral fractures,there were 1 case excellent and 1 good of shoulder function according to HAN score.[Conclusion]Reoperations with inter-locking intramedullary nail and limited open reduction are effective methods for treatment of internal fixation failure of long bone fracture.