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The incidence of dementia increased significantly in the context of an aging population,imposing a significant burden on the economy and society.Therefore,finding the specific mechanism underlying cognitive decline in aging is of paramount significance.Recently,the role of microglia in the initiation and progression of cognitive decline in aging has become a research hotspot.Microglia,the resident immune cells of CNS,play important roles in immunosurveillance,synaptic pruning,damage repair and maintaining immune homeostasis.However,microglia undergo a variety of changes in cell morphology,gene expression and functional status with aging.This article review the impact of normal aging on microglia and the role of microglia in the pathogenesis of cognitive decline in aging,to provide a novel strategy for slowing or preventing the onset of dementia.
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Objective:To explore the correlations of brain network functional connectivity (FC) alterations with cerebrospinal fluid (CSF) pathological biomarkers in patients with Alzheimer's disease (AD).Methods:A total of 39 patients with cognitive impairment, admitted to Department of Neurology, Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2020 to December 2022 were recruited; 23 patients were with AD and 16 with non-AD. Clinical data were compared between the 2 groups. Resting-state functional MRI (rs-fMRI) data were collected, and FC differences between brain networks and FC differences within brain networks were compared by independent component analysis. Correlations of FC differences between brain networks and FC differences within brain networks with concentrations of β-amyloid protein 1-42 (Aβ 1-42) and Tau protein in CSF were analyzed. Results:Compared with the non-AD group, AD group had significantly lower Aβ 1-42 in CSF ( P<0.05). Compared with those in the non-AD group, FC alterations between the left frontoparietal network (lFPN) and anterior default mode network (aDMN) and between the visual network (VN) and posterior cingulate cortex (PCC), as well as FC alterations in lFPN, were significantly increased in AD group ( P<0.05). Compared with those in the non-AD group, FC alterations between lFPN and cerebellar network (CEN), and FC alterations in aDMN, sensorimotor network (SMN) and VN were significantly decreased in AD group ( P<0.05). In AD group, FC in SMN was positively correlated with total Tau and phosphorylated-Tau181 in CSF ( P<0.05); FC between VN and PCC was positively correlated with total Tau in CSF ( P<0.05). CSF Aβ 1-42 was positively correlated with FC alterations in aDMN and VN, but negatively correlated with FC in FPN ( P<0.05). Conclusion:In AD patients, characteristic changes in FC within and between multiple brain networks are noted, which are related to changes of Tau protein and Aβ 1-42 in CSF.
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Objective:To investigate the feasibility and safety of endovascular mechanical thrombectomy (EMT) combined with continuous intrasinus thrombolysis for the treatment of severe hemorrhagic cerebral venous sinus thrombosis (CVST).Methods:The clinical and imaging data of 5 consecutive patients with severe hemorrhagic CVST who received EMT combined with continuous intrasinus urokinase thrombolysis in Beijing Tiantan Hospital from March 2019 to February 2020 were retrospectively analyzed.Results:The average age of 5 patients was 39 years (range, 19-65 years). Two were males and 3 were females. Risk factors associated with CVST were identified in 3 patients. Four had more than two venous sinuses involved, with a total of 10 blood vessels affected by CVST. The affected venous sinus thrombus burden was high, the lesion volume was large, and the clinical manifestations were severe. The average duration of heparin anticoagulation therapy before EMT was 2.3 d (range, 0.5-7 d), and the average duration of intrasinus thrombolysis was 64 h (range, 30-95 h). After treatment, 1 vessel was completely recanalized and 7 vessels were partially recanalized. Four patients who achieved recanalization had good long-term clinical outcomes (modified Rankin Scale score: 0-2 at 3 months, 0-1 at 1 year). One patient failed to achieve recanalization and underwent decompressive craniectomy due to intracranial hypertension, had residual hemiparesis at 1-year follow-up. No procedure-related complications occurred.Conclusion:EMT combined with continuous intrasinus thrombolysis is a potential treatment option for patients with severe hemorrhagic CVST.
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Objective:To investigate the differences in transcranial Doppler (TCD) hemodynamic parameters and their correlation with cognitive impairment in middle-aged and elderly populations with different cognitive states in rural communities.Methods:From January to February 2022, participants were recruited from rural communities in Yandu District, Yancheng for cognitive assessment and TCD examination. TCD parameters were recorded, including mean flow velocity (MFV), peak systolic velocity (PSV), pulsatile index, and resistance index of bilateral anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery and basilar artery. According to the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, the participants were divided into a normal cognitive function group, a mild cognitive impairment (MCI) group, and a dementia group. Spearman correlation analysis was used to investigate the correlation between hemodynamic parameters and blood pressure. Multivariate logistic regression analysis was used to identify the independent influencing factors of MCI and dementia, and multiple linear regression analysis was used to identify the correlation between hemodynamic parameters and cognitive assessment scale scores. Results:A total of 270 participants were enrolled, including 82 in the normal cognitive function group, 100 in the MCI group, and 88 in the dementia group. The comparison between groups showed that advanced age, female and low education years might be the risk factors for dementia in rural areas. The proportion of smoking and drinking in the dementia group was lower than that in the normal cognitive function group and the MCI group. The right ACA MFV and PSV in the dementia group were significantly lower than those in the normal cognitive function group and the MCI group, while the left PCA PSV was significantly lower than that in the MCI group (all P<0.05). Multivariate logistic regression analysis showed that compared with the normal cognitive function group, the right ACA PSV (odds ratio [ OR] 0.964, 95% confidence interval [ CI] 0.935-0.993; P=0.016) was an independent related factor associated with dementia; compared with the MCI group, right ACA PSV ( OR 0.967, 95% CI 0.936-0.999; P=0.043) and left PCA PSV ( OR 0.953, 95% CI 0.911-0.998; P=0.039) were the independent related factors for dementia. Multiple linear regression analysis showed that the right ACA PSV ( β=0.431, P=0.036) and left PCA PSV ( β=0.133, P=0.021) were the independent related factors for MMSE score. Spearman correlation analysis showed that there was a significant correlation between blood pressure and several hemodynamic parameters (all P<0.05). Conclusion:The right ACA and left PCA PSV are significantly associated with dementia in rural middle-aged and elderly people, and are expected to serve as non-invasive early screening biomarkers for cognitive impairment in rural population.
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Ischemic stroke is a common cerebrovascular disease with high mortality and disability rates. Astrocytes, as the most abundant glial cells in the brain, have the function of maintaining the homeostasis of the central nervous system, which requires precise coupling between neurotransmission and energy metabolism. Therefore, the metabolic crosstalk between astrocytes and neurons plays an important role in the occurrence and development of ischemic stroke. On the one hand, ischemic stroke leads to neuronal excessive excitation, metabolic disorders, and even death, simultaneously promoting changes in astrocyte metabolism profile and increased heterogeneity. On the other hand, the metabolic crosstalk between astrocytes and neurons can also affect the outcome of ischemic stroke. This article reviews the role of the metabolic crosstalk between astrocytes and neurons in ischemic brain injury, and looks forward to potential research directions and treatment targets in the future, in order to provide theoretical reference for the treatment of ischemic stroke.
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Ferroptosis is a cell death mode characterized by iron-dependent and excessive accumulation of lipid hydroperoxides, which has been discovered in recent years. Its regulatory mechanisms mainly involve iron metabolism, lipid peroxidation and amino acid metabolism. Ferroptosis is closely associated with the pathogenesis of ischemic stroke and is a promising therapeutic target for ischemic stroke. This article elaborates on the role of the main regulatory pathways of ferroptosis in ischemic stroke, providing new therapeutic ideas and targets for targeting the ferroptosis pathway to improve the outcome of ischemic stroke.
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The activator protein-1 (AP-1) complex is a transcription factor complex composed of Jun, Fos, activating transcription factors, and MAF protein subunits, involved in physiological and pathological processes such as cell proliferation, differentiation, apoptosis, and stress response. In recent years, research has shown that the AP-1 complex plays an important role in ischemic stroke, participating in processes such as microglial activation and neuronal apoptosis after ischemic brain injury, affecting the progression of neuroinflammation and the degree of neurological dysfunction after stroke.
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Chronic cerebral hypoperfusion leads to white matter injury (WMI), which subsequently causes neurodegeneration and even cognitive impairment. However, due to the lack of treatment specifically for WMI, novel recognized and effective therapeutic strategies are urgently needed. In this study, we found that honokiol and magnolol, two compounds derived from Magnolia officinalis, significantly facilitated the differentiation of primary oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes, with a more prominent effect of the former compound. Moreover, our results demonstrated that honokiol treatment improved myelin injury, induced mature oligodendrocyte protein expression, attenuated cognitive decline, promoted oligodendrocyte regeneration, and inhibited astrocytic activation in the bilateral carotid artery stenosis model. Mechanistically, honokiol increased the phosphorylation of serine/threonine kinase (Akt) and mammalian target of rapamycin (mTOR) by activating cannabinoid receptor 1 during OPC differentiation. Collectively, our study indicates that honokiol might serve as a potential treatment for WMI in chronic cerebral ischemia.
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Magnolia , White Matter , Brain Ischemia/metabolism , Oligodendroglia/metabolismالملخص
OBJECTIVE@#To analyze the characteristics of antibody-specific distribution, laboratory detection results of hemolytic disease of the fetus and neonatal(HDFN) caused by irregular blood group antibodies other than ABO, and its correlation with the clinical situation.@*METHODS@#The non-ABO-HDFN cases in our hospital from October 2012 to December 2021 were selected as the research objects, and the cases diagnosed with ABO-HDFN in the same period were randomly selected as the control group, and the data of antibody specific distribution, total bilirubin, direct antibodies, maternal history, age of the children, the presence or absence of combined ABO-HDFN, and whether to exchange/transfuse blood were retrospectively analyzed. The characteristics of non-ABO-HDFN in Jiangxi province were analyzed.@*RESULTS@#The detection rate of non-ABO-HDFN in Jiangxi province increased. Among 187 non ABO-HDFN cases, the highest percentage of Rh-HDFN was detected (94.6%). Compared with the control group of ABO-HDFN, the non-ABO-HDFN had higher mean integral value of direct antibody, higher peak total bilirubin, and longer duration. Anti-M-HDFN may have severe disease but the direct antibody weak positive/negative, it was easy missed in clinical and delayed the treatment. There is no correlation between the specificity of irregular antibodies, the sex of the child, the mother's previous childbirth history, the presence or absence of combined ABO-HDFN and the need for blood exchange/transfusion(P>0.05).@*CONCLUSION@#The irregular antibodies of causing non ABO-HDFN in Jiangxi area are mainly Rh blood group system, followed by MNS blood group system. Understanding the characteristics of HDFN disease, serological features and the correlation with clinical indexes will help to detect and treat non ABO-HDFN in time and reduce the risk of complications.
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Child , Female , Humans , Infant, Newborn , ABO Blood-Group System , Blood Group Antigens , Erythroblastosis, Fetal , Fetus , Hematologic Diseases/complications , Hemolysis , Isoantibodies , Retrospective Studiesالملخص
Objective: To explore the predictive factors of concurrent bile duct injury following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: A retrospective study was conducted on 483 HCC patients in relation to TACE postoperative complications. A total of 21 cases of bile duct injury were observed following the TACE procedure. Laboratory data, imaging data, and clinically relevant medical histories were recorded before and after one week following the TACE procedure and follow-up. The χ (2) test, or Fisher's exact probability method, was used for categorical variables. The mean of the two samples was compared using a paired t-test or Wilcoxon rank sum test. The comparison of multiple mean values was conducted using an analysis of variance. Results: Twenty-one cases with bile duct injury had intrahepatic bile duct dilatation, bile tumors, hilar biliary duct stenoses, and other manifestations. 14.3% (3/21) of patients showed linear high-density shadows along the bile duct on a plain CT scan, while 76.2% (16/21) of patients had ALP > 200 U/L one week following TACE procedure, and bile duct injury occurred in later follow-up. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) were significantly increased in all patients following TACE procedure (t = -2.721, P = 0.014; t = -2.674, P = 0.015; t = -3.079, P = 0.006; t = -3.377, P = 0.003, respectively). Conclusion: The deposition of iodized oil around the bile duct on plain CT scan presentation or the continuous increase of ALP (> 200 U/L) one week following TACE procedure has a certain predictive value for the later bile duct injury.
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Humans , Liver Neoplasms/therapy , Carcinoma, Hepatocellular/therapy , Retrospective Studies , Chemoembolization, Therapeutic/methods , Bile Ductsالملخص
Objective: To assess the effectiveness of transanal drainage tube (TDT) in reducing the incidence of anastomotic leak following anterior resection in patients with rectal cancer. Methods: We conducted a systematic search for relevant studies published from inception to October 2022 across multiple databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. Meta-analysis was performed using Review Manager 5.4 software. The primary outcomes included total incidence of anastomotic leak, grade B and C anastomotic leak rates, reoperation rate, anastomotic bleeding rate, and overall complication rate. Results: Three randomized controlled trials involving 1115 patients (559 patients in the TDT group and 556 in the non-TDT group) were included. Meta-analysis showed that the total incidences of anastomotic leak and of grade B anastomotic leak were 5.5% (31/559) and 4.5% (25/559), respectively, in the TDT group and 7.9% (44/556) and 3.8% (21/556), respectively, in the non-TDT group. These differences are not statistically significant (P=0.120, P=0.560, respectively). Compared with the non-TDT group, the TDT group had a lower incidence of grade C anastomotic leak (1.6% [7/559] vs. 4.5% [25/556]) and reoperation rate (0.9% [5/559] vs. 4.3% [24/556]), but a higher incidence of anastomotic bleeding (8.2% [23/279] vs. 3.6% [10/276]). These differences were statistically significant (P=0.003, P=0.001, P=0.030, respectively). The overall complication rate was 26.5%(74/279) in the TDT group and 27.2% (75/276) in the non-TDT group. These differences are not statistically significant (P=0.860). Conclusions: TDT did not significantly reduce the total incidence of anastomotic leak but may have potential clinical benefits in preventing grade C anastomotic leak. Notably, placement of TDT may increase the anastomotic bleeding rate.
الموضوعات
Humans , Anastomotic Leak/etiology , Rectal Neoplasms/complications , Drainage , Anastomosis, Surgical/adverse effects , Reoperation/adverse effects , Hemorrhage , Retrospective Studiesالملخص
Objective:To investigate the effects of Xiangshao granules on behavior and oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs) in the medial prefrontal cortex (mPFC) of post-stroke depression (PSD) mice.Methods:Eighty C57BL/6 mice were divided into sham-operated group, middle cerebral artery occlusion (MCAO) group, PSD+PBS group, and PSD+Xiangshao group ( n=20). PSD models were constructed using mild chronic unforeseeable stress (CUMS) and solitary feeding after MCAO. MCAO models were evaluated by laser speckle contrast imaging (LSCI), modified neurological severity score (mNSS) and TTC staining. PSD models were evaluated by body mass, sugar and water preference test and tail suspension test. After PSD modeling, mice in the sham-operated group, MCAO group, and PSD+PBS group were given 0.2 mL PBS, while mice in the PSD+Xiangshao group was given Xiangshao granules at dosage of 60 mg/kg (dissolved in 0.2 mL PBS); all were given via intragastric administration once a d for 28 d. Number of OPCs and OLs in mPFC was detected by immunofluorescence. Expressions of myelin basic protein (MBP) and phosphatidylinositol 3-kinase/serine/threonine kinase/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway proteins in mPFC were detected by Western blotting. Results:(1) Model verification results: LSCI showed obvious changes of cerebral blood flow in the middle cerebral artery supply area before, during and after MCAO; TTC staining showed typical red non-infarct area and white infarct area in MCAO group, PSD+PBS group and PSD+ Xiangshao group; mNSS scores in MCAO group, PSD+PBS group and PSD+ Xiangshao group were all >4, without significant differences ( P>0.05); the MCAO model was successfully constructed. After PSD and before treatment, the PSD+PBS group and PSD+Xiangshao group had significantly decreased body weight and sugar-water preference, and statistically prolonged tail suspension immobilization time compared with sham-operated group and MCAO group ( P<0.05); the PSD model was successfully constructed. (2) Results of mouse behavior experiment after treatment: significant differences in body weight, sugar-water preference and tail suspension time were noted in mice of the 4 groups 28 d after treatment ( P<0.05); PSD+Xiangshao group had significantly increased body weight and sugar-water preference and decreased tail suspension immobilization time compared with PSD+PBS group ( P<0.05). (3) Number of OPCs (Olig2 +PDGFRa +), proliferative OPCs (Ki-67 +PDGFRa +, EdU +PDGFRa +) and OLs (Olig2 +CC1 +), and relative MBP, p-PI3K, p-AKT and p-mTOR protein expressions in mPFC of the 4 groups were significantly different ( P<0.05); compared with those in PSD+PBS group, the above cell number and relative protein expressions in PSD+Xiangshao group were significantly increased ( P<0.05). Conclusion:Xiangshao granules can promote the OPCs proliferation and OLs maturation by activating PI3K/AKT/mTOR signaling pathway in mPFC, thus playing a role in PSD.
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Objective:To study the correlations of hippocampal subfield volumes with cerebrospinal fluid (CSF) biomarkers in Alzheimer's disease (AD) patients.Methods:Forty-nine patients with cognitive impairment, including 30 AD patients and 19 non-AD patients, were recruited in Department of Neurology, Drum Tower Clinical College, Nanjing University of Chinese Medicine from May 2017 to December 2021. Concentrations of Aβ 1-42, total tau protein and phosphorylated tau protein in CSF were analyzed by enzyme-linked immunosorbent assay (ELISA). Volumes of 12 hippocampal subfields were calculated using FreeSurfer image analysis. Differences of clinical data, neuropsychological scores and CSF biomarker concentrations between the 2 groups were compared. Partial correlation was performed to analyze the correlations of volumes of hippocampal subfields with CSF biomarker concentrations. Results:AD patients had significantly lower Mini-mental State Examination (MMSE) scores and Aβ 1-42 concentration in CSF than non-AD patients ( P<0.05); AD patients had significantly lower volumes of the right hippocampal parasitulum, dentate gyrus and CA4 than non-AD group ( P<0.05); the right parasubiculum volume was negatively correlated with CSF Aβ 1-42 ( r=-0.445, P=0.023) and positively correlated with CSF P-tau ( r=0.393, P=0.047) in AD patients. Volumes of left hippocampus tail, parasubiculum, CA1, molecular layer, dentate gyrus, CA3 and CA4 were negatively correlated with CSF total tau ( P<0.05). No significant correlation was noted between hippocampal subfield volumes and CSF biomarker concentrations in non-AD patients. Conclusion:Some right hippocampal subfields in AD patients atrophy compared with those in non-AD patients with cognitive impairment; the right parasubiculum may play a compensatory role in disease process, while volumes of the left hippocampus decreased with increased CSF total tau.
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In recent years， the incidence of colorectal cancer has been rising in China， and with the promotion of early screening and early diagnosis， most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless， 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety， depression， and fear of recurrence and metastasis， and they hope to seek help from traditional Chinese medicine（TCM） treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery， and to improve the diagnosis and treatment level， under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM， experts in oncology， integrated Chinese and western medicine， psychology， surgery， nursing， evidence-based medicine and other disciplines from 10 units nationwide participated in the work， led by Xiyuan Hospital，China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine， the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence， extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics， the needs and willingness to accept psychological rehabilitation， the interventions for psychological rehabilitation， evaluation of efficacy， follow-up review， educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM（integrated Chinese and western medicine） clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology， especially for doctors in primary medical institutions.
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Colorectal cancer is one of the most common malignant tumors of digestive tract. In 2020， 1.93 million new cases of colorectal cancer were diagnosed globally， ranking third in the global incidence spectrum， and 930 000 new deaths were reported， ranking second in the global cause of death spectrum. Meanwhile， the medical cost of metastatic colorectal cancer is the highest among all stages. A large number of studies have demonstrated that traditional Chinese medicine（TCM） treatment can bring clinical benefits to patients with metastatic colorectal cancer with unique efficacy. In order to further standardize the TCM diagnosis and treatment for metastatic colorectal cancer and improve the level of TCM diagnosis and treatment， Xiyuan Hospital， China Academy of Chinese Medical Sciences， together with other relevant units in China， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the relevant requirements of the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， the Regulations for Group Standards of China Association of Chinese Medicine and others， combined with the characteristics of TCM diagnosis and treatment and the actual situation in China， the Guidelines for TCM Diagnosis and Treatment of Metastatic Colorectal Cancer was developed in accordance with the Catalogue of TCM Diagnosis and Treatment Plans for 105 Diseases in 24 Specialties issued by Department of Medical Administration of National Administration of TCM.
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Gut microbiota is involved in maintaining intestinal homeostasis. The bidirectional communication between intestinal flora and brain can also be conducted through the neuro-immune-endocrine network, namely, the "microbiota-gut-brain axis". A number of studies have shown that the "microbiota-gut-brain axis" disorder plays an important role in the occurrence, development and prognosis of some cerebrovascular diseases, such as cerebral small vessel disease and stroke. This article introduces the latest research progress of the relationship between gut microbiota and cerebrovascular diseases, so as to provide more ideas and options for the treatment of cerebrovascular diseases.
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Cerebral small vessel disease (CSVD) is a group of pathological, imaging and clinical syndromes involving small cerebral vessels with different causes. The incidence rate of CSVD increases with age and is the most important cause of vascular cognitive impairment. Different diffusion imaging techniques can quantify white matter microstructure damage by revealing the diffusion movement of water molecules in specific brain tissues, explore the basis and biophysical mechanisms of tissue change, and have important value for the mechanism research, early diagnosis, progression risk, and therapeutic evaluation of cognitive impairment related to CSVD. This article reviews the research progress of diffusion magnetic resonance imaging in CSVD related cognitive impairment.
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Objective:To explore the application effect of continuous nursing based on hybrid electronic platform and fragmentation time in the out-of-hospital rehabilitation of patients with anterior cruciate ligament reconstruction.Methods:This was a randomized controlled study. From April 2020 to October 2021, a total of 90 patients undergoing anterior cruciate ligament reconstruction in Weifang People′s Hospital were selected as the research objects by convenience sampling. Forty patients from April to December 2020 were selected as control group, and 45 patients from January to October 2021 were selected as intervention group. The control group implemented routine discharge guidance and follow-up, while the intervention group was given continuous nursing plan based on the concept of hybrid electronic platform and fragmented time. Before operation and 1, 3 and 6 months after operation, the knee range of motion and Lysholm score of patients in the two groups were analyzed. At 1, 3 and 6 months after operation, the rehabilitation exercise compliance score, self-efficacy score and knee stability examination of the two groups were analyzed.Results:A total of 41 patients in each group completed the study. At 1 month after operation, the knee range of motion, Lysholm score, rehabilitation exercise compliance score and self-efficacy score of intervention group were (96.46 ±3.58) ° and (53.54 ± 6.57), (69.17 ± 6.27), (4.01 ± 0.38) points, respectively. In the control group, they were (89.02 ± 4.22)° and (45.02 ± 7.61), (56.78 ± 8.45), (3.61 ± 0.42) points. At 3 months after operation, they were (136.83 ± 4.30)° and (72.76 ± 4.96), (60.71 ± 5.87), (4.97 ± 0.32) points in the intervention group, (133.54 ± 3.58)° and (69.83 ± 6.65), (56.73 ± 8.57), (4.83 ± 0.45) points in the control group, respectively. At 6 months after operation, they were (139.39 ± 1.99)° and (85.61 ± 6.11), (57.71 ± 7.41), (6.58 ± 0.96) points in the intervention group, (138.29 ± 2.65)° and (81.80 ± 6.38), (47.90 ± 6.02), (6.35 ± 1.23) points in the control group, respectively. The knee range of motion, Lysholm score and rehabilitation exercise compliance score of the intervention group were better than those of the control group at 1, 3 and 6 months after operation, and the differences were statistically significant ( t values were 2.12-8.61, all P<0.05). The self-efficacy score of the intervention group was higher than that of the control group at 1 month after operation, and the difference was statistically significant ( t=4.57, P<0.05). Conclusions:The continuous nursing program based on hybrid electronic platform and fragmented time can improve the knee function of patients with anterior cruciate ligament reconstruction in the early postoperative period, improve the compliance of rehabilitation exercise and the level of early self-efficacy.
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The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
الموضوعات
Humans , Consensus , Prone Position , Wakefulness , China , Dyspneaالملخص
Objective To review the research progress, present the research status and analyze the evolution trend of hot spots through the bibliometric analysis of the research literature of cancer-related fatigue(CRF) at home and abroad. Methods We took CRF as the theme and the papers on CRF included in CNKI and WOS core database as the research object, and used VOSviewer and CiteSpace software as research tools, to make a visual atlas analysis on the research status and hot spot evolution at home and abroad. Results (1)Research status: ① Literature: 3 646 papers (1 959 in English and 1 687 in Chinese) were finally included. The number of papers published at home and abroad showed an overall upward trend, and the proportion of foreign fund papers was high; ② domestic papers focused on nursing and rehabilitation. The research area of foreign papers was more extensive, diverse and integrated; ③ Domestic cooperation was mainly small group cooperation, while foreign cooperation was more interdisciplinary and cross-team cooperation, forming a number of core teams and research institutions; ④ Domestic scholars paid attention to clinical application research and were good at learning from foreign countries and summarizing own experience. Foreign scholars paid more attention to basic research and the treatment was more systematic and standardized; ⑤ There were a variety of diagnostic and therapeutic evaluation tools, mainly foreign scales. (2) Hot spot evolution: "quality of life" had always been a common topic of concern at home and abroad. Domestic scholars focused on clinical research and emphasized "treatment based on examination of causes" and "treatment based on syndrome differentiation". Foreign scholars attached importance to basic research and methodological research, and advocated non-drug intervention such as sports. In recent years, complementary and alternative medicine had become a hot topic in the international research. Domestic scholars had paid more attention to the research of mechanism and methodology, and expanded the application of TCM characteristic therapy in CRF. Conclusion Integrated traditional Chinese and Western medicine and multi-disciplinary participation are the future diagnosis and treatment mode of CRF. It's the direction of future efforts to establish CRF evaluation and management mode with TCM characteristic non-drug therapy as the core under integrated medicine.