The Ottawa Decision-Making Supportive Framework-Based Nursing Care in the Outcome of Patients with Chronic Heart Failure.

Objective: To examine the psychological, compliance, and prognostic impact of care based on the Ottawa Decision Support Framework on patients with chronic heart failure. Methods: The medical profiles of 80 individuals with permanent heart failure from January 2020 to January 2021 were retrospectively analyzed. The care was provided in the framework of Ottawa Decision Support alongside the clinical standard of care. The self-assessment anxiety scale (SAS), Frankel treatment adherence scale, Minnesota quality of life questionnaire for heart failure, self-care competence scale (ESCA), complication rates, and readmission rates were compared prior to and postcare. Results: Following three-month nursing care, the score of the SAS scale was remarkably fewer, and the difference was statistically significant (P < 0.05). Three months of care later, the scores on the Frank Scale were substantially superior to those before care, and the difference was statistically significant (P < 0.05). Aftercare, the Minnesota quality of life questionnaire for heart failure was clearly inferior to precare, and the difference was statistically significant (P < 0.05). The ESCA scale scores were found to be considerably more favorable after three months of care than before care, and the difference was statistically significant (P < 0.05). After nursing care, one arrhythmia (1.25%) and one pulmonary infection (1.25%) were noted, and the difference was statistically significant (P < 0.05). The prevalence of complications was 2.50%, and the difference was statistically significant (P < 0.05). Three cases were readmitted for recurrent chronic heart failure, which was a 2.75% readmission rate. Conclusion: Continuous nursing based on the Ottawa Decision Support Framework has significant application value in an anxiety state, treatment compliance, and prognosis of patients with chronic heart failure, which can more effectively reduce patients' anxiety and the incidence of complications and readmission rate, in the meanwhile, effectively improve treatment compliance, quality of life, self-care ability, and prognosis, which is worthy of clinical application.

Primary Acute Angle-Closure Glaucoma: Three-Dimensional Reconstruction Imaging of Optic Nerve Heard Structure in Based on Optical Coherence Tomography (OCT).

BACKGROUND In glaucoma, the cup to plate ratio enlargement is a recognized pathological phenomenon. At present, the research on optic nerve in China and abroad mainly focuses on 2-dimensional research, and the measurement of 3-dimensional volume data is less well studied. Therefore, the recognition of 3-dimensional morphological changes is conducive to timely clinical intervention to prevent or slow down progressive vision loss. MATERIAL AND METHODS In this paper, optical coherence tomography (OCT) volume imaging technology was used to analyze and compare the morphological changes of primary acute angle-closure glaucoma in three-dimensional morphology, reconstruct the volume data of three-dimensional optic nerve head (ONH), and make morphological measurements. RESULTS The rim width of the glaucoma group was significantly lower than that of the control group, and the average volume and intraocular pressure of the optic cup were significantly increased (P<0.05), while the rim width and intraocular pressure of the other group were not significantly changed (P>0.05). CONCLUSIONS We used three-dimensional reconstruction to identify OCT images between glaucoma patients and the control group with significant differences.

Functional MRI reveals effects of high intraocular pressure on central nervous system in high-tension glaucoma patients.

PURPOSE: To evaluate the effects of high intraocular pressure (IOP) on central nervous system in patients with high-tension glaucoma (HTG) by using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Thirty-six patients with HTG and twenty age- and gender-matched healthy controls (HCs) were recruited and underwent IOP measurement and rs-fMRI scan. The whole brain regional homogeneity (ReHo) value was calculated among the enrolled subjects. Two-sample t tests with permutation test and threshold-free cluster enhancement was performed between HTG group and HCs. Correlation analyses between IOP and ReHo values were conducted. RESULTS: Compared with HCs, HTG group showed increased ReHo values in the left lobule 8 of cerebellar hemisphere, left lobule 4 and 5 of cerebellar hemisphere and left fusiform gyrus (FG) (p < 0.05). HTG group showed decreased ReHo value in the left middle frontal gyrus (MFG) (p < 0.05). Intraocular pressure of the left eye in HTG group experienced a significant positive correlation with ReHo value of the left FG (r = 0.370, p = 0.026), IOP of the right eye in HTG group showed a significant negative correlation with ReHo value in the left MFG (r = -0.421, p = 0.011). CONCLUSION: Resting-state fMRI ReHo analyses associated elevated IOP with abnormal regional activity in several brain regions related to higher visual function and visual memory consolidation. High-tension glaucoma patients also showed diminished integration of visual information and cerebellar function. These results may provide imaging support for pathophysiological research of HTG and may reveal new targets for the accurate treatment of HTG.

The association between red cell distribution width, erythropoietin levels, and coronary artery disease.

BACKGROUND: Red cell distribution width (RDW) is a cardiac marker for risk stratification and prognostic evaluation of coronary artery disease (CAD); however, the underlying mechanism remains unclear. Erythropoietin (EPO), a crucial factor affecting erythropoiesis, has been reported to be a protective molecule regulating the process of myocardial ischemia and relevant damage. No study has as yet reported the relationship between RDW and endogenous EPO in CAD patients. This cross-sectional study aimed to establish the association between endogenous EPO levels and increases in RDW in CAD patients. PATIENTS AND METHODS: Two hundred participants who underwent coronary arteriography were recruited from July 2015 to October 2015. The participants were divided into CAD and non-CAD groups on the basis of angiography diagnosis. Demographic data were obtained through personal interviews and general clinical methods. RESULTS: RDW and EPO levels in the CAD group were higher than those in the non-CAD group. The correlation between RDW and EPO levels was statistically significant among CAD patients (r=0.411, P<0.001). The increases in EPO and RDW were related to the prevalence of CAD. The levels of RDW were correlated to endogenous EPO levels in CAD patients. CONCLUSION: Increased EPO and RDW might be risk factors for CAD. Endogenous EPO levels are associated with increases in RDW in CAD patients.

Fabrication of a composite system combining solid lipid nanoparticles and thermosensitive hydrogel for challenging ophthalmic drug delivery.

The purpose of this study was to explore a composite thermosensitive in situ gelling formulation using the distribution of solid lipid nanoparticles (SLNs) among poloxamer-based hydrogels as a potential carrier for novel ocular drug delivery. SLNs containing the model drug Resina Draconis were prepared using a melt-emulsion ultrasonication method. A central composite design (CCD) was adopted to screen the thermosensitive hydrogel (THG) formulation. After aqueous SLNs were dispersed into the THG matrices, the physicochemical properties of the SLNs were characterized before and after their incorporation into hydrogels. The in vitro corneal penetration experiment, ocular irritant test and transcorneal mechanism across the cornea have been previously described to predict the feasibility for the proposed ophthalmic application. Finally, the optimal THGs consisted of 27.8% (w/v) poloxamer 407 and 3.55% (w/v) poloxamer 188. The particle size of the SLNs remained within the colloidal range. In vitro corneal penetration studies revealed a nearly steady sustained drug release. The hen's egg test-chorioallantoic membrane (HET-CAM) test indicated that all of the tested polymer systems were non-irritant. Coumarin-6 labeled SLNs formulated into THGs displayed a more homogeneous fluorescence with a deeper penetration intensity into the cornea at various times. Taken together, these results suggest that the SLN-based THG system can be used as a potential vehicle for ocular application.