Acceptability, Preferred Medium, and Components of Nurse-Led Cardiac Telerehabilitation: A Cross-Sectional Study.

Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t-test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program.

Value of Transabdominal Combined Transvaginal Color Doppler Ultrasonography in the Distinguish between Uterine Adenomyoma and Uterine Fibroids.

Objective: To investigate the value of transabdominal combined transvaginal color Doppler ultrasonography in the diagnosis of uterine adenomyoma. Methods: A total of 80 patients with suspected uterine adenomyoma in our hospital from January 2019 to December 2021 were selected as the study subjects. All of them were examined by transabdominal color Doppler ultrasound (TA-CDUS) and transvaginal color Doppler ultrasound (TV-CDUS), and the postoperative pathological examination results were taken as the gold standard to analyze the diagnostic efficacy of different examination methods for uterine adenomyoma. Results: By postoperative pathological biopsy, 46 cases (57.50%) were diagnosed as positive and 34 cases (42.50%) were diagnosed as negative, including 29 cases of uterine adenomyoma and 5 other cases. The sensitivity, accuracy, and negative predictive value of TA-CDUS combined with TV-CDUS in the diagnosis of adenomyoma were higher than those of TA-CDUS (P < 0.05), and the Kappa value between TA-CDUS and pathological diagnosis was 0.923, which was higher than the 0.615 between TV-CDUS and pathological diagnosis. TA-CDUS combined with TV-CDUS showed that there were significant differences in the distribution of Adier blood flow grades between patients with uterine adenomyoma and uterine fibroids (P < 0.05), and the Adier blood flow grades of patients with uterine adenomyoma were mainly grade 0 and grade I; and the resistance index (RI), peak systolic velocity (Vs), and pulsatile index (PI) in patients with uterine adenomyoma were higher than those in patients with uterine fibroids (P < 0.05). Conclusion: Compared with TA-CDUS, TA-CDUS combined with TV-CDUS is more sensitive and accurate in the diagnosis of uterine adenomyoma and has a good consistency with pathological diagnosis results. Attention should be paid to the blood flow parameter values in the differential diagnosis of uterine fibroids.

Weighted correlation network bioinformatics uncovers a key molecular biosignature driving the left-sided heart failure.

BACKGROUND: Left-sided heart failure (HF) is documented as a key prognostic factor in HF. However, the relative molecular mechanisms underlying left-sided HF is unknown. The purpose of this study is to unearth significant modules, pivotal genes and candidate regulatory components governing the progression of left-sided HF by bioinformatical analysis. METHODS: A total of 319 samples in GSE57345 dataset were used for weighted gene correlation network analysis (WGCNA). ClusterProfiler package in R was used to conduct functional enrichment for genes uncovered from the modules of interest. Regulatory networks of genes were built using Cytoscape while Enrichr database was used for identification of transcription factors (TFs). The MCODE plugin was used for identifying hub genes in the modules of interest and their validation was performed based on GSE1869 dataset. RESULTS: A total of six significant modules were identified. Notably, the blue module was confirmed as the most crucially associated with left-sided HF, ischemic heart disease (ISCH) and dilated cardiomyopathy (CMP). Functional enrichment conveyed that genes belonging to this module were mainly those driving the extracellular matrix-associated processes such as extracellular matrix structural constituent and collagen binding. A total of seven transcriptional factors, including Suppressor of Zeste 12 Protein Homolog (SUZ12) and nuclear factor erythroid 2 like 2 (NFE2L2), adrenergic receptor (AR), were identified as possible regulators of coexpression genes identified in the blue module. A total of three key genes (OGN, HTRA1 and MXRA5) were retained after validation of their prognostic value in left-sided HF. The results of functional enrichment confirmed that these key genes were primarily involved in response to transforming growth factor beta and extracellular matrix. CONCLUSION: We uncovered a candidate gene signature correlated with HF, ISCH and CMP in the left ventricle, which may help provide better prognosis and therapeutic decisions and in HF, ISCH and CMP patients.

Vancomycin exposure caused opportunistic pathogens bloom in intestinal microbiome by simulator of the human intestinal microbial ecosystem (SHIME).

Antibiotics are emerging organic pollutants posing high health risks to humans by causing human intestinal microbial disorders with increasing abundances of opportunistic pathogens, and fecal microbiota transplantation (FMT) has been confirmed to restore the dysbiosis of gut flora in many kinds of intestinal disease. However, to date, few studies have focused on the bloomed opportunistic pathogens associated human disease-related pathways as well as antibiotic resistance genes (ARGs) after vancomycin exposure, and there is limited information on using FMT for restoration of intestinal microbiome affected by antibiotics. Therefore, this study investigated effects of vancomycin on the opportunistic pathogens, human disease-related pathways as well as ARGs in human gut, and the restoration of intestinal microbiome by FMT. Results indicated that vancomycin treatment substantially increased human disease-related pathways and decreased abundances of ARGs. Besides, the bloomed opportunistic pathogens including Achromobacter, Klebsiella, and Pseudomonas, caused by vancomycin exposure, were positively correlated with human disease-related pathways. The microbiota abundance and genes of human disease-related pathways and antibiotic resistance showed a remarkable return towards baseline after FMT, but not for natural recovery. These findings suggest that impacts of vancomycin on human gut are profound and FMT will be a promising strategy in clinical application that can restore the dysbiosis of gut microbiota, which may be valuable for directing future work.

Amoxicillin Increased Functional Pathway Genes and Beta-Lactam Resistance Genes by Pathogens Bloomed in Intestinal Microbiota Using a Simulator of the Human Intestinal Microbial Ecosystem.

Antibiotics are frequently used to treat bacterial infections; however, they affect not only the target pathogen but also commensal gut bacteria. They may cause the dysbiosis of human intestinal microbiota and consequent metabolic alterations, as well as the spreading of antibiotic resistant bacteria and antibiotic resistance genes (ARGs). In vitro experiments by simulator of the human intestinal microbial ecosystem (SHIME) can clarify the direct effects of antibiotics on different regions of the human intestinal microbiota, allowing complex human microbiota to be stably maintained in the absence of host cells. However, there are very few articles added the antibiotics into this in vitro model to observe the effects of antibiotics on the human intestinal microbiota. To date, no studies have focused on the correlations between the bloomed pathogens caused by amoxicillin (AMX) exposure and increased functional pathway genes as well as ARGs. This study investigated the influence of 600 mg day-1 AMX on human intestinal microbiota using SHIME. The impact of AMX on the composition and function of the human intestinal microbiota was revealed by 16S rRNA gene sequencing and high-throughput quantitative PCR. The results suggested that: (i) AMX treatment has tremendous influence on the overall taxonomic composition of the gut microbiota by increasing the relative abundance of Klebsiella [linear discriminant analysis (LDA) score = 5.26] and Bacteroides uniformis (LDA score = 4.75), as well as taxonomic diversity (Simpson, P = 0.067, T-test; Shannon, P = 0.061, T-test), and decreasing the members of Parabacteroides (LDA score = 4.18), Bifidobacterium (LDA score = 4.06), and Phascolarctobacterium (LDA score = 3.95); (ii) AMX exposure significantly enhanced the functional pathway genes and beta-lactam resistance genes, and the bloomed pathogens were strongly correlated with the metabolic and immune system diseases gene numbers (R = 0.98, P < 0.001) or bl2_len and bl2be_shv2 abundance (R = 0.94, P < 0.001); (iii) the changes caused by AMX were "SHIME-compartment" different with more significant alteration in ascending colon, and the effects were permanent, which could not be restored after 2-week AMX discontinuance. Overall results demonstrated negative side-effects of AMX, which should be considered for AMX prescription.

Relationship between hOGG1 Ser326Cys gene polymorphism and coronary artery lesions in patients with diabetes mellitus.

To study the relationship between human 8-oxoguanine glycosylase (hOGG1) Ser326Cys gene polymorphism and coronary artery lesions in patients with diabetes mellitus, we analyzed 323 patients with diabetic mellitus, who underwent coronary angiography. Using PCR-RFLP, these patients were grouped into three genotypes: Cys/Cys (n=85), Ser/Ser (n=121), and Ser/Cys (n=117). Several clinical data, including history of diseases and biochemical indices were recorded. hOGG1 mRNA expression and 8-hydroxy deoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively. The quantities and severity of coronary artery with lesions were analyzed from coronary angiography. The Gensini and SYNTAX scores were detected by the unitary criteria. The 8-OHdG levels showed statistical difference among the three genotypes (F=21.56, P<0.05). Also, 8-OHdG in Cys/Cys genotype was higher than Ser/Ser and Ser/Cys genotype (q=2.32, q=3.12, P<0.05). In terms of the expression of hOGGl mRNA, the measure of hOGGl/ß-actin showed significant difference among the three groups (F=12.56, P<0.05). On comparing two groups, hOGGl/ß-actin in Cys/Cys genotype was higher thanSer/Ser and Ser/Cys genotypes (q=2.32, q=3.12, P<0.05). Percentage of 3-vessel lesions was high in Cys/Cys genotype and percentage of 1-vessel lesions was low in Ser/Cys genotype. Gensini and SYNTAX scores and ratio of complex lesions were significantly higher in the Cys/Cys genotype than the other two genotypes (FGensini=47.16, FSYNTAX=55.12; P<0.05). hOGG1 Ser326Cys polymorphism showed correlation with coronary artery lesions in patients with diabetes mellitus, and Cys/Cys genotype may have more impact on the severity of lesions.

[Establishment of normal reference values for thromboelastography on Chinese population in Beijing].

OBJECTIVE: To determine the normal values for thromboelastography (TEG) in Chinese healthy adult volunteers residing in Beijing for over three years and compare them with those of the manufacturer's. METHODS: A total of 137 healthy adult volunteers were enrolled from June 2010 to August 2010. The technique was standardized with citrated blood and kaolin activator. And a Haemoscope 5000 device was employed. The TEG parameters analyzed were R, K, α, maximal amplitude (MA), LY30 and coagulation index (CI). All volunteers underwent the tests of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen level with the same blood sample. RESULTS: The reference ranges of 95% for 137 volunteers were R: 3.8 - 8.4 min, K: 0.8 - 3.3 min, α-Angle: 46.2 - 76.2°, MA: 50.0 - 70.8 mm, LY30: -3.3% - 4.0% and CI: -3.8 - 2.9. Overall, 24.1% (33/137) of the volunteers had at least one abnormal parameter while 7.3% (10/137) would have been considered coagulopathy had the manufacturer's reference values been used, resulting in a test specificity of 76.0%. As compared with the western ethnicity (the manufacturer's reference values), Chinese healthy volunteers were associated with lower fibrinogen functions. There were significantly different in R, K, α-Angle, MA and CI between men and women groups (all P < 0.01). CONCLUSION: This study supports the manufacturer's recommendation that each institute should determine its own normal reference values.

[Molecular epidemiology of human adenovirus diarrhea among infants and young children in Lanzhou from July 2005 to June 2008].

OBJECTIVE: Gastroenteritis is a major cause of childhood morbidity and mortality worldwide. Adenovirus AdV is recognized to be one of the most important pathogens associated with severe dehydrating gastroenteritis. Studies reported elsewhere have shown that about 8%-10% of cases with infantile diarrhea are caused by AdV and in some areas AdV diarrhea even occurred in the form of outbreaks. Studies have confirmed that AdV infections are also very common in infants and young children in China. This study aimed to investigate the molecular epidemiologic characteristics of human adenovirus diarrhea among infants and children with acute diarrhea in Lanzhou, Gansu province, China. METHOD: Stool specimen and case information were collected from both outpatients and inpatients with acute diarrhea in Lanzhou. Polymerase chain reaction was used to detect AdV in stool specimens. The subjects included 709 urban children and 180 rural children, their age ranged from 19 d to 60 months. RESULT: Of the 889 cases, 43 (4.8%) were found positive for AdV. AdV was detected in 14 of 257 (5.4%) cases seen from July 2005 to June 2006, in 4 of 286 cases (1.4%) seen from July 2006 to June 2007. During the period of July 2007 to June 2008, adenovirus was detected in 346 specimens, the positive rate was 7.2% (25/346). AdV detection rates of the three-year period were significantly different. The major AdV subtypes detected were adenovirus (subgenus F) Ad40, Ad41 with a positive rate of 3.8% (34/889), followed by non-enteric adenovirus (Ad12, Ad18, Ad31, Ad2, Ad5, Ad6, Ad7) with a positive rate of 1.0% (9/889) in Lanzhou during the 3 years. Most of the AdV-positive specimens showed Ad41 group F (67.4%, 29/43) as the major epidemic strains, and Ade infection mainly occurred in children under one year of age and no seasonal cluster was found. CONCLUSION: Adenovirus was one of the major etiological agent of viral diarrhea among infants and children in Lanzhou between 2005 and 2008. Ad41 was the prodomiment serotype.

Human bocavirus in children hospitalized for acute gastroenteritis: a case-control study.

BACKGROUND: Human bocavirus (HBoV) was recently discovered in children with respiratory tract disease and gastroenteritis. The causative role of HBoV in human gastroenteritis remains uncertain, and, to our knowledge, no previous case-control study has studied the relationship between HBoV and gastroenteritis. METHODS: We conducted a case-control study that examined stool samples from 397 children with diarrhea and from 115 asymptomatic control subjects. HBoV was detected using polymerase chain reaction. Real-time polymerase chain reaction was used to quantify the HBoV loads in case and control groups. Common enteric viruses were examined using enzyme-linked immunosorbent assays, polymerase chain reaction, and reverse-transcription polymerase chain reaction. RESULTS: At least 1 viral agent was discovered in 60.2% of cases. HBoV was detected in 14 samples, and 9 were coinfected with either rotavirus (7 of 14 samples) or human calicivirus (2 of 14). Many (8 [57.1%] of 14) of the HBoV infections occurred during September-December 2006. Most (12 [85.7%]) of the HBoV-infected children were 7-18 months of age. The percentage of children with HBoV infection did not differ significantly between case patients and control subjects (3.5% vs. 3.5%), and the statistical analysis did not support a correlation between HBoV infection and more-severe clinical symptoms. The viral load differences between the 2 groups were not statistically significant (P = .09, by log-normal Student's t test). In addition, the VP1/VP2 partial gene of HBoV from case patients and control subjects showed minimal sequence variation. CONCLUSIONS: A single genetic lineage of HBoV was revealed in persons in China. Despite its high prevalence in stool samples, our study does not support a causative role of HBoV in gastroenteritis.