[Associations Among Changes in Meridian Energy, Quality of Life During Surgery, and Prognoses in Newly Diagnosed Lung Cancer Patients: A Longitudinal Study].

BACKGROUND: Approximately 30% of patients experience postoperative complications after surgery for early-stage lung cancer. However, the relationships among meridian energy during lung cancer surgery, changes in quality of life, and prognosis have not been investigated. PURPOSE: This study was designed to explore the associations among meridian energy, changes in quality of life, and prognosis in patients with newly diagnosed lung cancer undergoing surgery. METHODS: A longitudinal, repeated-measures design was used. Basic data forms, meridian energy measurements, and a concise 12-item health status questionnaire were administered to the participants at the time of diagnosis, 2 weeks post-surgery, and 12 weeks post-surgery. During this period, changes were analyzed, and their association with postoperative risks was explored. RESULTS: Forty-eight cases were investigated. Both meridian energy and quality of life were found to be significantly decreased 2 weeks after surgery. The high/low ratio of meridian energy, the physical component score of the Short Form 12-Item Health Survey Questionnaire, gender, cancer stage, and body mass index were identified as significantly associated with prognosis. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Conclusion/Implications for Practice: The declining trends in meridian energy and quality of life during the 2 weeks after surgery in patients with lung cancer are associated with poor postoperative prognoses. Nurses may use the findings of this study to identify patients at high risk of postoperative complications and develop appropriate strategies to provide comprehensive care.

Anxiety severity does not influence treatment outcomes in patients with interstitial cystitis/bladder pain syndrome.

AIMS: Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) typically experience anxiety mood status, which is closely connected with physical and psychological status and treatment outcome. This study aimed to evaluate the impact of anxiety severity on therapeutic results in IC/BPS patients. METHODS: We prospectively enrolled IC/BPS patients who had previously undergone any kind of treatment for their disease. The primary endpoint was a change in Beck Anxiety Inventory (BAI) scores at 3 months after treatment. Secondary endpoints included changes in the Global Response Assessment (GRA), O'Leary-Sant symptom score (OSS), and Numerical Rating Scale (NRS) at 3 months after treatment. Urodynamic studies were also compared with the clinical symptom scores. RESULTS: Overall, 85 IC/BPS patients (mean age, 53.1 ± 12.4 years) were included in the study. At 3 months, changes in the GRA were not significantly different among the different anxiety severity groups. At baseline, 55 (64.7%) patients had moderate or severe anxiety. We observed a significant positive correlation between the change in BAI and the change in OSS after treatment and a significantly negative correlation with GRA at 3 months. Moreover, improvements in OSS and NRS were associated with the change in GRA. Changes in IC symptoms, but not physiological outcomes, were associated with improved anxiety status after treatment. In addition, the change in BAI was significantly associated with age, baseline BAI, and changes in OSS and GRA after treatment. CONCLUSIONS: Baseline anxiety severity does not influence treatment outcomes of IC/BPS. Patients should receive active treatment regardless of their baseline anxiety status.

[Physiological Relevance and Nursing Care Applications of Moxibustion as Applied to the Sanyinjiao Acupoint on Females].

Moxibustion is a thermal therapy procedure that applies burning material to the surface of specific acupoints, which warms the meridians and dispels cold. This procedure is widely used in traditional Chinese medicine care and treatment. It is also an important complementary and replacement therapy in many countries. Moxibustion on the Sanyinjiao acupoint of females is one of the main methods used to treat and care for women's health problems. The physiological effects of moxibustion on the Sanyinjiao acupoint include heightening the skin surface temperature to improve circulation and adjusting the balance of the autonomic nervous system via the meridians in order to regulate the affiliated organs (liver, spleen, and kidney). Moxibustion carries health risks, including the possibility of burns. Therefore, this therapy must follow the principles of moxibustion in order to safely complete the course and achieve the intended efficacy. In nursing-care applications, we must consider the process, time, distances, and safety of moxibustion. In exploring this theme, we hope the present paper helps readers better apply moxibustion in nursing-care applications and in the nursing education curriculum.

Inflammatory and Nutritional Biomarkers in Patients With Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemotherapy and Radiation Therapy.

OBJECTIVES: To investigate the relationship between pretreatment inflammatory and nutritional biomarkers in patients with esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant chemotherapy and radiation therapy (nCRT). SAMPLE & SETTING: 213 patients with newly diagnosed stage II-III ESCC who received nCRT at an academic hospital in Taiwan. METHODS & VARIABLES: Electronic health record data were used. Records on inflammatory and nutritional biomarkers and clinical outcomes were extracted. Logistic regression analysis was used to predict treatment-related adverse events, Cox regression was used for survival outcomes, and receiver operating characteristic curve analysis was used to determine optimal cutoff values. RESULTS: There was a significant association between low prognostic nutritional index (PNI) and nCRT toxicities and survival. Advanced cancer stage, high platelet-to-lymphocyte ratio, and occurrence of pneumonia/infection were linked to survival outcomes. IMPLICATIONS FOR NURSING: PNI shows promise in predicting prognosis, helps identify high-risk patients, and enables nurses to apply tailored interventions.

Effects of freshwater clam extract supplementation on time to exhaustion, muscle damage, pro/anti-inflammatory cytokines, and liver injury in rats after exhaustive exercise.

The potent anti-inflammatory activities and tissue-protective effects of freshwater clams (Corbicula fluminea) have been well reported. The aim of this study was to determine the effects of freshwater clam extract (FCE) supplementation on time to exhaustion, muscle damage, pro- and anti-inflammatory cytokines, and liver injury in rats after exhaustive exercise. Thirty-two rats were divided into four groups: sedentary control (SC); SC group with FCE supplementation (SC+FCE); exhaustive exercise (E); and E group with FCE supplementation (E+FCE). The SC+FCE and E+FCE groups were treated with gavage administration of 20 mg/kg for seven consecutive days. Blood samples were collected for the evaluation of biochemical parameters. The cytokine levels of TNF-α and IL-10 were also examined. Twenty-four hours after exhaustive exercise, the rat livers were removed for H & E staining. The FCE supplementation could extend the time to exhaustion in exercised rats. The levels of CPK, LDH, AST, ALT, lactate, TNF-α and H & E stains of the liver injury were significantly decreased in the E+FCE group, but the blood glucose and IL-10 were significantly higher in comparison with the E group. This study suggests that FCE supplementation may improve endurance performance and reduce exercise-induced muscle damage, inflammatory stress and liver injury.

Predictors of success in the registered nurse licensure exam for nursing graduates whose education was affected by the COVID-19 pandemic.

The Coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on health-care education. However, the relationship between changes in nursing internships in Taiwan during the COVID-19 pandemic and outcome in the national registered nurse (RN) licensure exam for new nursing graduates is underexplored. The study was to explore the predictors of first-attempt success in the RN licensure exam in 2022. A retrospective review of secondary data was employed in this study. Adjusted binary logistic regression was used to analyze data. A convenience sample of 78 new graduates attempted the exam. Of these graduates, 87.2% passed the RN licensure exam. Age was the main predictor of exam success, followed by grand mean academic score and total alternative (nontraditional in-person) internship hours. Compared with those who failed the exam, the graduates who passed the exam were significantly more likely to be younger, have better academic performance, and have engaged in more alternative internship hours. Nursing faculties should consider implementing supportive strategies early for students who are underperforming or those who are older than their classmates on average to help them pass the RN exam on the first attempt. The optimal duration and long-term consequences of alternative nursing internships must be analyzed in further detail.

Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients during curative treatment: A prospective longitudinal study.

Objective: This prospective longitudinal study aimed to investigate changes in sarcopenia, physical activity, and inflammation biomarkers in patients with oral cavity cancer during curative treatment and explore their association with treatment outcomes. Methods: Patients newly diagnosed with oral cavity cancer who underwent primary surgery with (chemo)radiation therapy were included. Along with physical activity and inflammatory markers, sarcopenia was assessed using a 5-time chair stand test, hand grip strength, and skeletal muscle index (SMI). Data were collected before operation and after 3 months (T2) and 6 months after operation. Logistic regression and Cox proportional hazards models were used to identify predictors of treatment outcomes. Results: Out of 56 patients, 21 (37.5%) had sarcopenia. SMI score, physical activity, and neutrophil-to-lymphocyte ratio (NLR) showed significant changes after surgery, with exacerbation at T2. Patients with sarcopenia exhibited a significant decrease in SMI scores at T2. Advanced cancer stage and sarcopenia were associated with treatment-related dysphagia (odds ratio [OR] â€‹= â€‹3.01, P â€‹= â€‹0.034; OR â€‹= â€‹7.62, P â€‹= â€‹0.018). Sarcopenia (OR â€‹= â€‹3.02, P â€‹= â€‹0.002) and NLR (OR â€‹= â€‹5.38, P â€‹< â€‹0.001) were significantly associated with infections. Pretreatment SMI independently predicted poor survival outcomes (hazard ratio â€‹= â€‹7.00, P â€‹= â€‹0.005). Conclusions: Identifying patients with oral cavity cancer, sarcopenia, and high NLR levels can ensure prompt education and vigilant monitoring, potentially improving treatment outcomes and patient well-being during curative treatment.

The Experiences of Nursing Managers in Implementing Palliative Care in Long-Term Care Facilities.

Purpose: The purpose of this study was to explore the experiences of nursing managers in implementing palliative care in long-term care facilities and to provide recommendations for managers who plan to introduce palliative care into their facilities. Methods: This study used semi-structured interviews and grounded theory methodology, with purposive sampling. A total of 11 long-term care facilities in eastern Taiwan that had implemented palliative care were selected, and 11 facility nursing managers participated in in-depth, face-to-face interviews. Results: The introduction of palliative care in long-term care facilities can be divided into four stages: (1) the opportunity for change, (2) playing a supportive role, (3) a new collaboration model, and (4) facility transformation. The core category shared by the participants may be summed up as "the palliative care captain in the facility". It reflects the spirit of the successful implementation of palliative care by managers in long-term care facilities. Conclusion: The study reveals that during the initial phases of implementing palliative care, the palliative care teams assume a crucial leadership role, while the facilities play a supportive role. At this stage, managers should focus on personnel training and addressing internal issues within the facilities to facilitate successful collaboration with the palliative care teams. In the later stages, the facilities transition from a supportive role to one of independence, marking a critical juncture for the facilities' potential stable development. During this period, managers are tasked not only with establishing the facilities' own palliative care team but also with facilitating the transformation of staff from learners to instructors. Finally, even after successful implementation, managers must contemplate how to innovate and set more ambitious goals.

Comprehensive Assessment of the Clinical Risk Factors of Postoperative Adverse Events and Survival in Patients With Non-small-cell Lung Cancer.

BACKGROUND/AIM: Postoperative adverse events are associated with poor clinical outcomes and survival in patients with non-small-cell lung cancer (NSCLC) treated with curative operation. However, comprehensive evaluation of the clinical characteristics associated with postoperative adverse events and survival outcomes is lacking. PATIENTS AND METHODS: A retrospective study that evaluated patients with NSCLC who underwent curative surgery between 2008 and 2019 was conducted in a medical center. The baseline characteristics, five-item modified frailty index, sarcopenia, inflammatory biomarkers, surgical approach, postoperative adverse events, and survival were statistically analyzed. RESULTS: Patients with a history of smoking and preoperative sarcopenia were at a higher risk of developing postoperative pulmonary complications. Smoking, frailty, and traditional open thoracotomy (OT) were associated with infections, and sarcopenia was identified as a risk factor for major complications. Advanced tumor stage, high neutrophil-to-lymphocyte ratio, OT, major complications, and infections were identified as risk factors for overall and disease-free survival. CONCLUSION: Pre-treatment sarcopenia was found to be a predictor of major complications. Infections and major complications were associated with survival outcomes in patients with NSCLC.

Hypothermia caused by slow and limited-volume fluid resuscitation decreases organ damage by hemorrhagic shock.

BACKGROUND: Hypothermia frequently occurs during fluid resuscitation of trauma victims, especially in patients with a major blood loss. Recent studies have suggested that mild hypothermia may ameliorate hemorrhagic shock (HS) induced splanchnic damage. OBJECTIVE: The aim of the present study is to compare the status of body temperature and splanchnic injury under different resuscitation speeds for HS in conscious rats. METHODS: Experimental study in an animal model of HS. Twenty-four male Wistar-Kyoto rats were used in the study. To mimic HS, 40% of the total blood volume was withdrawn. Fluid resuscitation was given 30 min after blood withdrawal. The rats were randomly divided into three groups; the control group, the 10-min rapid group, and the 12-h slow group. RESULTS: Levels of blood biochemical parameters, including aspartate transferase (GOT), and alanine transferase (GPT), were measured. Levels of serum tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were measured and levels of bronchoalveolar lavage fluid (BALF) TNF-α and nitric oxide (NO) were measured by ELISA. The lung, liver and small intestine were examined for pathological changes 48 h after HS. CONCLUSIONS: Initially slow rate resuscitation with limited-volume significantly decreased body temperature, serum GOT, GPT, TNF-α, and IL-6 levels, levels of TNF-α, and NO in BALF. Moreover, the slow group had lower injury scores in the lung, liver and small intestine than the rapid group after HS. This finding suggests that mild hypothermia induced by a slow fluid resuscitation rate with limited-volume ameliorates HS-induced splanchnic damage in conscious rats.

[Relationships among clinical symptoms, bladder condition, and subjective perceptions in patients with interstitial cystitis/painful bladder syndrome].

BACKGROUND: Interstitial cystitis (IC) is a silent challenge for patients. Various symptoms related to IC are causes of physical disability and mental distress. PURPOSE: This study investigated the relationships between clinical symptoms, bladder condition and patient perceptions. METHODS: This study enrolled 107 patients diagnosed with interstitial cystitis at a medical center in eastern Taiwan and employed a cross-sectional design. Patient medical charts were reviewed. Structural questionnaires were used to collect data. RESULTS: Participants with a high symptom problem index had poor bladder compliance, severe glomerulation and high visual analog scale (VAS) scores. There was a positive correlation between Hunner's ulcer and a high VAS score. Patients with severe lower urinary symptoms, low competency and severe glomerulation earned significantly higher patient perception of bladder condition scores. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study found significant correlations between clinical symptoms, bladder condition and patient perceptions. This study may help enhance nursing staff knowledge of IC clinical symptoms so that they may provide appropriate interventions and education to improve patient self-care abilities and life quality.

Prognostic Values of Inflammatory Indexes and Clinical Factors in Patients with Epidermal Growth Factor Receptor Mutations in Lung Adenocarcinoma and Treated with Tyrosine Kinase Inhibitors.

This study aimed to access the predictive value of inflammatory indices and clinical factors in toxicity and survival in patients with epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma receiving first-line tyrosine kinase inhibitor (TKI)-treatment. A total of 259 patients with stage IIIB−IV lung adenocarcinoma and actionable EGFR mutation who received first-line TKI treatment between 2008 and 2020 were retrospectively enrolled and analyzed. The prognostic factors of TKI-related toxicity, overall survival (OS), and progression-free survival (PFS) were identified by using logistic regression analysis and Cox proportional hazards models. Pre-TKI high platelet-to-lymphocyte ratio (PLR) was associated with post-TKI anemia. Hypoalbuminemia was associated with acneiform rash. Elderly age (≥70 years) and lower body mass index (<18.5 kg/m2) were also associated with hypoalbuminemia. Elderly age, stage IV, EGFR-mutated with L858R and uncommon mutations, and neutrophil-to-lymphocyte ratio were found to be independent prognostic factors for PFS, while elderly age, uncommon EGFR-related mutations, and lymphocyte-to-monocyte ratio were found to be independent prognostic factors for OS. A useful prognostic scoring tool for improving the survival risk stratification of patients was established by incorporating the above essential factors. Baseline hypoalbuminemia and PLR could be crucial clinical assessment factors when initiating TKI therapy. In addition, the optimization of individualized treatment strategies for these patients may be assisted by using the risk-scoring model.

Movement-based mind-body interventions for cardiac rehabilitation: An updated systematic review of randomized controlled trials.

This study aimed to assess evidence for the effect of movement-based mind-body interventions (MMBIs) for cardiac rehabilitation (CR). Six databases were searched from January 1995 to September 2020. All randomized controlled trials (RCTs) evaluated the effect of MMBIs on heart disease (HD) patients' physical and psychological outcomes. Two reviewers independently assessed the quality of all the included studies using the revised Cochrane risk-of-bias tool for RCTs. Sixteen RCTs (5160 participants) published between 1996 and 2020 met all inclusion criteria. In total, these studies investigated the effect of MMBIs for CR. Outcome measures that emerged in these studies included physical and psychological, and/or biochemical parameters to comprehensively evaluate the effects of MMBIs on HD patients. Overall, these studies suggest that MMBIs seem to be an alternative with the optimal CR option.

Melatonin ameliorates hemorrhagic shock-induced organ damage in rats.

BACKGROUND: Hemorrhagic shock (HS) followed by resuscitation can result in production of several inflammatory mediators, such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), leading to multiple organ dysfunction. Melatonin can attenuate organ damage with its anti-inflammation effects. The present study was designed to investigate the effects of melatonin on the physiopathology and cytokine levels after HS in rats. METHODS: HS was induced in rats by withdrawing 40% of the total blood volume (6 mL/100 gm body weight) from a femoral artery catheter, immediately followed by intravenous injection of 10mg/kg melatonin. Mean arterial pressure and heart rate were monitored continuously for 48 h after the start of blood withdrawal. Biochemical parameters, including levels of hemoglobulin, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), blood urea nitrogen (BUN), creatinine (Cre), lactic dehydrogenase (LDH), creatine phosphokinase (CPK), and lactate, were determined 30 min before and 0, 1, 3, 6, 12, 24, and 48 h after induction of HS while an equal volume of normal saline was replaced as fluid resuscitation. Cytokine levels including TNF-α and IL-6 in the serum were measured at 1, 24, and 48 h after HS. The kidney, liver, lung, and small intestine were removed for pathology assessment at 48 h after HS. RESULTS: HS significantly increased the heart rate, blood GOT, GPT, BUN, Cre, LDH, CPK, lactate, TNF-α, and IL-6 levels, and decreased hemoglobulin and mean arterial pressure in rats. Treatment with melatonin preserved the mean arterial pressure, decreased tachycardia, and markers of organ injury, and suppressed the release of TNF-α and IL-6, with no change in hemoglobulin after HS in rats. CONCLUSION: Treatment with melatonin suppresses the release of serum TNF-α and IL-6, and decreases the levels of markers of organ injury associated with HS, thus ameliorating HS-induced organ damage in rats.

Rosiglitazone protects against severe hemorrhagic shock-induced organ damage in rats.

BACKGROUND: Hemorrhagic shock (HS) followed by resuscitation can induce the production of several inflammatory mediators and lead to multiple organ dysfunction. The molecular mechanism of biologic responses to rosiglitazone has an anti-inflammatory effect. The present study was designed to investigate the effects of rosiglitazone on physiopathology and inflammatory mediators after HS in rats. MATERIAL/METHODS: HS was induced in rats by withdrawing 60% of the total blood volume from a femoral artery catheter, immediately followed by intravenous injection of 0.3 mg/kg rosiglitazone. Mean arterial pressure (MAP) and heart rate (HR) were monitored continuously for 12 h. Levels of biochemical parameters, including GOT, GPT, BUN, Cre, LDH, CPK, and lactate were measured at 30 min before induction of HS and 0, 1, 3, 6, 9, and 12 h after HS, while an equal volume of normal saline was replaced as fluid resuscitation. Inflammatory mediators, including tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1), were measured in serum at 1 and 12 h after HS. The kidneys, liver, lungs, and small intestine were removed for histological assessment by hematoxylin and eosin stained at 48 h after HS. RESULTS: HS significantly increased blood GOT, GPT, BUN, Cre, LDH, CPK, lactate, glucose, TNF-alpha, IL-6 and MCP-1 levels, induced tachycardia, and decreased mean arterial pressure (MAP) in rats. Treatment with rosiglitazone improved survival rate, decreased the markers of organ injury, and suppressed the release of TNF-alpha, IL-6, and MCP-1 after HS in rats. CONCLUSIONS: Treatment with rosiglitazone suppresses the release of serum TNF-alpha, IL-6 and MCP-1, and ameliorates HS-induced organ damage in rats.

Psychophysiological responses to sedative music in patients awaiting cardiac catheterization examination: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: Cardiovascular diseases are the number 1 cause of death globally. Cardiac catheterization is a key step in the diagnosis and management of cardiovascular diseases. Decreasing the stress of cardiac catheterization is a key factor in improving patients' well-being. The aim of the study was to explore the effect of music on psychophysiological indices in patients awaiting cardiac catheterization examination. METHODS: Using a 2-group repeated-measures design, 54 subjects aged 47 to 70 years and scheduled for cardiac catheterization examination were recruited. The subjects were randomly assigned to either the music group (27 subjects) or the usual-care group (27 subjects). Subjects in the music group listened to 30 minutes of music, whereas the usual-care group rested quietly, as in routine care. The heart rate (HR), HR variability, and skin temperature (ST) were measured at 7 time points and were recorded by the MP150 recording system (BIOPAC Systems, Inc, Goleta, California). Heart rate variability was analyzed by power spectral analysis: low frequency, high frequency, and ratio of low frequency to high frequency. The state of anxiety was measured at baseline and at time 7. At the end of the study, the subjects' music preference was evaluated using a visual analog scale. RESULTS AND CONCLUSIONS: Listening to music resulted in a significantly reduced state of anxiety (P = .003). Both the music and quiet rest groups noted the beneficial effects of decreased HR and increased ST (all P < .001). The treatment effects of both interventions on HR variability were inconclusive. Moreover, we also found that the higher the scores of the music preference, the lower the subjects' perceived anxiety level (P = .05). Our findings provide the necessary scientific support for the use of sedative music and quiet rest as safe and effective interventions against anxiety, as manifested in the subjects' anxiety state, HR, and ST.

The Experience to Implement Palliative Care in Long-term Care Facilities: A Grounded Theory Study of Caregivers.

PURPOSE: The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. METHODS: Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. RESULTS: Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as "the guardians at the end of life" reflects the spirit of palliative care. CONCLUSION: This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.

Perioperative exercise intervention in patients with lung cancer: A systematic literature review of randomized controlled trials.

OBJECTIVES: During perioperative, lung cancer (LC) patients are often left to experience debilitating disease-related symptoms, impaired physical activity and health-related quality of life (HRQoL), and social difficulties, despite the progress achieved in terms of treatment efficacy. Nonpharmacological intervention, such as exercise, has been identified as an effective strategy in LC patients before and after lung resection. Therefore, we aimed to assess evidence of the effect of perioperative exercise among patients with LC. MATERIALS AND METHODS: Seven databases were searched from January 1998 to September 2020. All randomized controlled trials (RCTs) that evaluated the effect of exercise on the physical and psychological status of patients with LC during the perioperative period were reviewed. Two reviewers independently assessed the quality of all studies included here using the revised Cochrane risk of bias tool for RCTs. RESULTS: Seventeen RCTs (1199 participants) published between 2011 and 2019 met for this literature review. The outcome measures that emerged from these studies included subjective outcomes, such as HRQoL, pain score, fatigue, and objective effects, such as cardiorespiratory fitness, pulmonary function, physical activity, and biological markers. Overall, these studies suggest that exercise should be an optimal option for LC; however, its efficacy and effectiveness regarding HRQoL should be investigated further. CONCLUSION: Perioperative exercise could be included in the rehabilitation program of patients with LC. More extensive, high-quality RCTs evidence is needed on the ideal exercise type, duration, intensity, and timing across the LC perioperative care.

A new microsphere-based immunoassay for measuring the activity of transcription factors.

There are several traditional and well-developed methods for analyzing the activity of transcription factors, such as EMSA, enzyme-linked immunosorbent assay, and reporter gene activity assays. All of these methods have their own distinct disadvantages, but none can analyze the changes in transcription factors in the few cells that are cultured in the wells of 96-well titer plates. Thus, a new microsphere-based immunoassay to measure the activity of transcription factors (MIA-TF) was developed. In MIA-TF, NeutrAvidin-labeled microspheres were used as the solid phase to capture biotin-labeled double-strand DNA fragments which contain certain transcription factor binding elements. The activity of transcription factors was detected by immunoassay using a transcription factor-specific antibody to monitor the binding with the DNA probe. Next, analysis was performed by flow cytometry. The targets hypoxia-inducible factor-1α (HIF-1α) and nuclear factor-kappa B (NF-κB) were applied and detected in this MIA-TF method; the results that we obtained demonstrated that this method could be used to monitor the changes of NF-κB or HIF within 50 or 100 ng of nuclear extract. Furthermore, MIA-TF could detect the changes in NF-κB or HIF in cells that were cultured in wells of a 96-well plate without purification of the nuclear protein, an important consideration for applying this method to high-throughput assays in the future. The development of MIA-TF would support further progress in clinical analysis and drug screening systems. Overall, MIA-TF is a method with high potential to detect the activity of transcription factors.

[Fluid resuscitation therapy application and nursing following hemorrhagic shock].

Hemorrhagic shock is the most important cause of early death following major trauma. Aggressive fluid resuscitation therapy is an important treatment approach for hemorrhagic shock, and nurses in critical care units must be adept at the skills to administer such. However, past studies have shown that failure in multiple organs has been induced by aggressive fluid resuscitation therapy. This article first discusses the two hit theory following trauma or shock, then discusses how aggressive crystalloid-based resuscitation strategies are associated with cell, multiple organs and immunological and inflammatory mediator dysfunction. While the Advanced Trauma Life Support (ATLS) training program has provided fluid resuscitation therapy guidelines since 1997, resuscitation volume, rate and time as well as crystalloid and colloid ratios remain uncertain. Therefore, we hope this article can provide evidence-based knowledge related to fluid resuscitation therapy in order to avoid secondary organ damage in critical care.