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Objective: To observe the effects of electroacupuncture (EA) at Neiguan (PC6) on arrhythmia during acute myocardial ischemia-reperfusion and the expression of connexin 43 (Cx43) in rats. Methods: A total of 40 Sprague-Dawley male rats were used. Ten rats were randomly selected as the blank group, and the remaining 30 rats were randomly divided into a model group and an EA group, with 15 rats in each group. Before modeling, rats in the EA group received one session of EA intervention at bilateral Neiguan (PC6) for 30 min; the other groups were treated with the same grasping and anesthesia for 30 min without intervention. PowerLab physiological recorder was used to record electrocardiograph within 30 min of infarction. After the experiment, cardiac tissue and serum were collected from rats. Hematoxylin-eosin (HE) staining was used to observe the morphological changes of myocardial tissue in the ventricular infarction area of rats in each group. The expression of Cx43 protein in the myocardium of each group was detected by Western blotting (WB). Enzyme-linked immunosorbent assay (ELISA) was used to determine the activity of Na+-K+-ATPase in myocardial tissue and the serum content of endogenous digitalis-like factor (EDLF) in rats. Results: There was no statistical difference in arrhythmia score between the EA group and the model group, but the total duration and average duration of arrhythmia in the EA group were decreased (P<0.01). HE staining showed that compared with the blank group, myocardial cells in the model group were disorganized and seriously damaged. The pathological changes in the EA group were similar to those in the model group, but the damage was relatively minor. The results of WB showed that compared with the blank group, the Cx43 expression in myocardial tissue of the model group was decreased (P<0.01); compared with the model group, the Cx43 expression in the EA group was increased (P<0.01); compared with the blank group, the Na+-K+-ATPase activity in myocardial tissue of the model group was significantly decreased (P<0.01); compared with the model group, the Na+-K+-ATPase activity in the EA group was increased (P<0.01). ELISA results showed that compared with the blank group, the serum EDLF content in the model group was significantly increased (P<0.01); compared with the model group, the EDLF content in the EA group was decreased (P<0.01). Conclusion: EA at Neiguan (PC6) can delay and reduce the onset of arrhythmia during myocardial infarction in the rat model of myocardial ischemia-reperfusion. Its mechanism of action may be related to the regulation of the Cx43 expression in myocardial tissue, improvement of the activity of Na+-K+-ATPase in myocardial tissue, and increase in the content of serum EDLF.
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Nucleic acid drugs are highly applicable for cancer immunotherapy with promising therapeutic effects, while targeting delivery of these drugs to disease lesions remains challenging. Cationic polymeric nanoparticles have paved the way for efficient delivery of nucleic acid drugs, and achieved stimuli-responsive disassembly in tumor microenvironment (TME). However, TME is highly heterogeneous between individuals, and most nanocarriers lack active-control over the release of loaded nucleic acid drugs, which will definitely reduce the therapeutic efficacy. Herein, we have developed a light-controllable charge-reversal nanoparticle (LCCN) with controlled release of polyinosinic-polycytidylic acid [Poly(I:C)] to treat triple negative breast cancer (TNBC) by enhanced photodynamic immunotherapy. The nanoparticles keep suitably positive charge for stable loading of Poly(I:C), while rapidly reverse to negative charge after near-infrared light irradiation to release Poly(I:C). LCCN-Poly(I:C) nanoparticles trigger effective phototoxicity and immunogenic cell death on 4T1 tumor cells, elevate antitumor immune responses and inhibit the growth of primary and abscopal 4T1 tumors in mice. The approach provides a promising strategy for controlled release of various nucleic acid-based immune modulators, which may enhance the efficacy of photodynamic immunotherapy against TNBC.
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Objective:To analyze the level and latent categories of the training needs of the nursing staff of the social volunteer teams in Jiangsu Province, and to provide basis for the targeted training.Methods:From March to July in 2018, 224 elderly care teachers from 13 social volunteer teams of 100 Red Cross societies in Jiangsu Province were surveyed for the knowledge of the care for the aged and the needs of training by the self-designed questionnaires. A total of 207 valid questionnaires were collected, with an effective recovery rate of 92.4%. SPSS 21.0 and Latent GOLD 5.1 software were used for description analysis, hierarchical clustering and latent category analysis.Results:The number of answer of "very need" to knowledge and skills among the aged care teachers for the elderly, such as psychological care, elderly volunteer services and recreational activities for the elderly, was 196, 196 and 193, with a proportion of 94.7%, 94.7% and 93.2%, respectively. Cluster analysis showed that training needs could be divided into four aspects: life care knowledge and skills, health care knowledge and skills, psychological care knowledge and skills, and spiritual comfort knowledge and skills. The results of latent category analysis showed that the aged care teachers could be divided into three groups based on their different training needs: high demand group for overall knowledge and skills, partial demand group for overall knowledge and skills, and high demand group for medical care and psychological care knowledge and skills. The corresponding latent probability of the three groups were 80.2%, 13.0%, 6.8%, respectively.Conclusion:The training for the aged care of social volunteer teams should pay attention to the teaching of spiritual comfort knowledge and skills for the elderly. The training program should be oriented to the multi-level and individualized needs of the teachers, so as to meet the needs of the aged care teachers for their own development.
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In view of the problems existing in the traditional class of Advanced Nursing Practice for nursing masters and the learning characteristics of students, under the guidance of process orientated guided inquiry learning (POGIL) theory, with the medium of information technology, centered on the cultivation of students' clinical practice with different specialties of nursing practice as the carrier, the autonomous online teaching mode of teaching and learning is fully integrated into the teaching process. That has been adopted in the teaching of Advanced Nursing Practice for nursing students in grade 2019 of Nanjing Medical University. As a result, autonomous teaching and learning guided by POGIL theory can improve students' clinical nursing practice ability, critical thinking ability, problem-solving ability, communication and cooperation ability, thus achieving the teaching goal of this course.
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Objective:To conduct a systematic review on the experience of family caregivers of dementia patients during self-management, so as to provide reference to offer targeted self-management intervention for the family caregivers.Methods:Five English ( MedLine, Embase, CINAHL, PsycINFO, Web of Science) and four Chinese (CBM, CNKI, WANFANG,VIP) databases were chosen to retrieval literatures on self-management experience of family caregivers of dementia patients from inception to October 31st ,2019. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. Integrating method was applied to integrate the results.Results:Totally 18 findings were extracted from 6 qualified studies, 7 new categories were generated and finally 2 synthesized results were obtained: obstacles to self-management: insufficient information and service support; neglect of physical health and social interaction; heavy economic burden; mental and emotional trauma. Promote self-management: self-adjusting emotions. Actively managing physical health. Seeking for help and support.Conclusion:The external support for self-management of family caregivers is actually needed. And support that aim to help caregivers overcome the obstacles of self-management and facilitate self-management should be provided from various ways.
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Chemotherapy is among the limited choices approved for the treatment of hepatocellular carcinoma (HCC) at intermediate and advanced stages. Preferential and prolonged drug exposure in diseased sites is required to maximize the therapeutic index of the drug. Here, we report an injectable supramolecular peptide hydrogel as an intraperitoneal depot for localized and sustained release of triptolide for the treatment of orthotopic HCC. We chose peptide amphiphile C-GNNQQNYKD-OH-based nanofibers as gelators and carriers for triptolide. Sustained triptolide release from the hydrogel was achieved over 14 days , with higher accumulation in and cytotoxicity against human HCC Bel-7402 in comparison with L-02 fetal hepatocytes. After intraperitoneal injection, the hydrogel showed prolonged retention over 13 days and preferential accumulation in the liver, realizing HCC growth inhibition by 99.7 ± 0.1% and animal median survival extension from 19 to 43 days, without causing noticeable pathological changes in the major organs. These results demonstrate that injectable peptide hydrogel can be a potential carrier for localized chemotherapy of HCC.
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Hyperglycemia is a common complication of critical patients. Currently, clinical assessment of the changes in the blood glucose of critical patients is mainly based on the intermittent monitoring of peripheral blood glucose at a certain time point. This method cannot get the true blood glucose fluctuation, and it is more difficult to find asymptomatic hyperglycemia and hypoglycemia, so the guiding value of blood glucose control is limited. Arterial blood is the most accurate sample of blood glucose monitoring, so it is urgent to ensure the accuracy of arterial blood sample. A continuous arterial blood glucose monitoring equipment was independently developed by general surgical intensive care unit (ICU) of the First Affiliated Hospital of Nanjing Medical University, and National Utility Model Patent of China was obtained. It could greatly improve the efficiency of medical staff, and provide accurate and dynamic statistic data that would be an important basis for doctors' clinical decision-making. The continuous arterial blood glucose monitoring equipment was mainly composed of arterial pressure measuring monitor, program-controlled dynamic blood glucose meter, wire, electric switch, integrated collecting syringe, electric clip, rotary electric bracket, and blood glucose test strips, etc., which could be continuously and dynamically monitor patient blood glucose levels and perform various additional value-added functions such as automatic recording and alarming.
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Objective To explore impacts of social support and coping styles on self-perceived burden of patients with spinal cord injury. Methods A total of 150 patients with spinal cord injury were investigated using Self-Perceived Burden Scale, Social Support Rating Scale, and Medical Coping Modes Questionnaire by cross-sectional survey method. Results The total score of self-perceived burden was at a moderate level and the average score was (33.98±10.76) points. Resignation of coping style had directly positive effect on self-perceived burden, path coefficient was 0.19, subjective support, support utilization had directly negative effect on SPB, path coefficient were-0.18,-0.21;objective support exerted directly negative influence on self-perceived burden through resignation of coping style. In other words, the resignation of coping style played a mediating role between social support and self-perceived burden, effect size was 0.034. Conclusions Most of patients with spinal cord injury suffer from moderate self-perceived burden. Objective support, subjective support, support utilization and the resignation of coping style are the important factors that affect self-perceived burden.
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OBJECTIVE:To compare the effects of morphine and nalbuphine on related indexes of maternal after cesarean sec-tion. METHODS:A total of 120 maternal underwent cesarean section were randomly divided into observation group(60 cases)and control group (60 cases). After surgery,observation group was given Nalbuphine hydrochloride injection 20 mg+0.75% Ropiva-caine hydrochloride injection 20 mL for patient-controlled epidural analgesia. Control group was given Morphine hydrochloride injec-tion 8 mg+0.75% Ropivacaine hydrochloride injection 20 mL for patient-controlled epidural analgesia. VAS score,systolic pres-sure,diastolic pressure,respiration rate(RR),SpO2 at the onset of analgesia(T0),6 h(T1),12 h(T2),24 h(T3)and 48 h(T4) after analgesia as well as the levels of IL-6,IL-8,CRP and PRL at T0,T3,T4 were observed in 2 groups. The satisfaction rate of analgesia and the occurrence of ADR were also observed. RESULTS:There was no statistical significance in satisfaction rate of an-algesia between 2 groups(96.67% vs. 98.33%,P>0.05). At T0,T1,T4,there was no statistical significance in VAS score between 2 groups(P>0.05). VAS scores of 2 groups at T2-3 were significantly higher than at T0,T1,T4,with statistical significance(P0.05). There was no statistical significance in diastolic pres-sure,RR and SpO2 between 2 groups at T0-2(P>0.05). The systolic pressure of 2 groups at T3-4 were significantly higher than at T0, with statistical significance(P0.05). There was no statisti-cal significance in the levels of IL-6,IL-8,CRP or PRL between 2 groups at T0(P>0.05). The levels of IL-6,IL-8 and CRP in 2 groups at T3 were significantly higher than at T0,but the observation group was significantly lower than the control group;at T4,the levels of IL-6,IL-8 and CRP in control group were significantly higher than at T0,with statistical significance(P0.05). The levels of PRL in 2 groups at T3-4 were significantly higher than at T0,and increased gradually as time;the observation group and significantly higher than the control group,with statistical significance (P<0.05). The incidence of ADR in observation group was significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:For maternal after cesarean section,nalbuphine is similar to mor-phine in analgesic effect and cardiovascular effect,but it is better than morphine in reducing inflammatory level,promoting lacta-tion and safety.
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Objective To explore the rehabilitation outcome and influencing factors of functional recovery in patients with nontraumatic spinal cord injury (NTSCI). Methods A retrospective analysis was done on 49 cases suffering from NTSCI who recepted rehabilitation therapy from December 2014 to November 2016. The main indicator of the rehabilitation effect was Modified Barthel Index (MBI). A total of 49 cases were divided into two groups, effective group (31 cases) and ineffective group (18 cases) according to whether their MBI on discharge had beated the target setted on admission. The following factors:ages, gender, injury causes, injury level, injury grade, injury severity, the types of paralysis, hospitalization time, sick time, complications number, MBI on admission and discharge, operation, early rehabilitation were evaluated by Univarite analysis and Logistic stepwise regression to assess how they influenced rehabilitation outcome. Results After systematically rehabilitation training, MBI had apparent improvement, from (38.98 ± 24.90) score on admission to (56.35 ± 22.69) score on discharge and had statistical significance(Z=-4.95, P=0.00), which showed that rehabilitation training can effectively improve patients′ self-care ability of daily living. Regression analysis found that the MBI on admission (OR=1.044, P=0.010) and hospitalization time(OR=1.044, P=0.039) had a noticeable effect on the rehabilitation outcome, while all the other factors, such as age, sex, injury grade, injury level, injury severity, complications number hadn′t show concrete effect on rehabilitation outcome. Conclusions Patients with NTSCI should have early rehabilitation, medical staff should assess their admission MBI, make a strict rehabilitation training plan to improve rehabilitation efficiency, shorten hospitalization time, improve the patients quality of life.
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Objective To study the effect of fund support on cited times of Chinese papers on AIDS by controlling the influence of confounding factors.Methods The effect of publication time of fund-supported papers and non fund-supported papers, h-index of authors, IF of journals on accumulated cited times of each academic paper was controlled by propensity score matching.The cited times of matched fund-supported papers and non fund-supported papers were compared by paired t test.Results The balance of confounding factors which were unbalanced before matching was achieved between fund-supported papers and non fund-supported papers after matching.No significant difference was found between fund-supported papers and non fund-supported papers after matching.Conclusion Fund support does not affect the cited times of Chinese papers on AIDS, which shows that fund support can not noticeably improve the academic level and impact of Chinese papers on AIDS.
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Xerostomia is an important problem affecting oral health and quality of life, and effective assessment is the basis of management of xerostomia. This review summarizes the subjective and objective assessment tools for xerostomia, so as to provide references for the evaluation and management of xerostomia.
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Objective To analyze the correlation between students' scores and master degree of knowledge points in the close examination of the unit introduction of nursing. Methods A classification decision tree model was used to analyze the relationship between students' achievement and knowledge points in 321 grade 2014 nursing students. Results There were 20 knowledge points in the paper, 7 of which had significant influence on scores; there were 27 nodes,16 of which were leaf nodes; the overall predicted percentage was 86.0%. Conclusions The total score is related to knowledge score; the total score of gifted students is higher;and for total score of medium students is medium;and for total score of poor is lower. Measures to reform teaching methods and evaluation scheme should be taken.
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Objective To investigate the ability level of institutionalized elderly people and its correlation with pension service demand.Methods Ability assessment for older adults and a self-designed questionnaire about pension service demand were used to survey the ability level and service demand of 332elderly people in 7 institutions of Yancheng city in Jiangsu province in July 2014.The influence factors of pension service demand were analyzed by the binary classification Logistic regression.Results 67.8％ (225/332),14.8％(48/332) and 15.7％(52/332) institutionalized elderly's ability level were mild,moderate and severe impairment.The impairment of ability levels of the elderly had positive impact on helping eating,bath,cleaning,medical service and other services agency and negative impact on culture and entertainment.Conclusions The ability of institutionalized elderly were poor in Yancheng city in Jiangsu Province.We should provide service according to their abilities and demand,in order to ensure the rational use of the limited resources.
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Objective To analysis the reliability of the examination of Introduction of Nursing by using the methods of generalizability theory and to give advice on how to modify examination paper.Methods Estimation value of variance component from different variations and precision indexes were calculated by applying the principle of generalizability theory.Results The generalizability coefficient and index of dependability were greater than 0.4 in choice question and terminology explanation,the generalizability coefficient of short-answer question was also greater than 0.4.Short-answer question's index of dependability and generalizability coefficient and index of dependability of comprehensive problem were less than 0.4.Conclusions Generalizability theory can be used in analysis the reliability of the examination of Introduction of Nursing.Its result is helpful to improve the framework of examination papers and the reliability of examination.
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Objective To investigate the career decision-making self-efficacy as well as the psychological well-being of medical students and to discuss the correlation between them.Methods A cross-sectional survey with cluster random sampling was performed anonymously among 714 students of different majors and different grades in an medical University.The contents of the survey included the career decision making self-efficacy scale (CDMSE) as well as the self-reporting inventory(SCL-90).All data in the two groups were analyzed with t test; comparison of data between groups were analyzed with One-Way ANOVA; multiple comparison was analyzed with S-N-K; Pearson and Partial correlation analysis were used to analyzed the correlation between the career decision making self-efficacy and wellbeing.Results Totally 659 students completed the inventory,with response rate being92.3％.Average score of the participants' career decision-making self-efficacy was (124.72 ± 26.76)points,situating at the middle and lower level.There were differences in the scores of career decision making selfefficacy among different sexes,sources,grades and being student cadres or not (P =0.019,0.000,0.027,0.026) ; No differences was found among students of different majors and whether being the only child(P =0.243,0.223).Results of the SCL-90 inventory demonstrated that medical students had some psychological problems including obsessive-compulsive,interpersonal sensitivity and anxiety.Correlation analysis showed that psychological well-being and career decision-making self-efficacy was negatively correlated.Conclusions Measures should be taken to improve the medical students' career decision-making self-efficacy according to their psychological characteristics and to improve the medical students' psychological status by the improvement of career decision-making self-efficacy.