The role of physical literacy and mindfulness on health-related quality of life among college students during the COVID-19 pandemic.

This study aimed to examine the role played by the physical literacy and mindfulness in the health-related quality of life (QoL) of college students. In early 2022, 24,236 college students from three universities in southern China were recruited in the study. R software and the lavvan package was utilized to build the structural equation model. The measurement model was composed of three latent factors (physical literacy, mindfulness, and quality of life) and 16 observed variables in total. The results of the measurement model indicated goodness fit with p > .05 in Chi-square result, and GFI = .92. In addition, the comparative fit index (.92), Tucker-Lewis index (.91), root-mean-square error of approximation (.07), and root of mean square residual (.11) were in accord with the cutoff model-fit criteria. The results confirm that physical literacy and mindfulness can play a significant and positive role in the structural equation model of quality of life. In addition, this study provides initial evidence that mindfulness and physical literacy could potentially buffer declines in student QoL during the COVID-19 pandemic. Moreover, this study is the first to develop a structural equation model of QoL with multiple indicators, making it a strong addition to existing research on QoL during a pandemic.

Therapeutic Effect of Perioperative Mild Hypothermia on Postoperative Neurological Outcomes in Patients with Acute Stanford Type A Aortic Dissection.

BACKGROUND: Postoperative patients of acute Stanford type A aortic dissection (AAAD) often experience complications consisting of nervous system injury. Mild hypothermia therapy has been proven to provide the therapeutic effect of cerebral protection. We aimed to investigate the therapeutic effects of perioperative mild hypothermia on postoperative neurological outcomes in patients with AAAD. METHODS: A prospective randomized controlled study was conducted on adult patients undergoing aortic dissection surgery between February 2017 and December 2017. Patients in the treatment group underwent mild hypothermia (34° to 35°C) immediately after surgery, and in the conventional therapy group, patients were rewarmed to normal body temperature (36° to 37°C). Postoperative time to regain consciousness, postoperative serum neuron-specific enolase (NSE) and S-100ß levels, cerebral tissue oxygen saturation, presence of delirium or permanent neurological dysfunction, intensive care unit (ICU) and hospital stay duration, and 28-day mortality were compared. RESULTS: We enrolled 55 patients who underwent AAAD surgery and were randomly allocated into to 2 groups, 27 patients in the treatment group and 28 patients in the conventional therapy group. Compared with the conventional therapy group, postoperative time to regain consciousness was much shorter for patients in the mild hypothermia group (12.65 hours, interquartile range [IQR] 8.28 to 23.82, versus 25.80 hours, IQR 14.00 to 59.80; P = .02), and the rate of regaining consciousness in 24 hours after surgery was much higher (74.07% versus 46.42%; P = .037). At the same time, the ICU stay of patients in the mild hypothermia therapy group was significantly shorter than that in the conventional therapy group (5.53 ± 3.13 versus 9.35 ± 8.76 days; P = .038). Cerebral tissue oxygen saturation, incidence of delirium or permanent neurological dysfunction, duration of hospital stay, and 28-day mortality showed no statistical difference. Postoperative serum NSE and S-100ß levels increased compared with preoperative baseline values in both groups (P < .05), and the serum NSE levels of patients in the mild hypothermia therapy was significantly lower than the conventional therapy group 1 hour (P = .049) and 6 hours (P = .04) after surgery. There was no difference in the chest drainage volume or shivering between the 2 groups 24 hours after surgery. CONCLUSIONS: Perioperative mild hypothermia therapy is able to significantly reduce brain cell injury and shorten the postoperative time to regain consciousness, thus improving the neurological prognosis of patients with AAAD.

[Comparative study on the ultrastructure of radial artery in elderly patients underwent coronary artery bypass grafting with diabetes mellitus].

OBJECTIVE: To explore the impact of age and diabetes mellitus (DM) on the ultrastructure of radial artery (RA). METHODS: From June 2009 to December 2010, 64 patients underwent coronary artery bypass grafting (CABG) with autologous RA: 14 patients aged beyond 65 years without DM [9 male patients and 5 female patients, age (70 ± 4) years] and 18 patients aged beyond 65 years with DM [11 male patients and 7 female patients, age (68 ± 5) years], 20 patients aged under 60 years without DM [13 male patients and 7 female patients, age (53 ± 5) years] and 12 patients aged under 60 years with DM [7 male patients and 5 female patients, age (51 ± 6) years]. Four groups were subjected to routine electron microscopic examination and transmission electron microscopic examination. RESULTS: There were significant differences in percentage of endothelial denudation among four groups according to scanning electron microscopic evaluation (χ² = 18.082, P = 0.000). To compare with each other, there were significant differences between DM elderly patients and non-DM elderly patients, also between DM young patients and non-DM young patients according to scanning electron microscopic evaluation. There were no significant differences between DM elderly patients and DM young patients, also between non-DM elderly patients and non-DM young patients. Foam cells and the tendency of smooth muscle cells moving to intima could be visualized in DM patients according to transmission electron microscope. According to semiquantitative electron microscopic evaluation, non-DM young patients got the lower total scores than DM young patients (1.32 ± 0.20 vs. 4.38 ± 0.30) while non-DM elderly patients got the lower total scores than DM elderly patients (1.43 ± 0.20 vs. 4.67 ± 0.30). According to factorial design, there were significant differences between DM patients and non-DM patients (F = 41.22, P = 0.000). There were no differences between elderly patients and young patients (F = 1.24, P = 0.270). There is no interaction (F = 1.05, P = 0.309) between age and DM. CONCLUSIONS: After preoperative assessment with modified Allen's test and Doppler analysis, RA used as graft in the elderly has similar quality and function with young patients, and it may lead to a high patency in long term. However, the quality of RA in patients with DM is in bad condition, and further research on patency needs to be done.

[Surgical treatment of post-infarction left ventricular aneurysm: clinical analysis].

OBJECTIVE: To explore the clinical experiences, efficacies and postoperative left ventricular remodeling changes of surgical ventricular reconstruction in the treatment of post-infarction left ventricular aneurysm. METHODS: The investigators reviewed retrospectively the clinical data, operative approaches and follow-up outcomes of consecutive 194 patients with post-infarction left ventricular aneurysm, who underwent surgical ventricular reconstruction between January 1997 and December 2009. There were 54 cases in the linear group and 137 cases in the endoventricular patch plasty group. The changes of ventricular remodeling were measured by peri-operative and follow-up echocardiography. RESULTS: All patients underwent surgery with a mean cardiopulmonary bypass duration of (103 ± 35) min and aortic cross clamp duration of (62 ± 26) min. There were 8 per-operative deaths with a mortality rate of 2.2%. Angina pectoris of other cases disappeared and heart function greatly improved. After operation, the ventricular remodeling results showed that in the linear group, there was not significant difference in the changes of ventricular remodeling of post-op 2 weeks, 6 months, 1 year and 5 years versus pre-operation. However, in the endoventricular patch group, the changes of ventricular remodeling of post-op 2 weeks and follow-up 6 months versus pre-operation were significantly reduced (P < 0.05). End-systolic volume (LVESV) reduced from (129 ± 27) ml to (65 ± 8) ml and end-systolic volume index (LVESVI) decreased from (104 ± 14) ml/m(2) to (44 ± 6) ml/m(2) and the subgroup of LVEF < 35% was the most significant in the changes of LVESV and LVESVI. But LVEF improved significantly at post-operation and follow-up (from preoperation 42% ± 11% to 52% ± 7% during follow-up). CONCLUSIONS: For patients with infarction left ventricular aneurysm, left ventricular reconstruction is quite effective. The choice of operative approaches is determined by the size and range of ventricular aneurysm. Both string suture and endoventricular patch plasty technique can yield similarly satisfactory surgical outcomes. After operation, ventricular volume significantly decreases and cardiac function greatly improves.

[Left atrial plication for left atrium associated with mitral valve disease].

OBJECTIVE: To evaluate the effects of left atrial plication (LAP) in patients with giant left atrium (GLA) associated with mitral valve disease. METHODS: Twenty-three patients with left atrial diameter (LAD) over 8.0 cm were enrolled. All cases underwent valve replacement and LAP between November 1993 and November 2004 were studied retrospectively. According to New York Heart Association (NYHA) classification, 15 belonged to class III, 8 to class IV. Mitral valve replacements were performed in 18 patients (mechanical valve in 17 and biological valve in 1), double value replacement in 5, tricuspid valve plasty (TVP) in 15, atrial fibrillation radiofrequency ablation in 2. RESULTS: Low output syndrome happened in 3, respiratory failure in 2. The early death was in 3 cases (operative mortality 13%). The causes of death were: heart failure in 2 cases and stroke in 1. LAD was decreased significantly in patients after operation. CONCLUSIONS: LAP has considerably beneficial effects on improvement of postoperative respiratory and cardiac function, reducing operative mortality. Atrial fibrillation radiofrequency ablation is effective in patients with GLA associated with valve disease. It may be recommended for patients with GLA during mitral valve surgery, especially for patients with LAD > 8.0 cm.