Association between perioperative flurbiprofen administration and acute kidney injury (AKI) in spine surgery: a retrospective cohort study.

BACKGROUND: The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and postoperative acute kidney injury (AKI) remains controversial, with limited studies specifically examining flurbiprofen. Therefore, this research aimed to investigate the association between intraoperative flurbiprofen administration and postoperative AKI. METHODS: We retrospectively identified a cohort of patients at the Third Xiangya Hospital of Central South University. A total of 3882 adult patients undergoing spinal surgery between January 1, 2012, and July 31, 2018, were included and classified into two groups: those receiving flurbiprofen (50 or 100 mg once, 5 min after anesthesia start) and those not receiving flurbiprofen. The primary endpoint was the incidence of AKI. RESULT: The flurbiprofen group (4.4%) had a lower incidence of AKI compared to the non-flurbiprofen group (6.5%, P < 0.001). After adjusting for potential confounding variables, the multivariable regression analysis showed that the flurbiprofen group had a 49% reduced risk of postoperative AKI (OR 0.51; 95% CI 0.31 to 0.82) compared to the non-flurbiprofen group. Subgroup analysis indicated that flurbiprofen injection was associated with a reduced incidence of postoperative AKI in patients without diabetes (OR 0.61; 95% CI 0.19 to 0.74), surgical times of 2-5 h (OR 0.54; 95% CI 0.23 to 0.75), and preoperative anemia (OR 0.57; 95% CI 0.21 to 0.74). CONCLUSION: The study concluded that perioperative flurbiprofen treatment was associated with a lower risk of postoperative AKI in adult patients undergoing spinal surgery.

Stigma and its influencing factors for seeking professional psychological help among pregnant women: A cross-sectional study.

BACKGROUND: Although the stigma associated with seeking professional psychological help has received significant attention, few studies have focused on the status and factors influencing this stigma among pregnant women, especially those with a Chinese cultural background. This study aimed to assess the status of stigma associated with seeking professional psychological help and its influencing factors. METHODS: A total of 1325 pregnant women were recruited from Hunan Province, China. The Stigma for Seeking Professional Psychological Help questionnaire, Patient Health Questionnaire-9, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and questionnaires on sociodemographic characteristics and pregnancy-related information were used. Descriptive, univariate, correlation, and multivariate linear regression analyses were used to investigate the status of stigma and identify its influencing factors. FINDINGS: Pregnant Chinese women experienced a mild to moderate level of stigma associated with seeking professional psychological help, and self-stigma was more common than social stigma associated with seeking psychological help. The results of the multivariate analysis suggested that perceived social support, positive coping styles, negative coping styles, and depressive symptoms were the factors influencing self-stigma and social stigma associated with seeking professional psychological help. Advanced age and a low educational level were the only predictors associated with self-stigma, while a history of multiple pregnancies had an effect only on social stigma associated with seeking professional psychological help. CONCLUSION: Chinese pregnant women experienced a mild to moderate level of stigma associated with seeking professional psychological help. Destigmatizing interventions focusing on self-stigma and social stigma should be designed according to maternal characteristics, social support, coping style, and depressive symptoms.

Factors associated with stress among pregnant women with a second child in Hunan province under China's two-child policy: a mixed-method study.

OBJECTIVE: The purpose of the study was to investigate the status of pregnancy stress and to explore factors associated with pregnancy stress among women by China's two-child policy. METHODS: A mixed-method study involving both quantitative and qualitative methods was conducted using questionnaires and semi-structured interviews. The questionnaires encompassed socio-demographic and obstetric characteristics, as well as the Pregnancy Stress Rating Scale (PSRS) and the Social Support Rating Scale (SSRS). Initially, the participants were required to complete the questionnaires, enabling us to assess their respective pregnancy stress statuses. Subsequently, we selectively interviewed pregnant women with a second child and exhibited at least mild pregnancy stress. The qualitative study sought to uncover the factors contributing to their stress during pregnancy. RESULTS: A total of 463 subjects were enrolled; of the subjects, 22 (4.8%) had no stress, 407 (87.9%) had mild stress, 34 (7.3%) had moderate stress. Generalized linear regression analysis revealed significant factors (P<0.05) related to pregnancy stress, including family financial burden, subjective support, fertility desire, gender of the first child, and gender preference. Additionally, 16 subjects were interviewed, and through analysis, three major themes emerged, each comprising 12 sub-themes associated with pregnancy stress. These themes were identified as fertility factors (worry about maternal and child health, birth experience, and parenting stress), family factors ( financial burden, second child care problems, first child's acceptance of the second child, family concerns, fertility desire, and gender preference) and social factors (involving life events, career development and workload). CONCLUSION: The diver factors contribute to pregnancy stress among pregnant women under China's two-child policy. Our study could be used to develop appropriate interventions to reduce pregnancy stress and to enhance the mental health of women pregnant with a second child.

Influencing factors of early activity in patients with acute ischemic stroke based on social ecological model: A qualitative study. / åŸºäºŽç¤¾ä¼šç”Ÿæ€ç†è®ºæ¨¡åž‹çš„æ€¥æ€§ç¼ºè¡€æ€§è„‘å’ä¸­æ‚£è€ æ—©æœŸæ´»åŠ¨å½±å“å› ç´ çš„è´¨æ€§ç ”ç©¶.

OBJECTIVES: Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients. METHODS: Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data. RESULTS: According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures). CONCLUSIONS: Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.

Excited-state intramolecular proton transfer (ESIPT)-based fluorescent probes for biomarker detection: design, mechanism, and application.

Biomarkers are essential in biology, physiology, and pharmacology; thus, their detection is of extensive importance. Fluorescent probes provide effective tools for detecting biomarkers exactly. Excited state intramolecular proton transfer (ESIPT), one of the significant photophysical processes that possesses specific photoisomerization between Keto and Enol forms, can effectively avoid annoying interference from the background with a large Stokes shift. Hence, ESIPT is an excellent choice for biomarker monitoring. Based on the ESIPT process, abundant probes were designed and synthesized using three major design methods. In this review, we conclude probes for 14 kinds of biomarkers based on ESIPT explored in the past five years, summarize these general design methods, and highlight their application for biomarker detection in vitro or in vivo.

Amiodarone vs. metoprolol succinate in HFrEF complicated with persistent atrial fibrillation with rapid ventricular response: A prospective observational study.

Background: ß-blockers have been recommended for patients with heart failure (HF) and atrial fibrillation (AF), but studies have shown that ß-blockers do not reduce all-cause mortality or cardiovascular mortality in patients with HF and AF. Objective: To investigate the difference in efficacy between oral amiodarone and metoprolol succinate for patients with HF with reduced ejection fraction (HFrEF) and persistent atrial fibrillation (pAF) with rapid ventricular response (RVR). Methods: Patients with HFrEF complicated with pAF with RVR treated in the People's Hospital of Chongqing Hechuan between March 2018 and March 2019 were enrolled in this prospective observational study. The primary outcomes were cardiovascular mortality and the first hospitalization for HF rate. The secondary outcomes were type B pro-brain natriuretic peptide (NT-proBNP) before/after treatment, left ventricular ejection fraction (LVEF) before/after treatment, average heart rate (AhR), and the rate of sinus rhythm after 1 year of follow-up. Results: A total of 242 patients with HFrEF complicated with pAF with RVR were enrolled and divided into amiodarone + perindopril + spironolactone+ routine drug (amiodarone group, n = 121) and metoprolol succinate + perindopril + spironolactone +routine drug (metoprolol succinate group, n = 121) according to their treatment strategy. Cardiovascular mortality (4.9 vs. 12.4%, HR: 2.500, 95%CI: 1.002-6.237, P = 0.040) and first hospitalization for HF (52.9 vs. 67.8%, HR: 1.281, 95%CI: 1.033-1.589, P = 0.024) were significantly lower in the amiodarone group than in the metoprolol group. The mean ventricular rate in the amiodarone group was significantly lower than in the metoprolol group (64.5 ± 3.2 vs. 72.4 ± 4.2, P < 0.001). After 1 year of follow-up, the sinus rhythm rate was significantly higher in the amiodarone group than in the metoprolol group (38.8 vs. 7.4%, HR: 0.191, 95%CI: 0.098-0.374, P < 0.001). The difference in proBNP (3,914.88 vs. 2,558.07, P < 0.001) and LVEF (-6.89 vs. -0.98, P < 0.001) before and after treatment was significantly higher in the amiodarone group than in the metoprolol group. Conclusion: In conclusion, in this prospective observational study, the amiodarone group had lower risk of cardiovascular death and the first hospitalization for HF than metoprolol in HFrEF and persistent atrial fibrillation (pAF) with RVR. The mechanism may be related to improved cardiac function, rhythm control and ventricular rate control. Registration number: ChiCTR2200057816; Registered 7 March 2022-Retrospectively registered: http://www.medresman.org.cn/pub/cn/proj/projectshshow.aspx?proj=4222.

Application of contrast-enhanced ultrasound in the pathological grading and prognosis prediction of hepatocellular carcinoma.

BACKGROUND: To explore the clinical application value of contrast-enhanced ultrasound (CEUS) in the pathological grading and prognosis prediction of hepatocellular carcinoma (HCC). METHODS: A retrospective analysis was performed of 128 patients with primary HCC who underwent CEUS examination in our hospital from January 2017 to June 2020. Patients were divided into three groups: highly-differentiated group, moderately-differentiated group, and poorly-differentiated group. Quantitative analysis of the relationships between the rise time (RT), time to peak (TTP), mean transit time (mTT), intensity maximum (Imax), enhancement rate, and pathological grade of CEUS was performed. In addition, the follow-up patients were divided into a recurrence group and non-recurrence group, and the relationships between RT, TTP, mTT, Imax, and enhancement rate of CEUS were analyzed. RESULTS: Among the 128 patients, 23 were highly-differentiated, 63 were moderately-differentiated, and 42 were poorly-differentiated. In addition, there were 31 patients in the recurrence group and 97 patients in the non-recurrence group. RT, TTP, and enhancement rate had significant differences in the highly-differentiated, moderately-differentiated, and poorly-differentiated groups. At the same time, RT and TTP were positively correlated with the differentiation degree, while the enhancement rate was negatively correlated with the differentiation degree. Furthermore, RT, TTP, and enhancement rate were statistically significant for the diagnosis of HCC with high, moderate, and poor differentiation, among which RT had the highest diagnostic accuracy. In the recurrence group, RT, TTP, and Imax were lower than those in the non-recurrence group, and the enhancement rate was greater than that in the non-recurrence group. Moreover, low levels of RT, TTP, and Imax along with positive microvascular invasion (MVI) and poor differentiation were risk factors for HCC recurrence, and there was no significant relationship between the average tumor diameter and HCC recurrence. CONCLUSIONS: CEUS can significantly show the differences between the RT, TTP, and enhancement rate of HCC across different levels of differentiation. It can also predict whether the disease will relapse. Moreover, low levels of RT, TTP, and Imax as well as positive MVI and poor differentiation can cause the recurrence of HCC.

miR-374 improves cerebral ischemia reperfusion injury by targeting Wnt5a.

To date, studies have demonstrated the potential functions of microRNAs in cerebral ischemia reperfusion (IR) injury. Herein, we established a middle cerebral artery occlusion (MCAO) model in rats and then subjected them to reperfusion to explore the role of microRNA-374 (miR-374) in cerebral IR injury. After reperfusion, the endogenous miR-374 level decreased, and the expression of its target gene, Wnt5a, increased in brain tissues. Intracerebral pretreatment of miR-374 agomir attenuated cerebral damage induced by IR, including neurobehavioral deficits, infarction, cerebral edema and blood-brain barrier disruption. Moreover, rats pretreated with miR-374 agomir showed a remarkable decrease in apoptotic neurons, which was further confirmed by reduced BAX expression as well as increased BCL-2 and BCL-XL expression. A dual-luciferase reporter assay substantiated that Wnt5a was the target gene of miR-374. miR-374 might protect against brain injury by downregulating Wnt5a in rats after IR. Thus, our study provided a novel mechanism of cerebral IR injury from the perspective of miRNA regulation.

Efficacy of endostar combined with transcatheter arterial chemoembolization and analysis of vascular endothelial factor and C-reactive protein levels in patients with advanced hepatocellular carcinoma under contrast enhanced ultrasound.

PURPOSE: To evaluate the effect of transcatheter arterial chemoembolization (TACE) under the guidance of contrast-enhanced ultrasound (CEUS) in patients with advanced hepatocellular carcinoma (HCC). METHODS: One hundred and sixty patients with HCC admitted to Cangzhou Central Hospital from April 2015 to April 2017 were enrolled. The clinical data were retrospectively analyzed. Seventy-five patients who underwent TACE according to CEUS results were selected as the observation group. The remaining 85 cases that underwent digital subtraction augiography (DSA) angiography-guided TACE were selected as the control group and were intravenously infused with 15 mg of Endostar+500 mL of normal saline once a day for 3 consecutive days (Endostar 30 mg was reperfused during the operation). Both groups were re-contrasted at 1 month (T2) and 3 months (T3) to determine whether TACE was performed again. The numbers of TACEs re-performed were recorded. Color Doppler energy imaging was used to observe the neovascularization of the tumor. The changes of serum vascular endothelial growth factor (VEGF) and CRP levels were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: There were significant differences in the number of TACEs re-performed between the observation group and the control group (p<0.05). The serum VEGF level in the observation group was always lower than that in the control group (p<0.05). CRP levels in the control group showed an upward trend. The serum CRP level in the control group was significantly higher compared to the observation group at T3. The number of grades 0 and 1 neovascularization in the control group was significantly lower than in the observation group. The neovascularization rate of the observation group was significantly higher than the control group; the tumor effective rate of the observation group was not different from that of the control group, but the disease control rate was higher than in the control group. CONCLUSION: CEUS-guided TACE treatment of HCC can effectively inhibit tumor angiogenesis, control tumor progression, and prolong the survival of patients, which is conducive to the prognosis of patients.

Efficacy of endostar combined with transcatheter arterial chemoembolization and analysis of vascular endothelial factor and C-reactive protein levels in patients with advanced hepatocellular carcinoma under contrast enhanced ultrasound.

PURPOSE: To evaluate the effect of transcatheter arterial chemoembolization (TACE) under the guidance of contrast-enhanced ultrasound (CEUS) in patients with advanced hepatocellular carcinoma (HCC). METHODS: One hundred and sixty patients with HCC admitted to Cangzhou Central Hospital from April 2015 to April 2017 were enrolled. The clinical data were retrospectively analyzed. Seventy-five patients who underwent TACE according to CEUS results were selected as the observation group. The remaining 85 cases that underwent digital subtraction augiography (DSA) angiography-guided TACE were selected as the control group and were intravenously infused with 15 mg of Endostar+500 mL of normal saline once a day for 3 consecutive days (Endostar 30 mg was reperfused during the operation). Both groups were re-contrasted at 1 month (T2) and 3 months (T3) to determine whether TACE was performed again. The numbers of TACEs re-performed were recorded. Color Doppler energy imaging was used to observe the neovascularization of the tumor. The changes of serum vascular endothelial growth factor (VEGF) and CRP levels were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: There were significant differences in the number of TACEs re-performed between the observation group and the control group (p<0.05). The serum VEGF level in the observation group was always lower than that in the control group (p<0.05). CRP levels in the control group showed an upward trend. The serum CRP level in the control group was significantly higher compared to the observation group at T3. The number of grades 0 and 1 neovascularization in the control group was significantly lower than in the observation group. The neovascularization rate of the observation group was significantly higher than the control group; the tumor effective rate of the observation group was not different from that of the control group, but the disease control rate was higher than in the control group. CONCLUSION: CEUS-guided TACE treatment of HCC can effectively inhibit tumor angiogenesis, control tumor progression, and prolong the survival of patients, which is conducive to the prognosis of patients.