RESUMEN
Objectives: This study aimed to analyze the psychological status and quality of life (QoL) of patients with advanced lung cancer and assess the impact of continuous nursing intervention on these parameters. Methods: A total of 160 advanced lung cancer patients were randomly assigned to a control group or a study group, with 80 patients in each. The control group received the routine nursing intervention, while the study group received the continuous nursing intervention, including health record establishment, regular follow-ups, diet guidance, health knowledge education, psychological counseling, and work and rest guidance. Inflammatory markers (IL-6, TNF-α, PGE2, and SP), Spitzer Quality of Life Index (SQLI), anxiety and depression self-evaluation scales, Visual Analogue Scale (VAS) for pain, and patient satisfaction were measured before and after 4 weeks of intervention. Results: Post-intervention, the study group showed a significant reduction in serum IL-6 and TNF-α levels (P < .001), improved SQLI scores (P = .002), and lower anxiety and depression scores (P < .001) compared to the control group. A significant negative correlation between psychological status and QoL was observed (P < .001). The study group also reported lower VAS pain scores (P < .001) and higher patient satisfaction (P = .000) after the intervention. Conclusions: Continuous nursing intervention has significantly improved psychological well-being, alleviated pain, and enhanced the overall quality of life for patients facing advanced lung cancer. These results indicate that a comprehensive and sustained nursing intervention strategy can serve as an effective approach to improve the well-being of individuals navigating advanced lung cancer during chemotherapy.
RESUMEN
Cardiac remodeling is a determinant of the clinical progression of heart failure and now slowing or reversing remodeling is considered as a potential therapeutic target in heart failure. Pycnogenol has been reported to mediate a number of beneficial effects in the cardiovascular system but its effects on hemodynamic and functional cardiovascular changes following cardiac remodeling have not been elucidated. Therefore, we investigated the influence of Pycnogenol supplementation (30 mg/kg) on left ventricular function and myocardial extracellular matrix composition in old C57BL/6N mice following induction of cardiac remodeling by chronic nitric oxide synthase blockade by NG-nitro-L-arginine methyl ester (L-NAME) administration. L-NAME-treated mice demonstrated dilated cardiomyopathy at compensated state, associated with a significant increase of pro-matrix metalloproteinase (MMP)-9 gene expression and activity, a marked decrease in pro-collagen IIIalpha1 gene expression, and a subsequent reduction in cardiac total and cross-linked collagen content. Upon supplementation with Pycnogenol in L-NAME-exposed mice, cardiac gene expression patterns for pro-MMP-2, -9, and -13, and MMP-9 activity were significantly decreased, associated with a significant increase in cardiac tissue inhibitor of metalloproteinase (TIMP)-4 expression. These findings were coincided with a marked increase in myocardial total and cross-linked collagen content, compared with L-NAME-only-treated mice. Moreover, Pycnogenol treatment was associated with reversal of L-NAME-induced alternations in hemodynamic parameters. These data indicate that Pycnogenol can prevent adverse myocardial remodeling induced by L-NAME, through modulating TIMP and MMPs gene expression, MMPs activity, and further reduction in myocardial collagen degradation rate.
Asunto(s)
Envejecimiento/fisiología , Inhibidores Enzimáticos/toxicidad , Matriz Extracelular/efectos de los fármacos , Flavonoides/farmacología , Corazón/efectos de los fármacos , NG-Nitroarginina Metil Éster/toxicidad , Óxido Nítrico Sintasa de Tipo III/antagonistas & inhibidores , Remodelación Ventricular/efectos de los fármacos , Animales , Presión Sanguínea/efectos de los fármacos , Colágeno/metabolismo , Reactivos de Enlaces Cruzados , Metaloproteinasas de la Matriz/metabolismo , Ratones , Ratones Endogámicos C57BL , Miocardio/citología , Extractos Vegetales , ARN/biosíntesis , ARN/genética , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
The adrenal steroid hormone dehydroepiandrosterone (DHEA) and its sulfated derivative [DHEA(S)] have been extensively studied for their potential anti-aging effects. Associated with aging, DHEA levels decline in humans, whereas other adrenal hormones remain unchanged, suggesting that DHEA may be important in the aging process. However, the effect of DHEA(S) supplementation on cardiac function in the aged has not been investigated. Therefore, we administered to young and old female mice a 60-day treatment with exogenous DHEA(S) at a dose of 0.1 mg/ml in the drinking water and compared the effects on left ventricular diastolic function and the myocardial extracellular matrix composition. The left ventricular stiffness (beta) was 0.30 +/- 0.06 mmHg/mul in the older control mice compared with 0.17 +/- 0.02 mmHg/mul in young control mice. Treatment with DHEA(S) decreased left ventricular stiffness to 0.12 +/- 0.03 mmHg/mul in the older mice and increased left ventricular stiffness to 0.27 +/- 0.04 mmHg/mul in young mice. The mechanism for the DHEA(S)-induced changes in diastolic function appeared to be associated with altered matrix metalloproteinase activity and the percentage of collagen cross-linking. We conclude that exogenous DHEA(S) supplementation is capable of reversing the left ventricular stiffness and fibrosis that accompanies aging, with a paradoxical increased ventricular stiffness in young mice.