RESUMEN
PURPOSE: To explore the symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge. METHODS: A longitudinal qualitative study was employed. A heterogeneous sample of 22 patients who underwent hematopoietic stem cell transplantation from August 2022 to April 2023 were included. Semi-structured interviews were conducted at three time points post-discharge and provided a dataset of 56 interviews. The content analysis method was used for manual analysis. This study followed the COREQ checklist. RESULTS: The data from this study were categorized into four themes and 14 subthemes: (1) complexity and multidimensionality of symptom experience: diversity, dynamism, continuity, relatedness, and functional loading; (2) multiple variations in symptom self-management; (3) barriers to symptom self-management: limited access to information resources, insufficient awareness and skills in symptom self-management, lack of economic and social support, and difficulties in medical visits and reviews; and (4) facilitators of symptom self-management: perceived benefits, experience-driven, and peer experiences. CONCLUSION: Patients undergoing hematopoietic stem cell transplantation experience multiple and complex symptom experiences after hospital discharge, and their symptom self-management remains challenging. The findings underscore the necessity for healthcare professionals to regularly and consistently evaluate the symptoms and self-management practices of patients undergoing hematopoietic stem cell transplantation and execute focused interventions to alleviate their symptom load and enhance their long-term well-being.
RESUMEN
Brain Muscle ARNT-Like Protein 1 (BMAL1) suppresses oxidative stress in brain injury during surgery. Epigallocatechin-3-gallate (EGCG), a monomer in green tea, has been identified as an antioxidant and a potential agonist for BMAL1. In this work, the mechanism by which BMAL1 is regulated was investigated, as well as the therapeutic effect of EGCG on surgically injured rats. The pathological environment after brain injury during surgery was simulated by excising the right frontal lobe of rats. Rats received an intraperitoneal injection of EGCG immediately after surgery. Neurological scores and cerebral edema were recorded after surgery. Fluoro-Jade C staining, TUNEL staining, western blot, and lipid peroxidation analyses were conducted 3 days later. Here we show that the endogenous BMAL1 level decreased after brain injury. Postoperative administration of EGCG up-regulated the content of BMAL1 around the cerebral cortex, reduced the oxidative stress level, reduced neuronal apoptosis and the number of degenerated neurons, alleviated cerebral edema, and improved neurological scores in rats. This suggests that BMAL1 is an effective target for treating surgical brain injury, as well as that EGCG may be a promising agent for alleviating postoperative brain injury.
Asunto(s)
Factores de Transcripción ARNTL , Catequina , Ratas Sprague-Dawley , Regulación hacia Arriba , Animales , Catequina/análogos & derivados , Catequina/farmacología , Factores de Transcripción ARNTL/metabolismo , Masculino , Regulación hacia Arriba/efectos de los fármacos , Ratas , Estrés Oxidativo/efectos de los fármacos , Fármacos Neuroprotectores/farmacología , Modelos Animales de Enfermedad , Lesiones Encefálicas/metabolismo , Lesiones Encefálicas/tratamiento farmacológico , Edema Encefálico/metabolismo , Edema Encefálico/tratamiento farmacológico , Apoptosis/efectos de los fármacos , Antioxidantes/farmacologíaRESUMEN
PURPOSE: The aim of this study was to understand and explore the caregiving experience of adult children of patients with multiple myeloma (MM) during diagnosis and initial treatment based in Chinese filial piety culture. METHODS: A descriptive phenomenology study was conducted to investigate semi-structured interview responses from the adult children (N = 22) of MM patients within three months after diagnosis. Colaizzi's descriptive analysis framework was employed to analyze data. This study was reported following the COREQ checklist. RESULTS: Four themes and twelve subthemes were identified from the interviews. (1) Commitment to filial piety. Participants subconsciously fulfilled their commitment to filial piety by supporting their parents, obeying their wishes, providing emotional comfort, and protecting them from harm. (2) Experiencing multiple dilemmas. They faced challenges such as difficult treatment decisions, insufficient caregiving preparation, emotional distress, and role conflict. (3) Benefiting from setbacks. The caregiving experience allowed participants to cherish the present more and to establish a new view of life. (4) Adaptive coping. Family supports and self-adaptation are effective coping strategies to achieve their good psychosocial adaptation. CONCLUSIONS: Our study provides a culturally sensitive perspective on the caregiving experience of adult children of patients with MM. This study found that Chinese culture, especially filial piety culture, influenced the experiences and coping strategies of MM caregivers. Healthcare providers should focus on the challenges faced by adult children and develop various strategies to help them cushion the burden and adjust to caregiving roles, such as supportive care programs, meaning-centered psychotherapy, and family-centered medical communication interventions.
Asunto(s)
Adaptación Psicológica , Hijos Adultos , Cuidadores , Mieloma Múltiple , Investigación Cualitativa , Humanos , Mieloma Múltiple/psicología , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/terapia , Masculino , Femenino , Adulto , Persona de Mediana Edad , Hijos Adultos/psicología , Cuidadores/psicología , China , Padres/psicología , Relaciones Padres-Hijo , AncianoRESUMEN
PURPOSE: The aim of this study was to explore the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization. METHODS: This was a qualitative descriptive study. A heterogeneous sample of 19 patients who underwent hematopoietic stem cell transplantation from May to October 2021 were enrolled in the study. Semi-structured interviews were conducted at four time points during hospitalization, providing a total of 64 interview datasets. RESULTS: Four themes and 11 subthemes reflecting the symptom experience and self-management strategies of adult hematopoietic stem cell transplantation patients during hospitalization were observed. The four themes were (1) unexpected symptom burden: dynamic, disturbing, co-occurring, and correlative; (2) emotional complexity at different periods; (3) internal predicament: ineffectiveness of symptom management; and (4) external strength: desire for support from multiple sources. Hematopoietic stem cell transplantation patients experienced a complex and dynamic array of symptoms from admission to discharge, and they experienced the dual forces of internal predicament and external strength in symptom self-management during hospitalization. CONCLUSION: The findings of this study emphasize the need for a deeper understanding and precise management of the symptom experience of adult hematopoietic stem cell transplantation patients during hospitalization. Hematopoietic stem cell transplantation nurses need to assess symptoms on an ongoing basis; educate patients on ways to perceive, express, and self-manage multiple symptoms; and develop patients' self-symptom management skills to enhance their symptom relief and quality of life.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Automanejo , Adulto , Humanos , Calidad de Vida , Estudios Longitudinales , Trasplante de Células Madre Hematopoyéticas/psicología , HospitalizaciónRESUMEN
GRB2-associated binding protein 2 (GAB2), a highly conserved scaffold protein, is abnormally expressed and activated in patients with gastric cancer (GC). However, the genetic diversity of GAB2 in GC and its association with the clinical manifestations of patients are still unclear. Here, we explored the polymorphism of GAB2 rs2373115 in GC and its association with quality of life (QOL) and negative emotions of patients with GC after postoperative comprehensive care. A case-control study showed that the frequency of the GG genotype of GAB2 rs2373115 in the GC patients was higher than that in the healthy people, while the frequency of the TT + TG genotype was lower than that in the healthy people. Obvious distinctions were observed in the histological grade and TNM staging between the GG genotype and TT + TG genotype. In addition, SAS and SDS scores in the patients with GG genotype were higher than those in patients with TT + TG genotype, while the emotional function, cognitive function, dyspnea, fatigue, sleep disorder, and overall QOL in patients with GG genotype were lower than those in patients with TT + TG genotype. These results showed that GAB2 rs2373115 polymorphism was related to QOL and negative emotions in patients with GC after postoperative comprehensive care.
RESUMEN
Perovskite (ABO3) nanosheets with a high carrier mobility have been regarded as the best candidates for gas-sensitive materials arising from their exceptional crystal structure and physical-chemical properties that often exhibit good gas reactivity and stability. Herein, Ag in situ modified porous LaFeO3 nanosheets were synthesized by the simple and efficient graphene oxide (GO)-assisted co-precipitation method which was used for sensitive and selective ethanol detection. The Ag modification ratio was studied, and the best performance was obtained with 5% Ag modification. The Ag/LaFeO3 nanomaterials with high surface areas achieved a sensing response value (Rg/Ra) of 20.9 to 20 ppm ethanol at 180 °C with relatively fast response/recovery times (26/27 s). In addition, they showed significantly high selectivity for ethanol but only a slight response to other interfering gases. The enhanced gas-sensing performance was attributed to the combination of well-designed porous nanomaterials with noble metal sensitization. The new approach is provided for this strategy for the potential application of more P-type ABO3 perovskite-based gas-sensitive devices.
RESUMEN
Surgical brain injury (SBI) is unavoidable in neurosurgery, and could aggravate secondary brain injury. Post-brain injury, multiple inflammatory factors are released, resulting in neuroinflammation and cell apoptosis, with subsequent brain edema and nerve function injury. TREM2, an immune protein mainly expressed in microglia, is an important link for nerve cells to participate in the inflammatory response. TREM2 and nuclear factor кB (NF-кB) are indeed closely associated with the release of inflammatory cytokines following brain injury. This work aimed to determine the inflammatory function of TREM2 in SBI, and to investigate whether TREM2 regulates interleukin-1 beta (IL-1ß), IL-6 and tumor necrosis factor-α (TNF-α) release through the NF-кB p65 signaling pathway. We established a rat model of SBI, and performed Western blotting (WB), immunofluorescence (IF) and enzyme-linked immunosorbent assay (ELISA) for further analysis. Next, brain edema and neurological score analyses were performed. Finally, whether TREM2 regulating NF-кB p65 signaling affects blood-brain barrier (BBB) permeability and nerve cell apoptosis was examined. We found that post-SBI, TREM2 was upregulated, and inflammation and brain injury were aggravated. After TREM2 downregulation, NF-кB p65 production, inflammation and brain injury were enhanced, suggesting that TREM2 may play a protective role by inhibiting NF-кB p65 production after SBI. Overall, these findings suggest that TREM2 in SBI may have protective effects on postoperative nerve and BBB damage, possibly in part via the NF-κB p65 pathway.
Asunto(s)
Barrera Hematoencefálica , FN-kappa B , Animales , Apoptosis , Barrera Hematoencefálica/metabolismo , Regulación hacia Abajo , FN-kappa B/metabolismo , Ratas , Transducción de SeñalRESUMEN
Tumor distant metastasis is the primary cause of death in colorectal cancer (CRC) patients. GL-V9 is a newly synthesized flavonoid derivative with several beneficial biological functions including anti-tumor and anti-inflammation. However, the anti-metastatic effect of GL-V9 and related mechanisms in CRC remains unknown. In this study, the anti-invasive and anti-migratory activities of GL-V9 were investigated in CRC cells. Using MTT assay, cell wound healing assay, and transwell migration assay, we showed that GL-V9 suppressed CRC cell viability, migration, and invasion in a concentration-dependent manner. In addition, the protein expression levels as well as activities of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) were significantly reduced after GL-V9 treatment. Further analysis of the underlying mechanism revealed that GL-V9 inhibited PI3K/Akt signaling pathway upstream of MMP-2 and MMP-9. In conclusion, our study demonstrated that GL-V9 could suppress CRC cell invasion and migration through PI3K/Ak and MMP-2/9 axis. Therefore, GL-V9 might be a potential novel therapeutic agent against CRC metastasis.