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Objective:To compare the clinical efficacy and pharmacoeconomic evaluation of bevacizumab or cetuximab combined with chemotherapy in the treatment of advanced colorectal cancer.Methods:The clinical data of 68 patients with advanced colorectal cancer from January 2018 to December 2020 in Baotou Tumor Hospital were retrospectively analyzed. Among them, 40 patients with treated with bevacizumab combined with chemotherapy (bevacizumab group), 28 patients were treated with cetuximab combined with chemotherapy (cetuximab group), and the chemotherapy of two group was FOLFOX/FOLFIRI program. The short-term clinical efficacy, adverse reactions and pharmacoeconomic evaluation result were compared between two groups.Results:There were no statistical differences in effective rate and disease control rate between bevacizumab group and cetuximab group: 30.00% (12/40) vs. 28.57% (8/28) and 67.5% (27/40) vs. 60.71% (17/28), P>0.05. The incidence of Ⅲ to Ⅳ grade erythra in bevacizumab group was significantly lower than that in cetuximab group: 2.50% (1/40) vs. 71.43% (20/28), and there was statistical difference ( P<0.01); there were no statistical differences in the incidences of Ⅲ to Ⅳ grade bone marrow suppression, nausea vomiting, hepatic functional lesion and diarrhea between two groups ( P>0.05). The pharmacoeconomic evaluation result showed that the cost of monoclonal antibody and total cost in bevacizumab group were significantly lower than those in cetuximab group: (9 009 ± 1 500) yuan vs. (27 840 ± 2 202) yuan and (11 242 ± 1 731) yuan vs. (29 867 ± 3 002) yuan, and there were statistical differences ( P<0.01); the cost-effectiveness ratio in bevacizumab group was 37 473.3, and it in cetuximab group was 104 430.1, the incremental cost-effectiveness ratio of two programs was 11 640.6. Conclusions:In the treatment of advanced colorectal cancer, the efficacy of bevacizumab combined with chemotherapy is similar to that of cetuximab combined with chemotherapy, but bevacizumab combined with chemotherapy has lower costs and fewer adverse reactions, so bevacizumab is more economical and applicable.
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Objective:To study the effect of continuous subcutaneous insulin infusion(CSII)on the emotional disorder of children and adolescents with type 1 diabetes mellitus(T1DM)and their parents.Methods:A total of 72 children and adolescents with T1DM were divided into CSII group( n=40)and multiple daily injection(MDI)group( n=32).There were 58 healthy children and adolescents with their parents selected as control group.The emotional condition of children and adolescents in T1DM group and control group was evaluated by Depression Self-rating Scale for Children(DSRS)and the Screen for Child Anxiety Related Emotional Disorders(SCARED)respectively, and Symptom Checklist-90(SCL-90)was used for evaluating the mental health of all parents. Results:The average glycated hemoglobin A1c(HbA1c)of T1DM group was at the optimal level(7.406±1.294)%.The average HbA1c of CSII group was significantly lower than that of MDI group[(7.040±1.082)% vs(7.863±1.404)%, t=2.728, P=0.008].The depression rate of children and adolescents in T1DM group increased significantly than that of control group(31.9% vs 15.5%, χ2 =4.671, P=0.031).There were statistically significant differences among CSII group, MDI group and control group(20.0% vs 46.9% vs 15.5%, χ2 =11.591, P=0.003).The depression rate of children and adolescents in MDI group increased significantly than that of CSII group and control group(all P<0.05).CSII group showed similar results as compared with control group( P>0.05).Concerning the anxiety in children and adolescents, there was no significant difference between T1DM group and control group(19.4% vs 13.8%, χ2=0.730, P=0.393), and there were no significant differences among CSII group, MDI group and control group(15.0% vs 25.0% vs 13.8%, χ2=1.994, P=0.369).The emotional disorder prevalence of parents in T1DM group was remarkably higher than that of the control group(31.9% vs 5.2%, χ2=52.927, P<0.01).The factor scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoia and psychotic symptoms in T1DM group were higher than that of control group( P<0.05).There were statistically significant differences among CSII group, MDI group and control group(17.5% vs 50.0% vs 5.2%, χ2=26.126, P<0.01).The emotional disorder prevalence of parents in MDI group increased significantly than that of CSII group and control group(all P<0.05).But CSII group was same as that of control group( P>0.05). Conclusion:The children and adolescents with T1DM and their parents were high-risk population of emotional disorder.CSII can reduce not only the depression in the children and adolescents with T1DM, but also emotional disorder of their parents, thus CSII can improve the mental health in families suffering from T1DM.
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OBJECTIVE@#To investigate the effects of Naoluo Xintong Decoction (NLXTD) on pyroptosis and angiogenesis of brain microvascular endothelial cells (BMECs) and explore the possible mechanisms in rats with oxygen-glucose deprivation/ reperfusion (OGD/R).@*METHODS@#Rat BMECs with or without caspase-1 siRNA transfection were cultured in the presence of 10% medicated serum from NLXTD-treated rats (or blank serum) and exposed to OGD/R. CCK-8 assay, Transwell chamber assay, and tube formation assay were used to assess proliferation, migration, and tube-forming abilities of the cells. The activity of lactate dehydrogenase (LDH) in the culture supernatant was determined using a commercial assay kit, and the levels of inflammatory factors IL-1β and IL-18 were detected with ELISA. The cellular expressions of pro-caspase-1, caspase-1, NLRP3, Gasdermin D, and angiogenesis-related proteins VEGF and VEGFR2 were detected using Western blotting.@*RESULTS@#The BMECs showed obvious injuries after OGD/R exposure. Compared with the blank serum, the medicated serum significantly improved the cell viability, migration ability, and lumen-forming ability (P < 0.01) and lowered the levels of IL-1β and IL-18 and the LDH release (P < 0.01) of the cells with OGD/R exposure. Western blotting showed that in the BMECs exposed to OGD/R, the medicated serum strongly upregulated the expression of VEGF and VEGFR2 proteins (P < 0.01) and reduced the protein expressions of pro-caspase-1, caspase-1, NLRP3, and Gasdermin D (P < 0.01), and transfection of the cells with caspase-1 siRNA further promoted the expressions of VEGFR2 protein in the cells (P < 0.01).@*CONCLUSION@#NLXTD can improve the proliferation, migration, and tube- forming ability and promote angiogenesis of BMECs with OGD/R injury probably by inhibiting the caspase-1/Gasdermin D pathway in pyroptosis, alleviating cell injury, and upregulating the expressions of VEGF and VEGFR2.
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Animals , Rats , Endothelial Cells , Caspase 1 , Gasdermins , Interleukin-18 , NLR Family, Pyrin Domain-Containing 3 Protein , Vascular Endothelial Growth Factor A , Reperfusion Injury , Brain , Angiogenic Proteins , GlucoseABSTRACT
The purpose of this paper is to review the research status on non-suicidal self-injury （NSSI） in children and adolescents， so as to provide references for the cognition and intervention of NSSI behavior in children and adolescents. NSSI behavior is an independent risk factor for suicide， which not only poses a serious threat to the mental health of children and adolescents， but also brings a great burden on families and society. This paper focuses on the epidemiology， etiology， relationship with other psychiatric disorders， and treatment of NSSI behaviors in children and adolescents.
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Ovarian Leydig cell tumor(LCT), also known as ovarian testicular stromal cell tumor, is a rare sex cord stromal tumor, accounting for about 0.1% of all ovarian tumors. LCT is often accompanied by clinical manifestations of elevated androgen, and the imaging manifestations sometimes lack specificity. The diagnosis requires histopathological examination. Surgery is the primary treatment method, and postoperative prognosis is generally favorable. This paper retrospectively analyzes the diagnosis and treatment of a patient with LCT in our hospital combining relevant literature, explore the clinical characteristics, diagnosis, and treatment progress of LCT, aiming to improve disease management.
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Objective:To investigate the effect of laparoscopic ovarian cystectomy on anti-Mullerian hormone (AMH) level, ovarian response to gonadotropin stimulation and pregnancy rate for in vitro fertilization (IVF) patients with benign ovarian cysts.Methods:Patients with benign ovarian cysts who were admitted for cystectomy and had undergone IVF treatment were enrolled in the study. There were 373 participants with ovarian cysts underwent laparoscopic ovarian cystectomy in the experimental group. According to duration of post-surgery, there were four sub-groups: 1 year post-surgery (1Y POST), 2 years post-surgery (2Y POST), 4 years post-surgery (4Y POST) and ≥5 years post-surgery (≥5Y POST) in the experimental group. According to histopathologic types of ovarian cysts, there were two sub-groups: ovarian endometriotic cysts and ovarian non-endometriotic cysts. Two hundreds and three patients with no history of ovarian cysts and ovarian surgery were in the control group. The level of AMH and basic concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), estradiol (E 2) were measured. Antral follicle counts (AFC) were calculated. There were other study variables: total dose of gonadotropins, duration of ovarian stimulation, the number of oocyte retrieved, the number of embryo obtained, blastocyst transfer rate and pregnancy rate. Results:The control group was matched as closely as possible to the experimental group, including age, body mass index and menstrual cycle (all P>0.05). Compared to the women in control group, the women in ovarian endometriotic cystectomy sub-group had significantly higher levels of basal FSH and basal P, lower level of AMH (all P<0.05); the women in ovarian endometriotic cysts sub-group had significantly higher dose of gonadotropins (all P<0.05); the women in ovarian endometriotic cysts ≥5Y POST sub-group had significantly lower number of oocyte retrieved, lower number of embryo obtained, lower blastocyst transfer rate, and lower pregnancy rate (all P<0.05). Compared to the women in control group, the women in ovarian non-endometriotic cysts sub-group had a significantly higher level of basal FSH and basal P (all P<0.05). The women in ovarian non-endometriotic cysts sub-group had lower level of AMH, higher dose of gonadotropins, lower number of oocyte retrieved, lower number of embryo obtained, lower rate of blastocyst transfer and lower rate of pregnancy than the control group but there were no statistically significant differences among them (all P>0.05). The women with unilateral ovarian endometriotic cysts had significantly lower number of oocyte retrieved on the side of surgery than another side ( P<0.05). Conclusions:In short term laparoscopic ovarian cystectomy has no significant effect on ovarian reserve. But with long-term follow-up ovarian reserve, ovarian response to gonadotropin stimulation and pregnancy rate are decreased. The effect of laparoscopic ovarian cystectomy in benign cysts on ovarian is associated with whether or not it is the surgical side.
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Motoric cognitive risk syndrome (MCR), as a new type of "pre-dementia" , is a sensitive prediction indicators of falls.There may be multiple attribution pathways between MCR and falls, which provides a new health management strategy in the fall prevention for community-dwelling elderly.The paper reviews the current status of MCR-related falling, attribution characteristics, the methods of risk assessment and health management strategies for older adults with MCR, with the aim of providing a reference for promoting systematic research on falls among senior citizens with MCR and the practice of falls prevention in the community.
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Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.
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Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.
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Objective:To assess the nosocomial infection risk events of neonatology experienced by a hospital, for identifying those events deserving high priority in infection prevention and control and critical rooms of improvement, hence minimizing such risks of the hospital.Methods:The hazard vulnerability analysis was called into play, along with literature review and clinical practices, while the hazard vulnerability analysis team of neonatology of the hospital preliminarily screened the indexes in brainstorming method. Then the individual indexes from such screening evaluated by means of questionnaires, and the risk evaluation index system for neonatal infection prevention and control was formed in combination with the risk value evaluation table of Kaiser model. On such basis, an evaluation questionnaire for the prevention and control was developed.In May 2020, the team members scored the possibility and severity of these risk indexes in the form of questionnaire, calculated the hazard risk value, and divided the risk zones by matrix analysis.Results:The risk assessment index system of neonatology was composed of 11 management indexes, 20 implementation indexes and 7 outcome indexes. The top 5 indexes of hazard risk value were: incorrect hand hygiene method(39.20%), inadequate cleaning and disinfection of environmental object surface(39.04%), the formula was not used immediately when ready(38.19%), nosocomial infection outbreak(38.02%), and low hand hygiene compliance(37.99%). The indexes with high severity and low readiness include three indexes related to formula feeding and three indexes related to cleaning and disinfection of object surface. The matrix analysis results showed that there were 9 indexes in the high-risk zone, 7 indexes in the medium risk zone and 22 in the low-risk zone.Conclusions:This study identified risk management events in hospital infection management in neonatology by means of hazard vulnerability analysis. The neonatology administrators are recommended to prioritize indexes in the high risk zone, make a root cause analysis of those indexes of high risk value and low readiness and take intervention measures in time, hence reducing the incidence of nosocomial infection and avoiding the outbreak of nosocomial infection.
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Objective:To observe the characteristics of resting-state brain activity in Parkinson disease (PD) patients with peak-dose dyskinesia, and to explore its pathogenesis.Methods:From March 2017 to November 2019, totally 27 PD patients with peak-dose dyskinesia (dyskinetic group), and 29 PD patients without dyskinesia (non-dyskinetic group) treated in the First Affiliated Hospital of Nanjing Medical University and 27 healthy controls from the community were recruited.Resting-state functional magnetic resonance imaging (rs-fMRI) and clinical scale data were collected.SPSS 26.0 software and REST software were used for data analysis.The whole brain amplitude of low-frequency fluctuation (ALFF) values were compared among the three groups.Correlation analysis was performed between ALFF values of the significant brain regions and the scale scores.Finally, receiver operating characteristic (ROC) curve was used to evaluate the efficacy of ALFF values of significant brain regions in identifying three groups of subjects.Results:The peak-dose dyskinetic group showed decreased ALFF in right inferior frontal gyrus(MNI: x=36, y=21, z=30; x=36, y=18, z=30)and increased ALFF in right supplementary motor area (MNI: x=9, y=0, z=69; x=6, y=-3, z=72)(all P<0.05, Alphasim correction) compared with non-dyskinetic group and healthy controls.ALFF value in right inferior frontal gyrus was negatively correlated with unified dyskinesia rating scale (UDysRS) scores ( r=-0.47, P=0.018). The ALFF value of the right inferior frontal gyrus was more effective in identifying peak-dose dyskinetic patients from non-dyskinetic patients and healthy controls, and the area under the curve of right inferior frontal gyrus were 0.881 and 0.787 (both P<0.01), respectively. Conclusion:Abnormal spontaneous brain activity in right inferior frontal gyrus and right supplementary motor area can be the neurobiological basis of peak-dose dyskinesia in PD patients.The severity of peak-dose dyskinesia is associated with abnormal brain activity of right inferior frontal gyrus.The ALFF value of right inferior frontal gyrus is a potential imaging marker for identifying peak-dose dyskinetic patient.
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Objective@#To analyze the epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020, and to provide a basis for the scientific development of interventions and strategies.@*Methods@#Epidemiological distribution, time of onset and treatment, as well as treatment outcomes of student tuberculosis in Wuhan from 2011 to 2020 registered in the national tuberculosis information management system were described.@*Results@#During 2011-2020, 4 337 student tuberculosis patients in Wuhan were registered. The average annual incidence rate was 22.44/10 million, and the annual decreasing rate of 7.86% The incidence of male and female patients was 1.76:1, and the incidence rate of male was higher than that of female( χ 2=184.18, P <0.01). Most of patients aged 19-22 years old, accounting for 47.89%; Tuberculosis reports were highest during March to May, and September to November, and lowest during January to February, and July to August. Student patients were mainly concentrated in Hongshan District, Jiangxia District and Wuchang District, where schools were more distributed in Hongshan District, Dongxihu District, Wuchang District and Xinzhou District. The median duration from tuberculosis onset to treatment was 9(3, 21) days, which varied significantly by region, age, nationality, and patient residence ( Z =-9.25, 47.14, 9.88,43.96, P <0.01). The treatment and outcome of student tuberculosis patients were varied significantly by year and nationality( P <0.05).@*Conclusion@#The incidence of student tuberculosis in Wuhan City showed a slow downward trend. Most of student tuberculosis are college and high school students. Time and place of case detection are relatively fixed. The time of treatment and the outcome of treatment vary significantly. Tuberculosis prevention and control strategies should be formulated according to the local conditions according to the tuberculosis distribution characteristics, as well as enhancing surveillance, health promotion, active discovery and supervision management of tuberculosis in school settings.
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Primary ciliary dyskinesia (PCD) is a recessive genetic disorder of motile cilia with substantial genetic and phenotypic heterogeneity. Clinical features of PCD vary from one patient to another, and no single test has the sensitivity and specificity to accurately diagnose PCD. Genetic testing combined with other auxiliary tests can facilitate the confirmatory diagnosis of PCD. So far more than 40 genes have been associated with PCD, but most research have focused on common genes, which hinders our understanding of other rare PCD-genes. This review has summarized the PCD-associated genes and the corresponding characteristics of dysfunctional cilia, with an aim to provide a basis for early identification of such diseases.
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Humans , Cilia/genetics , Genetic Testing , Kartagener Syndrome/genetics , Sensitivity and SpecificityABSTRACT
Aspiration is the entry of oropharyngeal or gastric contents into the lower respiratory tract through the glottis, a common and important cause of death in elderly patients due to lung infections.However, a lack of accurate and rapid clinical methods for the diagnosis of aspiration leads to misdiagnosis, missed diagnosis or delayed diagnosis of aspiration, especially aspiration pneumonia.In recent years, with further research into the mechanisms of aspiration syndromes, multiple aspiration biomarkers with potential and clinical translational value have been found, and may help early detection of aspiration and have important and practical significance for elderly health.Therefore, this article reviews aspiration biomarkers such as pepsin, α-amylase, bile acid and other potential biomarkers as well as current relevant research, detection methods, their clinical value and prospects concerning challenges and directions of innovation in future research.
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Objective:To investigate the short-term efficacy and safety of albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy in treatment of stage Ⅲ massive cervical cancer.Methods:The clinical data of 84 patients with massive cervical cancer admitted to Harbin Medical University Cancer Hospital from April 2019 to April 2020 were retrospectively analyzed. According to the different treatment regimens, patients were divided into the observation group and the control group, each with 42 cases. The observation group received albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy, and the control group received solvent-based paclitaxel combined with nedaplatin followed by concurrent radiotherapy. The short-term efficacy and adverse reactions of the two groups were compared.Results:The partial remission (PR) rate of the observation group and the control group at 1 month of treatment was 92.9% (39/42) and 35.7% (15/42), respectively, and the difference was statistically significant ( χ2 = 29.867, P < 0.01). The complete remission (CR) rate of the observation group and the control group at 1 month after treatment was 59.5% (25/42) and 38.1% (16/42), respectively, and the difference was statistically significant ( χ2 = 3.859, P = 0.049). The incidence of diarrhea of the observation group was lower than that of the control group [33.33% (14/42) vs. 54.8% (23/42)], and the difference was statistically significant ( χ2 = 3.913, P = 0.048). There were no statistical differences in the incidence of hematological adverse reactions and abnormal liver and kidney functions between the two groups (all P > 0.05). Conclusion:The albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy have a good short-term efficacy in treatment of stage Ⅲ massive cervical cancer, and the adverse reactions are tolerable.
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Objective:To examine the effects of individualized exercise rehabilitation prescriptions based on cardiopulmonary exercise tests on ambulatory blood pressure and cardiopulmonary function in elderly hypertension patients.Methods:This was a prospective randomized controlled study.Sixty essential hypertension patients hospitalized in our hospital from January 2020 to November 2020 and on regular antihypertensive medication were selected and divided using a random number table into the control group(30 cases)and the study group(30 cases). The control group received only conventional medication and the study group conducted individualized exercise rehabilitation in addition to medication, with no adjustment in anti-hypertensive medication for patients in either group.All enrolled patients underwent cardiopulmonary exercise testing and ambulatory blood pressure monitoring before treatment and 12 weeks after treatment.Changes in blood pressure and cardiopulmonary function in the two groups were compared.Results:Compared with the control group, the study group recorded reductions in the 24-hour average systolic blood pressure(135.6±8.7 mmHg vs.141.8±6.3 mmHg), 24-hour average diastolic blood pressure(79.3±9.4 mmHg vs.85.1±6.7 mmHg), daytime average systolic blood pressure(136.4±7.8 mmHg vs.140.2±6.6 mmHg), daytime average diastolic blood pressure(78.2±7.6 mmHg vs.84.4±7.2 mmHg), night-time average systolic blood pressure(125.0±9.6 mmHg vs.129.7±7.9 mmHg), and night-time average diastolic blood pressure(76.6±7.6 mmHg vs.84.5±6.7 mmHg)after 12 weeks of exercise( P<0.05 for all). Compared with pre-exercise levels, the study group achieved decreases in body mass index, resting heart rate, resting systolic blood pressure, resting diastolic blood pressure, peak systolic blood pressure, peak diastolic blood pressure( P<0.05 for all), and increases in maximum metabolic equivalent, peak oxygen uptake, maximum power and peak heart rate( P<0.05 for all), while the control group saw decreases in resting heart rate and resting diastolic blood pressure( P<0.05). After 12 weeks, the study group had lower levels than the control group in body mass index(24.5±2.0 kg/m 2vs.26.7±2.2 kg/m 2), resting systolic blood pressure(133.8±10.8 mmHg vs.139.3±9.0 mmHg)and resting diastolic blood pressure(79.4±8.0 mmHg vs.84.9±9.3 mmHg)( P<0.05)and higher levels in maximum metabolic equivalent(6.0±0.6 vs.5.2±1.1), peak oxygen uptake(22.0±2.7 ml·min -1·kg -1vs.20.3±3.7 ml·min -1·kg -1), maximum power(124.3±19.9 W vs.112.4±25.1 W)and peak heart rate(130.1±15.5 times/min vs.122.9±11.7 times/min)( P<0.05). Conclusions:Compared with antihypertensive drugs alone, the addition of individualized exercise prescriptions for rehabilitation based on cardiopulmonary exercise tests can effectively reduce blood pressure, improve cardiopulmonary function, and enhance exercise endurance and quality of life for elderly hypertension patients.
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We have adopted various smart tools and applied multiple teaching models to smoothly carry out our on-line teaching. Aiming at encouraging students' self-learning and independent thinking, the first task is to cultivate students' self-learning ability and independent thinking way of clinical microbiology. Our online teaching model is based on the asynchronous small private online course (SPOC) of the Chinese University MOOC, the core part of our teaching model, and supplemented by the Sojump questionnaire test and WeChat, the inter-action channels among teachers and students. All of these build up an integrated teaching system which fully embodies the "student-oriented" teaching concept and pushes forward the promotion and application of online teaching in college specialized courses.
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Objective:To explore the effects of competency-based diversified training on the bedside nursing comprehensive ability aand transition shock of newly recruited nurses.Methods:A total of 62 newly recruited nurses from the Second Affiliated Hospital of Zhengzhou University in June 2018 were selected as the control group, and 70 newly recruited nurses from June 2019 were selected as the experimental group by cluster sampling. The control group received routine pre-job training, and the experimental group received diversified training based on the control group. After one year of training, the differences in the scores of bedside nursing comprehensive ability, post competency and transition shock between the two groups of nurses were analyzed.Results:After 1 year of training, the total scores and the scores of nursing problems, nursing evaluation, nursing plan, nursing theory, nursing operation and bedside nursing comprehensive ability in the experimental group were 12.20±1.76, 24.29±2.38, 13.54±1.88, 9.77±1.35, 15.14±2.30 and 79.24±6.59, which were all higher than those of the control group (10.26±1.55,22.31±1.84,10.45±1.58, 8.56±1.80, 13.27±2.38 and 69.82±4.09), the differences were statistically significant ( t value was 4.582-13.679, P<0.05). The total scores and the scores of each dimension of the Post-competency the experimental group were 31.46 ±4.32, 51.03± 4.64, 20.27± 3.78, 17.86±3.99, 58.43± 4.44, 179.37±9.97, which were all higher than those of the control group 24.76±4.12, 40.56±5.55, 16.61±2.88, 15.15± 2.96, 49.74±3.07, 146.66±17.98, the differences were statistically significant ( t value was 4.466-13.197, P<0.05). The scores of psychological knowledge, skills, social culture and development and the total scores of Transition shock in the experimental group were 30.90±3.15, 19.69±2.74, 32.17±3.06, 103.81±12.24, which were all higher than those in the control group (25.69±2.76, 15.92±3.24, 27.50±4.15, 88.32±11.54), the differences were statistically significant ( t value was 7.237-10.040, P<0.05). Conclusions:competency-based diversified training can effectively improve the bedside nursing comprehensive ability and post competency, reduce their transition shock, and has strong clinical reference significance.
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Mild cognitive impairment is a transitional state between normal aging and dementia, which is the best intervention window to delay cognitive decline.As one of the adjustable risk factors affecting cognitive function, perceived stress significantly increases the risk of cognitive impairment by causing hypothalamic-pituitary-adrenal axis dysfunction and psychological disorders.Therefore, perceived stress management will become a new hot spot in the research and practice of non-drug intervention techniques for cognitive impairment.This paper reviews the current situation of perceived stress in MCI population, the relationship between perceived stress and cognitive function, and the evaluation techniques of MCI individual perceived stress.Further more, this paper summarizes the relevant influencing factors of perceived stress based on stress attribution model, and comments on the action mechanism and practical enlightenment of perceived stress intervention program on cognitive function management, in order to provide theoretical reference for cognitive function management of MCI population.
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Objective:To explore the quality of life and its influencing factors in patients with hyperthyroidism.Methods:From June 2017 to June 2019, patients with hyperthyroidism who were first diagnosed in the First Affiliated Hospital of Hainan Medical College were selected as the research objects, and the quality of life of the patients was assessed by the Chinese version of World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the psychological status of the patients. Univariate analysis was used to compare the differences of general information (age, gender, course of disease, marital status, education level, occupation, monthly family income, family relationship, thyroid ophthalmopathy, laboratory examination, thyroid crisis, anxiety level, and depression level) among patients with different quality of life. Multivariate logistic regression analysis was used to analyze the related factors affecting the quality of life of patients with hyperthyroidism.Results:There were 120 patients, aged (45.42 ± 6.38) years old, including 42 males and 78 females. The WHOQOL-BREF score was (76.58 ± 10.42) points, ranging from 25 to 106 points. Among them, 49 cases (40.83%) had high scores (≥80 points) and 71 cases (59.17%) had low scores (<80 points). Univariate analysis showed that there were differences in the quality of life among different marital status, education level, monthly family income, family relationship, thyroid ophthalmopathy, FT 3, FT 4, anxiety level and depression level ( P < 0.05). Multivariate analysis showed that thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression or anxiety, abnormal FT 4 and FT 3 were the risk factors affecting the quality of life of patients with hyperthyroidism ( P < 0.05). Conclusion:The overall quality of life of patients with hyperthyroidism is low, especially those with thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression, anxiety, FT 4 or FT 3 abnormalities.