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Objective To systematically evaluate the medication experience of patients with chronic multimorbidities and to provide a reference for developing precise intervention programs to improve the medication experience of patients with chronic multimorbidities.Methods PubMed,Cochrane Library,Web of Science,Embase,CINAHL,PsycINFO,CNKI,Wanfang database,VIP database,and Chinese biomedical literature database were searched from the year of database establishment to October 2022,and qualitative studies on medication experiences of patients with chronic multimorbidities were retrieved.The Joanna Briggs Institute Critical Appraisal Tool for qualitative research(2016)in Australia was used to evaluate quality of the studies.A meta-synthesis method was used to integrate the results.Results A total of 11 articles were included,and 56 research results were extracted and integrated into 12 new categories,which were summarized into 4 integrated results:poor sensory experience of drugs,negative emotional and related experiences,reflective and behavioral experiences,and multi-dimensional debugging to improve medication experience.Conclusion The medication experience of patients with chronic multimorbidities should receive extensive attention from society and medical workers,and future research should be conducted to improve the level of patients'medication experience in 5 dimensions,including sensory experience,emotional experience,reflective experience,behavioral experience and associative experience,so as to provide a basis for further improving the medication experience of patients with chronic multimorbidities in China.
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Objective:To investigate the long-term clinical effect of deep brain stimulation (DBS) on patients with Parkinson's disease (PD) at Hoehn-Yahr stage 2.5-5 and the differences of clinical effect among patients at different Hoehn-Yahr stages.Methods:A total of 69 PD patients (7 at Hoehn-Yahr stage 2.5, 27 at stage 3, 31 at stage 4, and 4 at stage 5) accepted DBS in Department of Functional Neurosurgery, Affiliated Brain Hospital of Nanjing Medical University from May 2014 to December 2016 were selected for long-term follow-up observation at 60 months after DBS. Unified Parkinson's Disease Rating Scale (UPDRS) was evaluated in the "off" phase of the patients before DBS and the "off" phases of the drugs under DBS start-up and continuous treatment at 6, 12, 24, 36, 48 and 60 months after DBS, respectively; Parkinson's Quality of Life Questionnaire (PDQ-39) and levodopa equivalent dose (LED) data were collected before and 6, 12, 24, 36, 48 and 60 months after DBS. DBS parameters of the patients were collected at 12 months after DBS; the total stimulation power, single pulse average energy and large single pulse energy were calculated. The differences in UPDRS-III scores, PDQ-39 scores and LEDD in these patients before DBS and at different time points after DBS were compared; the differences in UPDRS-III and PDQ-39 scores at different time points after DBS and postoperative DBS parameters at 12 months after DBS in patients at different Hoehn-Yahr stages were compared.Results:Compared with those before DBS, the UPDRS-III scores, PDQ-39 scores and LED were significantly reduced at 6, 12, 24, 36, 48 and 60 months after DBS ( P<0.05). Significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and Hoehn-Yahr stage 2.5 and stage 3 at 12 and 24 months after DBS ( P<0.05); however, no significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and Hoehn-Yahr stage 4 at same time points ( P>0.05); and no significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and patients at Hoehn-Yahr stage 2.5, stage 3, and stage 4 at other time points ( P>0.05). No significant differences in PDQ-39 scores were noted between patients at different Hoehn-Yahr stages at 6, 12, 24, 36, 48, and 60 months after DBS ( P>0.05). No significant difference in total stimulation power, single pulse average energy or large single pulse energy was noted among patients at different Hoehn-Yahr stages at 12 months after DBS ( P>0.05). Conclusion:DBS is long-term effective in improving motor function and quality of life in PD patients at Hoehn-Yahr stage 2.5-5, and patients at Hoehn-Yahr stage 5 do not need higher DBS parameters to obtain similar clinical improved effects as patients at Hoehn-Yahr stage 2.5-4.
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【Objective】 To conduct a retrospective statistical analysis of the blood discarding situation in Xuzhou Central Blood Station in the past 5 years, so as to explore relevant measures and strategies to reduce blood discarding and save blood resources. 【Methods】 The discarding situation of our station from 2018 to 2022 was systematically sorted out, and Big data analysis base on the two causes, which was unqualified testing and non unqualified testing, was conducted. 【Results】 The total blood discarding rate of our station from 2018 to 2022 was 9.57% (94 273/985 178), and there was a difference in the total discarding rate between different years (Panti-TP(0.23%, 2 263/985 178)>anti-HCV(0.14%, 1 354/985 178)> HBsAg(0.13%, 1 285/985 178)>anti-HIV (0.12%, 1 140/985 178). The unqualified rate of ALT in males (0.63%, 1 993/317 437) was significantly higher than that in females (0.19%, 388/209 601) (P<0.05). The unqualified rate of ALT at the age of 18-25 accounted for 55% (0.49/0.89) of the total unqualified rate of ALT, and was significantly higher than other age groups (P <0.05). 【Conclusion】 It is suggested to improve the public awareness of voluntary blood donation, strengthen health consultation before blood donation, promote staff training so as to reduce blood discarding rate, as well as ensure sufficient, safe and effective clinical blood use.
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Objective:To study the expression of Proline rich protein11 (PRR11) in breast cancer and its relationship with clinical biological behavior, prognosis and survival.Methods:A prospective analysis method was used to select 80 patients with breast cancer from Jan. 2018 to Jan. 2019. Immunohistochemical S-P method was used to detect the expression of PRR11 in cancer tissues. Patients with positive expression of PRR11 were set as the study group ( n=47) and the patients with negative expression of PRR11 were set as the control group ( n=33) . All patients were followed up for 3 years to analyze and compare the survival rates of patients with positive and negative expression of PRR11. The relationship between PRR11 expression and clinical biological behavior, prognosis and survival was analyzed by Cox risk ratio review model. Results:80 patients were followed up for 3 years. It was found that the prognosis of patients with negative PRR11 expression was significantly better than that of patients with positive PRR11 expression ( χ2=5.75, P<0.001) . Chi square test was used to analyze the correlation between the expression of PRR11 and tumor size, TNM stage, lymph node metastasis, distant metastasis, histological grade, Ki67 expression and hormone receptor status ( P<0.05) . The expression of PRR11 in breast cancer tissues with larger tumors, distant metastasis and later staging was relatively high ( P<0.05) . Univariate Cox regression analysis showed that histological grade, TNM stage and PRR11 were independent risk factors affecting the prognosis of breast cancer patients ( P<0.001) . The AUC of prognosis prediction in patients with breast cancer was 0.812, and the 95% CI was 0.635-0.796. When PRR11 expression was positive, the sensitivity was 81.47%, and the specificity was 85.57%. Conclusions:The expression of PRR11 is relatively high in the late stage breast cancer tissue. The expression of PRR11 is closely related to the clinical biological behavior of breast cancer size, TNM stage and lymph node metastasis. The survival rate of patients with high PRR11 expression is low, and the positive expression of PRR11 is an independent risk factor affecting the prognosis of breast cancer patients. PRR11 detection has preferable clinical application value in predicting the prognosis of breast cancer.
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Objective:To compare the clinical effects of the two methods in surgical treatment of gynecomastia.Methods:The clinical data of 46 patients with gynecomastia were retrospectively analyzed, who received total removal of the glands through mastoscopic assistance (mastoscopic group) or traditional areola incision (traditional group) from Mar. 2017 to Mar. 2018. The two groups were compared in terms of blood loss, the mean operation duration, extubation time, the average hospitalization time, postoperative complications, the total cost and patients’ satisfaction at 6 month after operation. Chi-square test was used to compare the count data between groups, paired t test was used to compare the measurement data between groups, and SPSS18.0 statistical software was used for statistical analysis.Results:The operation was completed in both groups. There were no differences between the two group in age (0.473) , BMI (0.353) , lesion location (0.198) , Simon classification (0.683) , the mean blood loss ( P=0.999) , mean operation duration ( P=0.596) , extubation time ( P=0.755) , the average hospitalization time ( P=0.676) , postoperative complications and ( P=0.370) or the total cost ( P=0.486) . The difference of patients’ satisfaction at 6 month after operation had statistical significance ( P=0.012) . conclusion:Compared with traditional open surgery, mastoscopic surgery for gynecomastia is minimally invasive, beautiful and safe, which can be widely used in clinical practice.
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Objective To explore neglect dyslexia in unilateral spatial neglect patients,the error type and whether there exists word length and semantic effect.Methods Ten left spatial neglect patients were investigated by Chinese characters reading material.Results Unilateral spatial patients showed neglect dyslexia (202 neglect errors,94.0％ of the total 215 errors) when reading.The most common errors were omissions (148 errors,73.3％ of the total 202 neglect errors),followed by substitutions and additions.The error rate of two words was 9.9％ ± 8.4％,while the rate of three words was 18.8％ ± 16.2％.Performance was worse with the increase of word length (T =-55,P ＜ 0.05).The error rate of words was 8.3％ ± 7.5％,while the rate of non-words was 18.9％ ± 16.6％,and the rate of non-words was worse than that of words (T =-55,P ＜ 0.05).Conclusions Our study has shown that omissions are the most common error type of neglect dyslexia in Chinese unilateral spatial neglect patients,and the impairment include word length effect.The patients with unilateral spatial neglect show preserved semantic processing in the neglect side.
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ObjectiveTo investigate the effect of expressional chimeric faces on the attentional bias in unilateral spatial neglect (USN) patients.Methods12 USN patients and 30 matched healthy controls (HC) were involved in this study.All of them were performed with happy-neutral and sad-neutral expressional chimeric faces (ECF) and the attentional deviation scores were compared between and within groups.ResultsThere were statistically significant differences of attentional deviation scores ( happy-neutral ECF:t =15.550,P ＜ 0.0l ; sadneutral ECF:t=12.192,P＜0.01 ) between the USN group (happy-neutral ECF:0.78 ±0.22;sad-neutral ECF:0.50 ±0.20) and the HC group (happy-neutral ECF:-0.31 ±0.20;sad-neutral ECF:-0.25 ±0.17),with rightward bias in the USN group and small leftward bias in the HC group.For the USN group,the magnitude of rightward bias in the sad-neutral ECF condition was reduced than in the happy-neutral ECF condition ( t =3.954,P=0.002 ).There were no statistically differences under happy-and sad-neutral ECF conditions within the HC group ( t =- 1.302,P =0.203 ).ConclusionsUSN patients show rightward attentional bias under both happyand sad-neutral ECF conditions.However,the magnitude of rightward bias under the sad-neutral ECF condition are reduced significantly.This might be attributed to the unconscious processing of stimuli in the neglected side and emotion cognition of the brain hemispheres.
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ObjectiveTo explore the attentional biases in male alcohol dependent (AD) patients and the correlations between the attentional bias and alcohol-related factors.MethodsA total of 30 recently detoxified male individuals with alcoholism were compared with 37 healthy controls ( HC ) on the Chinese Emotional Stroop Task using negative,neutral,and alcohol-related words.ResultsThe comparison between AD group( ( 1382.13 ±323.38) ms,( 1365.76 ±313.03)ms,( 1433.20 ±342.23) ms,respectively) and HC group( (797.27 ±216.97)ms,( 794.11 ± 209.41 ) ms,(799.40 ± 215.82 ) ms respectively) on the reaction time of neutral,negative and alcohol-related words were significant ( t =8.822,P ＜ 0.001 ; t =8.922,P ＜ 0.001 ; t =9.234,P ＜ 0.001 ).The error number of of the neutral and negative- related words of the patients ( ( 3.70 ± 2.56) time,( 4.23 ± 2.53 ) time)was worse than that of HC group( ( 2.11 ± 1.87 ) time,( 1.92 ± 1.82 ) time) ( t =2.939,P =0.005 ; t =4.355,P ＜0.01 ).Error number of the alcohol- related words between two groups were not significant;Its alcohol-related words attentional bias negative correlation to the age of initial alcohol use(P＜ 0.05 ),and positive correlation to continue drinking and score of self-rating depression scale (P＜0.05).Age of addiction and the score of self-rating anxiety scale enter the regression equation of alcohol-related words.ConclusionThese results demonstrate that alcoholics have attentional bias in alcohol-related words and reward-related brain regions may be associated with craving among male patients with attentional bias.