Enhancing the Efficacy of Emergency Care Pathways in the Management of Stroke Patients.

Background: The rising incidence of emergency stroke cases emphasizes the need for refining care strategies. This study addresses this critical need to assess the effectiveness of optimized emergency care pathways for improving patient outcomes. Objective: This study evaluates the efficacy of optimized emergency care pathways for stroke patients in emergency situations. Methods: A total of 60 emergency stroke cases admitted to our hospital between June 2020 and June 2022 were included. Patients were assigned to a control group and an observation group based on care modalities in a 1:1 ratio. The control group received conventional emergency care, while the observation group underwent the optimized emergency care pathway. Baseline data, resuscitation effects, clinical outcomes, serum inflammatory factor levels, prognosis, nursing satisfaction, and related indices were recorded and compared between the two groups. Results: Patients in the observation group exhibited significantly reduced resuscitation and treatment times compared to the control group (P < .001). The observation group had fewer deaths within 48 hours (P < .001). Serum levels of interleukin (IL)-6, IL-8, and Intercellular Adhesion Molecule-1 (ICAM-1) decreased significantly in the observation group compared to the control group (P < .001). The observation group also had fewer cases of disability, vegetation, and death (6.66% vs. 40%, P < .001). Patient satisfaction in the observation group was 90%, significantly higher than the control group (20%, P < .001). Conclusions: The optimized emergency care pathway proves effective for emergency stroke patients, enhancing resuscitation, clinical outcomes, and prognosis while reducing inflammatory factors. Furthermore, it elevates patient satisfaction, warranting widespread implementation.

Biodegradable PBAT microplastics adversely affect pakchoi (Brassica chinensis L.) growth and the rhizosphere ecology: Focusing on rhizosphere microbial community composition, element metabolic potential, and root exudates.

Biodegradable plastics (BPs) have gained increased attention as a promising solution to plastics pollution problem. However, BPs often exhibited limited in situ biodegradation in the soil environment, so they may also release microplastics (MPs) into soils just like conventional non-degradable plastics. Therefore, it is necessary to evaluate the impacts of biodegradable MPs (BMPs) on soil ecosystem. Here, we explored the effects of biodegradable poly(butylene adipate-co-terephthalate) (PBAT) MPs and conventional polyethylene (PE) MPs on soil-plant (pakchoi) system at three doses (0.02 %, 0.2 %, and 2 %, w/w). Results showed that PBAT MPs reduced plant growth in a dose-dependent pattern, while PE MPs exhibited no significant phytotoxicity. High-dose PBAT MPs negatively affected the rhizosphere soil nutrient availability, e.g., decreased available phosphorus and available potassium. Metagenomics analysis revealed that PBAT MPs caused more serious interference with the rhizosphere microbial community composition and function than PE MPs. In particular, compared with PE MPs, PBAT MPs induced greater changes in functional potential of carbon, nitrogen, phosphorus, and sulfur cycles, which may lead to alterations in soil biogeochemical processes and ecological functions. Moreover, untargeted metabolomics showed that PBAT MPs and PE MPs differentially affect plant root exudates. Mantel tests, correlation analysis, and partial least squares path model analysis showed that changes in plant growth and root exudates were significantly correlated with soil properties and rhizosphere microbiome driven by the MPs-rhizosphere interactions. This work improves our knowledge of how biodegradable and conventional non-degradable MPs affect plant growth and the rhizosphere ecology, highlighting that BMPs might pose greater threat to soil ecosystems than non-degradable MPs.

Effect of CSMS Scale Combined with Narrative Psychological Nursing on Rehabilitation of Hypertensive Patients with Coronary Heart Disease.

Objective: This study investigated the impact of combining the Coronary Heart Disease Self-Management Scale (CSMS) with narrative psychological nursing on the rehabilitation of patients with hypertension and coronary heart disease. Methods: A total of 300 patients with hypertension and coronary heart disease were enrolled in this study at our hospital from June 2021 to June 2022. Random number tables were used to allocate the patients into two groups, with 150 patients in each group. The control group received conventional care, while the observation group received the CSMS scale combined with narrative psychological nursing. Results: Rehabilitation efficacy, disease self-management ability, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were compared between the two groups. After the intervention, the observation group showed lower systolic blood pressure, diastolic blood pressure, SAS scores, and SDS scores compared to the control group, with statistically significant differences (P < .05). Additionally, the CSMS scores in the observation group were significantly higher than those in the control group. Conclusions: The combination of the CSMS scale and narrative psychological nursing is an effective approach for rehabilitating hypertensive patients with coronary artery disease. It leads to decreased blood pressure, improved emotional well-being, and enhanced self-management abilities.

The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials.

BACKGROUND: Silymarin (SIL) is an active extraction of the silybum marianum, milk thistle, which is an ancient medicinal plant for treatment of various liver diseases for centuries. This study is to assess the therapeutic effect of SIL in the treatment of nonalcoholic fatty liver disease through meta-analysis. METHODS: Published randomized controlled trials (RCTs) were included from electronic databases (PubMed, Embase, Cochrane library, Web of Science, and so forth). Cochrane handbook was applied to evaluate the methodological quality. All statistical analyses were directed by Revman 5.3 software, and statistical significance was defined as P < .05. RESULTS: Eight RCTs involved 587 patients were included in this study. The results showed that SIL reduced the AST and ALT levels more significantly than the control group (AST UI/L: MD = -6.57; 95% CI, -10.03 to -3.12; P = .0002; ALT UI/L: MD = -9.16; 95% CI, -16.24 to -2.08; P = .01). Compared with other interventions, there were significant differences decreasing AST and ALT levels when SIL was used alone (AST UI/L: MD = -5.44; 95% CI, -8.80 to -2.08; P = .002; ALT UI/L: MD = -5.08; 95% CI, -7.85 to -2.32; P = .0003). CONCLUSION: SIL has positive efficacy to reduce transaminases levels in NAFLD patients. SIL can be an encouraging and considerable phytotherapy for NAFLD patients.