Development and validation of the self-volume management behaviour questionnaire for patients with chronic heart failure.

AIMS: We aim to develop and validate a questionnaire on the behaviour of self-volume management of patients with chronic heart failure. METHODS AND RESULTS: Based on the specific situation theory of heart failure self-care, the items of this questionnaire were formed through literature review and expert consultation. Content validity is judged by expert consultation. Item analysis was used for further filter entries. Cronbach's alpha and retest were used for reliability. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity. The questionnaire finally contained 3 subscales and 22 items. The Cronbach's α was between 0.732 and 0.797. The reliability of the retest was between 0.983 and 0.998. In expert consultation, the I-CVI of each item was 0.92-1, and the S-CVI of each subscale was 0.99, 1.00, and 0.99. In exploratory factor analysis, each subscale has two factors. In confirmatory factor analysis, the model fits of the three subscales were good: χ2/df < 3, RMSEA < 0.08, CFI > 0.9, TLI > 0.9, and SRMR < 0.05. CONCLUSIONS: The study has shown that the questionnaire on the behaviour of self-volume management of patients with chronic heart failure has good reliability and validity. It can be used as an evaluation tool for evaluating the self-volume management behaviour of patients with chronic heart failure.

Empowered But Isolated: A Qualitative Research on Experiences of Family Caregivers of Patients With Acute Heart Failure in China.

BACKGROUND: Family caregivers play crucial roles in the self-management of patients with heart failure (HF). However, little is known about caregiving experiences of Chinese family caregivers during acute HF. OBJECTIVE: The aim of this study was to describe Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. METHODS: This is an exploratory, qualitative study using the Consolidated Criteria for Reporting Qualitative Research guidelines. Data were collected through semistructured interviews and analyzed with thematic analysis. FINDINGS: A total of 21 family caregivers of patients with acute HF were enrolled in this study. "Empowered but isolated" was identified as the overarching theme during data analysis, including 3 themes and 6 subthemes: (1) "Responsible symptom managers: leading the home-based symptom management," including 2 subthemes, "Proxy in symptom management" and "Only knowing the surface, instead of the truth"; (2) "Powerless anchors: care-seeking is a torturous journey," including 2 subthemes, "Facing discrepancies in care-seeking" and "Seeing a doctor is the last choice"; (3) "Carrying the weight forward: responsibility combing with emotional burnout," including 2 subthemes, "Living on tenterhooks" and "Submitting to fate." CONCLUSIONS: In this study, we described Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. Although empowered as proxy, they were also isolated bearing a great burden, receiving insufficient support from patients, family, and the medical system.

Characteristics of workplace violence, responses and their relationship with the professional identity among nursing students in China: a multicenter cross-sectional study.

BACKGROUND: Nursing students are one of the most vulnerable groups suffering from workplace violence. This study aimed to investigate the workplace violence incidence of Chinese nursing students during clinical practice, to describe the characteristics of violence and students' responses and to analyse the relationship between the experience of workplace violence and professional identity. METHODS: A cross-sectional study was conducted among 954 nursing students in ten universities in China through convenience sampling. Workplace violence was surveyed through Hospital Workplace Violence Questionnaire for Nursing Students. Students' professional identity was measured by Professional Identity Questionnaire for Nursing Students. Statistical methods included descriptive statistics, chi-square test, independent-samples t-test, analysis of variance and linear regression analysis. RESULTS: It was found that the incidence of workplace violence among nursing students was 42.98%. The violent incidents ranking from high to low were: verbal abuse, threat, physical attack, sexual harassment, and gathering disturbance. The majority of the nursing students chose to avoid the conflict during the incident. 86.34% of the students didn't report the incidents. More than half of the victims developed post-traumatic stress disorder after the incidents. Regression analysis results showed that workplace violence experience (ß = - 0.076, P < 0.05) was a significantly negative predictor of professional identity. CONCLUSIONS: Chinese nursing students were exposed to physical and psychological violence during clinical practice with insufficient coping solutions and psychological adjustment. The professional identity of the nursing students was significantly associated with the experience of workplace violence.

The effects of thiamine supplementation on patients with heart failure: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Micronutrients can benefit patients with heart failure (HF). Thiamine is a critical vitamin, while the impact of thiamine supplementation on patients with HF remains unclear. Systematic review and meta-analysis were conducted to evaluate the effects of thiamine supplementation on clinical outcomes in patients with HF. METHODS: Databases including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Scopus, and CNKI were searched from inception to June 29th 2022. Randomized controlled trials (RCTs) comparing thiamine supplementation with placebo were included. Meta-analysis was conducted with the software Review Manager 5.4. The quality assessment was performed according to Cochrane Risk of Bias Tool 2.0. RESULTS: Eight studies including 384 patients were included in this review. The results of overall systematic review showed no benefit of thiamine supplementation in HF patients. Compared with the control group, the experimental group had no statistically significant improvements in LVEF (Mean Difference, - 0.19; 95 % CI, - 2.78 to 0.96; I2 = 49 %; P = 0.10) in patients with chronic heart failure (CHF). Other outcomes including NYHA class, BNP or NT-proBNP, thiamine status, symptom changes, and quality of life were not improved by thiamine supplementation in CHF patients. Similarly, no improvements in clinical outcomes were found in patients with acute heart failure (AHF) in the studies included. CONCLUSIONS: This systematic review and meta-analysis found no evidence to support the effects of thiamine supplementation in patients with HF, though thiamine supplementation is promising in improving cardiac functions, thiamine status and relieving HF-related symptoms. More well-designed RCTs with large sample sizes are required.

Thirst and factors associated with thirst in hospitalized patients with heart failure in China.

BACKGROUND: Thirst is a distressing symptom and increases burden of the patients with heart failure (HF). Knowledge about thirst in HF patients is still not clear in China. OBJECTIVE: To describe thirst intensity, distress, frequency, and duration and to identify factors associated with thirst intensity in hospitalized HF patients in China. METHODS: A cross-sectional descriptive study was conducted in two public hospitals in Shanghai, China. Patients were recruited in cardiology wards. Sociodemographic and clinical data were collected by the social-demographic and disease-related questionnaire. Thirst was assessed by Visual Analog Scale (VAS, 0-100 mm), Thirst Distress Scale for HF patients (scores 8 to 40) and three questions about thirst frequency and duration. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. RESULTS: Four hundred and thirty-one patients participated in this study. Their mean (SD) thirst intensity was 47 (±22) mm, and the thirst distress was 21(±4). It was found that 75% patients had moderate to severe feeling in thirst intensity and 73% in distress. Most patients experienced thirst several times a week (33%) or several times a month (38%). Most patients (88%) felt thirst for one hour or less. The most intense thirst occurred in the morning (26%), afternoon (19%) and before sleeping (16%). Factors associated with thirst were omeprazole, renal insufficiency, coronary heart disease, high NYHA class and low room humidity. No links were found between physiological indicators of HF (ProBNP) and thirst. CONCLUSIONS: HF patients have strong sense of thirst. However, it is rarely identified by healthcare professionals. It is crucial for healthcare providers to keep an eye on patients' thirst symptoms. More attention should be paid to patients with thirst risk factors to minimize the discomfort of thirst.

[Evaluation of the effect of Er:YAG laser combined with guided bone regeneration in the treatment of peri-implantitis with osseous defects].

PURPOSE: To evaluate the clinical benefits of Er:YAG laser combined with guided bone regeneration (GBR) in the treatment of peri-implantitis-assocaited osseous defects. METHODS: Twenty-six patients (34 implants in total) who underwent implant restoration in Dental Disease Prevention and Treatment Institute, Jiading District, from 2017 to 2019 and were diagnosed with peri-implantitis with osseous defects, and randomly divided into the experimental group and control group. The two groups of patients received open flap surgery, debridement and GBR treatment. The only difference in the experimental group was the use of Er: YAG laser to modulate and remove inflammatory tissue as well as to decontaminate the implant surface, instead of traditional mechanical treatment in the control group. The probing depth (PD), bleeding on probing (BOP), and plaque index (PI), the height of the bone defect around the implant (reduce of marginal bone level, RBL) were recorded and compared. SPSS 20.0 software package was used to analyze the data. RESULTS: The PD, BOP, PI and RBL of the two groups of patients were significantly improved after treatment with different methods. There was no significant difference in the improvement of PD, BOP and PI between the two groups 6, 12 and 24 months after treatment, while the improvement of RBL in the experimental group was significantly better than that of the control group 12 and 24 months after treatment. CONCLUSIONS: In the treatment of GBR with peri-implantitis and osseous defects, Er: YAG laser therapy is more effective than traditional mechanical methods, and is more conducive to the regeneration of new bone.

iTRAQ-based proteomic and physiological analyses of broccoli sprouts in response to exogenous melatonin with ZnSO4 stress.

Exogenous melatonin (10 µM) enhances ZnSO4 (4 mM) stress tolerance and regulates the isothiocyanate content of broccoli sprouts. Nevertheless, the molecular mechanism underlying the role of melatonin in isothiocyanate metabolism under ZnSO4 stress is unclear. The effects of exogenous melatonin on growth and isothiocyanate metabolism in broccoli sprouts under ZnSO4 stress during germination were investigated by physio-biochemical methods, quantification of relative gene expression levels, and the isobaric tags for the relative and absolute quantitation (iTRAQ) labelling technique. Compared with sprouts under ZnSO4 stress alone, sprout length, fresh weight and free calcium content increased significantly in sprouts under ZnSO4 stress plus melatonin treatment while electrolyte leakage and malonaldehyde content decreased. The glucosinolate content and myrosinase activity also significantly increased in sprouts under ZnSO4 stress plus melatonin treatment compared with the control, and thus the isothiocyanate and sulforaphane content increased markedly. Meanwhile, the expression of glucoraphanin biosynthesis genes, such as MYB28, CYP83A1, AOP2, BoSAT1, and BoHMT1 was significantly induced by melatonin in sprouts under ZnSO4 stress. Furthermore, compared with sprouts under ZnSO4 stress alone, a total of 145 proteins in broccoli sprouts under ZnSO4 stress plus melatonin treatment showed differential relative abundances. These proteins were divided into 13 functional classes and revealed that pathways for sulfur metabolism, glucosinolate biosynthesis, selenocompound metabolism, biosynthesis of secondary metabolites and peroxisome were significantly enriched. The present study indicates that exogenous melatonin alleviates the adverse effects of ZnSO4 stress on sprout growth and promotes glucoraphanin biosynthesis and the hydrolysis of glucoraphanin to form isothiocyanates in broccoli sprouts.

Abnormalities in periodontal and salivary tissues in conditional presenilin 1 and presenilin 2 double knockout mice.

We used forebrain-specific conditional presenilin 1 (PS1) and presenilin 2 (PS2) double knockout mice (dKO mice), which exhibit neurodegenerative disease-like symptoms, including inflammation of the brain and periphery, to investigate whether periodontal and salivary tissues display alterations. Mandibles were dissected for alveolar bone height analysis. Maxillae were fixed and decalcified for histological observation and osteoclast detection. Submandibular glands were fixed for histological observation. The submandibular gland and the gingiva of the mandibular incisor teeth were used to assay inflammatory mediators. At 9 months, the number of osteoclasts had significantly increased in the periodontal ligament and the periodontal tissues exhibited obvious histomorphological abnormalities in the dKO mice compared to the control mice at the same age. Alveolar bone loss in dKO mice increased with age. The salivary tissues in dKO mice exhibited obvious age-dependent histomorphological abnormalities. The levels of the inflammatory mediators IL-1ß, TNF-α, and GM-CSF in the submandibular gland and gingiva also increased in an age-dependent manner. These findings suggest that inflammation in the dKO brain could expand to the periphery, including the oral tissue, which could ultimately induce abnormalities in the periodontal and salivary tissues.

Probiotic properties of lactic acid bacteria isolated from stool samples of longevous people in regions of Hotan, Xinjiang and Bama, Guangxi, China.

A total of 567 lactic acid bacteria (LAB) strains were isolated from the stool samples of longevous people in regions of Hotan, Xinjiang and Bama, Guangxi, China. In order to reduce the number of strains for further examinations, 36 isolates were screened out for further examination whilst the other strains, which had lower probiotic properties, were not suitable for yogurt production due to the absence of growth in pH 3.5 MRS medium and no curding during fermentation, and so were excluded. The result of identification by API, sequence analysis of 16S rRNA and random amplified polymorphic DNA (RAPD) analysis showed that there were three strains of Lactobacillus acidophilus, 10 strains of Lactobacillus rhamnosus, three strains of Lactobacillus casein, three strains of Lactobacillus brevis, two strains of Enterococcus faecium, two strains of Enterococcus faecalis, four strains of Bifdibacterium infantis, three strains of Bifdibacterium brevise, three strains of Bifdibacterium bifidium, two strains of Bifdibacterium adolecentis and one strain of Bifdibacterium longam among the 36 isolates. These strains were evaluated by in vitro methods including survival upon exposure to pH 2.0, 3.0 and/or 0.3% oxgall and adhesion to the human colon adenocarcinoma cell line Caco-2 as well as antimicrobial activity against potential pathogens. The results presented here show that L. rhamnosus LV108, L. rhamnosus F, B. brevise R39 and B. infantis R42 are acid and bile tolerant, adhere to the cultured human intestinal Caco-2 cell line, antagonistic activity against potential pathogenic bacteria infection in vitro, and so are potential strains for probiotic use.

[Analysis of different Lactobacillus rhamnosus by random amplified polymorphic DNA].

OBJECTIVE: We developed a molecular method to mark and differentiate Lactobacillus rhamnosus strains and to analyze genetic diversity among isolates from different sources. METHODS: Ten strains of Lactobacillus spp. were isolated from 56 feces samples of elderly people above 90 years of age in regions of Hetian, Xinjiang and Bama, Guangxi, China. We used API 50CHL test chip for strain identification. These isolates belonged to Lactobacillus rhamnosus with 98.6%-99.9% satisfactory. Ten L. rhamnosus isolates and one reference strain ATCC7496 were analyzed by random amplified polymorphic DNA (RAPD) technique to differentiate L. rhamnosus strains at molecular level. We screened 5 random primers named P14, OPG28, OPG25, P7 and P4 and developed optimum RAPD amplifying system. RESULTS: The clear and stable DNA fingerprints of each strain were obtained; the amplicon size ranged from 100 to 2000 bp, and the band patterns showed polymorphism among different L. rhamnosus strains. Genetic similarity coefficients based on RAPD patterns varied from 0.581 to 0.935, which suggested genetic diversity and different genetic relationship among these strains. Eleven strains of Lr could be clustered into 5 groups (group A to E) at the level of 80% similarity. Seven L. rhamnosus strains isolated from Hetian, Xinjiang, were grouped in group B and C, 3 isolates from Bama, Guangxi, were grouped in group D and E. CONCLUSION: RAPD method is feasible for molecular mark and differentiation of L. rhamnosus strains and high level of genetic diversity and different relationship are found among L. rhamnosus isolates.