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Objective To investigate the effect of cognitive-behavioral intervention under the family-centered care(FCC)model on continuing care of patients after aortic dissection surgery.Methods One hundred and six patients undergoing aortic dissection in the Department of Cardiac Surgery of the hospital from January 2021 to December 2022 were evenly divided into control group and observation group by using random number table method,with 53 cases in each group.The control group was given routine continuing care,and the observation group was treated with continuing care with the cognitive behavior intervention under the FCC mode based on the control group,and both groups intervened for 8 weeks.The control group was treated with routine continuity care,while the observation group received continuity care with cognitive-behavioral intervention based on the FCC model in addition to routine continuing care,with a intervention duration of 8 weeks for both groups.The two groups were compared in terms of blood pressure,body mass index(BMI),self-care ability(measured using the Self-Care Ability Scale-ESCA),quality of life(measured using the Short Form-36 Health Survey-SF-36),and levels of depression and anxiety(measured using the Hospital Anxiety and Depression Scale-HADS)before and after the intervention.Results The level of blood pressure,BMI,and level of depression and anxiety after the intervention were all significantly lower than before the intervention(P<0.05)and the scores by ESCA and SF-36 were signifi-cantly higher than before intervention(P<0.05).The blood pressure and BMI in the observation group were both significantly better than in the control group[(116.47±28.23)mmHg vs.(124.48±29.81)mmHg and(25.33±1.11)kg/m2 vs.26.18±1.35)kg/m2,t = 7.193,2.454,P<0.01,respectively].The scores of self-care ability and quality of life in the observation group were higher than in the control group[(121.15±29.69)vs.(106.68±24.71)and(67.92±13.69)vs.(60.81±10.77),t = 8.243,7.436,P<0.01,respectively].The scores of depression and anxiety in the observation group were significantly lower than in the control group[(11.07±4.00)vs.(12.20±4.28)and(12.39±3.59)vs.(13.45±4.15),t = 3.873,2.852,P<0.01,respectively].Conclusion The cognitive-behavioral intervention under the FCC mode can significantly improve blood pressure,BMI,and psychological condition,as well as enhance patients'self-care ability and quality of life,when applied in the continuity of care for patients after aortic dissection.Therefore,it is worth promoting and applying in clinical practice.
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BACKGROUND:Periodontitis is an inflammatory and destructive disease with plaque biofilm as the main pathogenic material,which occurs in the gingiva,periodontal ligament,alveolar bone and cementum.The antigen of bacterial complex and its secreted toxin and enzyme directly lead to the destruction of periodontal tissue and trigger the host's immune response,causing indirect damage to the body tissue.Silence information regulatory factors(Sirtuins,SIRTs)play an important role in anti-aging,anti-oxidative stress,regulating inflammation,and mediating autophagy,and are closely related to the occurrence and development of periodontitis. OBJECTIVE:To review the research status of Sirtuins in periodontitis. METHODS:The first author used the computer to search the relevant research regarding the role of Sirtuins in periodontitis in PubMed,Web of Scene,CNKI and WanFang databases.The key words were"Sirtuins,Sirtuin1-7,periodontitis"in English and Chinese.After literature screening,57 articles were included for review and analysis. RESULTS AND CONCLUSION:SIRT1,SIRT2,SIRT3,and SIRT6 participate in regulating the occurrence and development of periodontitis.Inhibition of SIRT1 expression may be the target of periodontitis treatment,while overexpression of SIRT1 can inhibit periodontitis and protect periodontal tissue.The activator of SIRT1 can reduce the inflammation of periodontal tissue and improve the systemic pathological changes caused by periodontitis.SIRT2 is involved in nicotinamide phosphoribosyltransferase-mediated periodontal inflammation and plays a role in the treatment and prognosis of periodontal diseases.SIRT3 can improve age-related periodontal disease.Gastrodin promotes the osteogenic differentiation of periodontal ligament stem cells through the up-regulation of SIRT3.The activator of SIRT3 reduces the damage of periodontitis to periodontal and renal tissues by regulating the level of autophagy in the cells.SIRT6 can inhibit the inflammatory reaction of periodontal tissue and inhibit the differentiation and mineralization of cementoblasts.SIRT6 is beneficial to the prognosis of periapical periodontitis.The relationship between SIRT4,SIRT5,SIRT7 and periodontitis is rarely reported.
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Objective:To investigate the relationship between peripheral blood lipid levels and hepatitis B-related liver cancer, and to provide a theoretical basis for the early prevention and treatment of liver cancer.Methods:A total of 188 patients with hepatitis B-related liver cancer who received treatment in The First Hospital of Shanxi Medical University from June 2018 to June 2021 met the inclusion and exclusion criteria and had complete data, were included in this study. They were divided into three groups: chronic hepatitis B group ( n = 72), hepatitis B cirrhosis group ( n = 62), and hepatitis B-related liver cancer group ( n = 54) according to different stages of the disease. All patients' medical records were obtained from the medical data room. Fasting venous blood was collected in all patients on the second day after admission to detect peripheral blood lipid, liver function, and other relevant indicators. General data and biochemical indicators were collected. The Kruskal-Wallis test was performed to compare the measurement data among groups. The chi-squared test was performed to compare the count data among groups. Spearman's correlation (bivariate) was performed. Binary logistic regression was performed to analyze the influential factors of liver cancer. Results:There were significant differences in the levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) among the three groups ( F = 32.14, 27.59, 10.88, 34.09, all P < 0.05). TC and LDL-C levels in the hepatitis B-related liver cancer group were significantly higher than those in the hepatitis B cirrhosis group ( F = -32.31, -50.19, both P < 0.05). There were no significant differences in TG and HDL-C levels between hepatitis B-related liver cancer and hepatitis B cirrhosis groups ( F = -10.69, 4.46, both P > 0.05). TC, TG, HDL-C and LDL-C levels in the hepatitis B cirrhosis group were significantly lower than those in the chronic hepatitis B group ( F = 53.30, 46.98, 24.61, 48.57, all P < 0.05). LDL-C level was positively correlated with the occurrence of liver cancer ( r = 0.20, P < 0.05). HDL-C level was negatively correlated with the occurrence of liver cancer ( r = -0.15, P < 0.05). LDL-C was an independent risk factor for liver cancer ( OR = 3.35, P < 0.05), and HDL-C was a protective factor for liver cancer ( OR = 0.12, P < 0.05). Conclusion:Compared with patients with chronic hepatitis B and hepatitis B cirrhosis, patients with hepatitis B-related liver cancer had abnormal peripheral blood lipid levels, which may be related to the abnormal lipid metabolism of tumor cells. Moreover, peripheral blood lipid levels may affect the occurrence and development of tumor cells.
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Objective:To investigate the clinical characteristics of drug-induced liver injury and provide a theoretical basis for the prevention and treatment of drug-induced liver injury.Methods:The clinical data of 202 patients with complete information on drug-induced liver injury who received treatment in First Hospital of Shanxi Medical University from November 2018 to November 2021 were collected. The information including gender, age, type and name of drugs taken or exposed, clinical characteristics, autoantibodies, and liver function was statistically analyzed.Results:Among the 202 patients with drug-induced liver injury, 77 patients (38.1%) were male and 125 patients (61.9%) were female. Age distribution was mainly at > 40-60 years. There were 141 cases (69.8%) of hepatocellular type, 27 cases (13.4%) of cholestatic type, and 34 cases (16.8%) of mixed type. There were statistically significant differences in alanine aminotransferase, aspartate aminotransferase, γ-glutamine transferase, alkaline phosphatase, prothrombin time, international standardized ratio, and prothrombin activity between different clinical types ( H = 91.43, 58.65, 9.25, 32.69, 9.56, 8.19, 9.40, all P < 0.05). Among the 202 patients with drug-induced liver injury, severe liver injury occurred in the largest proportion of cases (40.6%). There was no significant difference in the disease severity between different clinical types ( P = 0.789). The top three types of drugs causing liver injury were traditional Chinese medicine [52.0% (105/202)], antineoplastic drugs [6.4% (13/202)], and antipsychotics [5.9% (12/202)]. The detection rate of autoantibodies in 202 patients with drug-induced liver injury was 29.7% (60/202). Conclusion:Drug-induced liver injury lacks specificity in clinical manifestations. A wide variety of drugs can cause liver injury. Clinicians should strengthen liver function monitoring in key populations. The proportion of patients with mixed-type liver failure is high, which should be taken seriously. When patients with drug-induced liver injury are positive for liver disease-related antibodies, clinicians should be vigilant about the possibility of drug-induced liver injury.
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Nonalcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease in the world. From the perspective of its disease spectrum, nonalcoholic steatohepatitis (NASH) is a form of disease progression and can progress to liver fibrosis, leading to NAFLD-related liver cirrhosis and liver cancer. NASH-related liver fibrosis is closely associated with prognosis, and effective measures are urgently needed for the diagnosis and intervention of disease progression. This article summarizes the research advances in the diagnosis and treatment of NAFLD-related liver fibrosis.
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Acute-on-chronic liver failure (ACLF) is the most common type of liver failure.Although artificial liver support systems and liver transplantation provide a favorable means for the treatment of liver failure, the mortality rate of liver failure remains high.At present, liver failure is a hot spot and a difficult point in clinical diagnosis and treatment, and liver failure does bring a great economic burden to society and families.This article reviews the definition, pathogenesis, prognosis and treatment of chronic acute liver failure.
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With the increasing incidence of obesity and metabolic syndrome, non-alcoholic fatty liver disease(NAFLD) has become the most common chronic liver disease worldwide, and is one of the leading causes of cirrhosis.Cirrhosis can lead to a sharp deterioration of liver function in patients, and is closely related to patients’ mortality.Therefore, non-alcoholic fatty liver cirrhosis should be strengthened the emphasis on.This article reviews the prevalence, risk factors, clinical features, diagnosis and treatment of NAFLD cirrhosis in recent years.
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RATIONALE: Granular cell tumor (GCT) is a relatively uncommon, usually benign lesion that often presents as a solitary, painless cutaneous or submucosal nodule. GCTs of the head and neck are not uncommon; however, involvement of the trunk of the facial nerve is rare. PATIENT CONCERNS: A 55-year-old woman presented a lesion at the posterior border of the left parotid gland. Doppler ultrasound revealed a hypoechoic mass and magnetic resonance imaging disclosed an irregularly shaped lesion with unsharp borders in the posterior aspect of the left parotid gland that was hyperintense on T2-weighted images and enhancing with contrast on T1-weighted images. The remainder of the parotid gland was normal. DIAGNOSIS: Following excision of the mass, diagnosis of a GCT was established and confirmed by immunohistochemistry. INTERVENTIONS: The patient underwent surgical excision of the lesion. OUTCOMES: The patient is currently asymptomatic and without recurrence after 10 months follow-up. LESSONS: GCT involvement of the trunk of the facial nerve is rare. Immunohistochemical staining is helpful for its diagnosis.
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Cranial Nerve Neoplasms/diagnosis , Facial Nerve Diseases/diagnosis , Granular Cell Tumor/diagnosis , Cranial Nerve Neoplasms/pathology , Cranial Nerve Neoplasms/surgery , Diagnosis, Differential , Facial Nerve/diagnostic imaging , Facial Nerve/pathology , Facial Nerve/surgery , Facial Nerve Diseases/pathology , Facial Nerve Diseases/surgery , Female , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Humans , Middle AgedABSTRACT
Motor neuron disease(MND) is a group of progressive motor neuron diseases and the pathogenesis is not well defined.The pathologic hallmark of MND is death of lower motor neurons (consisting of anterior horn cells in the spinal cord and their brainstem homologues innervating bulbar muscles ) and upper, or corticospinal,motor neurons.The clinical manifestations of MND are mucsle weakness ,muscle atrophy,fasciculations,bulbar paralysis and positive pyramidal signs.Traditional Chinese medicine ( TCM) named MND as flaccidity syndrome.Recently,some scholars have proposed that "MND" can be regarded as an independent research object of TCM.At present,symptomatic supportive treatment is the main treatment for MMD in western medicine ,which can only slow the progress of the disease.TCM treatment for MND has advantages of more effective than western medicine ,fewer adverse reactions and lower price.So TCM can be used as an effective method for combined treatment of MND.This article reviews the research progress of syndrome and treatment of MND with TCM.
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Motor neuron disease(MND) is a group of progressive motor neuron diseases and the pathogenesis is not well defined.The pathologic hallmark of MND is death of lower motor neurons(consisting of anterior horn cells in the spinal cord and their brainstem homologues innervating bulbar muscles) and upper, or corticospinal, motor neurons.The clinical manifestations of MND are mucsle weakness, muscle atrophy, fasciculations, bulbar paralysis and positive pyramidal signs.Traditional Chinese medicine(TCM) named MND as flaccidity syndrome.Recently, some scholars have proposed that "MND" can be regarded as an independent research object of TCM.At present, symptomatic supportive treatment is the main treatment for MMD in western medicine, which can only slow the progress of the disease.TCM treatment for MND has advantages of more effective than western medicine, fewer adverse reactions and lower price.So TCM can be used as an effective method for combined treatment of MND.This article reviews the research progress of syndrome and treatment of MND with TCM.
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Currently,there are a lot of targets for the treatment of HBV infection,both for the host,and for the virus itself.However,existed clinical drugs can only control HBV infection,and can not remove the HBV,especially cccDNA.Therefore,the chronic persistent infection caused by HBV related diseases is still seriously threat to human health.People are still impatient for the development of new effective anti-HBV drugs.In this paper,we review the recent research of the anti-hepatitis B virus based on the host as the target.
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Objective To compare the influence of different genotypes of hepatitis B virus to the body's immune function.Methods 377 patients with chronic hepatitis B virus (serum HBV DNA are all positive)were selected.The serum specimens were collected.Nest PCR method was used to detect all entrants subtype HBV genotypes,ELISA method was used to detect serum levels of IL -10 and IL -17,fully automatic biochemical instrument was used to test all entrants liver function.Results Of 377 patients with chronic hepatitis B,C genotype in 323 cases,C2 type in 321 cases (85.1%),C1 type 2 cases (0.5%);Genotype B 41 cases (10.9%),were B2 subtype;B and C mixed 12 cases (3.2%);Type D in 1 case (0.3%).The sex,age,ALT,AST,TBIL of B2,C2 subtypes,BC mixed infection had no statistically significant differences.B2,C2 subtypes,BC mixed infection had no statistically significant difference in serum IL -17 level.And B2,C2 subtype infection had statistically significant difference in IL -10 level (F =0.444,P <0.05).Conclusion Different genotype HBV subtypes may have different effect to the body's immune function.
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Large pedunculated esophageal lipoma is uncommon. The presenting symptoms of esophageal lipoma are dysphagia, regurgitated mass, and persistent sensation of a lump in the throat. The most frequent location of the tumor pedicle is the upper esophageal sphincter. Here, we present the case of a 52-year-old man who had the symptoms of pharyngeal unwell and dysphagia. Panendoscopy showed a pedunculated tumor mass within the esophageal lumen with its peduncle arising from the cervical esophagus. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed that he might have anesophageal submucosal or intraluminal and pedunculated tumor mass. The tumor mass measured 25 × 16 × 45 mm in size. Cervical approachvia the right neck was performed for confirmation. After removal of the intraluminal mass, the patient became symptom free. Pathology showed a lipoma arising from the submucosa of the esophagus.
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Esophageal Neoplasms/pathology , Lipoma/pathology , Esophageal Neoplasms/surgery , Humans , Lipoma/surgery , Male , Middle Aged , PrognosisABSTRACT
Objective To investigate the relationship between the genotype /sub -genotype and antiviral treatment.Methods The clinical data of 159 patients with chronic HBV infections were collected,who were treated by adefovir dipivoxil (10mg/d)or entecavir(0.5mg/d)according to the disease′s conditions.The genotypes and subtypes of hepatitis B virus were determined by Nested polymerase chain reaction(nt PCR).The levels of serum HBVDNA replication,ALT levels and HBV serologic markers were detected pre or post -treatment 24 weeks, 48 weeks.Observed the relationship between the HBV genotypes/sub -genotypes and the antiviral efficacy of adefovir dipivoxil or entecavir treatment.Results After 24 weeks of adefovir dipivoxil therapy,ALT normalization rate of subgenotype Ba and subgenotype C2 was 66.7% vs 66.2%(χ2 =0.74,P >0.05),HBeAg negative conversion rate of two subgenotypes was 27.3% vs 23.1%(χ2 =0.10,P >0.05),HBVDNA negative conversion rate of two sub genotype Ba and subgenotype C2 was 33.3% vs 30.9%(χ2 =0.03,P >0.05),respectively.After treatment for 48 weeks,ALT normalization rates of subgenotype Ba and subgenotype C2 were 83.3% vs 82.4%(χ2 =0.01,P >0.05),HBeAg negative conversion rates of two subgenotypes were 45.5% vs 34.4%(χ2 =0.49,P >0.05 ),HBVDNA negative conversion rates of two subgenotypes were 58.3% vs 48.5%(χ2 =0.39,P >0.05).After 24 weeks of entecavir therapy, ALT normalization rates of subgenotype Ba and subgenotype C2 were 71.4% vs 69.6%(χ2 =0.02,P >0.05 ), HBeAg negative conversion rates of two subgenotypes were 33.3% vs 30.8%(χ2 =0.03,P >0.05 ),HBVDNA negative conversion rates of two subgenotypes were 42.9% vs 39.3%(χ2 =0.06,P >0.05 ),respectively.After treatment for 48 weeks,ALT normali zation rates of subgenotype Ba and subgenotype C2 were 85.7% vs 83.9%(χ2 =0.03,P >0.05),HBeAg negative conversion rates of two subgenotypes were 50.0% vs 44.9%(χ2 =0.10, P >0.05),HBVDNA negative conversion rates of two subgenotypes were 71.4%vs 67.8%(χ2 =0.07,P >0.05). Conclusion The study showed that genotype C(C2)is a predominant HBV genotype among people with chronic HBV infections in Shanxi province.HBV subgenotypes Ba and C2 have no significant difference in virologic,biochemi-cal,and immunologic response to ADV or ETV.
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<p><b>OBJECTIVE</b>To investigate the association of mutations in the hepatitis B virus (HBV) X gene (HBX, encoding the HBx protein) and development of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Forty-four patients with HBV-related HCC participated in the study, along with 76 patients with chronic HBV infection who assessed as controls. All patients had serum HBV DNA levels that were higher than 10(3) copies/ml. Extracted HBV DNA was subjected to nested PCR to amplify the HBX gene, followed by direct sequencing. All sequencing data were compared to the consensus HBV sequence to identify mutations. The sequencing data were analyzed by Chromas and SeqMan software.</p><p><b>RESULTS</b>Mutations of G1467C, G/C1479A, C1485T and C1653T in the X region were found, but did not show any significant difference in occurrence between the HCC group and the chronic HBV infection group (P>0.05). The T1674C mutation in the X region, however, occurred more frequently in the HCC group (29.27% vs.6.67%, P<0.05). Prevalence of the T1753C mutation and the A1762T/G1764A double mutation in the BCP region was significantly higher in the HCC group than in the chronic HBV infection group (P<0.05) and in the group of patients with hepatitis B e antigen (HBeAg)-negative status compared to the patients with HBeAg-positive status (P<0.05).</p><p><b>CONCLUSION</b>Incidence of the T1674C mutation in the X region and of the T1753C mutation and the A1762T/G1764A double mutation in the BCP region was higher for patients with HBV-related HCC; the T1753C mutation and the A1762T/G1764A double mutation may inhibit the formation of HBeAg.</p>
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Humans , Carcinoma, Hepatocellular , Hepatitis B e Antigens , Hepatitis B virus , Hepatitis B, Chronic , Incidence , Liver Neoplasms , Mutation , Polymerase Chain ReactionABSTRACT
OBJECTIVE@#To study the methods of the surgical treatment for the nasal septum mass.@*METHOD@#Two hundred and fifty-three cases of nasal septum mass were treated by surgery in our department from March 1983 to August 2007. Their clinical data were retrospectively analyzed.@*RESULT@#After follow-up, most cases had no postoperative recurrence of nasal obstruction and epistaxis.@*CONCLUSION@#If the diagnosis was confirmed, the effect of the surgical treatment for the nasal septum benign tumor is satisfactory. Follow-up should be done in cases with malignant tendency and malignant tumors.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Nasal Septum , Pathology , Nose Neoplasms , Diagnosis , General Surgery , Retrospective StudiesABSTRACT
OBJECTIVE@#To observe the changes of GABA and GABAergic neurons in rat inferior colliculus following unilateral cochlear damage and explore the function and significance of GABA in reorganization of auditory center after deafferentation.@*METHOD@#Twenty sprague dawley rats were divided into four groups randomly. The technique of direct anti-GABA immunocytochemistry (SP) was used in this study. The quantity of GABA was measured by 835-50 type Amino Acid Automatism Analyzer and compared at one week, two weeks and one month after unilateral cochlear ablation, respectively.@*RESULT@#Compared with controlled groups, the quantity levels of GABA decreased and the number of GABAergic neurons also reduced one week after unilateral cochlear damage and there was a significant difference in GABA between two groups( P <0. 05); after one month, the quantity of GABA and the number of GABAergic neurons almost reached the normal level, the differences were no significant.@*CONCLUSION@#The dynamic change of GABA in rat inferior colliculus reflected the neuronal activity, which implied that GABA may play an important role in reorganization of auditory center after unilateral cochlear damage.
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Animals , Rats , Cochlea , Metabolism , Pathology , Inferior Colliculi , Metabolism , Neurons , Metabolism , Rats, Sprague-Dawley , gamma-Aminobutyric Acid , MetabolismABSTRACT
This animal experiment was aimed to apply fibrin in facial nerve repair and to quest for technical improvements in facial surgery. In each of 15 healthy large ear white rabbits, a unilateral 5 mm intratemporal facial nerve gap was created, the proximal and distal stumps were inserted into chitin tube, 1 ml autologous fibrin glue was applied around the anastomotic zone, and no suture was employed. At 3 months and 5 months after opertion, electrophysioligical study was performed. Compared with normal nerves, the regenerating nerves in both the chitin tube bridged group and the perineurium suture group had longer incubation period, lower amplitude, slower nerve-muscle conduction velocity at 3 months postoperatively. The differences were distinctly significant (P < 0.01). Although being decreased at 5 months after operation, the differences were still statistically significant (P < 0.05). There were no significant differences between the chitin tube bridged group and perineurium suture group at 3 months and 5 months, respectively. The study suggests that facial nerve repair using fibrin glue and chitin tube has the advantages of being easier,faster and more stable.
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Animals , Female , Male , Rabbits , Anastomosis, Surgical , Methods , Chitin , Therapeutic Uses , Facial Nerve Injuries , General Surgery , Fibrin Tissue Adhesive , Therapeutic Uses , Nerve Regeneration , Tissue Adhesives , Therapeutic UsesABSTRACT
OBJECTIVE To observe the changes of GABA and Glu in rat inferior colliculus following unilateral cochlear ablation and explore the function and significance of GABA and Glu in reorganization of auditory center after deafferentation. METHODS Twenty-five Sprangue Dawley (SD) rats were divided randomly into 5 groups. The content of GABA and Glu were measured by 835-50 type Amino Acid Automatism Analyzer and compared at 1 week, 2 week and 1 month after unilateral cochlear ablation respectively. RESULTS Compared with sham operated groups, the content levels of GABA decreased (from 78.00?7.50 to 51.65?10.36, about decreasing 33.6 %)1 week after unilateral cochlear ablation and there was a significant difference in GABA levels between 2 groups(P0.05). CONCLUSION The dynamic change of GABA and Glu in rat inferior colliculus reflected the neuronal activity, which implied both GABA and Glu may play an important role in reorganization of auditory center after unilateral cochlea ablation.
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Objective To probe into the effect of the endotoxin(ET) on cellular immunity function of patients wih chronic hepatitis B.Methods 98 patients and 15 normal persons as control group were studied.Measurements of endotoxin,interleukin-2 and peripheral blood T lymphocyte subset were done.Results The level of endotoxin in patients was higher than that in controls(P