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The catalytic asymmetric construction of axially chiral C-N atropisomers remains a formidable challenge due to their low rotational barriers and is largely reliant on toxic, cost-intensive, and precious metal catalysts. In sharp contrast, we herein describe the first nickel-catalyzed atroposelective C-H alkylation for the construction of C-N axially chiral compounds with the aid of a chiral heteroatom-substituted secondary phosphine oxide (HASPO)-ligated Ni-Al bimetallic catalyst. A wide range of alkenes, including terminal and internal alkenes, were well compatible with the reaction, providing a variety of benzimidazole derivatives in high yields and enantioselectivities (up to 97:3 e.r.). The key to success was the identification of novel HASPOs as highly effective chiral preligands. Mechanistic studies revealed the catalyst mode of action, and in-depth data science analysis elucidated the key features of the responsible chiral preligands in controlling the enantioselectivity.
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AIMS AND OBJECTIVES: The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses. BACKGROUND: Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources. DESIGN: A cross-sectional survey. METHODS: The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience. RESULTS: Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity. CONCLUSION: To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience. RELEVANCE TO CLINICAL PRACTICE: Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system. PATIENT OR PUBLIC CONTRIBUTION: Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.
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Resilience, Psychological , Self Efficacy , Humans , Cross-Sectional Studies , Adult , Female , Male , Surveys and Questionnaires , China , Nursing Staff, Hospital/psychology , Young AdultABSTRACT
Recent years have witnessed a boom of machine learning (ML) applications in chemistry, which reveals the potential of data-driven prediction of synthesis performance. Digitalization and ML modelling are the key strategies to fully exploit the unique potential within the synergistic interplay between experimental data and the robust prediction of performance and selectivity. A series of exciting studies have demonstrated the importance of chemical knowledge implementation in ML, which improves the model's capability for making predictions that are challenging and often go beyond the abilities of human beings. This Minireview summarizes the cutting-edge embedding techniques and model designs in synthetic performance prediction, elaborating how chemical knowledge can be incorporated into machine learning until June 2022. By merging organic synthesis tactics and chemical informatics, we hope this Review can provide a guide map and intrigue chemists to revisit the digitalization and computerization of organic chemistry principles.
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PURPOSE: This study aimed to explore whether self-concealment (SC) affects the quality of life (QOL), and whether cognitive emotion regulation (CER) mediates the relationship between SC and QOL among breast cancer chemotherapy patients. METHODS: This cross-sectional study was conducted among 228 breast cancer chemotherapy patients from November 2021 to March 2022 in Anhui Province, China. Data were collected using the Self-Concealment Scale, Cognitive Emotion Regulation Questionnaire, and Short Form 36 Questionnaire. Descriptive statistics, independent-sample t test, one-way analysis of variance, and structural equation modeling were used to explore associations among SC, CER, and QOL. RESULTS: QOL levels differed significantly by participant age, monthly per capita household income and home location. SC was negatively correlated with QOL. SSC was negatively correlated with adaptive-CER strategies and positively correlated with maladaptive-CER strategies. Adaptive-CER strategies were positively correlated with QOL. Maladaptive-CER strategies were negatively correlated with QOL. CER fully mediated the association between SC and QOL in breast cancer chemotherapy patients. CONCLUSION: Nursing staff should help breast cancer chemotherapy patients reduce the use of maladaptive-CER strategies in the care of patients in the future. Helping patients reduce SC is more conductive to improving the QOL of breast cancer chemotherapy patients.
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Breast Neoplasms , Emotional Regulation , Humans , Female , Breast Neoplasms/drug therapy , Breast Neoplasms/psychology , Quality of Life/psychology , Cross-Sectional Studies , Surveys and Questionnaires , CognitionABSTRACT
BACKGROUND: Blended learning is increasingly being adopted, and yet a gap remains in the related literature pertaining to its skill performance, learning engagement and inner experience in undergraduate surgical nursing skills course. OBJECTIVES: To investigate the changes in skills performance and learning engagement in the application of blended learning, and what it actually brings to nursing students. DESIGN: The study uses a historical control, two-armed, mixed and quasi-experimental design. METHODS: The blended learning version of the course was offered to the 2019 class of 334 nursing undergraduates. Quantitative and qualitative data were collected after the course to obtain a comprehensive understanding of the course effects compared with the 304 nursing undergraduates of grade 2017 who adapted traditional learning. Quantitative data were analyzed by descriptive and inferential statistics using IBM SPSS 26.0, and qualitative data were encoded using Nvivo11.0. RESULTS: There were significant differences in skill performance and learning engagement between the class of 2017 and 2019 (p < 0.001). Combined with further analysis of the interview data, 3 first-level nodes and 8 secondary nodes were determined. Students' opinions, comments and suggestions on the application of blended learning are refreshing. CONCLUSION: Moving forward with blended learning: opportunities and challenges go hand in hand. Researchers need to continually modify their research designs to respond to variable educational environments.
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PURPOSE: To examine a predictive theoretical model of psychological distress based on the following variables reflected on family caregivers of patients with cancer: the unmet supportive care needs, subjective caregiving burden, social support, and the positive aspects of caregiving. METHODS: A cross-sectional descriptive study was conducted on a sample of 484 dyads of patients and their family caregivers. The caregivers completed structured questionnaires designed to measure psychological distress, unmet supportive care needs, subjective caregiving burden, positive aspects of caregiving, and social support. Patients' demographic variables and medical data were collected from a medical record review. We used a structural equation modeling to test the predictive theoretical model. RESULTS: Path analysis results partially supported the proposed model with satisfactory fit indices. Specifically, family caregivers with an increasing number of unmet needs or a heavier caregiving burden were more likely to have more severe psychological distress. Bootstrapping results supported that the caregiving burden and social support were significant mediators. Greater unmet supportive care needs predicted higher psychological distress through increasing caregiving burden. Stronger social support predicted lower psychological distress through decreasing caregiving burden. Positive aspects of caregiving predicted lower caregiving burden through the increasing perceived social support, which in turn eliminated psychological distress. CONCLUSIONS: Unmet supportive care needs could cause psychological distress through increasing caregiving burden. The positive aspects of caregiving reduced caregiving burden through increasing social support, which subsequently alleviated psychological distress. Interventions that aim to satisfy supportive care needs, to reduce caregiving burden, and to strengthen social support ties may boost the mental health of family caregivers.
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Caregivers , Neoplasms , Psychological Distress , Cost of Illness , Cross-Sectional Studies , Family , Humans , Neoplasms/therapy , Social Support , Stress, Psychological/epidemiology , Surveys and QuestionnairesABSTRACT
Garcinol from the fruit rind of Garcinia indica shows anti-carcinogenic and anti-inflammatory properties, but its mechanism and key functional groups were still need to be identified. Our previous computer modeling suggested that the C8 side chain of Garcinol is so large that it may influence the bioactivity of the compound. 8-Me Garcinol, a derivative of Garcinol in which the bulky side chain at the C8 position of Garcinol is replaced with a much smaller methyl group, was synthesized through a 12-step procedure starting from 1,3-cyclohexanedione. The antitumor activity of Garcinol and 8-Me Garcinol was evaluated in vitro by MTT, cell cycle and cell apoptosis assays. The results showed that 8-Me Garcinol had weaker inhibitory activity on cells proliferation, and little effects on cell cycle and apoptosis in oral cancer cell line SCC15 cells when compared with Garcinol. All of the results indicated 8-Me Garcinol exerts weaker antitumor activity than Garcinol, and the C8 side chain might be an important active site in Garcinol. Changing the C8 side chain will affect the inhibitory effect of Garcinol.
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Antineoplastic Agents, Phytogenic/chemistry , Antineoplastic Agents, Phytogenic/pharmacology , Garcinia/chemistry , Mouth Neoplasms/drug therapy , Terpenes/chemistry , Terpenes/pharmacology , Apoptosis/drug effects , Cell Cycle/drug effects , Cell Line, Tumor , Cell Proliferation/drug effects , Cyclohexanones/chemistry , Fruit/chemistry , Humans , MethylationABSTRACT
OBJECTIVES: To investigate the impact of combined treatment of colorectal cancer (CRC) with electroacupuncture (EA) and capeOX (combined administration of fluorouracil, oxaliplatin and capecitabine) on the tumor volume, weight, spleen coefficient, apoptosis and ferroptosis of tumor tissue, and liver and kidney functions in nude mice with CRC, so as to explore its mechanisms underlying inhibiting CRC and alleviating toxic reactions of capeOX. METHODS: Female Balb/c nude mice were randomly assigned to 3 groupsï¼model, capeOX, and EA+capeOX, with 8 nude mice in each group. The CRC model was established by subcutaneous injection of colon cancer cells at the right inguinal region. Nude mice of the capeOX group received intraperitoneal injection of oxaliplatin for 1 day and gavage of capecitabine from day 2 to day 7. EA (1 mA, 2 Hz/100 Hz) was applied to bilateral "Zusanli" (ST36) for 20 min, once daily for 7 days. During the interven-tion, the tumor volume and weight were measured every day, and at the end of intervention, the weight of the tumor tissue and spleen were measured, with tumor volume difference and spleen coefficient calculated. The proportion of apoptotic cells was measured by flow cytometry, and the contents of serum malondialdehyde (MDA), alanine aninotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine (Cr) were detected using ELISA. The expression level of glutathione peroxidase 4 (GPX4, a key regulator for ferroptosis) protein of the tumor tissue was determined using Western blot. RESULTS: Compared to the model group, both the capeOX group and EA+capeOX group showed a decrease in the tumor volume (on day 3 and 4 in the capeOX group, and from day 2 to 7 in the EA+capeOX group) and body weight (P<0.05, on day 3 to 7 in the EA+capeOX group and on day 2 to 7 in the capeOX group), being evidently lower in the tumor volume on day 7 in the EA+capeOX than in the capeOX group (P<0.05), and evidently higher in the body weight on day 6 and 7 in the EA+capeOX group than in the capeOX group (P<0.05). In comparison with the model group, the tumor volume difference, tumor weight and spleen coefficient in both capeOX and EA+capeOX groups were significantly decreased (P<0.05), and MDA content in EA+capeOX group was significantly decreased (P<0.05), while the contents of ALT, BUN and Cr in the capeOX group, the proportion of apoptotic cells in both capeOX and EA+capeOX groups, and the GPX4 expression level in the EA+capeOX group were all significantly increased (P<0.05). The tumor volume difference, tumor weight, and contents of MDA, ALT, AST, BUN and Cr in the EA+capeOX group were markedly lower than in the capeOX group (P<0.05), while the spleen coefficient, proportion of apoptotic cells and GPX4 expression level in the EA+capeOX group were markedly higher than those in the capeOX group (P<0.05). CONCLUSIONS: EA of ST36 can enhance the effect of capeOX in inhibiting colorectal cancer growth in nude mice with CRC, which may be related with its functions in promoting tumor cell apoptosis, inhibiting ferroptosis, and modulating immune tolerance. In addition, EA can lower the side effects of capeOX in hematopoietic and immune, liver, and kidney functions.
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Acupuncture Points , Apoptosis , Colorectal Neoplasms , Electroacupuncture , Ferroptosis , Mice, Inbred BALB C , Mice, Nude , Animals , Mice , Ferroptosis/drug effects , Humans , Apoptosis/drug effects , Colorectal Neoplasms/therapy , Colorectal Neoplasms/metabolism , Colorectal Neoplasms/drug therapy , Female , Phospholipid Hydroperoxide Glutathione Peroxidase/metabolism , Phospholipid Hydroperoxide Glutathione Peroxidase/geneticsABSTRACT
BACKGROUND: Sleep disturbance is one of the symptoms with high incidence and negative influence in patients with cancer. A better understanding of the biological factors associated with sleep disturbance is critical to predict, treat, and manage this condition. OBJECTIVE: The aim of this study was to determine the correlation between sleep disturbance and proinflammatory markers in adult patients with cancer. METHODS: A systematic search was conducted in 7 databases from inception to March 1, 2020, for this meta-analysis. Two reviewers independently screened the studies, extracted data, and appraised the quality of the studies. Meta-analyses were conducted using Stata 12.0 software. RESULTS: Sixteen studies were included. Results indicated that sleep disturbance was associated with higher levels of the overall proinflammatory markers and that the effect size was small yet significant. Further subgroup analyses suggested that sleep disturbance was significantly associated with interleukin-6 and C-reactive protein, but not with interleukin-1ß or tumor necrosis factor-α. Meta-regression results indicated that only the sample source affected the association between sleep disturbance and proinflammatory markers. CONCLUSION: There was a positive relationship between sleep disturbance and selected proinflammatory markers in adult patients with cancer. IMPLICATION FOR PRACTICE: This review provides empirical support for the association between sleep disturbance and certain proinflammatory markers. Healthcare providers can further explore specific biomarkers to precisely identify the individuals at risk of sleep disturbance and develop targeted strategies for therapeutic and clinical interventions.
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Neoplasms , Sleep Wake Disorders , Adult , Humans , Sleep Wake Disorders/epidemiology , Neoplasms/complications , Biomarkers , SleepABSTRACT
BACKGROUND: Nursing talent training should be adjusted in accordance with policies and regulations, the priority areas of health care, the development of nursing disciplines, and changes in nurses' roles. Experience from nursing education stakeholders indicates that postgraduate education faces numerous challenges. Thus, it is necessary to discuss postgraduates' experience in cultivating innovative practical ability. OBJECTIVES: To analyze the experiences of nursing specialist postgraduates in cultivating innovative practical ability to provide a reference for further improvement of the Master of Nursing Specialist program. DESIGN: A qualitative study. SETTING: A university and its three affiliated tertiary hospitals in H city, China. PARTICIPANTS AND METHODS: Individual, semi-structured interviews were conducted face-to-face with 12 postgraduates currently in clinical practice and six postgraduate nurses within two years of graduation between April and June 2022. All interviews were audio-recorded and transcribed verbatim, and the data were analyzed using the Colaizzi method. RESULTS: Three key themes emerged: (1) the cognition of innovative practical ability; (2) the experience of cultivating innovative practical ability at school; and (3) the experience of cultivating innovative practical ability in the hospital. CONCLUSIONS: With a full understanding of the training experience of postgraduates' innovative practical ability, policymakers and training units can clarify the shortcomings of the training model, make targeted improvements, and work together to build a more scientific and complete MNS training model. Our findings have the potential to inform faculty structure, catalyze curriculum reform, optimize clinical practice to facilitate the development of Master of Nursing Specialist programs, improve the quality of care, and promote patient recovery.
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Education, Nursing , Humans , Nurse's Role , Qualitative Research , Cognition , ChinaABSTRACT
Accurate prediction of reactivity and selectivity provides the desired guideline for synthetic development. Due to the high-dimensional relationship between molecular structure and synthetic function, it is challenging to achieve the predictive modelling of synthetic transformation with the required extrapolative ability and chemical interpretability. To meet the gap between the rich domain knowledge of chemistry and the advanced molecular graph model, herein we report a knowledge-based graph model that embeds the digitalized steric and electronic information. In addition, a molecular interaction module is developed to enable the learning of the synergistic influence of reaction components. In this study, we demonstrate that this knowledge-based graph model achieves excellent predictions of reaction yield and stereoselectivity, whose extrapolative ability is corroborated by additional scaffold-based data splittings and experimental verifications with new catalysts. Because of the embedding of local environment, the model allows the atomic level of interpretation of the steric and electronic influence on the overall synthetic performance, which serves as a useful guide for the molecular engineering towards the target synthetic function. This model offers an extrapolative and interpretable approach for reaction performance prediction, pointing out the importance of chemical knowledge-constrained reaction modelling for synthetic purpose.
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Electronics , Engineering , Knowledge , Knowledge Bases , LearningABSTRACT
Electrooxidation has emerged as an increasingly viable platform in molecular syntheses that can avoid stoichiometric chemical redox agents. Despite major progress in electrochemical C-H activations, these arene functionalizations generally require directing groups to enable the C-H activation. The installation and removal of these directing groups call for additional synthesis steps, which jeopardizes the inherent efficacy of the electrochemical C-H activation approach, leading to undesired waste with reduced step and atom economy. In sharp contrast, herein we present palladium-electrochemical C-H olefinations of simple arenes devoid of exogenous directing groups. The robust electrocatalysis protocol proved amenable to a wide range of both electron-rich and electron-deficient arenes under exceedingly mild reaction conditions, avoiding chemical oxidants. This study points to an interesting approach of two electrochemical transformations for the success of outstanding levels of position-selectivities in direct olefinations of electron-rich anisoles. A physical organic parameter-based machine learning model was developed to predict position-selectivity in electrochemical C-H olefinations. Furthermore, late-stage functionalizations set the stage for the direct C-H olefinations of structurally complex pharmaceutically relevant compounds, thereby avoiding protection and directing group manipulations.
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Oxidants , Palladium , Palladium/chemistry , Oxidation-ReductionABSTRACT
Challenging enantio- and diastereoselective cobalt-catalyzed C-H alkylation has been realized by an innovative data-driven knowledge transfer strategy. Harnessing the statistics of a related transformation as the knowledge source, the designed machine learning (ML) model took advantage of delta learning and enabled accurate and extrapolative enantioselectivity predictions. Powered by the knowledge transfer model, the virtual screening of a broad scope of 360 chiral carboxylic acids led to the discovery of a new catalyst featuring an intriguing furyl moiety. Further experiments verified that the predicted chiral carboxylic acid can achieve excellent stereochemical control for the target C-H alkylation, which supported the expedient synthesis for a large library of substituted indoles with C-central and C-N axial chirality. The reported machine learning approach provides a powerful data engine to accelerate the discovery of molecular catalysis by harnessing the hidden value of the available structure-performance statistics.
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AIM: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. METHODS: This study was a quasi-experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow-up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor-Davidson resilience scale (CD-RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi-squared test, Fisher's exact test, and repeated-measures analysis of variance. RESULTS: There were no significant differences between the two groups (p > .05) regarding demographic questions, professional identity, or resilience at baseline (p > .05). Significant differences were found in professional identity between groups (p < .001), measurement times (p = .026), and in the interaction between groups and measurement times (p = .018) from T0 to T2. Significant differences were found in resilience between groups (p < .001), measurement times (p = .007), and in the interaction between groups and measurement times (p = .035) from T0 to T2. CONCLUSIONS: The PIPS program improved nursing students' professional identity and resilience. Further long-term effectiveness of the program needs to be tested with implementation through various forms of mobile technology.
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COVID-19 , Education, Nursing, Baccalaureate , Students, Nursing , COVID-19/prevention & control , Humans , Pandemics , Surveys and QuestionnairesABSTRACT
Purpose: Since there was no consensus on treatment options for localized prostate cancer, we performed a retrospective study to compare the long-term survival benefit of radiotherapy (RT) versus laparoscopic radical prostatectomy (LRP) in Taiwan. Methods: 218 patients with clinically localized prostate cancer treated between 2008 and 2017 (64 with LRP and 154 with RT) were enrolled in this study. The outcomes of RT and LRP were assessed after patients were stratified according to Gleason score, stage, and risk group. Crude survival, prostate cancer-specific survival, and metastasis-free survival were evaluated using the log-rank test. Results: The 5-year crude survival rate was 93.3% in the LRP group and 59.3% in the RT group. A significant survival benefit was found in the LRP group compared with the RT group (p = 0.004). Furthermore, significant differences were found in disease-specific survival (93.3% vs. 64.7%, p = 0.022) and metastasis-free survival (48% vs. 40.2%, p = 0.045) between the LRP and RT groups. Conclusions: Men with localized prostate cancer treated initially with LRP had a lower risk of prostate cancer-specific death and metastases compared with those treated with RT.
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OBJECTIVE: To explore the mechanism of nourishing kidney and reducing urine effect of suoquan capsule by discussing the adjusting action on ALD synthase. METHODS: Built the model of deficiency of the kidney and diuresis by adenine,inspectd the contents of Cort, ALD in blood and the mRNA expression of CYP11B2 with ELISA and RT-PCR technology of the mice. RESULTS: Compared with model group, Suoquan capsule could remarkedly increase the contents of Cort, ALD in blood and the mRNA expression of CYP1 1 B2 of model rats. CONCLUSIONS: Suoquan capsule can increase the contents of Cort, ALD in blood and the mRNA expression of CYP11B2 in deficiency of the kidney and diuresis rats. Promote the combining of ALD by adjusting the ALD synthase may be the mechanism of nourishing the kidney and reducing urine of Souquan capsule from ALD synthase approach.
Subject(s)
Cytochrome P-450 CYP11B2/metabolism , Drugs, Chinese Herbal/pharmacology , Kidney Diseases/drug therapy , Kidney/metabolism , Adenine/adverse effects , Aldosterone/blood , Animals , Corticosterone/blood , Cytochrome P-450 CYP11B2/genetics , Disease Models, Animal , Diuretics/pharmacology , Diuretics/therapeutic use , Drug Combinations , Drugs, Chinese Herbal/administration & dosage , Drugs, Chinese Herbal/therapeutic use , Female , Kidney/drug effects , Kidney Diseases/chemically induced , Kidney Diseases/metabolism , Plants, Medicinal/chemistry , RNA, Messenger/genetics , RNA, Messenger/metabolism , Random Allocation , Rats , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
OBJECTIVE: To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy. METHODS: Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them, there were 2 males and 9 females, aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society (ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoralcondyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb. RESULTS: All 8 patients were followed up for more than 12 months, ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageâ , and no complications such as internal fixation rupture and infection occurred during and after the operation. CONCLUSION: High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment, and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau.
Subject(s)
Arthroscopy , Cartilage, Articular , Female , Humans , Knee Joint , Male , Middle Aged , Osteoarthritis, Knee , Osteotomy , Regeneration , Tibia , Treatment OutcomeABSTRACT
OBJECTIVE: To observe early clinical effect of high tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment. METHODS: Sixty-one elderly patients with medial compartment knee osteoarthritis were treated with high tibial osteotomy combined with arthroscopy from August 2017 to October 2018. Among them, including 17 males and 44 females, aged from 60 to 83 years old with an average of (67.87±6.45) years old. Weight bearing line (WBL) and femora-tibial angle (FTA) were analyzed to assess lower limb alignment before and 12 months after surgery. Visual analogue scale (VAS) score and Hospital for Special Surgery (HSS) score were used to evaluate knee pain and function before and 1, 3, 12 months after surgery. RESULTS: All patients were followed up from 12 to 19 months with an average of (14.27±4.69) months. WBL was improved from (14.79±5.61) % before operation to (59.33±7.82) % at 12 months after operation (t=2.294, P<0.05), FTA was improved from (182.14±2.19) ° before operation to (171.54±3.16) ° at 12 months after operation (t=1.827, P<0.05) . VAS score decreased from 6.14±2.21 before operation to 3.64±0.92, 2.02±0.63 and 0.93±0.61 at 1, 3 and 12 months after operation (F=458.24, P<0.001), HSS score increased from 49.66±13.79 to 58.39±9.26, 71.82±6.06 and 82.71±6.97 at 1, 3 and 12 months after operation (F=266.45, P<0.001) . Three patients had contralateral cortical fracture during surgery, whose osteotomy area healed well at 12 months after surgery. The incision healing of 4 cases was slow, while all healed at 3 to 4 weeks after surgery. CONCLUSION: High tibial osteotomy combined with arthroscopy could adjust lower limb alignment effectively, relieve knee pain and functional dysfunction, which indicated a significant short term efficacy on the elderly patients with knee osteoarthritis of medial compartment.
Subject(s)
Osteoarthritis, Knee , Aged , Aged, 80 and over , Arthroscopy , Female , Humans , Knee Joint , Male , Middle Aged , Osteoarthritis, Knee/surgery , Osteotomy , Tibia , Treatment OutcomeABSTRACT
Background: Nonobese individuals with disproportionate body fat distribution are also vulnerable to dysglycemia. This study aimed to evaluate the association between three visceral adiposity surrogates and impaired fasting glucose (IFG) in nonobese Chinese individuals. Methods: A total of 70,200 nonobese adults without diabetes were included in this analysis. Two diagnostic criteria (IFG-ADA and IFG-WHO) were used to define IFG. The values of the visceral adiposity index, lipid accumulation product index (LAP), and cardiometabolic index (CMI) were calculated. Multivariable logistic analysis was used to evaluate the association between these surrogates and IFG. Results: Among the three indicators, only LAP and CMI were positively correlated with fasting plasma glucose (all P < 0.001). After fully adjusting for confounders, only LAP and CMI exhibited significant associations with IFG. For women, the odds ratios (ORs) for IFG-ADA in the highest quartile of the LAP and CMI were 1.967 (95% confidence interval [CI]: 1.645-2.353) and 1.594 (95% CI: 1.383-1.836), respectively; and were 2.025 (95% CI: 1.597-2.567) and 2.017 (95% CI: 1.647-2.470), respectively, for IFG-WHO (all P < 0.001). For men, the ORs for IFG-ADA of the LAP and CMI were 1.503 (95% CI: 1.233-1.833) and 2.045 (95% CI: 1.752-2.388), respectively; and were 1.534 (95% CI: 1.174-2.005) and 2.541 (95% CI: 2.025-3.188), respectively, for IFG-WHO (all P < 0.001). Conclusions: The LAP and CMI, cost-effective and simple visceral adiposity surrogates, are strongly associated with IFG in nonobese Chinese individuals. These surrogates might be potential targets to monitor for the recognition and management of excess visceral adiposity in nonobese individuals with prediabetes.
Subject(s)
Adiposity/physiology , Blood Glucose/analysis , Prediabetic State/diagnosis , Adult , Algorithms , Asian People , Cost-Benefit Analysis , Cross-Sectional Studies , Female , Humans , Lipid Metabolism , Male , Middle Aged , Obesity, Abdominal/complications , Odds Ratio , Prediabetic State/blood , Risk FactorsABSTRACT
PURPOSE: To investigate the apoptotic mechanisms in rabbits with blast-induced acute lung injury (ALI). METHODS: A total of 40 rabbits were randomly divided into a blank control group (A, n=10) and an experimental group (EXP, n=30). Explosion-induced chest-ALI models were prepared and sampled at different time points (4, 12, and 24h after modeling, T1-T3) to test the lung dry weight/wet weight ratio (W/D) and arterial oxygen pressure (PaO2), apoptosis of lung tissue by the TUNEL assay, and Caspase-3, Bax, and Bcl-2 levels by immunohistochemical analysis. Furthermore, lung tissue was sampled to observe pathological morphology by microscopy. RESULTS: Under a light microscope, Group EXP exhibited obvious edema in the pulmonary interstitial substance and alveoli, a large number of red blood cells, inflammatory cells, and serous exudation in the alveolar cavity, as well as thickening of the pulmonary interstitial fluid. Compared to Group A, the W/D ratio was significantly increased in Group EXP (P<0.01), while PaO2 was significantly reduced (P<0.01). The apoptosis index was significantly increased (P<0.01), and caspase-3 and Bax/Bcl-2 levels were increased (P<0.01). CONCLUSION: Apoptosis plays an important role in the occurrence and development of acute lung injury in rabbits by participating in lung injury and promoting the progression of ALI.