Development and psychometric testing of physiopsychological disorders scale for medical rescuers fighting epidemics in China.

OBJECTIVE: Develop and psychometrically test the physiopsychological disorders scale for medical rescuers fighting epidemics (PDS-MRFE). METHOD: A three-phase approach was used to develop and test the physiopsychological disorders scale: (1) creating the item pool, (2) preliminarily evaluating items, and (3) refining the scale and estimating the psychometric properties. The items of the instrument were generated based on a comprehensive literature review and a qualitative study conducted with 31 medical rescuers (18 nurses and 13 doctors) fighting epidemics. A preliminary evaluation of items was conducted using content validity which was evaluated by a panel of 15 experts. Validity and reliability examinations were conducted to refine the scale and evaluate its psychometric properties. This was done using two different samples. Specifically, Sample A (360 medical rescuers) was employed for item reduction and exploratory factor analysis (EFA), and Sample B (287 medical rescuers) was employed for the confirmatory factor analysis (CFA) and determination of other psychometric properties (i.e., reliability, concurrent, convergent, and discriminant validity), which further confirmed the structure of the scale and evaluated its final psychometric properties. RESULTS: The final scale has 39 items with three subscales, including before, during, and after rescue. The exploratory factor analysis result indicated that the before-rescue scale of four items, during-rescue of 21 items, and after-rescue of 14 items explained 52.07%, 69.75%, and 52.30% of the cumulative variance, respectively. The confirmatory factor analysis result indicated that model fit indices of three subscales were acceptable and showed evidence of adequate content, convergent, discriminate, and concurrent validity. The Cronbach's α coefficients for each subscale and all dimensions ranged from 0.81 to 0.92, indicating good reliability for the PDS-MRFE. CONCLUSIONS: The physiopsychological disorders scale is a psychometrically valid and reliable instrument and can be used in both clinical practice and research to evaluate different physiopsychological disorders at different medical rescue stages among medical rescuers fighting epidemics.

Distinct dyadic quality of life profiles among patient-caregiver dyads with advanced lung cancer: a latent profile analysis.

PURPOSE: This study aimed to identify the heterogeneity of dyadic quality of life (QoL) profiles, determine whether these profiles differ in terms of demographic and medical factors, neuroticism, resilience, and family functioning, and explore the combined effect of patient and caregiver neuroticism, resilience, and family functioning on dyadic QoL profiles. METHODS: A cross-sectional study was conducted with 304 advanced lung cancer patient-caregiver dyads. Self-report questionnaires were administered to patient-caregiver dyads to assess demographic and medical characteristics, neuroticism, resilience, family functioning, and QoL. RESULTS: The latent profile analysis identified four subgroups of dyadic QoL: patient-low-caregiver-high profile (38.82%), patient-high-caregiver-high profile (22.37%), patient-high-caregiver-low profile (19.74%), and patient-low-caregiver-low profile (19.08%). Additionally, when both patients and their caregivers had a high level of neuroticism or low level of resilience and low family functioning, compared with only member having them, there was a higher risk of poorer dyadic QoL. CONCLUSIONS: Our study identified the four heterogeneities of dyadic QoL profiles among advanced lung cancer patient-caregiver dyads. Future dyadic interventions should consider the heterogeneity of dyadic QoL in this population and prioritize patient-caregiver dyads at risk of poor dyadic QoL. Furthermore, when high neuroticism, low resilience, or family functioning coexist between patients and their caregivers, both parties exhibit much lower dyadic QoL.

Circulating eosinophils associated with responsiveness to COVID-19 vaccine and the disease severity in patients with SARS-CoV-2 omicron variant infection.

OBJECTIVE: This study aimed to investigate the longitudinal circulating eosinophil (EOS) data impacted by the COVID-19 vaccine, the predictive role of circulating EOS in the disease severity, and its association with T cell immunity in patients with SARS-CoV-2 Omicron BA.2 variant infection in Shanghai, China. METHODS: We collected a cohort of 1,157 patients infected with SARS-CoV-2 Omicron/BA.2 variant in Shanghai, China. These patients were diagnosed or admitted between Feb 20, 2022, and May 10, 2022, and were classified as asymptomatic (n = 705), mild (n = 286) and severe (n = 166) groups. We compiled and analyzed data of patients' clinical demographic characteristics, laboratory findings, and clinical outcomes. RESULTS: COVID-19 vaccine reduced the incidence of severe cases. Severe patients were shown to have declined peripheral blood EOS. Both the 2 doses and 3 doses of inactivated COVID-19 vaccines promoted the circulating EOS levels. In particular, the 3rd booster shot of inactivated COVID-19 vaccine was shown to have a sustained promoting effect on circulating EOS. Univariate analysis showed that there was a significant difference in age, underlying comorbidities, EOS, lymphocytes, CRP, CD4, and CD8 T cell counts between the mild and the severe patients. Multivariate logistic regression analysis and ROC curve analysis indicate that circulating EOS (AUC = 0.828, p = 0.025), the combination of EOS and CD4 T cell (AUC = 0.920, p = 0.017) can predict the risk of disease severity in patients with SARS-CoV-2 Omicron BA.2 variant infection. CONCLUSIONS: COVID-19 vaccine promotes circulating EOS and reduces the risk of severe illness, and particularly the 3rd booster dose of COVID-19 vaccine sustainedly promotes EOS. Circulating EOS, along with T cell immunity, may have a predictive value for the disease severity in SARS-CoV-2 Omicron infected patients.

Clinical characteristics and risk factors predictive of pulmonary embolism complicated in bronchiectasis patients: a retrospective study.

OBJECTIVE: Pulmonary embolism (PE) is a rare complication in bronchiectasis (BE) patients associated with a high rate of mortality and morbidity. However, data regarding bronchiectasis patients complicated with PE are limited. Early diagnosis of PE in bronchiectasis patients can improve the prognosis, this study aimed to investigate the clinical features and potential risk factors for early diagnosis of PE in bronchiectasis patients. METHODS: Data of Patients were collected from Tongji Hospital of Tongji University of China. Bronchiectasis patients complicated with pulmonary embolism were named as BE/PE group (n = 63), as well as contemporaneous aged- and sex-matched bronchiectasis patients without pulmonary embolism named as BE group (n = 189), at a ratio of 1:3(cases to controls). Clinical parameters and risk factors were analyzed. RESULTS: Univariate analysis shows that long-term bed rest, chronic lung disease, autoimmune disease, peripheral artery disease (PAD), tuberculosis history, dyspnea, blood homocysteine, CD4/CD8 ratio, or SIQIIITIII syndrome were closely correlated with the incidence of PE in the bronchiectasis patients (p < 0.05). Multivariate logistic regression analysis of significant variables showed that CD4/CD8 ratio (OR 1.409, 95% CI 1.045-1.901) and autoimmune disease (OR 0.264, 95% CI 0.133-0.524) are independent risk factors for BE/PE patients, compared with the BE patients. 53 out of 189 (28.0%) BE patients had hemoptysis, and 15 out of 63 (23.8%) BE/PE patients had hemoptysis (p > 0.05). CONCLUSIONS: The coexistence of pulmonary embolism and bronchiectasis are rarely encountered and easily to be ignored. Early identification of the clinical characteristic and potential risk factors of pulmonary embolism in bronchiectasis patients may help optimize the treatment strategies.

Porous boron nitride nanofibers as effective nanofillers for poly(vinyl alcohol) composite hydrogels with excellent self-healing performances.

New composite hydrogels with excellent self-healing properties were prepared by combining poly(vinyl alcohol) (PVA) and boron nitride nanofibers (BNNFs) via a facile one-pot assembly method. One-dimensional porous BNNFs with high aspect ratio, abundant hydroxyl functional groups, especially excellent flexibility which has been first demonstrated in experiments, can act as a decent inorganic nanofillers to effectively improve the mechanical and self-healing properties of PVA hydrogels. Both the tensile and compression performances of hydrogels have been greatly improved by the trace addition of BNNFs (only ∼1.25 wt%). Compared with other BN nanofillers with spherical particles and lamellar morphologies, BNNFs with high aspect ratios and good flexibility play a unique role in the preparation of PVA composite hydrogels with cross-linked three-dimensional polymeric networks. This can be explained by the different topological structures of composite hydrogels formed. The abundant hydroxyl functional groups can form a lot of reversible hydrogen bonds with the molecular chains of PVA, so the as-prepared hydrogels have a high self-healing efficiency. The best healing efficiency of the composite hydrogels with 2.25 wt% BNNFs reaches as high as 97.31% after self-healing for 30 minutes. The good flexibility of BNNFs is beneficial to the movement of the PVA chain, which is beneficial to the self-healing process of composite hydrogels. The outstanding self-healing performance is very important for the application of composite hydrogels in the biomedical field and wearable flexible devices.

Eudragit S100-Coated Chitosan Nanoparticles Co-loading Tat for Enhanced Oral Colon Absorption of Insulin.

In order to improve oral absorption of insulin, especially the absorption at the colon, Eudragit S100® (ES)-coated chitosan nanoparticles loading insulin and a trans-activating transcriptional peptide (Tat) were employed as the vehicle. In vitro releases of insulin and Tat from ES-coated chitosan nanoparticles had a pH-dependant characteristic. A small amount of the contents was released from the coated nanoparticles at pH 1.2 simulated gastric fluid, while a fairly fast and complete release was observed in pH 7.4 medium. Caco-2 cell was used as the model of cellular transport and uptake studies. The results showed that the cellular transport and uptake of insulin for ES-coated chitosan nanoparticles co-loading insulin and Tat (ES-Tat-cNPs) were about 3-fold and 4-fold higher than those for the nanoparticles loading only insulin (ES-cNPs), respectively. The evaluations in vivo of ES-Tat-cNPs were conducted on diabetic rats and normal minipigs, respectively. The experimental results on rats revealed that the pharmacodynamical bioavailability of ES-Tat-cNPs had 2.16-fold increase compared with ES-cNPs. After oral administration of nanoparticle suspensions to the minipigs, insulin bioavailability of ES-Tat-cNPs was 1.73-fold higher than that of ES-cNPs, and the main absorption site of insulin was probably located in the colon for the two nanoparticles. In summary, this report provided an exploratory means for the improvement of oral absorption of insulin.

[Analysis on clinical palpation laws of muscle meridian focus in scapulohumeral periarthritis].

OBJECTIVE: To explore the distribution rules of proximal and distal focus of muscle meridian region in scapulohumeral periarthritis. METHODS: Three hundred and six shoulder joints of affected side were selected in 216 patients of scapulohumeral periarthritis. Under the guidance of muscle meridian theory, with the anatomical characteristics of muscle meridian focuses, the frequency and location where proximal and distal focus appeared were calculated by palpation. RESULTS: The percentages of the frequency that the focus of muscle meridian of Hand-Yangming, Hand-Shaoyang, Hand-Taiyang, and three yin meridians of hand appeared at proximal points of shoulder joint were 25.6% (1 146/5 657), 30.9% (1 749/5 657), 19.0% (1 075/5 657), and 24.5% (1 387/5 657), respectively, the focuses of muscle meridian region were Jianyuci, Juguci, Xiaoshuoci, Naohuici, etc. The percentages of the frequency that the focus of muscle meridian region appeared at distal points of shoulder joint were 31.77% (287/905), 23.2% (210/905), 10.9% (99/905), and 34.1% (304/905), the focuses of muscle meridian were Yangxici, Shousanlici, Yangchici, etc. CONCLUSION: The location and frequency of proximal and distal focus of muscle meridian in scapulohumeral periarthritis are closely related with the anatomical structure and biomechanical characteristics of the shoulder joints, thus new therapy for scapulohumeral periarthritis is implied.

Aldose reductase is involved in the development of murine diet-induced nonalcoholic steatohepatitis.

Hepatic aldose reductase (AR) expression is known to be induced in liver diseases, including hepatitis and hepatocellular carcinoma. However, the role of AR in the development of these diseases remains unclear. We performed this current study to determine whether and how AR might be involved in the development of diet-induced nonalcoholic steatohepatitis. Our results showed that the level of AR protein expression was significantly higher in db/db mice fed the methionine-choline-deficient (MCD) diet than in mice fed the control diet. In parallel with the elevation in AR, steatohepatitis was observed in MCD diet-fed mice, and this diet-induced steatohepatitis was significantly attenuated by lentiviral-mediated knock-down of the AR gene. This suppressive effect of AR knock-down was associated with repressed levels of serum alanine aminotransferase and hepatic lipoperoxides, reduced mRNA and protein expression of hepatic cytochrome P450 2E1 (CYP2E1), and decreased mRNA expression of pro-inflammatory tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Moreover, AR-induced elevations on the level of CYP2E1 expression, reactive oxygen species, mRNA expression of TNF-α and IL-6 were confirmed in AML12 hepatocytes. Further, lentiviral-mediated knock-down of AR ameliorated MCD diet-induced collagen deposition in the livers of db/db mice. With the improvement in liver fibrosis, the mRNA levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-2 (MMP-2), two genes involved in hepatic fibrogenesis, were found to be significantly suppressed, while TIMP-2 and MMP-13 were unaffected. Together these data indicate that inhibition of AR alleviates the MCD diet-induced liver inflammation and fibrosis in db/db mice, probably through dampening CYP2E1 mediated-oxidative stress and ameliorating the expression of pro-inflammatory cytokines.