Individualized Nursing Interventions in Patients with Comorbid Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.

Objective: Individuals with chronic obstructive pulmonary disease (COPD) are more likely to develop heart failure (HF) compared with the general population, and the presence of HF may contribute to reduced quality of life (QoL), increased hospitalizations and worse survival rates in patients with COPD. Our study examined the exercise capacity, QoL, mental health, family burden and rehospitalization rate of patients with comorbid COPD and chronic heart failure (CHF) after individualized inpatient and outpatient nursing care. Methods: A total of 100 patients with comorbid COPD and CHF admitted to Affiliated Hospital of Jiangnan University January 2021 to July 2022 were enrolled in our study and then randomly assigned to one of two groups of 50 patients: patients receiving traditional nursing care and patients receiving individualized nursing care. Exercise capacity, mental health, QoL and family burden were assessed by means of the 6-minute walk test (6MWT), Zung's Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), the short-form health survey (SF-36) and the Perceived Family Burden Scale (PFBS). Results: The patients receiving individualized nursing care had notable differences regarding distance walked in the 6MWT, the scores in all domains of both the physical and mental composites, SAS and SDS scores and PFBS scores of patients at on admission (T0), at discharge (T1) and at 2 months after discharge (T2) (P < .05). The patients receiving individualized nursing care walked longer distances on the 6MWT, more scores reflecting improved QoL and reduced SAS and SDS scores at both T1 and T2 compared with patients receiving traditional nursing care (P < .05). The patients receiving individualized nursing care exhibited decreased PFBS scores at T2 compared with patients receiving traditional nursing care (P < .05). None of the patients receiving individualized nursing care were rehospitalized, but 2 patients receiving traditional nursing care were rehospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute HF, respectively. Conclusion: Our study demonstrates that individualized inpatient and outpatient nursing care can enhance exercise capacity and improve QoL and mental health in patients with comorbid COPD and CHF.

Rational design of heterointerface between MoO2 and N-doped carbon with tunable electromagnetic interference shielding capacity.

Exploring highly efficient electromagnetic interference (EMI) shielding filler is urgently desired for next-generation wireless communication and integrated electronics. In this regard, a series of heterogeneous MoO2/N-doped carbon (MoO2/NC) nanorods with tunable conductivity have been successfully synthesized by regulating the pyrolysis temperature within 600, 700 and 800 °C. Profiting from the rational design of heterointerface and low-dimensional structure, the MoO2/NC powder achieves stronger EMI shielding capacity with the incremental temperature. It is found that the MoO2/NC-800 nanorods exhibit the optimal average EMI shielding effectiveness (SE) of 57.2 dB at a thickness of ∼0.3 mm in the X band. Meanwhile, the corresponding shielding mechanisms of MoO2/NC nanorods are also elaborately explained. More interestingly, the increase of sintering temperature makes an obvious effect on absorption loss but has little influence on reflection loss, demonstrating that adjusting the pyrolysis temperature is an effective strategy to strengthen the electromagnetic energy dissipation.

Situational Analysis of Low-density Lipoprotein Cholesterol Control and the Use of Statin Therapy in Diabetes Patients Treated in Community Hospitals in Nanjing, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Comprehensive management of diabetes should include management of its comorbid conditions, especially cardiovascular complications, which are the leading cause of morbidity and mortality among patients with diabetes. Dyslipidemia is a comorbid condition of diabetes and a risk factor for cardiovascular complications. Therefore, lipid level management is a key of managing patients with diabetes successfully. However, it is not clear that how well dyslipidemia is managed in patients with diabetes in local Chinese health-care communities. This study aimed to assess how well low-density lipoprotein cholesterol (LDL-C) was managed in Nanjing community hospitals, China.</p><p><b>METHODS</b>We reviewed clinical records of 7364 diabetic patients who were treated in eleven community hospitals in Nanjing from October 2005 to October 2014. Information regarding LDL-C level, cardiovascular risk factors, and use of lipid-lowering agents were collected.</p><p><b>RESULTS</b>In patients without history of cardiovascular disease (CVD), 92.1% had one or more CVD risk factors, and the most common CVD risk factor was dyslipidemia. The overall average LDL-C level was 2.80 ± 0.88 mmol/L, which was 2.62 ± 0.90 mmol/L and 2.82 ± 0.87 mmol/L in patients with and without CVD history respectively. Only 38% of all patients met the target goal and 37.3% of patients who took lipid-lowering agents met target goal. Overall, 24.5% of all patients were on lipid-lowering medication, and 36.3% of patients with a CVD history and 20.9% of patients without CVD history took statins for LDL-C management. The mean statin dosage was 13.9 ± 8.9 mg.</p><p><b>CONCLUSIONS</b>Only a small portion of patients achieved target LDL-C level, and the rate of using statins to control LDL-C was low. Managing LDL-C with statins in patients with diabetes should be promoted, especially in patients without a CVD history and with one or more CVD risk factors.</p>

Mechanisms of cordycepin on improving renal interstitial fibrosis via regulating eIF2α/TGF-β/Smad signaling pathway / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effects and mechanisms of cordycepin,an effective component of cordyceps militaris, on renal interstitial fibrosis (RIF) and its related eIF2α/TGF-β/Smad signaling pathway.</p><p><b>METHOD</b>Firstly, 15 C57BL/6 mice were randomly divided into 3 groups,the control group (Group A), the model group (Group B) and the cordycepin-treated group (Group C). After renal interstitial fibrotic model was successfully established by unilateral ureteral obstruction (UUO), the mice in Group C were intraperitoneally administrated with cordycepin(5 mg x kg(-1) d(-1)) and the ones in Group A and B were administrated with physiological saline for 5 days. At the end of the study, the obstructed kidneys were collected and detected for the pathological changes of RIF, and the mRNA expressions of collagen type I (Col I) and α-smooth muscle actin (α-SMA) in the kidney by Northern blot. Secondly, after renal tubular epithelial (NRK-52E) cells cultured in vitro were exposed to transforming growth factor (TGF) -β with or without cordycepin, the mRNA expressions of Col I and collagen type IV( Col IV) by Northern blot, and the protein expressions of eukaryotic initiation factor 2α (eIF2α), phosphorylated eIF2α ( p-eIF2α), Smad2/3 and phosphorylated Smad2/3 (p-Smad2/3) were tested by Western blot.</p><p><b>RESULT</b>In vivo, cordycepin alleviated RIF in model mice, including improving fibrotic pathological characteristics and mRNA expressions of Col I and α-SMA. In vitro, cordycepin induced the high expression of p-elF2α, and inhibited the expressions of p-Smad2/3, Col I and Col IV induced by TGF-β in NRK-52E cells.</p><p><b>CONCLUSION</b>Cordycepin attenuates RIF in vivo and in vitro, probably by inducing the phosphorylation of eIF2α, suppressing the expression of p-Smad2/3, a key signaling molecule in TGF-β/Smad signaling pathway, and reducing the expressions of collagens and α-SMA in the kidney.</p>

Validity of Glycated Hemoglobin in Screening and Diagnosing Type 2 Diabetes Mellitus in Chinese Subjects

BACKGROUND/AIMS: The application of glycated hemoglobin (HbA1c) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA1c as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China. METHODS: In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) > or = 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA1c test. Plasma lipid, uric acid, and blood pressure were also measured. RESULTS: Using a receiver operating characteristic curve, the optimal cutoff point of HbA1c related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA1c level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA1c > or = 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA1c levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups. CONCLUSIONS: Our results suggest that HbA1c > or = 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.

Chronic Kidney Disease and Associated Cardiovascular Risk Factors in Chinese with Type 2 Diabetes

BACKGROUND: To determine the frequency of chronic kidney disease (CKD) and its associated risk factors in Chinese type 2 diabetic patients, we conducted a cross-sectional study in Nanjing, China, in the period between January 2008 and December 2009. METHODS: Patients with type 2 diabetes under the care by Jiangsu Province Official Hospital, Nanjing, China were invited for assessment. CKD was defined as the presence of albuminuria or estimated glomerular filtration rate or =30 mg/g. RESULTS: We recruited 1,521 urban Chinese patients with type 2 diabetes (mean age, 63.9+/-12.0 years). The frequency of CKD and albuminuria was 31.0% and 28.9%, respectively. After adjusted by age and sex, hypertension, anemia and duration of diabetes were significantly associated with CKD with odds ratio (95% confidence interval) being 1.93 (1.28 to 2.93), 1.70 (1.09 to 2.64), and 1.03 (1.00 to 1.06), respectively. CONCLUSION: In conclusion, CKD was common in the urban Nanjing Chinese with type 2 diabetes. Strategies to prevent or delay progression of kidney disease in diabetes should be carried out at the early disease course of type 2 diabetes.

Controlled hypotension with remifentanil and propofol in children during endoscopic sinus surgery / 中国医师进修杂志

Objective To observe the effect of remifentanil combined with propofol to induce and sustain controlled hypotension in children during endoscopic sinus surgery(ESS). Methods Forty ASA Ⅰ children undergoing adenoidectomy in ESS were divided into control group and controlled hypotension group by random digits table with 20 cases in each group. No controlled hypotension in control group. Anesthesia was induced with propofol,remifentanil and atracurium, and maintained with continuous infusion of propofol 2 min until the target mean arterial pressure (MAP)(55 - 60 mm Hg, 1 mm Hg = 0.133 kPa) was reached,and MAP was maintained at this level during operation in controlled hypotension group. During 15 min before surgical procedure pharynx nasalis blood flow was measured and recorded with laser Dopper flowmetry continuously. The quality of the surgical field in term of blood loss and dryness was established at 15 min after operation starting. Results Controlled hypotension was induced within (2.5 ± 0.3 ) min, the infusion rate ofMAP and heart rate at 15 min after controlled hypotension and 15 min after operation starting were significantly lower than those at controlled hypotension instantly in controlled hypotension group and control group (P ＜ 0.05 ). The pharynx nasalis blood flow decreased at 15 min after controlled hypotension from baseline [(68.3 ± 8.3 )% vs. (99.8 ± 7.9 )%] (P ＜ 0.05 ). The operation time and the quality of the surgical field in term of blood loss and dryness in controlled hypotension group were better than those in control group [(21 ± 4) min vs. (32 ± 6) min and ( 1.8 ± 0.1 ) scores vs. (3.5 ± 0.5) scores] (P ＜ 0.05 ). The awakeextubate time was within 10 min in two groups, and there were no anesthesia related complications.Conclusion Remifentanil combined with propefol can induce and sustain controlled hypotension,reduce pharynx nasal is blood flow and provide good surgical conditions in children for ESS.

Familial pedigree analysis of Shen-yin deficiency syndrome in families with type 2 diabetes mellitus GU / 中国中西医结合杂志

To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.

Arterial lesions of lower extremity and metabolic disorders in diabetic patients aged over forty years / 中华老年医学杂志

Objective To investigate the relationship between atherosclerotic lesions of arteries of lower extremities and metabolic disorders in patients with diabetic foot. Methods Three hundreds and sixty two patients with type 2 diabetes were selected, including 232 males and 130 females, with average age of (64.9?11.2) years and the average diabetic duration of (9.2?7.5) years. Atherosclerotic lesions of the arteries were detected by type B ultrasound. According to severity of lesions of femoral, popliteal and tibial arteries, the patients were classified into four groups: A-control group, B-plague formation (plague), C-arterial stenosis (stenosis) (luminal narrowing≥50%) and D-arterial occlusion (occlusion). Fasting blood glucose, GHbAlc and lipid levels (Total cholesteral, TC; Triglyceride, TG; Low density iipoprotein, LDL) were tested in all patients. Results (1)GHbAlc levels in group B and group C were significantly different from that in group A respectively[(8.4?2.2%)vs(7.8?2.2%),P