Conservative Interventions for Urinary Incontinence on Postpartum Women: A Systematic Review and Meta-Analysis.

INTRODUCTION: Urinary incontinence (UI) is common in postpartum women and can lead to a reduced quality of life and withdrawal from fitness and exercise activities. Conservative management interventions such as pelvic floor muscle training (PFMT), use of vaginal cones, and biofeedback have been recommended as first-line treatment. We aimed to explore the effects of conservative interventions on UI rate, severity, and incontinence-specific quality of life in postpartum women with UI. METHODS: Nine databases were searched from inception to August 2022: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, Wanfang, China National Knowledge Infrastructure, China Biological Medicine, and VIP Journal Integration Platform. Randomized controlled trials examining the effects of conservative interventions on postpartum UI were included. RESULTS: Initial searches produced 1839 results, of which 17 studies were eligible. All included studies had a low to moderate risk of bias. Supervised PFMT and use of a vaginal cone were more effective than individual PFMT in decreasing rates of UI (odds ratio, 0.29; 95% CI, 0.14-0.61). Individual PFMT combined with acupuncture (mean difference, -1.91; 95% CI, -2.46 to -1.37) or electroacupuncture and supervised PFMT combined with moxibustion were more effective than individual supervised PFMT alone in improving the severity of symptoms. Furthermore, electrical stimulation and biofeedback combined with acupoint stimulation or core training were more effective than electrical stimulation and biofeedback alone. For improving the incontinence-specific quality of life, supervised PFMT was more efficacious than individual PFMT; electrical stimulation and biofeedback plus core training were more beneficial than electrical stimulation and biofeedback alone. DISCUSSION: Supervised PFMT and use of a vaginal cone were more beneficial in decreasing rates of UI compared with individual PFMT. Superior effects in decreasing UI severity may be achieved by combining PFMT or electrical simulation and biofeedback with other therapies. Electrical stimulation and biofeedback plus core training, as well as supervised PFMT, are most effective in improving incontinence-specific quality of life. Further research is required to provide more evidence on the efficacy of these therapies.

The association between sleep architecture, quality of life, and hypertension in patients with obstructive sleep apnea.

OBJECTIVE: The aim of this study was to investigate the association between hypertension and overnight polysomnography measures of sleep duration, sleep architecture, and quality of life (QoL) in patients with obstructive sleep apnea (OSA). METHODS: Participants were patients suspected of having OSA with or without hypertension. All patients underwent overnight polysomnography and completed the Epworth Sleepiness Scale (ESS), Self-Rating Anxiety Scale, Self-Rating Depression Scale, and 12-item Short-Form Health Survey. RESULTS: Of 128 patients (mean age 46.2 ± 12.5 years), 53% had hypertension. The average total sleep duration was 344 min (standard deviation 90) or 5.7 h and sleep efficiency was < 70%. There was no significant difference between patients with OSA with/without hypertension in total sleep duration, sleep architecture, anxiety, depression, ESS scores, or QoL. In patients with OSA, nocturnal minimum oxygen saturation was significantly negatively correlated with bodily pain and physical component summary (PCS) scores; mean nocturnal saturation was negatively correlated with bodily pain and social function; anxiety showed a significant negative correlation with role emotional; and depression was significantly negatively correlated with physical function, role physical, general health, role emotional, PCS, and mental component summary (MCS) scores. In the group with OSA and hypertension, N3 duration was negatively correlated with social function, mental health, and MCS scores. Anxiety was significantly negatively correlated with physical function, role physical, vitality, mental health, role emotional, PCS, and MCS scores. Depression was significantly negatively correlated with physical function, role physical, vitality, mental health, role emotional, PCS, and MCS scores. In patients with mild, moderate, and severe OSA, QoL was associated with depression. In mild OSA, PCS was correlated with ESS and anxiety. In moderate OSA, MCS was correlated with apnea-hypopnea index scores. In severe OSA, MCS and PCS were correlated with anxiety. CONCLUSIONS: There were no significant associations between the presence of hypertension and total sleep duration, sleep architecture, or QoL in patients with OSA. However, hypertension may affect the influencing factors of QoL in patients with OSA. Further cohort studies are needed to confirm these findings.

Use of music to enhance sleep and psychological outcomes in critically ill patients: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Music listening is used as a non-pharmacological intervention in various populations with positive results; however, evidence for its effect on sleep and psychological outcomes in critically ill patients remains unclear. It is essential to understand the impact of music listening for critically ill patients to optimise care and minimise the risk for harm. We will assess whether music listening improves sleep and psychological outcomes in critically ill patients. METHODS AND ANALYSIS: We will systematically search scientific databases for relevant studies, including PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest, the Cochrane Central Register of Controlled Trials, China Biological Medicine Database, China National Knowledge Infrastructure Library, Wan fang databases, VIP Database for Chinese Technical Periodicals and the Chinese Clinical Trial Registry. Databases will be searched for articles published from inception to 10 June 2020. Music therapy journals and reference lists in some articles will be hand-searched. Grey literature will also be searched. We will include randomised and quasi-randomised controlled trials that used music listening to improve sleep and psychological outcomes in critically ill patients. The primary outcomes will be sleep-related outcomes, and secondary outcomes will be anxiety and depression scores and physiological outcomes. Two reviewers will independently verify study eligibility and methodological quality; disagreements will be resolved by a third reviewer or through discussion. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The Consolidated Standards of Reporting Trials checklist will be used to examine the quality of included papers. Data will be extracted from eligible studies by two researchers. RevMan V.5.3 will be used for meta-analysis. ETHICS AND DISSEMINATION: This work will review existing trial data and will not introduce new patient data or interventions; therefore, ethics committee approval is not required. We will disseminate this protocol in a related peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019147202.

A Fluorescent Zn(II) Coordination Polymer: Sensitive Detection of Cr2O72- in Water and Prevention Activity On the Deep Vein Thrombosis in Orthopedic Nursing.

A novel coordination polymer (CP) based on Zn(II) of [Zn(tptc)0.5(bpy)(H2O)]n (1) was synthesized through utilizing the 2,2'-bipyridine (bpy) chelating N donors and p-terphenyl-2,2'',5'',5'''-tetracarboxylate acid (H4tptc) as the co-ligands. The measurements of the fluorescence were implemented for the complex 1 in solution and solid state, and the result reveals that 1 has a strong fluorescence and it is a sensory material with great development space to determine the trace Cr2O72- (with the detection limit of 36 ppb) in the water solutions via applying the fluorescence quenching effect. As the common disease in the orthopedic nursing, the deep vein thrombosis was the objective in this research. The weigh and length of the thrombus in the animals were measured and analyzed. In addition to this, the inflammatory response in the deep vein thrombosis animal was evaluated by RT-PCR. Molecular docking results indicate that only the carboxyl group could provide polar oxygen atoms for the formed hydrogen bonds to the protein.

Richards-Campbell sleep questionnaire: psychometric properties of Chinese critically ill patients.

BACKGROUND: Sleep abnormalities occur frequently in critically ill patients. Nurses are strategically placed, specifically in intensive care units, to promote sleep in such patients. Currently, an effective sleep assessment tool in Chinese is not available for intensive care settings. AIM: This study aimed to assess the reliability and validity of the Chinese version of the Richards-Campbell Sleep Questionnaire (RCSQ-C). It also aimed to evaluate patient-nurse reliability and agreement of the RCSQ-C in the intensive care unit (ICU). METHODS: We translated the original RCSQ into Chinese and then back-translated it into English to ensure its accuracy of translation. Internal consistency, discrimination validity and construct validity of the RCSQ-C were examined in 150 critically ill patients. The convergent validity of the RCSQ-C was evaluated in 44 of 150 critically ill patients, and data from the RCSQ-C were compared with those of the Chinese version of St Mary's Hospital Sleep Questionnaire (SMHSQ). Comparisons were also made between RCSQ-C scores obtained from patients and their nurses. RESULTS: Cronbach's α of the RCSQ-C was 0.923; thus, it showed high reliability. The corrected item-total correlation coefficient was in the range of 0·680∼0·805, which showed that the items were homogeneous for evaluating sleep. The content validity was 0·84. One factor was extracted with a cumulative contribution rate of 76·597%. Confirmatory factor analysis showed that the original single-factor structure proposed by Richards adequately fit the data. The RCSQ-C could discriminate poor and good sleepers, which supported discriminant validity. There was a close correlation between the scores obtained from the RCSQ patient's version and those from the SMHSQ. The intraclass correlation coefficients of the patient and nurse ranged from 0·315 to 0·609. CONCLUSIONS: The psychometric properties of the RCSQ-C suggest its utility in critically ill patients. Patient-nurse reliability on the RCSQ-C was "fair" to "substantial", with nurses tending to overestimate patients' perceived sleep quality. RELEVANCE TO CLINICAL PRACTICE: If the validity of this questionnaire is supported in other ICU samples, RCSQ-C could be used as a routine evaluation instrument to distinguish good and poor sleepers and then direct nurses to form corresponding treatment plans to promote sleep.

Determination of Pneumatic Tourniquet Pressure of Lower Limb by Ultrasonic Doppler.

OBJECTIVE: The aim of this study was to investigate the clinical effect of tourniquet inflation pressure setting by ultrasonic Doppler on lower limb operation. METHODS: Ninety-six patients with total knee arthroplasty were selected in this study from January 2015 to December 2015. The patients were randomly divided into the study group and the control group with 48 cases in each group. In the control group, the tourniquet pressure is determined by the doctor's request for the patient's condition, but all the tourniquet pressure values should be 80 KPa or less. In the study group, ultrasonic Doppler was used to monitor the popliteal artery blood flow of surgery limb with the maximum systolic velocity in artery as a reference value. The pressure of pneumatic tourniquet gradually increased until the maximum systolic velocity was reduced to 0. At this time, the popliteal artery blood flow was not present. The 2 groups of patients with lower extremity tourniquet pressure, hemostatic effect of intraoperative tourniquet, and the incidence of adverse reaction using tourniquets were observed and recorded. RESULTS: In the study group, the lower extremity tourniquet pressure and the incidence of adverse reaction using tourniquets were all better than that in control group; the difference between 2 groups was significant (P < 0.05). There was no significant difference between the 2 groups in the effect of hemostasis and the time of tourniquet operation (P > 0.05). CONCLUSIONS: The method of ultrasonic Doppler setting lower extremity tourniquet pressure during the operation could not only ensure the hemostatic effect, but it could also provide the optimum individual pneumatic tourniquet pressure value for patients. In the meanwhile, it could reduce the incidence of adverse reaction using tourniquets effectively as well as improve the safety of the tourniquet. This method played an important role in the recovery of patients.

Inhibition of CYP3A4 and CYP2C9 by podophyllotoxin: implication for clinical drug-drug interactions.

Podophyllotoxin (PPT) and its derivatives exert significant anti-cancer activities, and one derivative etoposide is often utilized to treat various cancers in the clinic. The aim of the present study is to investigate the inhibitory effects of PPT on major cytochrome P450 (CYP) isoforms in human livers. Inhibition of CYP3A4, CYP2C9, CYP2C8, CYP2D6, CYP2E1 and CYP2A6 by PPT was investigated in the human liver microsomal system. Time-dependent inhibition of CYP3A4 by PPT was also evaluated. The results showed that PPT strongly exhibited inhibitory effects on CYP3A4 and CYP2C9 in a concentration-dependent manner. Half inhibition concentration (IC50) was 1.1 +/- 0.3 and 4.6 +/- 0.3 meu M for CYP3A4 and CYP2C9, respectively. Inhibition kinetic analysis showed that PPT exhibited competitive inhibition towards CYP3A4 and CYP2C9 with Ki of 1.6 and 2.0 meu M, respectively. Additionally, PPT exerted time-dependent inhibition towards CYP3A4 and the kinetic parameters were 4.4+/- 2.1 meu M and 0.06 +/- 0.01 min-1 for KI and kinact, respectively. Our experimental data indicate that potential drug-drug interaction (DDI) might exist when PPT is co-administered with the substrates which mainly undergo CYP3A4- or CYP2C9-mediated metabolism.