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Objective:To investigate the effect of problem-oriented nursing intervention in the self-management rehabilitation of patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 128 patients with coronary heart disease undergoing PCI operation in Changzhou Second People′s Hospital from January 2019 to January 2021 were selected and randomly divided into the observation group and the control group with 64 cases in each group. The control group was given routine self-management intervention, and the observation group was given problem-oriented self-management intervention. After 6 months of intervention, the indicators of self-management ability, cardiac function, and quality of life were compared between the two groups.Results:After 6 months of intervention, the observation group actually completed 58 cases, and the control group actually completed 62 cases. Before the intervention, there were no significant differences between the two groups in the scores of coronary self-management ability scale, cardiac function index and Seattle Angina Questionnaire ( P>0.05). Six months after intervention, the scores of disease knowledge management, symptom management, first aid management, daily life management, bad addiction management, treatment compliance, and self-management ability in the observation group were 16.34 ± 2.36, 13.36 ± 2.42, 12.26 ± 2.23, 17.45 ± 2.74, 16.52 ± 2.45, 12.16 ± 2.15, 103.54 ± 14.32, which were significant higher than those of in the control group, 14.32 ± 2.45, 12.45 ± 2.23, 10.75 ± 2.32, 16.05 ± 2.45, 15.24 ± 2.53, 10.36 ± 2.24, 94.09 ± 13.36 ( t=2.14-4.59, all P<0.05). After six months of intervention, the left ventricular end-systolic diameter (LVESD) and the left ventricular end-diastolic diameter(LVEDD) were (34.39 ± 6.75) mm and (52.60 ± 6.31) mm, which were significant lower than those of the control group, (38.56 ± 6.52) mm and (55.79 ± 5.74) mm ( t=3.52 and 2.90, both P<0.05). Left ventricular ejection fraction (LVEF) and left ventricular short-axis shortening rate (FS) in the observation group after 6 months intervention were (44.25 ± 3.65)% and (23.86 ± 2.41)%, which were significant higher than those of in the control group, (39.24 ± 3.52)% and (22.26 ± 2.51)%( t=7.65 and 3.56, both P<0.05). Six months after the intervention, the scores of the degree of body limitation, angina pectoris, stable angina pectoris attack degree, treatment satisfaction, disease cognition degree, quality of life score in the observation group were 73.09 ± 8.13, 68.21 ± 10.15, 74.10 ± 4.45, 79.36 ± 8.21, 76.53 ± 9.43, 72.26 ± 9.12, which were significant higher than those of in the control group, 64.15 ± 8.11, 59.38 ± 10.23, 63.51 ± 5.23, 62.45 ± 8.16, 67.68 ± 9.20, 63.44 ± 8.65 ( t=4.74-11.91, all P<0.05). Conclusion:Problem-oriented nursing intervention is helpful to promote the development of self-management ability of patients with coronary heart disease after PCI, promote the recovery of postoperative cardiac function, and improve the quality of life of patients.
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The development of nanomedicine has recently achieved several breakthroughs in the field of cancer treatment; however, biocompatibility and targeted penetration of these nanomaterials remain as limitations, which lead to serious side effects and significantly narrow the scope of their application. The self-assembly of intermediate filaments with arginine-glycine-aspartate (RGD) peptide (RGD-IFP) was triggered by the hydrophobic cationic molecule 7-amino actinomycin D (7-AAD) to synthesize a bifunctional nanoparticle that could serve as a fluorescent imaging probe to visualize tumor treatment. The designed RGD-IFP peptide possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. This fluorescent nanoprobe with RGD peptide could be targeted for delivery into tumor cells and released in acidic environments such as endosomes/lysosomes, ultimately inducing cytotoxicity by arresting tumor cell cycling with inserted DNA. It is noteworthy that the RGD-IFP/7-AAD nanoprobe tail-vein injection approach demonstrated not only high tumor-targeted imaging potential, but also potent antitumor therapeutic effects in vivo. The proposed strategy may be used in peptide-driven bifunctional nanoparticles for precise imaging and cancer therapy.
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This article, based on the current quality management of medical institutions in China, put forward the concept of implementing the core medical quality system by way of path-based management. This effort aims at achieving the homogenization of the medical quality core systems among different medical institutions,thus ultimately homogenizing the management and service homogeneity in different regions, levels and categories of medical institutions. The present experiment proves satisfactory within a small scale.
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Objective This meta-analysis aims to identify consistent results of vulnerable brain regions through the existing resting-state fMRI studies, thus exploring the changes of neural spontaneous brain activity in type 2 diabetes mellitus (T2DM) patients. Methods A systematic analysis of studies on brain resting-state changes in T2DM patients using ALFF, fALFF and ReHo analysis. The meta-analysis was based on the activation likelihood estimation method, using the software of Ginger ALE 2.3. Results Ten studies from 7 references (188 T2DM patients and 170 healthy controls) were included. Based on the analysis of ALFF and ReHo data, this meta-analysis identi fied the robust reduction of resting-state spontaneous brain activity in T2DM patients, including the left lingual gyrus of occipital lobe, right cerebellum posterior lobe,left postcentral gyrus and right insula(cluster size= 800,488,368,256 mm3,P<0.05 after FDR correction),while no increased spontaneous brain activation was found in any regions.The meta-analysis from ReHo studies showed reduced resting-state spontaneous brain activity in the left lingual gyrus of occipital lobe,left postcentral gyrus,right insula and posterior cingulum/lingual gyrus(cluster size=832,368,280,232 mm3,P<0.05 after FDR correction),while no increased spontaneous brain activation was found in any regions. Conclusion This meta-analysis study using the activation likelihood estimation method demonstrated that the resting-state spontaneous brain anomalies in T2DM patients might contribute to exploring machenism underlying diabetic encephalopathy.
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Objective To explore the effect of methadone maintenace treatment (MMT)in functional connectivity (FC)of nucleus accumbens (Nacc)on heroin addicts,and to identify the potential neuromechanism of MMT performing on heroin craving.Methods Craving scores and resting-state fMRI (rs-fMRI)were performed in 37 heroin addicts under MMT and 26 matched heroin addicts (HA) without any treatment.The rs-fMRI data preprocessing was performed by data processing assistant for rs-fMRI (DPARSF)soft-ware based on Matlab 2009a.Bilateral Naccs were set as regions of interesting (ROIs)respectively,and then the mean time series and other voxels within whole brain were analyzed by the rs-fMRI data analysis toolkit (REST).Intra-and inter-group analysis was performed with a single sample t-test and two sample t-test respectively.The partial correlation between the intensity of FC in brain regions showed abnormal FC and the duration/doses of methadone consumption was further investigated by SPSS.Craving scores were tested with two sample t-test.Results Inter-group analysis showed the FC of the right Nacc with left dorsal medial/lateral prefrontal cortex and right dorsal anterior cingulate was significantly increased in the MMT group in comparisonwith HA group,how-ever,it was decreased with right medial orbitofrontal cortex.The FC between the left Nacc and left dorsal medial/lateral prefrontal cortex,right dorsal lateral prefrontal cortex,right dorsal anterior cingulate and left insular cortex was also significantly increased in the MMT group (P 26,t=2.91).There were no regions with induced FC.The craving scores of MMT were signifi-cantly lower than those of HA (t = - 2.03,P <0.05 ).There was no significant correlation between the abnormal FC and the duration/doses of methadone consumption in MMT group.Conclusion MMT may influence the function of the nucleus accumbens through cognitive control and motivation/drive circuits,thereby reduce drug craving of heroin addicts.
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Objective To explore the changes and effect of functional connectivity(FC) of reward network in chronic heroin addicts(HA) using resting-state fMRl(rs-fMRI). Methods rs-fMRI was performed on 26 chronic heroin addicts(HA group) and 25 matched normal volunteers(control group).The rs-fMRI data were proceeded by usingrs-fMRI(DPARSF) software on Matlab 2009a. Bilateral nucleus accumbens(Nacc) were set as ROIs. Then the mean time series of ROI were compared with other voxels within the brain by the rs-fMRI data analysis toolkit(REST). Intra-and inter-group analysis was performed with single sample and two sample t test respectively.The association of intensity of FC in brain regions and the duration/doses of heroin consumption was investigated. Results In HA group, positiveresting-state FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus and pons, while temporal lobe, negative found in part of parietal cortex and occipital cortex, part of dorsal lateral prefrontal cortex and cerebellum. Within control group, positive FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus, hippocampal gyrus and pons, occipital cortex, negative FC with ROIs found in part of dorsal lateral prefrontal cortex and cerebellum(P26). Compared with the control group,the FC between the right Nacc and the bilateral calcarinegyrus, left middle occipital gyrus(voxel numbe r=31,28,47;t=3.99, 3.74,3.74;and P0.05). Conclusion The abnormal interaction between Nacc and the regions involved in cognitive control and visual spatial attention may contribute to the heroin addiction.
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Objective To identify the applicability of Traditional nutritional evaluation method,short-form mini-nutritional assessment (MNA-SF) and nutrition risk screening 2002 (NRS 2002) on screening malnutrition in elderly in-patients.Methods 100 elderly in-patients with malnutrition were screened by the above screening instruments.The evaluation effects of the 3 methods were compared by sensitivity,specificity and ROC curve.Results The detection rates of elderly in-patients with malnutrition by BMI,MNA-SF and NRS 2002 was 7％,58％ and 39％ respectively.Taking the human body measurement instrument as standard,the sensitivities of BMI,MNA-SF and NRS 2002 was 0.475,0.918 and 0.410respectively,the specificities was 0.615,0.103 and 0.641 respectively.3 tools series test sensitivity and specificities was 0.557 and 0.913 respectively,parallel test sensitivity and specificities was 0.929 and 0.435 respectively.Conclusions There is significant difference among the sensitivities of the 3 methods,NRS 2002 has the highest accuracy and is applicable to the screening of nutrition risks in elderly patients.Combined 3 kinds of tool can better improve the effect.
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Objective To explore the changes of cerebral local neuronal spontaneous activity between heroin dependent individuals and normal controls.Methods 3.0 T MRI were used for data acquisition,fMRI data were acquired during resting state from 20 male heroin dependent individuals(HD)and 1 5 matched normal controls(NC),and then the difference of amplitude of low frequency fluctuation (ALFF)between groups were analysised.Results Compared with NC,ALFF in rostral cingulated zone(bilateral anteri-or cingulate cortex ,medial prefrontal cortex )was significantly reduced in HD.Conclusion Dysfunction of resting state in RCZ were observed in HD,which may result in cognitive impairment and plays an important role in the transitions from ideas into behav-ior of relapse in addiction.