Analysis of the Influencing Factors of Delirium after PCI for Acute Myocardial Infarction and its Impact on the Quality of Life of Patients.

Objective: Delirium is a common and serious issue in patients recovering from percutaneous coronary intervention (PCI). It can lead to longer hospital stays, increased mortality, and decreased quality of life. This study aims to investigate different nursing interventions to improve care for post-PCI patients by reducing the incidence and duration of delirium. Methods: Between December 2021 and April 2023, we enrolled patients who underwent PCI surgery for acute myocardial infarction at our hospital as study participants. Utilizing a clinical randomized controlled trial design, we allocated these patients randomly into either the intervention group or the control group. The control group received conventional nursing care, while the intervention group received routine nursing care augmented by family visit nursing care, encompassing emotional support, education, and enhanced communication with family members. Upon the completion of all intervention measures, we assessed the incidence of delirium in post-PCI patients using the Richmond Agitation Sedation Scale (RASS) and the ICU Ambiguity Assessment Method for the Intensive Care Unit (CAM-ICU). Furthermore, we evaluated the patients' quality of life using the US Medical Bureau's Quality of Life Health Survey (SF-36). Result: Significant differences were observed in Richmond Agitation Sedation Scale (RASS) scores at 24 and 48 hours post-PCI, favoring the intervention group (P < .05). The intervention group also exhibited a lower incidence of delirium at 24 hours (P < .05) and a significantly shorter delirium duration (P < .05). While baseline quality of life scores did not differ significantly between the groups, post-intervention, the intervention group demonstrated significantly higher quality of life scores. These results underscore the positive impact of combined nursing interventions on sedation levels, delirium incidence and duration, and overall quality of life for post-PCI patients. Conclusion: The combined approach of routine nursing care and home visit interventions significantly reduced delirium incidence and duration in post-PCI patients. This personalized care strategy emphasizes patient well-being and is indicative of a broader shift towards individualized healthcare. It highlights the potential for enhanced patient outcomes and improved quality of life in the context of post-PCI patient management.

Association of selenium and cadmium with heart failure and mortality based on the National Health and Nutrition Examination Survey.

BACKGROUND: The association of selenium and cadmium with heart failure and mortality has not been thoroughly explored. METHODS: We analysed data from the National Health and Nutrition Examination Survey (NHANES) database over 12 years (1999-2000, 2003-2004 and 2011-2018), which includes blood selenium and cadmium. Multivariable logistic regression and Cox proportional hazards regression were used. RESULTS: In total, 15,689 participants were enrolled. The multivariate analysis showed that low blood selenium (odds ratio [OR] = 0.952, p < 0.001) and high blood cadmium (OR = 1.345, p < 0.001) were independent risk factors of heart failure. During 96802 person-year follow-up, 1697 deaths occurred. The multivariable adjusted hazard ratio (HR) for all-cause mortality was 0.82 (95% confidence interval [CI] = 0.71-0.95) for middle selenium levels and 0.76 (95% CI = 0.65-0.88) for high selenium levels compared to low selenium levels. Taking the low cadmium levels as reference, the multivariable adjusted HR for all-cause mortality among high cadmium levels was 1.68 (95% CI = 1.44-1.96). Furthermore, the association between selenium, cadmium and cardiovascular mortality was similar to that of all-cause mortality. A subgroup analysis of the study population showed that in individuals with heart failure, although selenium levels were not associated with risk of all-cause mortality, high selenium levels were associated with a lower risk of cardiovascular mortality (HR = 0.33, p = 0.0032). CONCLUSIONS: Low blood selenium and high blood cadmium were independent risk factors of heart failure. Blood selenium was inversely associated with all-cause mortality and cardiovascular mortality, whereas blood cadmium was positively associated with them. Furthermore, blood selenium was associated with a lower risk of cardiovascular mortality in individuals with heart failure.

Efficacy and Safety of Ejiao (Asini Corii Colla) in Women With Blood Deficient Symptoms: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial.

Equus asinus L [Equidae; Asini Corii Colla] (donkey-hide gelatin, Ejiao), a well-known traditional Chinese medicine, has been widely used to nourish the blood, especially for women. The aim of this study was to assess the efficacy and safety of Ejiao in blood-deficient patients. A total of 210 participants were recruited and randomly allocated into the placebo control group and Ejiao-treated group (6 g/day). The primary outcomes on the efficacy of Ejiao included traditional Chinese medicine symptom scores, blood indicators, and SF-36. The secondary outcomes were changes in fireness and safety evaluation. Results showed that Ejiao treatment for 8 weeks had significantly improved dizziness symptoms. Among the tested 24 blood biochemical parameters, the hematocrit and red blood cell numbers decreased in the placebo control group, but decreased significantly less in the Ejiao treatment group. The white blood cell and neutrophil counts increased in the Ejiao group but were within the normal range. In addition, the quality of life improved as the scores in SF-36 domains were significantly higher in the Ejiao group. At the same time, there was no significant change in the fire-heat symptoms score or other safety parameters. Considering all these, our study showed that Ejiao has a promising effect in women suffering from blood deficiency without obvious adverse effects.

The efficacy of intravenous vitamin C in critically ill patients: A meta-analysis of randomized controlled trials.

BACKGROUND & AIMS: A large number of clinical studies have shown that intravenous vitamin C supplementation is beneficial for critically ill patients, but current research conclusions are controversial. This meta-analysis included high-quality randomized controlled trials (RCTs) to evaluate the efficacy of intravenous vitamin C in critically ill patients. METHODS: We searched PubMed, EMBASE and the Cochrane Library from inception to August 15, 2020 to identify published reports of RCTs evaluating the role of intravenous vitamin C in critically ill patients. Risk ratios values (RRs) and 95% confidence intervals (CIs) were calculated by random-effects meta-analysis. Trial sequential analysis (TSA), meta-regression, subgroup analyses and sensitivity analyses were also performed. RESULTS: Our meta-analysis included 18 RCTs involving 2001 patients (1005 with vitamin C treatment and 996 control treatment). Intravenous vitamin C administration reduced the intensive care unit (ICU) length of stay (LOS) (MD = -0.36, 95% CI: -0.60 to -0.11, P = 0.004) and hospital LOS (MD = -1.50, 95% CI: -2.64 to -0.35, P = 0.01) but had no significant effect on the longest follow-up mortality, hospital or ICU mortality and change in Sequential Organ Failure Assessment (SOFA) score. TSAs for mortality, ICU and hospital LOS were inconclusive. CONCLUSIONS: Intravenous vitamin C administration may shorten ICU LOS and hospital LOS. It had no effect on mortality and organ failure. All TSAs were inconclusive, and the value of vitamin C for critically ill patients needs to be demonstrated in more high-quality RCTs.

The efficiency and safety of high-dose vitamin C in patients with COVID-19: a retrospective cohort study.

BACKGROUND: The inflammatory reaction is the main cause of acute respiratory distress syndrome and multiple organ failure in patients with Coronavirus disease 2019, especially those with severe and critical illness. Several studies suggested that high-dose vitamin C reduced inflammatory reaction associated with sepsis and acute respiratory distress syndrome. This study aimed to determine the efficacy and safety of high-dose vitamin C in Coronavirus disease 2019. METHODS: We included 76 patients with Coronavirus disease 2019, classified into the high-dose vitamin C group (loading dose of 6g intravenous infusion per 12 hr on the first day, and 6g once for the following 4 days, n=46) and the standard therapy group (standard therapy alone, n=30). RESULTS: The risk of 28-day mortality was reduced for the high-dose vitamin C versus the standard therapy group (HR=0.14, 95% CI, 0.03-0.72). Oxygen support status was improved more with high-dose vitamin C than standard therapy (63.9% vs 36.1%). No safety events were associated with high-dose vitamin C therapy. CONCLUSION: High-dose vitamin C may reduce the mortality and improve oxygen support status in patients with Coronavirus disease 2019 without adverse events.

Integrated analysis of microRNA and mRNA expression profiles in rats with selenium deficiency and identification of associated miRNA-mRNA network.

Selenium deficiency is closely related with various type of cardiovascular disease. However, the miRNA-mRNA regulatory network in Selenium deficiency related cardiac change remains to be understand. In the present study, a reliable Selenium deficiency rat model was established and confirmed by pathological and biochemical examination. The mRNA and miRNA expression profiles were conducted by microarray technology. Gene Ontology (GO) Analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway Analysis was performed to investigate the function of targeted genes, and the relationship between miRNA and mRNA was studied by network analysis. A total of 4931 mRNAs and 119 miRNAs was differentially expressed between any two groups (control group, low-selenium group and selenium supplementation group). GO and KEGG pathway analysis of selected miRNAs target genes found that selenium deficiency was related to several different biological processes. Furthermore, a miRNA-mRNA regulatory network was conducted to illustrate the interaction of miRNAs and these targeted genes. In conclusion, our present study provides a new insight that potential molecular mechanism of Selenium deficiency was a multiply miRNAs and mRNA caused biological change.

MicroRNA expression profiles in rats with selenium deficiency and the possible role of the Wnt/ß-catenin signaling pathway in cardiac dysfunction.

Selenium deficiency is a causative factor in heart failure and microRNAs (known as miRNAs or miRs) play an important role in numerous cardiovascular diseases. However, the changes of miRNA expression during selenium deficiency and whether selenium deficiency is involved in cardiac dysfunction remain unclear. In the present study, miRNA expression profiling was carried out in normal rats, selenium-deficient rats and selenium-supplemented rats by miRNA microarray. Cardiac function was evaluated by analyzing the plasma brain natriuretic peptide level, echocardiographic parameters and hemodynamic parameters. Cardiac glutathione peroxidase activity was assessed by spectrophotometry. The histological changes were examined by hematoxylin and eosin staining. Electrocardiograph was used to test the arrhythmia. The differentially expressed miRNAs were verified by reverse transcription-polymerase chain reaction. Additionally, the underlying mechanism associated with the Wnt/ß-catenin signaling pathway was further explored. The cardiac dysfunction of the rat with selenium deficiency was mainly associated with five upregulated miRNAs, which were miR-374, miR-16, miR-199a-5p, miR-195 and miR-30e*, and three downregulated miRNAs, which were miR-3571, miR-675 and miR-450a*. Among these, the expression of miR-374 was the highest, which may be of vital importance in rats with selenium deficiency. In conclusion, the possible mechanism of selenium deficiency-induced cardiac dysfunction was associated with the Wnt/ß-catenin signaling pathway.

Selenium deficiency is associated with endoplasmic reticulum stress in a rat model of cardiac malfunction.

The relationship between selenium (Se) deficiency-induced cardiac malfunction and endoplasmic reticulum (ER) stress is poorly understood. In the present study, 18 weaning Sprague Dawley rats were randomly fed with three different Se diets, and myocardial glutathione peroxidase (GPx) activity was measured by an enzyme activity assay. Cardiac function was evaluated by hemodynamic parameters. ER stress markers immunoglobulin-binding protein (BiP)/glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) were detected by western blotting. Our data showed that myocardial GPx activity and cardiac function were conspicuously impaired in Se-deficient rats. Expression of GRP78 and CHOP was significantly upregulated by treatment of Se deficiency. Improvements in myocardial GPx activity and cardiac function, as well as decreases in expression of GRP78 and CHOP, were observed after Se supplementation. Consequently, our data show that ER stress was involved in Se deficiency-induced cardiac dysfunction.

Selenium attenuates adriamycin-induced cardiac dysfunction via restoring expression of ATP-sensitive potassium channels in rats.

The possible mechanism of adriamycin (ADR) and/or selenium (Se) deficiency-induced cardiac dysfunction, and cardioprotective effects of Se against ADR-induced cardiac toxicity were investigated in this study. Cardiac function was evaluated by plasma brain natriuretic peptide level and echocardiographic and hemodynamic parameters. Cardiac glutathione peroxidase (GPx) activity was assessed spectrophotometrically. Expression of ATP-sensitive potassium channels (KATP) subunits-SUR2A and Kir6.2-were examined by real-time PCR and Western blotting. The results showed that cardiac function and cardiac GPx activity decreased remarkably after administration of ADR or Se deficiency; more dramatic impairment of cardiac function and cardiac GPx activity were observed after co-administration of ADR and Se deficiency. Mechanically, it is novel for us to find down-regulation of KATP subunits gene expression in cardiac tissue after administration of ADR or Se deficiency, and more significant inhibition of cardiac KATP gene expression was identified after co-administration of ADR and Se deficiency. Furthermore, cardiac toxicity of ADR was found alleviated by Se supplementation, accompanied by restoring of cardiac GPx activity and cardiac KATP gene expression. These results indicate that decreased expression of cardiac KATP is involved in adriamycin and/or Se deficiency-induced cardiac dysfunction; Se deficiency exacerbates adriamycin-induced cardiac dysfunction by future inhibition of KATP expression; Se supplementation seems to protect against adriamycin-induced cardiac dysfunction via restoring KATP expression, showing potential clinical application in cancer chemotherapy.

[Arnebia root oil promotes histological change and up-regulates bFGF and it's mRNA expression in the raw surface of the rabbits].

OBJECTIVE: To explore the molecular biological mechanism of arnebia root oil in promoting wound surface healing by observing histological change and basic fibroblast growth factor(bFGF) mRNA expression in the wound surface tissues of 2 groups, as well as the wound surface healing rate. METHOD: Experimental model of incised-wound was produced on the back of 18 New Zealand albino rabbits. The wound surfaces were randomly divided into two groups, namely, experimental group and control group. The wound surfaces in the experimental group were treated by arnebia root oil and those in control group were treated by petrolatum gauze. Then raw surfaces were evaluated by the techniques of histology, histochemistry and electron microscope and the healing rates of the raw surfaces were compared between the two groups. Content of bFGF and it's mRNA expression in wound surface tissue was also measured by means of Western-blot and RT-PCR. RESULT: The wound surface healing rate in experimental group was higher than that in control group( P < 0.05). The fibroblast, collagen and blood capillaries were comparatively richer in experimental group as compared with those in control group, and similarly, the expression of bFGF mRNA was also significantly enhanced in the experimental group as compared with control group during the various periods of treatment. In addition, the changes in the expressions of bFGF and it's mRNA paralleled the changes of healing rates in the two groups. CONCLUSION: the present results showed that amebia root oil significantly can promote the healing of raw surfaces, which may be mediated by up-regulation of bFGF expression.

[Arnebia root oil promotes wound healing and expression of basic fibroblast growth factor on the wound surface in rabbits].

OBJECTIVE: To observe the promoting effect of arnebia root oils on expression of basic fibroblast growth factor (bFGF) in skin wound of rabbits and the histomorphological changes in the wound surface, and to discuss its mechanism. METHODS: Bilateral round skin wounds were made on the back of 15 rabbits. The three wounds on one side of the back of each rabbit were treated with arnebia root oils, while the three wounds on the other side were treated with vaseline in order to promote the wound healing. The histomorphology and ultrastructure under electron microscopy of the wounds, and the rate of wound healing were examined at different time. Western blotting assay was used to detect the expression of bFGF in the wound surface. RESULTS: The healing rate of the arnebia root oils-treated wounds was evidently higher than that of the vaseline-treated wounds (P<0.05). The quantities of fibroblast, collagen and capillary in the arnebia root oils-treated wounds were much more than those in the vaseline-treated wounds, and the expression of endogenous bFGF in the arnebia root oils-treated wounds was enhanced obviously as compared with that in the vaseline-treated wounds in different period of wound healing. There existed a parallel correlation between the expression level of bFGF and the rate of wound healing. CONCLUSION: The promoting effect of arnebia root oils on wound healing may be related to increasing the expression level of basic fibroblast growth factor in the skin wound.

[Effect of arnebia root oil in promoting the tissue recovery of surface of wound and basic fibroblast growth factor (bFGF) mRNA expression].

OBJECTIVE: To explore the molecular biological mechanism of Arnebia Root oil (AO) in promoting the recovery of surface of wound by observing basic fibroblast growth factor (bFGF) mRNA expression in the wound tissue and healing rate of the wound. METHODS: Patients in the observed group with their wound treated by AO and those in the control group treated by petrolatum gauze. The wound surface healing rate was estimated and bFGF mRNA expression was observed by RT-PCR. RESULTS: Endogenous bFGF mRNA expression existed in the wound surface of both groups, but its level in the observed group at any time point was obviously higher than that in the control group respectively, with significant difference in comparison of the gray density between the two groups (P < 0.05). The wound surface healing rate kept abreast with bFGF mRNA expression in wound tissues, so it was significantly higher in the observed group than that in the control group (P < 0.05). GAPDH gene, which was taken as a parameter for internal reference, expressed with a certain amount unchanged in different periods of healing (P > 0.05 ). CONCLUSION: AO shows obviously promotive action on bFGF, an important regulatory factor on wound healing, it might complete the recovery process by stimulating the increase of bFGF.