Professional identity and supporting willingness of nurses during the COVID-19 epidemic in China.

AIM: To investigate the professional identities and the willingness of nurses to respond to the call for support during the COVID-19 epidemic. BACKGROUND: The COVID-19 epidemic has resulted in nearly 300 million cases worldwide, causing more than five million deaths. However, the professional identities and the willingness of nurses to provide support during the COVID-19 epidemic in China remain unclear. METHODS: A total of 1,505 eligible nurses from 120 hospitals during the COVID-19 outbreak in China were included. Questionnaires were used to evaluate the willingness of these nurses to participate in epidemic control efforts. The Nurses' Professional Identity Scale was used to measure their sense of professional identity. RESULTS: About 90% of the nurses were willing to lend support in Hubei Province during the epidemic. The most common reason (93.84%) was found to be their beliefs as medical personnel in helping others in need. Nearly 10% of the nurses were unwilling to go to Hubei, primarily due to family reasons. The average total score of the Professional Identity Scale for all nurses reached a moderate to high level as indication of professional identity (116-125). Nurses who were willing to go to Hubei had a significantly higher total score than those who were not. CONCLUSIONS: The professional identity of nurses in China improved during the epidemic, and those with higher professional identities were more likely to respond to calls for support during the epidemic.

Is 10/12 Fr Ureteral Access Sheath more Suitable for Flexible Ureteroscopic Lithotripsy?

PURPOSE: To choose the ideal ureteral access sheath (UAS) size for an unstented ureter in flexible ureteroscopic lithotripsy (FURL). MATERIALS AND METHODS: A retrospective study was conducted in patients treated with FURL for renal calculi from 2005 to 2020. The patients were divided into two groups: smaller (10/12 Fr) vs. larger (12/14 Fr) calibre UAS. The outcomes were the insertion success rate, systemic inflammatory response syndrome (SIRS) complication rate after the operation, ureteral wall injury, operative time, and stone-free rate. RESULTS: Of the 1573 patients enrolled, 10/12 Fr UAS was used in 957 patients (Group A), and 12/14 Fr UAS was used in the remaining patients (Group B). The insertion success rate was significantly better in Group A (91.2% vs. 86.9%, P = .006), with no significant difference between the groups regarding the stone-free rate, postoperative pain, operative time or hospital stay. The severity of visible ureteral lesions with 10/12 Fr UAS was significantly lower than that with larger UASs (80.1% vs 85.2%, P < .001). Despite the lack of a significant difference in the incidence of SIRS between the two groups, the incidence of SIRS in the 10/12 Fr group showed a sharp increase with stones > 2 cm (17.0% vs. 8.5%, P = 0.037). CONCLUSION: The use of 10/12 Fr UAS was beneficial with respect to insertion success rate, avoiding ureteral wall injury and not increasing postoperative infectious complications in FURL. We recommend the use of a smaller calibre (10/12 Fr) UAS in patients with renal calculi < 2 cm.

Effects of Hand Holding on Anxiety and Pain During Prostate Biopsies: A Pilot Randomized Controlled Trial.

BACKGROUND: Effective pain management is limited for patients during prostate biopsy (PBx). Touch support, such as hand holding, has stress-buffering benefits and effective analgesic effects. We conducted a prospective, single-center randomized clinical trial to assess whether hand holding can reduce patient anxiety, pain, and dissatisfaction during PBx. METHODS: Between April 2020 and October 2020, 120 male patients were randomized into three groups: a hand holding with relatives (HR) group, a hand holding with strangers (HS) group and a control group. A visual analog scale (VAS) was used for self-assessments of pain and satisfaction. Anxiety levels were quantified according to the State-Trait Anxiety Inventory (STAI). Hemodynamic changes were also measured. RESULTS: The degree of pain and anxiety in the hand-holding groups was significantly better than that in the control group (P<0.001), and the patients were more willing to undergo repeat PBx (P=0.017). The anxiety levels in the HR group were significantly lower than those in the HS group (P=0.019). During PBx, the changes in systolic blood pressure and heart rate in the hand-holding groups were more stable than those in the control group (P<0.01), and the fluctuations in heart rate in the HR group were smaller than those in the HS group (P<0.01). CONCLUSION: Hand holding, especially with relatives, can promote incremental reductions in anxiety, pain and dissatisfaction in patients during PBx. Hence, we recommend hand holding with relatives as an effective adjunct during PBx.

Exosomes derived from miR-301a-3p-overexpressing adipose-derived mesenchymal stem cells reverse hypoxia-induced erectile dysfunction in rat models.

BACKGROUND: Erectile dysfunction (ED) has often been observed in patients with obstructive sleep apnea (OSA). Research on adipose-derived mesenchymal stem cell (ADSC)-derived exosomes has shown that they have significant therapeutic effects in many diseases including ED. METHODS: In this study, ED was induced in Sprague Dawley (SD) rats using chronic intermittent hypoxia (CIH) exposure. CIH-mediated influences were then measured in the corpus cavernous smooth muscle cells (CCSMCs). RESULTS: Our data showed that miR-301a-3p-enriched exosome treatment significantly recovered erectile function in rats and CCSMCs by promoting autophagy and inhibiting apoptosis. The treatment also significantly recovered the level of alpha smooth muscle actin (α-SMA) in rats and CCSMCs. Bioinformatics predicted that phosphatase and tensin homolog (PTEN) and Toll-like receptor 4 (TLR4) might be targets of miR-301a-3p. CONCLUSIONS: Our results indicate that PTEN-overexpression vectors or TLR4-overexpression vectors reverse the therapeutic effects achieved by miR-301a-3p in CCSMCs indicating that PTEN/hypoxia-inducible factor-1 alpha (HIF-1α) and TLR4 signaling pathways play key roles in the progression of ED. The findings in this study suggest that miR-301a-3p should be considered a new therapeutic target for treating ED associated with OSA.