Correlations between activation, family adaptation, and self-perceived burden in breast cancer patients with an implanted venous access port: A cross-sectional study.

We found that activation and family adaptation on the self-perceived burden of breast cancer patients with an implanted venous access port (IVAP), and to analyze the correlations among these scores. A total of 256 patients completed a general data questionnaire, the Patient Activation Measure (PAM), the Family adaptation and Cohesion Scale II-Chinese version (FACES-II-CV), and the Self-perceived Burden Scale (SPBS). The total scores for activation, family adaptation, and self-perceived burden were 63.31 ± 18.92, 42.72 ± 7.937, and 28.55 ± 7.89, respectively. We analyzed activation and family adaptation were associated with self-perceived burden (P < .05) the patients' self-perceived burden main factors is included Main caregiver, disease stage, complications, Type of health insurance, activation, and family adaptation. The activation, family adaptation, and self-perceived burden of breast cancer patients with an IVAP are closely related, which suggests that clinical workers should consider the patient family to formulate an intervention plan to improve patient activation, and thus reduce the self-perceived burden. For example, hospitals regularly conduct breast cancer health education activities, or invite psychological counselors to provide services to patients.

Influences of Heider Balance on Knowledge, Attitude, Practice, and Quality of Life in Bladder Cancer Patients after Urinary Diversion.

Objective: To explore the influences of Heider balance on knowledge, attitude, practice (KAP), and quality of life in bladder cancer patients after urinary diversion. Methods: A set of bladder cancer patients after urinary diversion in our hospital from January 2016 to December 2020 were included in this study. Patients who received out-hospital intervention based on Heider balance were included in the observation group (85 cases). Meanwhile, patients who received routine out-hospital intervention were included in the control group (85 cases), and these patients matched with the observation group by gender, age, and education level. The scores of KAP, WHO quality of life-100 (WHOQOL-100) before discharge and at 6 months after discharge, and the rate of complications were compared in the two groups. Results: At 6 months after discharge, the score of these items of KAP including basic knowledge of disease, procedure of pouch replacement, dealing with pouch leakage, skin care of stoma, purchase and storage of pouch, dealing with stoma complications, optimistic mentality for disease, optimistic mentality for stoma, trust in medical staff, willingness to correct bad habits, confidence in maintaining health behavior, maintaining in health dietary habit, maintaining in health behavior, learning from relevant books, learning from relevant videos, experienced in pouch replacement, and experienced in care of stoma of the observation group were significantly higher than those of the control group (t = 6.144, 9.366, 3.129, 3.809, 4.173, 5.923, 2.788, 8.871, 3.291, 10.797, 7.067, 7.805, 3.828, 9.454, 2.827, 4.059, and 8.662, respectively, all P < 0.05). The scores of 16 items of WHOQOL-100 such as energy and fatigue, sleep and rest, positive feelings, thinking, learning, memory and concentration, self-esteem, body image and appearance, negative feelings, mobility, activities of daily living, dependence on medical support, personal relationships, social support, health and social care: availability and quality, opportunities to get new information/skills, opportunities for recreation and leisure, and quality of life from viewpoint in the observation group were significantly higher than those in the control group (t = 2.666, 2.571, 2.961, 3.453, 4.279, 2.781, 3.775, 4.807, 5.850, 4.194, 3.324, 3.873, 5.118, 3.244, 2.956, and 4.218, respectively, all P < 0.05). The rate of complications of the observation group was significantly lower than that of the control group (x 2 = 5.829, P < 0.05). Conclusion: The Heider balance can help to reduce the rate of complications, improve knowledge, attitude, practice, and quality of life in urinary diversion patients. These merits make it an attractive approach in guidance of out-hospital intervention.

Scutellarin Reduces Cerebral Ischemia Reperfusion Injury Involving in Vascular Endothelium Protection and PKG Signal.

Flavonoid glycoside scutellarin (SCU) has been widely applied in the treatment of cerebral ischemic diseases in China. In this article, we conducted research on the working mechanisms of SCU in hypoxia reoxygenation (HR) injury of isolated cerebral basilar artery (BA) and erebral ischemia reperfusion (CIR) injury in rat models. In isolated rat BA rings, HR causes endothelial dysfunction (ED) and acetylcholine (ACh) induces endothelium-dependent vasodilation. The myography result showed that SCU (100 µM) was able to significantly improve the endothelium-dependent vasodilation induced by Ach. However, SCU did not affect the ACh-induced relaxation in normal BA. Further studies suggested that SCU (10-1000 µM) dose-dependently induced relaxation in isolated BA rings which were significantly blocked by the cGMP dependent protein kinase (PKG) inhibitor Rp-8-Br-cGMPs (PKGI-rp, 4 µM). Pre-incubation with SCU (500 µM) reversed the impairment of endothelium-dependent vasodilation induced by HR, but the reversing effect was blocked if PKGI-rp (4 µM) was added. The brain slice staining test in rats' model of middle cerebral artery occlusion (MCAO) induced CIR proved that the administration of SCU (45, 90 mg/kg, iv) significantly reduced the area of cerebral infarction. The Western blot assay result showed that SCU (45 mg/kg, iv) increased brain PKG activity and PKG protein level after CIR surgery. In conclusion, our findings suggested that SCU possesses the ability of protecting brain cells against CIR injury through vascular endothelium protection and PKG signal.

Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China.

The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.

Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China.

OBJECTIVES: To provide an empirical examination of patient-provider relationships (PPR) and its association with organizational and individual factors. METHODS: A national cross-sectional survey was conducted by stratified cluster sampling in 77 hospitals across seven provinces in China between July 2014 and April 2015, involving 3621 doctors, 5561 nurses, and 8022 patients with response rates of 62.93%, 61.16%, and 33.08%, respectively. Self-perceived PPR was the outcome variable. Organizational factors included hospital type (western medicine [WM] and traditional Chinese medicine [TCM] hospital); hospital level (tertiary and secondary hospital); area of specialization (internal medicine and surgery); ratio of doctors (nurses) to ward beds; doctors/nurses' concerns about performance assessment; and patients' perceptions of healthcare cost. Individual factors included consultation, listening to patients and socio-demographic factors. RESULTS: 54.6% of doctors, 36.6% of nurses, and 10.2% of patients perceived PPR as poor. Organizational factors independently associated with providers' perception of poor PPR included hospital type (WM vs TCM: OR = 1.25 [95% CI: 1.06-1.47]) and concerns about performance assessment (high vs low levels: OR = 1.40 [95% CI: 1.14-1.72]) for doctors, and concerns about performance assessment (average vs low levels: OR = 0.79 [95% CI: 0.67-0.93]) for nurses. Those associated with patients' perception of poor PPR included hospital type (WM vs TCM: OR = 0.63 [95% CI: 0.53-0.74]) and hospital level (tertiary vs secondary: OR = 0.65 [95% CI: 0.51-0.82]). Doctors and nurses reporting listening to patients "frequently" had better perceptions of PPR (OR = 0.46 [95%CI: 0.38-0.56] and 0.49 [95% CI: 0.41-0.59] for doctors and nurses, respectively), as did their patients (OR = 0.24 [95% CI: 0.18-0.31] and 0.54 [95% CI: 0.35-0.84] for doctors and nurses, respectively). CONCLUSIONS: Although our findings require validation in different organizational settings given the likely variability of these associations across systems, our results suggest that implementing moderate levels promoting the level of medical treatment, and broadening doctors/nurses training regarding listening to patients, may benefit to enhance PPR.

[Characteristics of Atmospheric Dry and Wet Deposition of Trace Metals in the Hinterland of the Three Gorges Reservoir, China].

In order to investigate the characteristics of atmospheric trace metals deposition in the hinterland of the Three Gorges Reservoir, the wet and dry deposition samples were collected at an urban area sampling site in Wanzhou during January to June 2014. Besides, the samples were collected at five other sampling sites in April 2014 for comparative analysis, including factory region, town suburb, nature reserve, county suburb, and rural area. pH, conductivity, and trace metals (Al, As, B, Ba, Bi, Cd, Co, Cr, Cu, Fe, Li, Mn, Pb, Ni, Sb, Sr, Sn, Ti, Zn, V) were analyzed. In urban area, the acid rain frequency was 48.44% , and the acid rain occurred mainly in the period of January to April. The order of acid rain frequency in various functional areas was factory region > urban area > county suburb > town suburb > nature reserve > county rural area. All of the trace metals in wet deposition during the sampling period were lower than the National Environmental Quality Standard for Surface Water Standard of Class III. Cd, Cu, Ph and Zn were found exceeding the standard of class I , and the pollution in factory region was more serious compared to other functional areas. The extract pH of dry deposition in urban area was in the range of 4.91-6.74, with an average value of 5.79. The order of dry deposition in various functional areas was factory region > county suburb > urban area > county rural area > town suburb > nature reserve, which was exactly the same as that of the wet deposition, indicating the similar sources of dry and wet deposition. In urban area, the contents of Ba, Co, Cu, Cr, Li, Mn, Ni, Sr, Zn in dry deposition were greater than those in wet deposition, but the contents of Al, As, B, Bi, Cd, Fe, Ph, Sb, Sn, Ti, V showed the opposite trend. Analysis of the enrichment factors showed that Al was in moderate enrichment, while Bi and Cd were significantly enriched.

Effects of a family-assisted smoking cessation intervention based on motivational interviewing among low-motivated smokers in China.

OBJECTIVE: To test the efficacy of a family-assisted smoking cessation intervention based on Motivational interviewing (MI) among low-motivated Chinese smokers. METHODS: A two-armed randomized controlled trial study design was utilized. 159 Smoker-supporter pairs were randomly allocated to the intervention (a family-assisted MI intervention-77) or control (an intensity-matched health education-82) group (IG & CG). Change in smoking characteristics, communication characteristics, Partner Intervention Questionnaire (PIQ), Decisional Balance Scale (DBL), and Situational Temptations Scale (STP) were measured at baseline, post-intervention, 3-month and 6-month follow-up. RESULTS: Compared to CG, IG had more significant increase over time in self-report quitting attempts of at least 24h, biochemically verified 7-day smoking abstinence, the Positive dimension of PIQ and the Cons in DBL, whereas the daily cigarettes smoked, the Pros in DBL and STP were showed more significant decrease over time in IG (P<0.05). After intervention, the communication frequency and satisfactory were also improved by smokers (P<0.01). CONCLUSION: The family-assisted MI intervention is more effective in changing the smoking behaviors and increasing the communication between smokers and family, than health education. PRACTICAL IMPLICATIONS: Using the family-assisted smoking cessation intervention based on MI, community health service providers can influence and empower low-motivated smokers positively for quit smoking.

[Determination of metal elements in PM2. 5 by ICP-OES with microwave digestion].

In the present work, a method was developed for determining lead, zinc, copper, cadmium, znd chromium in PM2. 5 by inductively coupled plasma-optical emission spectrometry (ICP-OES) analysis with microwave digestion and glass fibre filter collection of samples. The microwave digestion systems were investigated and the experimental conditions were optimized. The results show that (1) HNO3-H2O02 digestion system is more stable and complete than HNO3-HCl and HNO3-H2 SO4 digestion systems; (2) The most sensitive emission wave length of lead, zinc, copper, cadmium, and chromium are 220.353, 213.857, 327.393, 228.802, and 267.716 nm, respectively; (3) The highest signal-to-noise ratios were observed under the conditions: RF power of 1 300 W, peristaltic pump flow rate of 1.5 mL x min(-1), cooling gas flow rate of 15 L x min(-1), and carrier gas flow rate of 0.8 L x min(-1). In addition, the detection limit for these elements ranged between 2.02 x 10(-3) and 8.20 x 10(-3(µg x mL(-1), the relative standard deviations (RSD, n = 6) for the samples were in the range of 1.86%-2.82%, and the recovery for the elements determined was from 91.6% to 103.7%. The proposed method was used for determination of the above five elements in atmospheric fine particulate matter at Wanzhou Monitoring Site of Chongqing Institute of Green and Intelligent Technology. The results revealed that the atmospheric fine particulate matter at this monitoring site was not polluted by cadmium and chromium, lead was at the level of potential contamination, while zinc and copper were at the level of slight pollution.

Protection of preconditioning, postconditioning and combined therapy against hepatic ischemia/reperfusion injury.

OBJECTIVE: To study the protective effect of ischemic preconditioning (I-pre) and ischemic postconditioning (I-post) against ischemia/reperfusion (I/R) injury in rat's liver. METHODS: Using rat model of hepatic segmental I/R injury, rats were divided into 5 groups: Group A (sham group), Group B (I/R injury), Group C (I-pre group), Group D (I-post group) and Group E (combined treatment of I-pre and I-post). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and myeloperoxidase (MPO) in hepatic tissues were determined, respectively. In addition, 7 days'survival of Groups B, C, D and E were evaluated. RESULTS: Compared with Group B, Groups C, D and E exhibited significantly decreased ALT and AST release, minimized tissue injury, suppressed values of MDA and MPO, increased activities of SOD, GSH-Px and GSH (P less than 0.05), as well as improved animal survival. The differences among Groups C, D and E were not statistically significant. CONCLUSIONS: I-pre, I-post and combined therapy of I-pre and I-post have protective effect against hepatic I/R injury, which is correlated with its function of reducing the production of reactive oxygen species, maintaining the activities of antioxidant systems and suppressing neutrophils recruitment. No additive effect can be obtained in Group E.

A novel mouse model of experimental asthma.

BACKGROUND: Animal models that mimic the pulmonary features observed in human asthma are important tools to study the mechanism(s) of allergen-induced asthma. Cockroach and dust mite allergens are two common allergens found in the 'inner city' environment. In this study, we examined the interaction between recombinant cockroach (r Bla g 2) and dust mite (r Der f 1) allergens in inbred mouse strain (A/J). The tested hypothesis was that there are enhanced effects of exposure to r Bla g 2 and r Der f 1 allergens in the airway inflammatory response in A/J mice. METHODS: Five groups of mice (male, 6-8 weeks) were examined: vehicle (saline) controls; adjuvant (alum) controls; r Bla g 2 immunized (0.01-10 microg/mouse), r Der f 1 immunized (0.01-10 microg/mouse), and combined immunization with r Der f 1 (0.05 microg/mouse) and r Bla g 2 (0.0 5 microg/mouse). Mice were immunized at days 0 and 7, challenged by oro-tracheal inhalation with r Der f 1 and/or r Bla g 2 allergen at day 14, and were studied and sacrificed on day 17. Airway hyperreactivity was measured by peak airway pressure and airway pressure time index (APTI). Differential cell analysis and total proteins in bronchoalveolar lavage returns were used to assess airway inflammation and epithelial injury. RESULTS: Dose-related statistically significant increases in peak pressure, APTI, total cells, eosinophils, epithelial cells, but not total proteins, were induced by r Bla g 2 challenge in r Bla g 2-immunized mice. Similar allergen-induced dose-related increases in airway total cells, eosinophils, epithelial cells and total proteins were observed in r Der f 1 immunized mice. Compared to either allergen alone, enhanced airway inflammation and epithelial damage, but not airway reactivity, were detected in the combined group. CONCLUSION: This novel mouse model will allow investigation of the immunopathogenesis of human asthma and should provide insight into the common form of 'inner city asthma'.

Role of NRF2 in protection against hyperoxic lung injury in mice.

NRF2 is a transcription factor important in the protection against carcinogenesis and oxidative stress through antioxidant response element (ARE)-mediated transcriptional activation of several phase 2 detoxifying and antioxidant enzymes. This study was designed to determine the role of NRF2 in the pathogenesis of hyperoxic lung injury by comparing pulmonary responses to 95-98% oxygen between mice with site-directed mutation of the gene for NRF2 (Nrf2-/-) and wild-type mice (Nrf2+/+). Pulmonary hyperpermeability, macrophage inflammation, and epithelial injury in Nrf2-/- mice were 7.6-fold, 47%, and 43% greater, respectively, compared with Nrf2+/+ mice after 72 h hyperoxia exposure. Hyperoxia markedly elevated the expression of NRF2 mRNA and DNA-binding activity of NRF2 in the lungs of Nrf2+/+ mice. mRNA expression for ARE- responsive lung antioxidant and phase 2 enzymes was evaluated in both genotypes of mice to identify potential downstream molecular mechanisms of NRF2 in hyperoxic lung responses. Hyperoxia-induced mRNA levels of NAD(P)H:quinone oxidoreductase 1 (NQO1), glutathione-S-transferase (GST)-Ya and -Yc subunits, UDP glycosyl transferase (UGT), glutathione peroxidase-2 (GPx2), and heme oxygenase-1 (HO-1) were significantly lower in Nrf2-/- mice compared with Nrf2+/+ mice. Consistent with differential mRNA expression, NQO1 and total GST activities were significantly lower in Nrf2-/- mice compared with Nrf2+/+ mice after hyperoxia. Results demonstrated that NRF2 has a significant protective role against pulmonary hyperoxic injury in mice, possibly through transcriptional activation of lung antioxidant defense enzymes.

Linkage analysis of susceptibility to hyperoxia. Nrf2 is a candidate gene.

A strong role for reactive oxygen species (ROS) has been proposed in the pathogenesis of a number of lung diseases. Hyperoxia (> 95% oxygen) generates ROS and extensive lung damage, and has been used as a model of oxidant injury. However, the precise mechanisms of hyperoxia-induced toxicity have not been completely clarified. This study was designed to identify hyperoxia susceptibility genes in C57BL/6J (susceptible) and C3H/HeJ (resistant) mice. The quantitative phenotypes used for this analysis were pulmonary inflammatory cell influx, epithelial cell sloughing, and hyperpermeability. Genome-wide linkage analyses of intercross (F2) and recombinant inbred cohorts identified significant and suggestive quantitative trait loci on chromosomes 2 (hyperoxia susceptibility locus 1 [Hsl1]) and 3 (Hsl2), respectively. Comparative mapping of Hsl1 identified a strong candidate gene, Nfe2l2 (nuclear factor, erythroid derived 2, like 2 or Nrf2) that encodes a transcription factor NRF2 which regulates antioxidant and phase 2 gene expression. Strain-specific variation in lung Nrf2 messenger RNA expression and a T --> C substitution in the B6 Nrf2 promoter that cosegregated with susceptibility phenotypes in F2 animals supported Nrf2 as a candidate gene. Results from this study have important implications for understanding the mechanisms through which oxidants mediate the pathogenesis of lung disease.