Sex differences and related estrogenic effects in heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is an essential subtype of heart failure accounting for 40% of the total. However, the related pathological mechanism and drug therapy research have been stagnant for a long time. The direct cause of this dilemma is the heterogeneity of HFpEF. And some researchers believe that there is no common pathway to reach the origin of HFpEF; others argue that there is an unidentified unified pathophysiological process hidden beneath the ice surface. Aside from the debate, a series of clinical studies have shown that hypertension and obesity play a fundamental role in the pathogenesis of HFpEF. These results imply that there may be two parallel pathological processes interweaved in one disease, manifested as multiple coexistent pathological phenomena, like a shadow. Meanwhile, the prevalence of HFpEF in women is higher than in men in any given age group, especially prominent in elderly patients. These pathological processes and epidemiological data reflect gender differences, reminding us to shift our attention to estrogen. This article will review the parallel pathogenesis of HFpEF, and also introduce sex differences and the potential effect of estrogen in this condition below.

Nursing of patients with acute ocular surface diseases undergoing amniotic membrane transplantation / 现代临床护理

Objective To explore the nursing strategy for the patients with acute ocular surface diseases undergoing amniotic membrane transplantation.Method Nineteen patients with acute ocular surface diseases treated with amniotic membrane transplantation were nursed during transplantation.Results After 6-12 months postoperative follow-up,19 cases(19 eyes)of 13 patients got recovered(68.4%);4 cases(10.5%)had central transparency in the cornea restored with nebula around it;2 cases(10.5%) had nebula or white spots.Conclusion The nursing strategy including preoperative preparation and mental care,postoperative observations of changes in the diseased eyes together with pertinent health education can help promote the rehabilitation of patients.

The medical, functional and social challenges faced by older adults with intellectual disability

<p><b>INTRODUCTION</b>Little is known about the sociodemographic and clinical profile of older adults with intellectual disabilities (ID) in Singapore. We studied the sociodemographic and clinical profile of older adults with ID and investigated factors associated with caregiver availability and identity in this population.</p><p><b>MATERIALS AND METHODS</b>The study population involved all adults with ID aged ≥40 years receiving services from the Movement for the Intellectually Disabled of Singapore (MINDS), the largest such provider in Singapore. Information on sociodemographic and clinical profiles, functional status, and availability of caregivers were collected via interviewer-administered questionnaires from guardians of older adults with ID. Descriptive characteristics were computed and chi-square and logistic regression identifi ed predictors of caregiver availability and identity.</p><p><b>RESULTS</b>Participation was 95% (227/239). There were differences in client age, gender, and caregiver availability between recipients of residential and non-residential services (all P <0.05). Common comorbidities included hyperlipidaemia (17.6%), hypertension (15.9%), psychiatric diagnoses (16.3%) and epilepsy (10.6%). The majority were fully independent in basic activities of daily living, but only 21.1% were fully communicative. Only a small minority (9.4%) were exercising regularly. The majority (73.5%) of clients had a primary caregiver; almost equal proportions relied on either parents or siblings. Older client age was associated independently with the lack of a primary caregiver, independent of greater functional dependence and presence of medical comorbidities in the client.</p><p><b>CONCLUSION</b>Older adults with ID have multiple medical, functional, and social issues. More can be done to support the care of this unique group of adults with special needs.</p>

Perioperative nursing care to patients with open angle glaucoma undergoing EX-PRESS drainage device implantation / 现代临床护理

Objective To investigate the key points in the care of patients with open angle glaucoma undergoing EX-PRESS drainage device implantation during perioperative period.Method Eighteen patients with open angle glaucoma underwent EX-PRESS glaucoma drainage device implantation and received individualized nursing care during perioperative period.Results Drainage device implantation was successfully performed in 18 patients.The mean operation time was(30.0±5.0)mins,ranged 25 to 45 mins.The postoperative intraocular pressure was stable.Conclusions EX-PRESS glaucoma drainage device implantation is an innovative and effective strategy in the treatment of open angle glaucoma.Comprehensive nursing during perioperative period is important to ensure the clinical efficacy.

Nursing cooperation of implantation of modified capsular tension ring and foldable posterior chamber intraocular lens combined with phacoemusification in treatment of Marfan syndrome accompahied with lens subluxation / 中国实用护理杂志

Objective To explore the nursing care of patients with Marfan syndrome accompanied with lens subluxation, and the clinical efficacy of phacoemusification combined with the implantation of modified capsular tension ring and foldable posterior chamber intraocular lens. Methods 11 patients (11 eyes) were performed the surgery. Uncorrected visual acuity preoperatively was (0.13±0.09). Best corrected visual acuity preoperatively was (0.20±0.17). Preoperative preparation, intraoperative observation and postoperative guidance were executed. The prognosis of these patients were observed. Results The operations were performed successfully. No intraoperative complications were founded. Mean uncorrected visual acuity at 2 year postoperatively was (0.60±0.28), and mean best corrected visual acuity was (0.70±0.28). Conclusions Careful preparation before surgery, close cooperation during surgery and the correct management after surgery were the important measures for the success of surgery.