[Application and Effect of Patient Portal System in the Remote Management of Chronic Diseases for Older Adults With Coronary Heart Disease]. / æ‚£è€ é—¨æˆ·ç³»ç»Ÿåœ¨è€å¹´å† å¿ƒç— æ ¢ç— è¿œç¨‹ç®¡ç†ä¸­çš„åº”ç”¨åŠæ•ˆæžœ.

Objective: To investigate the application of personal health record (PHR) and chronic disease management platform established on the basis of patient portal system (PPS) in managing older adults with coronary heart disease and to examine the effect on patients' self-care ability, coping mode, and quality of life. Methods: A total of 532 elderly patients with coronary heart disease were included in the study. All the participants enrolled were admitted to a tertiary-care hospital between January 2019 and June 2021. They were randomly assigned to the study group (269 cases) and the control group (263 cases). Patients in the control group were discharged with the routine discharge procedures and received the routine follow-up care. On the other hand, patients in the study group were discharged and followed up through the PHR and chronic disease management platform established on the basis of PPS. After 6 months, 12 months, and 18 months of patient management, the Exercise of Self-Care Agency (ESCA) Scale, Medical Coping Modes Questionnaire (MCMQ) and Seattle Angina Questionnaire (SAQ) were used to evaluate the patients' self-care ability, coping mode, and quality of life, respectively. The patient management effects of the two groups were analyzed. Results: Before the management programs started, there was no statistically significant difference in the scores for the scales between the two groups of patients. After 6 months, 12 months, and 18 months of patient management, the ESCA scores of both groups were higher than those before patient management started (P<0.05). Facing scores in the MCMQ of both groups were higher than those before patient management started (P<0.05), while the scores for avoidance and yielding were lower than those before patient management started (P<0.05). The SAQ scores of both groups were higher than those before patient management started (P<0.05). After 6 months, 12 months and 18 months of patient management, the ESCA scores of the study group were always higher compared with those of the control group (P<0.05). The facing score of the study group was higher, while the scores for avoidance and yielding were lower compared with those of the control group (P<0.05). The SAQ scores of the study group were higher compared with those of the control group (P<0.05). The medication compliance rate in the study group (83.27%) was higher than that in the control group (69.96%) (P<0.05). The incidence of adverse cardiovascular events in the study group (4.09%) was lower than that in the control group (10.27%) (P<0.05). The average times of emergency treatment and readmission in the study group were lower compared with those of the control group (P<0.05). The patient satisfaction score of the study group was higher compared with that of the control group (P<0.05). Conclusion: The PHR and chronic disease management platform established on the basis of PPS can increase the convenient access to medical care among elderly patients with coronary heart disease, which is conducive to improving their self-care ability, coping mode, and quality of life. In addition, the patient management effect is good.

Role of T-box genes in cancer, epithelial-mesenchymal transition, and cancer stem cells.

Sharing a common DNA binding motif called T-box, transcription factor T-box gene family controls embryonic development and is also involved in cancer progression and metastasis. Cancer metastasis shows therapy resistance and involves complex processes. Among them, epithelial-mesenchymal transition (EMT) triggers cancer cell invasiveness and the acquisition of stemness of cancer cells, called cancer stem cells (CSCs). CSCs are a small fraction of tumor bulk and are capable of self-renewal and tumorsphere formation. Recent progress has highlighted the critical roles of T-box genes in cancer progression, EMT, and CSC function, and such regulatory functions of T-box genes have emerged as potential therapeutic candidates for cancer. Herein we summarize the current understanding of the regulatory mechanisms of T-box genes in cancer, EMT, and CSCs, and discuss the implications of targeting T-box genes as anticancer therapeutics.

Analysis of the pathogenic bacteria, drug resistance, and risk factors of postoperative infection in patients with non-small cell lung cancer.

BACKGROUND: To analyze the pathogenic bacteria, drug resistance, and risk factors of postoperative infection in patients with non-small cell lung cancer (NSCLC). METHODS: A total of 119 patients with NSCLC who were admitted to our hospital from January 2017 to March 2020 were selected. The patients' clinical data were collected to evaluate the postoperative infection. The pathogenic bacteria, drug resistance, and risk factors of postoperative infections in patients with NSCLC were analyzed. RESULTS: Among 119 patients, 33 cases (27.73%) had postoperative infection, and 86 cases (72.28%) had no infection. In total, 81 pathogens were isolated from the secretions via bacterial culture from the infected sites of the 33 patients. Of these, 43 (53.09%) were gram-negative bacteria, 34 (41.98%) were Gram-positive bacteria, and four (4.94%) were fungi. Postoperative gram-negative infection showed the highest resistance rate to ciprofloxacin (81.39%), and the drug resistance rate to imipenem and meropenem was low (9.30% and 4.65%, respectively). Postoperative gram-positive infection exhibited the highest resistance rate to erythromycin (82.35%), and the drug resistance rate to vancomycin was low (5.88%). According to the univariate analysis, there were differences between the two groups in age, length of hospitalization, combined diseases, operation time, invasive procedures, hemoglobin, and serum albumin (P<0.05). However, there were no differences in terms of gender, TNM staging, and pathological classification (P<0.05). Based on the unconditional multivariate logistic regression model analysis, age ≥60 years, hospitalization time >30 d, combined diseases, operation time ≥3 h, hospitalization time >30 d, invasive operation, hemoglobin ≤90 g/L, and serum albumin ≤30 g/L were independent risk factors leading to postoperative infection in patients with NSCLC (P<0.05). CONCLUSIONS: The postoperative infection rate of patients with NSCLC is high. gram-negative bacteria infection is the primary infection in patients. There are many factors that cause postoperative infections in patients, and it is necessary to strictly control these risk factors in clinical practice, which is an effective means to prevent postoperative infection.