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Objectives: The COVID-19 pandemic has taken a significant toll on people worldwide for more than 2 years. Previous studies have highlighted the negative effects of COVID-19 on the mental health of healthcare workers (HCWs) more than the positive changes, such as post-traumatic growth (PTG). Furthermore, most previous studies were cross-sectional surveys without follow-ups. This study draws on PTG follow-up during the COVID-19 outbreak at 12-month intervals for 2 years since 2020. The trajectories and baseline predictors were described. Methods: A convenience sampling method was used to recruit frontline nurses or doctors at the COVID-19-designated hospital who were eligible for this study. A total of 565 HCWs completed the 2 years follow-up and were used for final data analysis. The latent growth mixture models (GMM) was used to identify subgroups of participants with different PTG trajectories. Multinomial logistic regression model was used to find predictors among sociodemographic characteristics and resilience at baseline. Results: Four trajectory PTG types among HCWs were identified: 'Persistent, "Steady increase", "High with drop", and "Fluctuated rise." Comparing the "Persistent low" type, the other three categories were all associated with older age, higher education. Furthermore, "Persistent low" was also negatively associated with resilience at baseline. Conclusion: The PTG of HCWs with different characteristics showed different trends over time. It is necessary to increase the measure frequency to understand the PTG status in different times. Improving HCW's resilience could help improve staff PTG.
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Objective:To explore the changes of disease structure in a tertiary general hospital during the COVID-19 pandemic.Methods:A database of 783 diagnosis-related groups(DRG) patients in a tertiary general hospital from 2017 to 2020 was used. The rank sum test was used to compare the number of patients among different years, and the Chi-square test was used to compare the composition of patients among different years. With the patient composition ratio as the main index, the thermal cluster analysis was used to analyze the changes of disease structure during the COVID-19 pandemic, from the perspectives of major diagnostic categories(MDC) and the key DRG(the number of patients in any year more than 2 000)respectively. All analyses were performed in R software, with P<0.05 indicating significance. Results:There were significant differences in the number and composition of patients in MDC groups and key DRG groups among different years( P<0.05). The results of thermal clustering analysis showed that the MDC composition of patients in 2020 was significantly different from those in 2017 to 2019; the 26 MDC groups were classified into four main categories. The results of thermal clustering analysis also showed that the DRG composition of patients in 2020 were significantly different from those in 2017 to 2019; The RU14 group and the other 19 key DRG groups were classified into different groups; and the other 19 key DRG groups except RU14 were classified into five main categories. Conclusions:The disease structure of tertiary general hospitals has changed significantly during the COVID-19 pandemic.
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The programmed cell death 4 (PDCD4) tumor-suppressor gene regulates cell apoptosis, protein translation, signal transduction, and induction of mediators of inflammation. However, the mechanism by which PDCD4 is down-regulated and regulates tumor growth remains elusive. In this study, we showed that PDCD4 is down-regulated in glioma cells and acts as a tumor suppressor. Based on the TCGA data, we confirmed that AKT2, but not AKT1 or AKT3, interacts with PDCD4, thus leading to the suppression of PDCD4 in glioma cells. Moreover, the analysis suggested that PDCD4 regulates the expression of IL-5, CCL-5, VEGF, and CXCL10 via the NF-kB pathway. Additionally, depletion of levels of PDCD4 promoted angiogenic activity of glioma cells via the VEGF-STAT3 pathway. When tumor cells over-expressing PDCD4 were injected into nude mice, the increased expression of PDCD4 blocked tumorigenesis and prolonged overall survival. Our study indicates the need to develop drugs that can modulate the expression of PDCD4 and test their efficacy in clinical trials.
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PURPOSE: The present report intended to introduce the hemilaminoplasty technique and evaluate the efficacy of our surgical procedure for LISCs. METHODS: This retrospective study was conducted to analyze the results in 24 LISCs who had undergone our hemilaminoplasty between 2000 and 2012 in two hospitals. All were confirmed by pathological histology and mid- to long-term follow-up had been performed in all cases with a mean of 4.9 years. Using the Japanese Orthopedic Association scoring system (JOA score) and visual analog scale (VAS), symptoms resulting from cyst compression were quantified at various stage for statistical analysis. RESULTS: The JOA score and VAS of back/leg pain following surgery were improved significantly (P < 0.01). At final follow-up, with normal aging there was a little decrease in JOA score and VAS of back/leg pain, but still significantly improved (P < 0.01). Similarly, mean improvement rate of JOA was 83.5 % at 1 year after surgery while 75.6 % at final visit. Successful bone healing was obtained at a mean of 3.8 months after surgery. No cyst reformation and recurrent back/leg pain were observed around the surgical sites. CONCLUSIONS: These lesions could be regarded as a result of facet arthrosis/instability and repetitive facet minor trauma with herniation of synovium through the defective joint capsule. Improvement in lumbago and leg pain may be a consequence of complete cyst resection via hemilaminoplasty plus partial facetectomy with anatomical reconstruction of the posterior spinal elements.
Subject(s)
Laminoplasty , Lumbar Vertebrae/surgery , Synovial Cyst/surgery , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
BACKGROUND: Because recurrent peroneal subluxation can produce functional impairment in athletes, most authors suggest operative intervention for patients who fail nonoperative treatment. The present report introduces the modified sliding fibular graft repair for this pathology. METHODS: This retrospective study was conducted to analyze the clinical results for 26 patients with recurrent peroneal subluxation who underwent this procedure with a follow-up of a minimum of 3 years. RESULTS: Intraoperative observations revealed 15 convex grooves and 11 shallow sulci with a low-lying peroneus brevis muscle belly in 6 patients and a peroneus quartus muscle in 4 patients. All underwent the procedure plus excision of redundant muscle and tendon repair, with an improvement rate of 88.5% according to American Orthopaedic Foot & Ankle Society (AOFAS) score at the final visit. All but 3 patients returned to normal function in 4.4 months with no infection, nonunion, or intra-articular screw placement. A total of 8 patients had minor complications including neurapraxia, synovitis, stress fracture, and delayed union. CONCLUSION: We found that an anomalous fibular groove plus tendon variants could lead to a further decrease in the volume of the osteofibrous tunnel and might be the reason for recurrent peroneal dislocation; thus, our modified procedure may be a reasonable treatment for this pathological malposition. We found less functional recovery in aged patients due to a higher incidence of tendon tear and postoperative complications. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
