Dual trajectory of sleep and frail in elderly people / 中南大学学报(医学版)

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.

The potential mechanism of Yiqi Jiedu Tongluo Decoction in the treatment of liver cirrhosis based on network pharmacology and molecular docking technology / 西安交通大学学报(医学版)

【Objective】 To investigate the targets and related pathways of Yiqi Jiedu Tongluo Formula (YQJDTLF) in the treatment of liver cirrhosis based on network pharmacology and molecular docking technology, so as to predict its potential mechanism. 【Methods】 Based on the TCMSP database, the effective active ingredients and action targets of YQJDTLF were extracted, and the therapeutic targets of liver cirrhosis were obtained through Drugbank, OMIM, TTD and DisGeNET; the common targets were screened. We constructed a visualization regulatory network diagram of "drug active components-disease targets" with Cytoscape and a protein interaction network diagram (PPI) with the STRING database. Then we screened the core proteins of PPIs with Cytoscape. Finally, we made Gene Ontology (GO) function enrichment analysis and KEGG pathway enrichment analysis of the core targets by using Metascape. Finally the molecular docking was completed. 【Results】 A total of 93 active ingredients and 135 common targets were obtained. The main active compounds included quercetin, baicalein, and stigmasterol. KEGG pathway enrichment analysis revealed 135 pathways involved in cancer signaling pathways (pathways in cancer) and other pathways. Through molecular docking, it was found that the binding activity between key traditional Chinese medicine components and the key targets was good. 【Conclusion】 YQJDTLF has the characteristics of being multi-component, multi-target and multi-pathway, and can play a role in the treatment of liver cirrhosis by regulating related pathways and targets.

Influencing factors of willingness to participate in time banking mutual care model among the elderly in urban communities in China: a literature review / 中国实用护理杂志

With the accelerating process of aging, the burden of elderly care in China is increasing dramatically. However, the current care models were difficult to meet the multi-level and diversified needs of the elderly. Time banking mutual care model is proposed as an important auxiliary model. Since the elderly in urban communities are the major participants of time banking mutual care model, understanding their willingness to participate is very important for the effective implementation and sustainable development of time banking mutual care model. This paper summarizes the research progress and the major influencing factors of the willingness of the elderly to participate in time banking mutual care model, in order to provide theoretical support for alleviating the increasingly severe burden of elderly care in China and realizing active aging.

Application of narrative nursing in parent-child conflict of a patient with chronic viral hepatitis b complicated with epilepsy / 中国实用护理杂志

Objective:To study the intervention effect of narrative nursing on parent-child conflict in patients with chronic viral hepatitis b complicated with epilepsy.Methods:In 1 case because of parent-child conflicts caused by frequent attacks, depression, and anorexia behavior of chronic hepatitis b patients with viral hepatitis with epilepsy care process, the application of narrative postmodernism theory model of nursing and the nursing of the five core technologies: somatization, rewrite, restore, definition file, ceremony and treatment during the stay in hospital for patients and their parents were conducted three narrative counseling, two telephone follow-up after discharge, psychological intervention to the parent-child conflict problem.Results:Through narrative psychological intervention, no epileptic seizures caused by parent-child conflict occurred, depression was relieved, and no anorexia behavior was observed.Conclusion:Narrative nursing can help to solve the parent-child conflict between patients and their parents and promote physical and mental recovery.

Bibliometric analysis of papers on case management from Web of Science / 现代临床护理

Objective To search the Web of Science for the papers related to case management to understand the present situation and direction of case management. Methods Papers on case management were retrieved in the Web of Science from 1999 to 2017.The Web of Science and excel were used to analyze the publication years, research themes, journals, countries and institutes. Results Totally,970 articles were included,with a sum of cited times,12,075.The number of publications on the case management was going up. Most of the authors were from the USA and China was ranked at 7 in authorship. Most of the papers concerned the research in chronic diseases such as chronic heart failure,mental disease and HIV. Conclusions Case management has been widely researched in the developed countries.China still has a lot of room for improvement in the study.The future research should be focused on the establishment of case manager training,multidisciplinary combination,case management mode suitable for chronic disease and aging population and exploration of the mode's effectiveness.

Clinical Study of Acute Vasoreactivity Testing in Patients with Chronic Thromboembolic Pulmonary Hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The clinical significance of acute vasoreactivity testing (AVT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We analyzed changes in hemodynamics and oxygenation dynamics indices after AVT in patients with CTEPH using patients with pulmonary arterial hypertension (PAH) as controls.</p><p><b>METHODS</b>We analyzed retrospectively the results of AVT in 80 patients with PAH and 175 patients with CTEPH registered in the research database of Beijing Chao-Yang Hospital between October 2005 and August 2014. Demographic variables, cardiopulmonary indicators, and laboratory findings were compared in these two subgroups. A long-term follow-up was conducted in patients with CTEPH. Between-group comparisons were performed using the independent-sample t-test or the rank sum test, within-group comparisons were conducted using the paired t-test or the Wilcoxon signed-rank test, and count data were analyzed using the Chi-squared test. Survival was estimated using the Kaplan-Meier method and log-rank test.</p><p><b>RESULTS</b>The rates of positive response to AVT were similar in the CTEPH (25/175, 14.3%) and PAH (9/80, 11.3%) groups (P > 0.05). Factors significantly associated a positive response to AVT in the CTEPH group were level of N-terminal pro-brain natriuretic peptide (≤1131.000 ng/L), mean pulmonary arterial pressure (mPAP, ≤44.500 mmHg), pulmonary vascular resistance (PVR, ≤846.500 dyn·s-1·m-5), cardiac output (CO, ≥3.475 L/min), and mixed venous oxygen partial pressure (PvO2, ≥35.150 mmHg). Inhalation of iloprost resulted in similar changes in mean blood pressure, mPAP, PVR, systemic vascular resistance, CO, arterial oxygen saturation (SaO2), mixed venous oxygen saturation, partial pressure of oxygen in arterial blood (PaO2), PvO2, and intrapulmonary shunt (Qs/Qt) in the PAH and CTEPH groups (all P > 0.05). The survival time in patients with CTEPH with a negative response to AVT was somewhat shorter than that in AVT-responders although the difference was not statistically significant (χ2 =3.613, P = 0.057). The survival time of patients with CTEPH who received calcium channel blockers (CCBs) was longer than that in the group with only basic treatment and not shorter than that of patients who receiving targeted drugs or underwent pulmonary endarterectomy (PEA) although there was no significant difference between the four different treatment regimens (χ2 =3.069, P = 0.381).</p><p><b>CONCLUSIONS</b>The rates of positive response to AVT were similar in the CTEPH and PAH groups, and iloprost inhalation induced similar changes in hemodynamics and oxygenation dynamics indices. A positive response to AVT in the CTEPH group was significantly correlated with milder disease and better survival. Patients with CTEPH who cannot undergo PEA or receive targeted therapy but have a positive response to AVT might benefit from CCB treatment.</p>

Serum Bilirubin and 6-min Walk Distance as Prognostic Predictors for Inoperable Chronic Thromboembolic Pulmonary Hypertension: A Prospective Cohort Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inoperable chronic thromboembolic pulmonary hypertension (CTEPH) is a severe clinical syndrome characterized by right cardiac failure and possibly subsequent liver dysfunction. However, whether serum markers of liver dysfunction can predict prognosis in inoperable CTEPH patients has not been determined. Our study aimed to evaluate the potential role of liver function markers (such as serum levels of transaminase, bilirubin, and gamma-glutamyl transpeptidase [GGT]) combined with 6-min walk test in the prediction of prognosis in patients with inoperable CTEPH.</p><p><b>METHODS</b>From June 2005 to May 2013, 77 consecutive patients with inoperable CTEPH without confounding co-morbidities were recruited for this prospective cohort study. Baseline clinical characteristics and 6-min walk distance (6MWD) results were collected. Serum biomarkers of liver function, including levels of aspartate aminotransferase, alanine aminotransferase, GGT, uric acid, and serum bilirubin, were also determined at enrollment. All-cause mortality was recorded during the follow-up period.</p><p><b>RESULTS</b>During the follow-up, 22 patients (29%) died. Cox regression analyses demonstrated that increased serum concentration of total bilirubin (hazard ratio [HR] = 7.755, P < 0.001), elevated N-terminal of the prohormone brain natriuretic peptide (HR = 1.001, P = 0.001), decreased 6MWD (HR = 0.990, P < 0.001), increased central venous pressure (HR = 1.074, P = 0.040), and higher pulmonary vascular resistance (HR = 1.001, P = 0.018) were associated with an increased risk of mortality. Serum concentrations of total bilirubin (HR = 4.755, P = 0.007) and 6MWD (HR = 0.994, P = 0.017) were independent prognostic predictors for CTEPH patients. Patients with hyperbilirubinemia (≥23.7 μmol/L) had markedly worse survival than those with normobilirubinemia.</p><p><b>CONCLUSION</b>Elevated serum bilirubin and decreased 6MWD are potential predictors for poor prognosis in inoperable CTEPH.</p>

Chronic kidney disease in 5 708 people receiving physical examination / 中南大学学报(医学版)

Objective: To investigate chronic kidney disease (CKD) and its risk factors in people receiving physical examination. Methods: hTis retrospective study included people over 20 years old who had physical examination in the Health Management Center of Third Xiangya Hospital from Janurary 2008 to June 2011. CKD and its risk factors as well as questionnaire were recorded. hTe risk factors were analyzed by multivariate logistic analysis. CKD was deifned by kidney damage (microalbuminuria≥30 mg/L) and/or hematuria and/or reduced kidney function [evaluate glomerular ifltration rate (eGFR)<60mL/(min.1.73 m2)]. We counted eGFR according to the modiifcation of diet in renal disease (MDRD). Results: A total of 5 708 physical examination reports were included. The detection rate of albuminuria, reduced renal function and hematuria was 25.0%, 1.7% and 1.1%. hTe detection rate of CKD was 25.6%, and detection rate of CKD stage 1-5 was 17.8%, 6.7%, 1.1%, 0 and 0, respectively. Multivariate logistic analysis indicated that diabetes mellitus, hypertension, hypercholesterolemia, male, age, and smoking were the risk factors for CKD. Increasing physical activity was the protective factor against CKD. Conclusion: High prevalence of CKD in people receiving physical examination is found in Changsha, especially stage 1 and 2 CKD. Physical examination is important to screen CKD. Stopping smoking, control of blood glucose, blood pressure, blood lipids and increasing physical activity may help reduce the prevalence of CKD.