Research progress of lipoprotein a in cardiovascular diseases / 重庆医学

Lipoprotein a[Lp(a)]is a risk factor for cardiovascular disease.This paper summarizes the structure,anabolism and mechanism of action of Lp(a),and the relationship between Lp(a)and cardiovascular diseases,liver and kidney diseases,diabetes mellitus and other diseases.It focuses on the traditional lipid-low-ering regimen to reduce plasma Lp(a)level and the current popular novel therapies,such as mipomersen,pel-acarsen,olpasiran,and the interfering effect of related drugs on Lp(a)level and the degree of benefit on cardi-ovascular events.How to reduce plasma Lp(a)level and improve patient prognosis will be the key to future Lp(a)related research.

Application of silk fibroin coatings for biomaterial surface modification: a silk road for biomedicine / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Silk fibroin (SF) as a natural biopolymer has become a popular material for biomedical applications due to its minimal immunogenicity, tunable biodegradability, and high biocompatibility. Nowadays, various techniques have been developed for the applications of SF in bioengineering. Most of the literature reviews focus on the SF-based biomaterials and their different forms of applications such as films, hydrogels, and scaffolds. SF is also valuable as a coating on other substrate materials for biomedicine; however, there are few reviews related to SF-coated biomaterials. Thus, in this review, we focused on the surface modification of biomaterials using SF coatings, demonstrated their various preparation methods on substrate materials, and introduced the latest procedures. The diverse applications of SF coatings for biomedicine are discussed, including bone, ligament, skin, mucosa, and nerve regeneration, and dental implant surface modification. SF coating is conducive to inducing cell adhesion and migration, promoting hydroxyapatite (HA) deposition and matrix mineralization, and inhibiting the Notch signaling pathway, making it a promising strategy for bone regeneration. In addition, SF-coated composite scaffolds can be considered prospective candidates for ligament regeneration after injury. SF coating has been proven to enhance the mechanical properties of the substrate material, and render integral stability to the dressing material during the regeneration of skin and mucosa. Moreover, SF coating is a potential strategy to accelerate nerve regeneration due to its dielectric properties, mechanical flexibility, and angiogenesis promotion effect. In addition, SF coating is an effective and popular means for dental implant surface modification to promote osteogenesis around implants made of different materials. Thus, this review can be of great benefit for further improvements in SF-coated biomaterials, and will undoubtedly contribute to clinical transformation in the future.

Development, and reliability and validity testing of a knowledge needs questionnaire of respiratory rehabilitation training for in-service healthcare workers / 中国康复理论与实践

ObjectiveTo develop a questionnaire on the knowledge needs of respiratory rehabilitation training for in-service healthcare workers, and test its reliability and validity. MethodsA theoretical framework was constructed based on the contents of the respiratory rehabilitation course modules of American Association of Cardiopulmonary Rehabilitation and American Association for Respiratory Care. The first draft of the questionnaire was prepared through literature searches and analyses, semi-structured interviews, and expert group discussions. The reliability and validity of the questionnaire was tested by interviewing 17 respiratory rehabilitation professionals and 16 respiratory rehabilitation experts by correspondence, and investigating 380 cases of in-service healthcare workers engaged in respiratory rehabilitation. ResultsThe knowledge needs questionnaire of respiratory rehabilitation training for in-service healthcare workers included progress in respiratory rehabilitation, physiological basis and diagnosis of chronic lung diseases, individualized assessment and management principles of chronic lung diseases, treatment of chronic lung diseases and guideline-recommended medications, oxygen therapy, exercise assessment and exercise prescription, tobacco addiction and cessation, nutritional assessment and weight management, psychological screening and intervention, self-management and health behavior promotion, and effectiveness assessment of respiratory rehabilitation, totaling eleven dimensions and 52 items. The total Cronbach's α was 0.921, the total folded half reliability was 0.904, the total retest reliability was 0.922, and the Cronbach's α of each dimension ranged from 0.909 to 0.953; the folded half reliabilities ranged from 0.882 to 0.924, and the retest reliabilities ranged from 0.908 to 0.950. The validity of the questionnaire's content was 0.902. In exploratory factor analysis, eleven metric factors were extracted, and their cumulative variance contribution rate was 75.324%. ConclusionThe questionnaire on the knowledge needs of respiratory rehabilitation training for in-service healthcare workers is reliable and valid, and can be used to assess the knowledge needs of healthcare workers participating in in-service training in respiratory rehabilitation.

Characteristic of medication compliance behavior in renal transplantation patients / 中南大学学报(医学版)

OBJECTIVES@#After renal transplantation, patients need to take various immunosuppressant, but the drug compliance is poor. The theory of planned behavior suggests that the past medication behavior and subjective norms of individuals are closely related to medication compliance. This study aims to explore the change of medication compliance behavior and its influenting factors for renal transplantation patients at different stages.@*METHODS@#This study was a prospective longitudinal study. The Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS), Medication Belief Scale, Social Support Scale and Quality of Life Scale were used to dynamically follow up renal transplantation patients at pre-operation and 1-month, 6-month, and 12-month after transplantation.@*RESULTS@#A total of 300 patients completed the whole follow-up. The percentage of patients with good medication compliance was 97.60%, 87.30% and 84.30% at 1-month, 6-month and 12-month after transplantation respectively. The life quality of the patients was decreased at 6 months after the operation, and the patients with better self-reported life quality had poor medication compliance. After adjusting for demographic data, the risk of medication incompliance in patients with poor medication compliance before operation was 37.646 times than those with good compliance. Patients who did not use medication reminders had high risk (odds ratio=2.467) of drug non-adherence. The risk of drug non-adherence in patients with more postoperative misgivings was 1.265 times compared with that in patients with less postoperative misgivings.@*CONCLUSIONS@#The medication compliance decreases with the time of transplantation, but the medication compliance of patients with good self-reported life quality is poor. Medication concerns reduce the compliance behavior. Preoperative medication behavior has a significant predictive effect on postoperative behavior. Medication reminder is a protective factor for promoting compliance. Medical staff should pay more attention to preoperative medication belief, behaviors and reminder of using drug so as to provide precise intervention in the renal transplantation patients.

Cost-effectiveness of Morse Fall Scale assessment in fall prevention care in hospitalized patients / 中南大学学报(医学版)

OBJECTIVES@#To analyze the cost-effectiveness of the Morse Fall Scale by clinical big data for nurses in the prevention of falls in hospitalized patients.@*METHODS@#A total of 59 358 hospitalized patients, who came from the Third Xiangya Hospital of Central South University in 1 year before nurses were trained by the Morse Fall Scale, served as a control, including 26 862 males and 32 496 females. While the 66 203 hospitalized patients served as an observation group in 1 year after nurses were trained by the Morse Fall Scale, including 29 881 males and 36 322 females. The time spent by clinical nurses in the fall-risk assessment and the fall number were recorded in the 2 groups, and the relationship was analyzed between the Morse Fall Scale assessment and the clinical ending along with the labor cost of nursing. The cost-effectiveness was analyzed. In addition, the incidence of fall in the observation group was compared between the falling high-risk patients and the non-high-risk patients.@*RESULTS@#The Morse Fall Scale showed that the incidences of fall in the observation group and the control group were 3.39/100 000 and 3.82/100 000,respectively, there was no significant difference between the 2 groups (@*CONCLUSIONS@#The evaluation of the Morse Fall Scale has a certain effect, but it is limited in the prevention of falls in adult hospitalized patients, and the cost-effectiveness analysis is not good. It is recommended to implement the intervention measures for high-risk patients after the assessment, which may improve the management level and efficiency of fall prevention.

Nursing standard of internet-based rehabilitation for patients with coronavirus disease 2019 / 中南大学学报(医学版)

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with COVID-19 may have respiratory dysfunction, physical dysfunction, and psychological dysfunction. Rehabilitation and long-term follow-up management are particularly important for these patients. Traditional face-to-face rehabilitation possesses high risk of infection, low coverage, time-consuming and laborious. While online rehabilitation nursing mode will be more feasible by using mobile internet technology. Based on literature review and focus group discussion, we standardize the internet-based nursing assessment, plan formulation, implementation, and effectiveness evaluation on discharged patients with COVID-19.We hope it can give guidance for nurses to provide better care for patients.

Introduction to the Four Principles of Biomedical Ethics in Confucius / 中国医学伦理学

It is not only the problem of the real life,but also the challenge of the biomedical ethics for how to get the balance and compromise between the principlism and situationism.The fairness in Confucian is constructed on the basis of the external nature,and also is a standard and content-full ethical principle,which is different from the political one in the western culture.The Confucian basis is the principlism but does not refuse the situationism.In the four principles of Confucian,both fairness and respect for autonomy belong to the principlism,while the other two of knowing where to stop and no harm or the principle of benefit of utilitarianism are the basis of the situationism.The principle of knowing where to stop is the internal core spirit of the Confucian moral virtue and ethical principles,but fairness is the first principle of its all external principles.

Current status of the prevalence, diagnosis, and treatment of hepatitis C in patients undergoing hemodialysis / 中华肝脏病杂志

Patients undergoing hemodialysis have a higher rate of hepatitis C virus infection than the general population, and due to various factors including hemodialysis and immunosuppression, it is difficult to make a diagnosis. The appearance of direct-acting antiviral agents greatly promotes the treatment of hepatitis C, but there are still no adequate data on their effect and safety in patients undergoing hemodialysis. This article discusses the prevalence, diagnosis, and treatment of hepatitis C in patients undergoing hemodialysis.

Application of mini-nutritional assessment in malnutrition risk evaluation of elderly inpatient with cardiovascular disease / 重庆医学

Objective To investigate the application of the mini nutritional assessment (MNA)in the malnutrition risk eval-uation of elderly inpatients with cardiovascular disease(CVD).Methods The MNA method was adopted to detect the MNA scores in 316 elderly inpatients with CVD.The inpatient′s nutritional status was evaluated according to the MNA scores.Results Among 316 cases,52 cases(16.46%)were malnutrition,60 cases (18.99%)had the malnutrition risk and 204 cases (64.56%)were in a good nutritional status;the occurrence rate of malnutrition and malnutrition risk in the female elderly patients were higher than those in the male patients,the differences were statistically significant(P 0.05);the occurrence rate of malnutrition and malnutrition risk in the rural patients were higher than those in the patients lived in city,the differences were statistically significant(P <0.05).Conclusion Elderly inpatients with CVD have the higher prevalence of the malnutrition risk,the MNA can be applied in elderly inpatients with CVD for conduc-ting the nutritional status monitoring and early screening the malnutrition risk.

Guided bone regeneration at a dehiscence-type defect using chitosan/collagen membranes in dogs / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare a developed absorbable chitosan/collagen membrane (CCM) with a standard biodegradable collagen membrane for the treatment of implant dehiscence-type defect in dog model.</p><p><b>METHODS</b>The right four mandibular premolars and the first molar were extracted in each of 10 beagle dogs.Four months later, acute buccal dehiscence-type defects were surgically created following implant site preparation in each dog. Using self-control, defects were randomly assigned to four different groups: CCM-1 (with the ratio of chitosan and collagen of 40: 1), CCM-2(with the ratio of chitosan and collagen of 20: 1), Bio-Gide collagen membrane (BG collagen), control. The animals were sacrificed after 4 (3 animals), 8 (3 animals) and 12 (4 animals) weeks of healing interval for histological observation and histomorphometrical analysis including defect length (DL), new bone height (NBH), bone-to-implant contact (BIC) and area of new bone fill (BA).</p><p><b>RESULTS</b>Newly formed bone was observed in all the groups and became mature with time. At 8 weeks, increased mean NBH and BIC values were obtained for all the groups, the mean NBH values of the CCM-1, CCM-2 and BG groups [( 1.1 0 ± 0.11)∼(1.48 ± 0.07) mm]were significantly higher than that of the control [(0.74 ± 0.12) mm] (P < 0.05). At 12 weeks, the membranes treated groups obtained more mean NBH,BIC and BA values compared with the control. The CCM-1 groups showed the highest mean NBH value [(1.91 ± 0.25) mm], which was significantly higher than the control [(1.20 ± 0.34) mm](P < 0.05).However, no statistically significant differences in BIC and BA were found between membrane groups and control and among the membranes treated groups.</p><p><b>CONCLUSIONS</b>The results of this study demonstrated that the developed CCM can enhance bone regeneration and obtaine similar amounts of newly formed bone compared with defects regenerated with a standard collagen membrane.</p>

Perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS / 中南大学学报(医学版)

Objective: To determine the relationship among perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS. Methods: Cross-sectional research was used to interview people living with HIV/AIDS (PLWHA) from April 2012 to March 2013 in Changsha, China. The questionnaires included General Questionnaire, Sexual Behavior Questionnaire, Patient Health Questionnaire Depression Scale (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Psychometric Assessment of the HIV Stigma Scale. hTe results were statistically analyzed with SPSS18.0. Results: hTe total score of perceived stigma and its 4 dimensions were positively correlated with anxiety and depression. The total score of perceived stigma and its dimensions were associated with disclosure, but no signiifcantly correlated with other sexual behaviors. Hierarchical regression showed perceived stigma had an effect on anxiety. Conclusion: hTe stigma perceived by PLWHA is above the average level. Perceived stigma has an effect on mental health, especially anxiety, but no effect on unsafe sexual behaviors.