Barriers to lifestyle modification in patients with non-alcoholic fatty liver disease: a scoping review / Journal of Rural Medicine

Objective: Non-alcoholic fatty liver disease is common worldwide, and lifestyle modifications are key to its treatment. This study aimed to identify the barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease and to organize the results using the Capability Opportunity Motivation-Behavior (COM-B) model.Materials and Methods: The framework of Arksey and O’ Malley was used in this scoping review. We searched PubMed, Scopus, and the Cochrane Library without language restrictions for reports published up to September 11, 2022, including peer-reviewed literature reporting barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease. Patient-reported barriers were analyzed inductively and organized into the components (capability, opportunity, and motivation) of the COM-B model.Results: The literature search yielded 583 articles, of which seven qualitative studies, four quantitative studies, and one mixed-methods study met the inclusion criteria. Lack of time, lack of information on the diagnosis and management of non-alcoholic fatty liver disease, negative perceptions of the prescribed exercise and diet, physical symptoms interfering with the behavior, presence of comorbidities, and lack of family cooperation were frequently reported as barriers.Conclusion: The results of this study may contribute to the development of appropriate care and education strategies to promote behavioral changes in patients with non-alcoholic fatty liver disease.

Application of Novel Uterovaginal Pubic Comb Suspension Surgery with Mer-silene Tape in the Treatment of Pelvic Organ Prolapse / 实用妇产科杂志

Objective:To explore the economic applicability and safetyof the novel uterovaginal pubic comb suspension(UPCS)surgery with Mersilene tape in the treatment of pelvic organ prolapse(POP).Methods:A ret-rospective analysis was conducted on the clinical data of patients who underwent UPCS surgery due to POP from January 1st,2021 to February 28,2023.They were divided to the UPCS surgery with Mersilene tape group(group A)and suspension surgery with Y-shaped mesh group(group B)respectively.The POP-Q indication points,sus-pension surgery duration,intraoperative bleeding volume,material expense,postoperative catheter retention time,anal exhaust time and hospitalization duration were recorded for both groupbefore and after surgery.Evaluate the severity of POP related symptoms in patients before and after surgery using the pelvic Floor Distress Invento-ry-short Form 20(PFDI-20)and Pelvic Organ Prolapsed/Urinary Incontinence Sexual Questionnaire-12(PISQ-12),and follow up and observe the patients and analyze the complications.Results:A total of 17 POP patients were included in the study.There were 12 patients in group A while 5 patients in group B.The suspension material expense of group A was considerably lower than that of group B(P＜0.05).There was no significant difference between the two groups in preoperative PFDI-20 score,preoperative PISQ-12 score,UPCS surgery duration,intr-aoperative bleeding volume,postoperative urinary catheter retention time,postoperative anal exhaust time and hospitalization duration.All patients showed stable vital signs during the surgery and no severe complications were reported.Compared with the preoperative status,the positions of the Aa,Ba,and C indicatorpoint in group A and group B were all increased significantly(P＜0.05).The PFDl-20 and PISQ-12 scores of the two groups at the last follow-up after surgery showed significant improvement compared to those before surgery(P＜0.05).No signifi-cant difference was found in the PFDI-20 and PISQ-12 scores between the two groups after surgery(P＞0.05).There were no significant differences in the postoperative complications between the two groups(P＞0.05).Con-clusions:Compared with suspension surgery with Y-shaped mesh,UPCS surgery with Mersilene tape is safe and effective in the treatment of POP.The UPCS surgery with Mersilene tape showed better cost-effectiveness in the treatment of POP,and the surgical steps are relatively simple.Therefore,UPCS surgery with Mersilene tape was worthy of promotion in clinical practice.

Influence pathway of self-management behavior in maintenance hemodialysis patients based on COM-B model / 实用医学杂志

Objective To explore the potential impact pathways of self-management behavior based on COM-B model,in maintenance hemodialysis(MHD)patients,and provide reference for the intervention of self-manage-ment behavior.Methods Judgment sampling was used to select 350 MHD patients undergoing dialysis at the hospital in a certain district of Guangzhou,and a questionnaire survey was conducted among them.Smart PLS software was used to construct a partial least squares structural equation model and perform path analysis.Results Self-manage-ment behavior score of MHD patients was(57.06±13.28).Univariate analysis showed that age,education back-ground,employment status,occupational classification,per capita monthly income of families,and the number of comorbidities could directly affect self-management behavior of MHD patients(P<0.05).PLS-SEM model showed that self-efficacy(β = 0.246),family care level(β = 0.124)and social support(β = 0.140)positively impacted patients' self-management behavior,while disease perception negatively affected self-management behavior(β =-0.097).Self-efficacy can mediate the impact of disease perception and social support on self-management behavior of MHD patients(P<0.05).Conclusions Self-management behavior of MHD patients is currently at a low level.Therefore,when devising intervention plans for these patients,it is crucial to consider the combined effects of disease knowledge education,disease perception reconstruction,opportunity provision,and motivation.The primary focus should be on enhancing patients' self-efficacy,which will ultimately elevate their overall level of self-management.

Research progress of vascular interventional therapy in the conversion therapy of hepato-cellular carcinoma / 中华消化外科杂志

Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, which poses a serious threat to the life and health of the Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of the pathology of primary liver cancer, among them around 60% of patients are at the intermediate-advanced stage when diagnosed. Therefore, increasing the rate of resection via conversion therapies is particularly important to improve the prognosis of these patients. Vascular interventional therapies represented by transarterial chemoembolization and hepatic arterial infusion chemotherapy are important treatment methods for HCC patients in intermediate-advanced stage, showing good rates of tumor response and surgical conversion. Combined with research data at home and abroad, the authors analyze research progress of vascular interventional therapy in the conversion therapy of HCC, review the history and the strategies of conversion therapies based on vascular interventional therapy in this article.

Application and effect evaluation of self-care health platform for colorectal cancer patients with enterostomy based on COM-B model / 中国实用护理杂志

Objective:To explore the application effect of capacity, opportunity, motivation-behavior (COM-B) model based self-care health platform for colorectal cancer patients with enterostomy.Methods:A total of 84 patients with permanent enterostomy for colorectal cancer treated in our hospital from May 2020 to April 2021 were selected and divided into the intervention group and the control group by random number table method, 42 cases in each group. The control group was treated with routine nursing, and the intervention group was treated with a self-care health platform based on COM-B model. Patients′ self-care ability, self-efficacy level and the incidence of enterostomy-related complications were evaluated before and after the intervention.Results:Finally, 41 cases were included in the intervention group and 40 cases in the control group. Before intervention, there were no significant differences in self-concept, self-care skills, self-responsibility, health knowledge level and total score of self-care ability between the 2 groups ( P>0.05). After intervention, the total scores of self-concept, self-care skills, self-responsibility, health knowledge and self-care ability in the intervention group were (26.14 ± 1.13), (39.49 ± 2.13), (16.20 ± 2.08), (50.95 ± 5.56), (132.78 ± 6.47), which were higher than those in the control group (19.35 ± 2.07), (29.88 ± 3.52), (9.85 ± 3.25), (43.13 ± 6.71), (102.20 ± 11.47), the difference was statistically significant ( t values were 5.72-18.28, all P<0.05). Before intervention, there was no significant difference in self-efficacy scores between the 2 groups ( P>0.05). After intervention, the self-efficacy score of the intervention group (88.20 ± 6.90) was higher than that of the control group (74.63 ± 3.59), the difference was statistically significant ( t=11.14, P<0.05). After intervention, the incidence of enterostomy-related complications in the intervention group was 7.31%(3/41), lower than 27.50%(11/40) in the control group, the difference was statistically significant ( χ 2=5.36, P<0.05). Conclusion:The construction of self-care health platform for colorectal cancer patients with enterostomy based on COM-B model can effectively improve the self-care ability and self-efficacy of patients, and reduce the incidence of complications.

Seroreactivity of HIV among patients attending a tertiary care hospital in North India: a retrospective analysis

Background: HIV (Human Immunodeficiency Virus) is the causative agent of AIDS (Acquired Immunodeficiency Syndrome). It belongs to the lentivirus subgroup of the family Retroviridae. The HIV/AIDS is spreading worldwide at an alarming rate. India has the third largest number of estimated people living with HIV/AIDS. Most common mode of HIV transmission is through heterosexual contact, blood transfusion, percutaneous, mucosal and perinatal mode. The present study was done to evaluate the seroreactivity of HIV among patients attending Integrated Counselling and Testing Centre (ICTC) of our Tertiary care hospital.  Methods: This retrospective study was conducted on data of patients who had attended ICTC and undergone HIV testing from January 2017 to January 2019. A total of 4519 patients were included in the study who gave their consent followed by pre-test and post-test counseling and were screened for HIV antibody by using rapid kit Comb-Aids.Results: Out of 4519 samples tested, 23 were reactive to HIV screening test, hence sero-reactivity of HIV was found to be 0.50%. Higher seroreactivity was seen among males (56.5%, 13/23), and patients aged 31-40 years (39.1%, 9/23). Maximum seroreactivity was found among patients of rural areas (73.9%, 17/23), indoor patients (91.3%, 21/23) and married patients (73.9%, 17/23).Conclusions: In this study the seroreactivity of HIV was found to be low among patients attending ICTC but still HIV continues to be a major contributor to the global burden of disease. ICTC data can be used as an important tool for planning and improving the national HIV/AIDS intervention strategy.

Establishment and application of a new immune-comb assay for detection of serum antibody against simian immunodeficiency virus / 中国实验动物学报

Objective SIV30 protein of simian immunodeficiency virus(SIV)was prepared by genetic engineering technique as an antigen diagnostic reagent, to establish an immune comb method for the specific detection of anti SIV IgG in monkey serum. Methods Recombinant expression plasmid of SIV SIV30 gene was constructed by prokaryotic expression vector pGEX-4T-1, and expressed in the competent BL21 cells. The recombinant protein was purified as a diagnostic antigen, and a standardized procedure for the detection of immune comb was established and applied for clinical detection. Results The optimum coating amount of antigen was 0.02 mg/mL. The prepared IC was able to specifically detect the positive serum of SIV. There was no cross reaction between the sera of other viruses. It showed a high specificity of the detection method. Sensitivity analysis showed that the SIV30 protein was able to detect 1:400 times diluted SIV positive sera. The result of stability and repeatability test(the same sample was repeated 3 times) showed that the coefficient of variation(CV)was less than 10%. The serum samples of 10 suspicious monkeys were detected by this method, showing a consistent rate of comb method and ELISA test result of 100%, Kappa =1.000. Conclusions SIV30 protein is expressed in prokaryotic cells. The immune comb is prepared,and is successfullyl applied in clinical examination. It shows that the method has a high sensitivity, strong specificity, good reproducibility and practicability.

Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis

Abdominal computed tomography (CT) can noninvasively image the entire gastrointestinal tract and assess extraintestinal features that are important in differentiating Crohn's disease (CD) and intestinal tuberculosis (ITB). The present meta-analysis pooled the results of all studies on the role of CT abdomen in differentiating between CD and ITB. We searched PubMed and Embase for all publications in English that analyzed the features differentiating between CD and ITB on abdominal CT. The features included comb sign, necrotic lymph nodes, asymmetric bowel wall thickening, skip lesions, fibrofatty proliferation, mural stratification, ileocaecal area, long segment, and left colonic involvements. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (DOR) were calculated for all the features. Symmetric receiver operating characteristic curve was plotted for features present in >3 studies. Heterogeneity and publication bias was assessed and sensitivity analysis was performed by excluding studies that compared features on conventional abdominal CT instead of CT enterography (CTE). We included 6 studies (4 CTE, 1 conventional abdominal CT, and 1 CTE+conventional abdominal CT) involving 417 and 195 patients with CD and ITB, respectively. Necrotic lymph nodes had the highest diagnostic accuracy (sensitivity, 23%; specificity, 100%; DOR, 30.2) for ITB diagnosis, and comb sign (sensitivity, 82%; specificity, 81%; DOR, 21.5) followed by skip lesions (sensitivity, 86%; specificity, 74%; DOR, 16.5) had the highest diagnostic accuracy for CD diagnosis. On sensitivity analysis, the diagnostic accuracy of other features excluding asymmetric bowel wall thickening remained similar. Necrotic lymph nodes and comb sign on abdominal CT had the best diagnostic accuracy in differentiating CD and ITB.

Effects of aminolevulinic acid-based photodynamic therapy on chicken combs, an animal model for port wine stains / 中华皮肤科杂志

Objective To investigate the effects of aminolevulinic acid-based photodynamic therapy(ALA-PDT) on chicken combs, an animal model for port wine stains (PWS), and to explore the feasibility of PWS treatment with ALA-PDT. Methods A total of 80 leghorns were randomly and equally divided into 10 groups: blank control group receiving no treatment, ALA group treated with ALA alone, four single laser groups irradiated with 630-nm red laser at 75, 100, 150 and 200 J/cm2 respectively, four ALA-PDT groups pretreated with ALA followed by 630-nm red laser radiation at 75, 100, 150 and 200 J/cm2 respectively. An area sized 1 cm × 1 cm were marked at one side of combs in all these leghorns, and served as the experiment area to receive corresponding treatment, with that in the other side as the control area. Tissue specimens were obtained on the 14th and 28th days after treatment followed by the observation of morphological and histological changes, calculation of decrement rate in capillary number, and determination of apoptosis index in vascular endothelial cells (VECs) in chicken combs. Results In all the four ALA-PDT groups, the combs became lighter in color with apoptosis of some VECs as well as a decrease in capillary count and diameter in the dermis of the experiment areas. The decrement rate in capillary number was 33.53% ± 4.89%, 52.02% ± 2.77%, 67.48% ± 5.58%and 88.96% ± 2.47% respectively, and apoptosis index in VECs was 63.44 ± 1.09, 88.50 ± 6.11, 94.32 ± 3.67 and 113.76 ± 10.57 respectively, in the 75-, 100-, 150- and 200-J/cm2 ALA-PDT groups on the 14th day after treatment, and both the decrement rate and apoptosis index in each of these groups were significantly different from those in the blank control group, ALA group, single laser groups receiving red laser radiation at the corresponding dose, and the other ALA-PDT groups (all P < 0.01)separately. The apoptosis depth of VECs, defined as the vertical distance from the basal layer to the deepest level at which VEC apoptosis occurred, was 201.19 ± 0.33 μm, 266.15 ± 1.02 μm, 546.09 ± 2.45 μm and 766.37 ± 1.08 μm respectively in the 75-, 100-, 150- and 200-J/cm2 ALA-PDT groups on the 14th day, with significant differences between these four groups (all P < 0.01). Conclusions ALA-PDT can markedly damage capillaries in the animal model of port wine stains, chicken combs, with the degree and depth of capillary damage associated with red light energy density. The induction of VEC apoptosis may be an action mechanism of ALA-PDT in the treatment of PWS.

Escores de cloaca e de crista e morfometria testicular em galos de matriz pesada com 71 semanas de idade e três categorias de peso corporal / Cloaca and comb scores and testicular morphometry in broiler breeder roosters at 71 weeks of age and three body weight categories

Em galos de matriz pesada, o peso dos testículos se associa positivamente com a produção diária de espermatozoides e com a fertilidade. Contudo, os testículos de aves se localizam na cavidade abdominal, não sendo acessíveis para exame andrológico como os testículos de mamíferos. A avaliação reprodutiva de galos de matriz pesada é subjetiva e se baseia em características como peso corporal (PC), qualidade de pés e pernas e morfologia de cloaca e crista. Estudos que validem o potencial de associação dessas características fenotípicas com parâmetros da morfometria testicular são raros, principalmente quando se consideram galos de matriz pesada manejados em lotes comerciais. Escores de cloaca e de crista e parâmetros da morfometria testicular foram avaliados em galos Cobb 500 Slow adultos das categorias de PC leve (<4,300kg), médio (entre 4,300 e 5,250kg) e pesado (≥5,250kg). O coeficiente de variação para PC foi de 12%. Os galos da categoria de PC pesado apresentaram testículos mais pesados e maiores escores de cloaca e de crista do que os galos da categoria de PC leve. Não houve diferença estatística entre as categorias de PC, considerando-se índice gonadossomático, porcentagens de túbulo seminífero e de tecido intersticial, diâmetro de túbulo seminífero e altura de epitélio seminífero. Correlação positiva, moderada e significativa foi observada entre peso de testículo e características de PC, escores de cloaca e de crista, diâmetro de túbulo seminífero e altura de epitélio seminífero. Um dos seis galos da categoria de PC leve avaliados quanto à histologia de testículo apresentou atrofia testicular. Em galos Cobb 500 Slow, conclui-se que o PC influencia o peso e a qualidade histológica de testículos e que os escores de cloaca e de crista podem ser utilizados com potencial moderado de predição para identificar galos com baixo peso de testículos...

In broiler breeder roosters the weight of the testes is positively associated with daily sperm production and fertility. However, the avian testes are located in the abdominal cavity, not being accessible for reproductive evaluation as mammalian testes. The reproductive evaluation of broiler breeder roosters is subjective and is based on characteristics such as body weight (BW), quality of feet and legs and morphology of cloaca and comb. Studies that validate the potential of associating these phenotype characteristics with testicular morphometric parameters are rare, especially when broiler breeder roosters of commercial flocks are considered. Cloaca and comb scores and testicular morphometric parameters were evaluated in adult Cobb 500 Slow roosters with low (<4.300kg), medium (between 4.300 and 5.250kg) and high (≥5.250kg) BW categories. The coefficient of variation for BW was 12%. The high BW roosters have heavier testes and higher cloaca and comb scores than the low BW roosters. There was no statistical difference between the BW categories in gonadosomatic index, percentage of seminiferous tubule and interstitial tissue, diameter of the seminiferous tubule and height of the seminiferous epithelium. Testis weight is positive, moderate and significantly correlated with BW, cloaca and comb scores, diameter of seminiferous tubule and height of seminiferous epithelium. One of six low BW roosters evaluated for histology of the testis had testicular atrophy. We conclude that in Cobb 500 Slow roosters BW influences the weight and histological quality of the testes. Besides this, cloaca and comb scores can be used with moderate prediction potential to identify roosters with underweight testes...

Chave de identificação dos Ctenophora da costa brasileira / Identification key for the ctenophores from Brazilian coast

Embora abundantes e importantes ecologicamente no meio marinho, os ctenóforos do litoral brasileiro têm sido pouco estudados. O presente estudo tem por objetivo prover informações para auxiliar na identificação desses organismos. Para tal, são descritos métodos de fixação e documentação fotográfica dos ctenóforos. A terminologia referente ao grupo, em língua portuguesa, é apresentada na forma de um glossário. Além disso, as características que distinguem as treze espécies registradas para águas brasileiras são organizadas em uma chave de identificação. A complementação da identificação pode ser feita pela literatura indicada para cada espécie.

Although ctenophores are abundant and ecologically important in the marine environment, they are poorly known in the Brazilian coast. The present study is a taxonomic key for the ctenophores from the Brazilian coast. It aims to help students and non-specialist researchers with the identification of those organisms. Collecting, preserving and photographing methods are described. Characters that distinguish the thirteen species registered in Brazilian marine territories are presented.

A modulation method for the data transmission of the telemedicine system / 医疗卫生装备

Telemedicine is the significant object of the medicine in the future. This paper introduces an available counteractive mechanism which is derived from the orthogonal Latin squares, and a modulation method for the data transmission of the telemedicine system is proposed. This method could resolve the problem of overlapping interference from multiple accesses on one channel efficiently. At the same time, it also has potential advantages in increasing the user numbers in one channel and improving the channel utilization.

Research and realization of ECG monitoring system against high-frequency interference by electrosurgical unit / 医疗卫生装备

In modern surgeries, ESU is an important electrosurgical equipment. However, the interference caused by ESU usually affects real-time monitoring of the patient. To solve these problems, the paper introduces some new ideas in analog circuits. To the problem of interference and base-line excursion, this paper proposes an adaptive comb filter with Phase-Locked Loop(PLL), besides digital comb filters. Following the frequency of power and sampling accordingly, this method could easily clear the interference, which could make the cost reduced.