RESUMEN
Diabetes is one of the most important non-communicable chronic diseases. Although a large amount of clinical evidence on the effectiveness of diabetes prevention and treatment interventions has been established, the current quality of care and results are still insufficient. Implementation Research can bridge the gap between research and practice. Implementation Research on diabetes management can clarify what is effective and what is ineffective in management, and promote the transformation of complex, multi-component interventions into medical practice faster and more effectively. This paper reviews the main research contents and application of implementation research of diabetes management at home and abroad, aiming to provide reference for related research and promote the application of implementation research in diabetes management in China.
Asunto(s)
Humanos , Autocuidado/métodos , China , Diabetes Mellitus/prevención & controlRESUMEN
Diabetes is one of the most important non-communicable chronic diseases. Although a large amount of clinical evidence on the effectiveness of diabetes prevention and treatment interventions has been established, the current quality of care and results are still insufficient. Implementation Research can bridge the gap between research and practice. Implementation Research on diabetes management can clarify what is effective and what is ineffective in management, and promote the transformation of complex, multi-component interventions into medical practice faster and more effectively. This paper reviews the main research contents and application of implementation research of diabetes management at home and abroad, aiming to provide reference for related research and promote the application of implementation research in diabetes management in China.
Asunto(s)
Humanos , Autocuidado/métodos , China , Diabetes Mellitus/prevención & controlRESUMEN
Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0‒8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.
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Masculino , Humanos , Anciano , Femenino , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Estudios Transversales , Estudios de Cohortes , Sueño , Trastornos del Sueño-Vigilia , Cognición , China/epidemiologíaRESUMEN
In Taiwan, the first human-infecting H6N1 avian influenza virus was isolated in 2013. To better understand the origin, evolutionary relationship and pathogenesis of the H6N1 virus, we studied the adaptive evolution and evolutionary dynamics of the hemagglutinin (HA) genes of the H6N1 virus in Taiwan. We felt that such studies woud contribute to the further study and control of the virus. Datasets were gained from the Flu and Global Initiative on Sharing All Influenza Data (GISAID) databases. Then, phylogenetic trees and evolutionary dynamics were reconstructed. The evolutionary rate and characterization of adaptive evolution were analyzed by bioinformatic methods. Results indicated that the HA genes of H6N1 in Taiwan were divided into at least five types, and that the new types that the infected human H6N1 belonged to could be local advantage type at present. Evolutionary dynamics revealed the viral population expanded first at the end of 1971, reduced sharply in 2008, and then increased slightly. Three sites were identified under positive selection, suggesting that various sites might increase the adaptive ability of the virus. Eighty-nine sites were under negative selection, revealing that these sites might play an important role in the replication and epidemiology of the virus. Interestingly, site 329 upstream from the cleavage site was also under negative selection, suggesting that this site might be associated with the virulence of H6N1. These data suggest that the HA genes of the Taiwanese H6N1 virus have been undergoing adaptive evolution, and that an outbreak may occur again. Hence, more attention should be paid to the identified sites, to enable timely monitoring and control of a future epidemic.
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Animales , Aves , Evolución Molecular , Glicoproteínas Hemaglutininas del Virus de la Influenza , Genética , Virus de la Influenza A , Genética , Gripe Aviar , Virología , TaiwánRESUMEN
<p><b>OBJECTIVE</b>To investigate the efficacy of surgical treatment of sternal tumors and repairing methods of the chest wall defects.</p><p><b>METHODS</b>Fifteen patients with sternal tumors were diagnosed and underwent resection of the sternal tumors according to the en-bolck principle and repair of the chest wall defects using various materials from January 1968 to December 2010 in our hospital.</p><p><b>RESULTS</b>Of 6 patients with sternal manubrim tumors, one patient had reconstruction only with steel wire, other 5 patients healed completely after repair with soft materials. Of 7 patients with sternal body tumors, one patient recovered quickly without reconstruction because he had only partial resection; four patients had chest wall repair with soft materials, but they breathed hardly; and two patients had chest wall reconstruction with rigid materials. One patient had ventilatory support, another patient recovered quickly. Ventilatory support was needed in two patients treated by subtotal sternectomy because they had chest wall repair with soft materials.</p><p><b>CONCLUSIONS</b>In surgical treatment of sternal tumors by manubrim sternetomy, the chest wall defects can be constructed with soft materials. After resection of sternal body tumors and subtotal sternectomy, the thoracic wall defects need to be reconstructed with rigid materials.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma , Cirugía General , Neoplasias Óseas , Patología , Cirugía General , Condrosarcoma , Patología , Cirugía General , Procedimientos de Cirugía Plástica , Métodos , Esternón , Patología , Cirugía General , Procedimientos Quirúrgicos Torácicos , Métodos , Pared Torácica , Patología , Cirugía GeneralRESUMEN
Alzheimer's disease (AD) is a complex neurodegenerative disorder which seriously causes the dementia in elderly people and afflicts millions of people worldwide. Drug discovery for Alzheimer's disease therapy has been a hot research area and a big challenge, in which development of acetylcholinesterase (AChE) inhibitors design was the most active and some AChE inhibitors are commercially available for AD medication already. However, practical using of commercial AChE inhibitors showed their limited usefulness and related adverse effects. Thus, it is extremely urgent to find novel AChE inhibitors with higher potency and less adverse effects. Based on the accurate crystallographic studies about AChE, strategies for multi-binding site AChE inhibitors have been formed, followed by design of the multi-target directed ligands. In this review, the structures and binding modes of commercial AChE inhibitors were briefly discussed, together with the development of AChE inhibitor design for AD therapy: from multi-binding site inhibitors to multi-target directed ligands.
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Animales , Humanos , Acetilcolinesterasa , Química , Metabolismo , Enfermedad de Alzheimer , Quimioterapia , Secretasas de la Proteína Precursora del Amiloide , Péptidos beta-Amiloides , Metabolismo , Ácido Aspártico Endopeptidasas , Sitios de Unión , Butirilcolinesterasa , Química , Metabolismo , Inhibidores de la Colinesterasa , Química , Farmacología , Usos Terapéuticos , Diseño de Fármacos , Ligandos , Inhibidores de la Monoaminooxidasa , Química , Receptores de N-Metil-D-Aspartato , Relación Estructura-ActividadRESUMEN
<p><b>OBJECTIVE</b>To report replantation of amputated ear with microtechnique in 5 cases.</p><p><b>METHODS</b>From 2002 to 2005, 5 totally amputated ears were replanted and 4 obediently, 1 retrogressively. In every case, 1-2 arteries and 1-3 veins were anastomosed. Seven vessels were detective and 1-6 cm vessels were transplanted from forearm or dorsal side of hand. Amputated ears obtained blood supply again in about 6-10 hours after injury and exploration was enforced for venous crisis in 2 cases, and bloodletting in 1 case.</p><p><b>RESULTS</b>All 5 cases survived. Auricles possess perfect shape, no pigmentation, slight atrophy and perfect sensation.</p><p><b>CONCLUSIONS</b>Amputated ear should be replanted as long as no obvious contusion occurred, and the keys to prevent vascular crisis are cutting off unhealthy vessels, grafting superficial veins for bridging, and the high quality of vascular anastomosis.</p>
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Adulto , Femenino , Humanos , Masculino , Adulto Joven , Anastomosis Quirúrgica , Métodos , Oído Externo , Heridas y Lesiones , Cirugía General , Microcirugia , Microvasos , Cirugía General , Reimplantación , MétodosRESUMEN
<p><b>OBJECTIVE</b>To study the protective effect of jasminoidin on cascade of damage of cerebral ischemia.</p><p><b>METHOD</b>The rats were randomly divided into four groups: sham-operated group, ischemic group, the jasminoidin-treatment group and PNS-treatment group. Focal cerebral ischemia was produced by permanent occlusion of left middle cerebral artery (PMCAO) in rats. Radioimmunoassay (RIA) was utilized to identify the content of tumor necrosis factor-alpha (TNF-alpha) and interlukin 1beta (IL-1beta) in brain tissue of rats following ischemia. and that of Neuron-specific enolase (NSE) in rat's serum was observed too. The plasma concentration of vonWillebrand factor (vWF) was identified by enzyme-linked immunoadsordent assay (ELISA).</p><p><b>RESULT</b>After 12 h and 24 h of ischemia, the contents of TNF-alpha and IL-1beta and vWF as well as on NSE showed concomitant increase. Jasminoidin dramatically inhibited the increase of TNF-alpha and IL-1beta after 12 h and 24 h of ischemia, and repressed the increase of vWF after 12 h and 24 h of ischemia too. However, the influence of jasminodin NSE after 12 h and 24 h of ischemia was not significant.</p><p><b>CONCLUSION</b>Jasminoidin had good effect on repressing the expression of TNF-alpha and IL-1beta as well as vWF caused by cerebral ischemia, thus it manifested the effect of relieving the damage to vascular endothelial cell and blocking the progress of cascade damage of cerebral ischemia through inhibiting the process of inflammation.</p>
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Animales , Masculino , Ratas , Encéfalo , Metabolismo , Isquemia Encefálica , Metabolismo , Medicamentos Herbarios Chinos , Farmacología , Gardenia , Química , Infarto de la Arteria Cerebral Media , Metabolismo , Interleucina-1 , Sangre , Fármacos Neuroprotectores , Farmacología , Fosfopiruvato Hidratasa , Sangre , Plantas Medicinales , Química , Distribución Aleatoria , Ratas Sprague-Dawley , Saponinas , Farmacología , Factor de Necrosis Tumoral alfa , Metabolismo , Factor de von Willebrand , MetabolismoRESUMEN
Objective To investigate the clinical method of closing defect and regain the sensory on forefoot injury.Methods Lateral tarsal artery,flap was designed as a reverse flow flap to close forefoot de- fect in dorsal lateral foot while perforating branche of lateral tarsal artery as turning point.Lateral cutaneous nerve was inosculated to lateral plantar fascia.Donor site was covered by skin-grafting.Results seventeen cases survived satisfactorily with good shape and regaining sensory.Conclusion Lateral tarsal artery flap can be used in coveraged of forefoot defect.Lateral tarsal artery flap was thin flap with good shape and to regain the sensory of forefoot.