Application of a standardized early activity program on enhanced recovery after surgery in patients after surgery for pulmonary nodules.

BACKGROUND: Early postoperative activity, an important part of enhanced recovery after surgery (ERAS) in clinical practice, is considered to be a significant component of postoperative quality care. OBJECTIVE: To evaluate the effect of a standardized early activity program on ERAS in patients after surgery for pulmonary nodules. METHODS: A total of 100 patients with pulmonary nodules who underwent a single-port thoracoscopic segmental resection or a wedge resection of the lung were selected for the present study. These patients were divided into a control group (n= 50) and an intervention group (n= 50) by a digital random method. The patients in the control group received routine perioperative nursing intervention for thoracic surgery due to lung cancer, and those in the intervention group received an intervention using a standardized early activity program along with routine nursing care. The evaluation indexes in both groups included postoperative indwelling time of the closed chest drainage tube, the time to the first off-bed activity after surgery, the incidence of postoperative pulmonary complications, the length of postoperative hospital stay, and patient satisfaction. RESULTS: The postoperative indwelling time of the closed chest drainage tube and the time to the first off-bed activity in the intervention group were less than in the control group. The length of the postoperative hospital stay in the intervention group was shorter than in the control group, and the patient satisfaction in the intervention group was higher than in the control group. The difference for these evaluation indexes were statistically significant (P< 0.05). The number of cases of postoperative complications was four and eight in the intervention group and the control group, respectively, and the difference was not statistically significant (P> 0.05). CONCLUSION: A standardized early activity program is a safe and effective nursing measure for ERAS for patients after surgery for pulmonary nodules, which can promote earlier off-bed activity, shorten the postoperative indwelling time of the closed chest drainage tube, shorten the postoperative hospital stay, improve patient satisfaction, and promote rapid recovery.

The Application and Influence of Hospice Care Among Patients with Advanced Esophageal Cancer.

OBJECTIVE: To investigate the application effect of hospice care in patients with advanced esophageal cancer (EC), provide a practical basis for improving sleep quality, dignity, and subjective well-being, and relieving depression and anxiety in patients with advanced EC. METHODS: A randomized cluster sampling method was used to select 60 patients with advanced EC who received routine intervention (control group) and 64 patients with advanced EC who received hospice care (study group). The intervention time was three months, and the self-rated anxiety scale (SAS) before and after the interventions was compared between the two groups. The Hamilton Depression Scale (HAMD), the Pittsburgh Sleep Quality Index (PSQI), the General Well-being Scale (GWB), the Patient Dignity Scale (PDI), and patients' physical pain state were recorded. RESULTS: No significant differences were found in the HAMD, SAS, PSQI, GWB, or PDI scores between the two groups before the interventions (P > 0.05); after the interventions, the HAMD, SAS, PSQI, and PDI scores of the two groups were significantly decreased, and the HAMD, SAS, PSQI, and PDI scores of the study group were lower compared with the control group. The GWB scores of the two groups were significantly increased, and those of the study group were significantly higher compared with the control group; the difference was statistically significant (P < 0.05). After the interventions, pain grades of III and above decreased in both groups to grade II, and pain sensation in the study group was lower compared with the control group; the difference was statistically significant (P < 0.05). CONCLUSION: Hospice care can reduce the level of pain related to depression and anxiety in patients with advanced EC and improve their sleep quality, as well as their sense of dignity and subjective well-being.

[Study on Health-related Quality of Life in Patients with Jiang's Gastroesophageal Anastomosis after Oncologic Esophagectomy].

OBJECTIVE: To compare the difference of health-related quality of life after oncologic esophagectomy between the patients using Jiang's gastroesophageal anastomosis and traditional end-to-end gastroesophageal anastomosis. METHODS: A total of 419 patients (223 in Jiang's anastomosis group, and 196 in end-to-end anastomosis group) underwent minimal invasive esophagectomy with cervical anastomosis from October 2012 to August 2016. All patients received radical esophageal cancer resection and cervical anastomosis. EORTC-QLQ-C30 and QLQ-OES18 were used to assess the health-related quality of life at the 1st, 3rd, 6th, 12th, 24th month after esophagectomy. RESULTS: There were 25 dimensions and items in EORTC-QLQ-C30 and QLQ-OES18. The postoperative quality of life decreased obviously at the 1st month and then recovered obviously at the 6th month after the surgery, and it ranged small at the 12th and 24th month. Compared with end-to-end anastomosis group, Jiang's anastomosis group had less reflux and less cough at the 1st month (P=0.023, P=0.010) and the 3rd month (P=0.004, P=0.013), then had better emotional function, less reflux and less cough at the 6th month (P=0.013, P=0.014, P=0.043), better emotional function, less nausea, and less reflux at the 12th month(P=0.004, P=0.023, P=0.021), as well as less reflux at the 24th month (P=0.020). There was no significant difference in other dimensions and items between the two groups during the follow-up period. CONCLUSION: Jiang's anastomosis is safe and feasible, and could improve the postoperative quality of life of the patients with esophagectomy. It is worth to further application in clinical practice.

Plant allelochemicals affect tolerance of polyphagous lepidopteran pest Helicoverpa armigera (Hübner) against insecticides.

Cotton bollworm, Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae), is a polyphagous lepidopteran pest distributed worldwide with a broad spectrum of host plants. However, the mechanism of H. armigera adaptation to various insecticides and defensive allelochemicals in its host plants is not fully understood. Therefore, this study examined the influence of consumption of plant allelochemicals on larval tolerance to methomyl and chlorpyrifos insecticides in H. armigera and its possible mechanism. Twelve plant allelochemicals were screened to evaluate their effects on larval sensitivity to methomyl. Of which flavone, coumarin, DIMBOA (2,4-Dihydroxy-7-methoxy-1,4-benzoxazin-3-one) and visnagin significantly reduced larval sensitivity to methomyl. Application of cytochrome P450 inhibitor piperonyl butoxide (PBO) significantly increased the mortality of methomyl-treated larvae. In contrast, PBO addition significantly decreased the mortality of chlorpyrifos-treated larvae. Moreover, allelochemical consumption enhanced the activities of glutathione S-transferase, carboxylesterase, cytochrome P450 and acetylcholinesterase in the midgut and fat body. The qRT-PCR analysis confirms that P450 genes, CYP6B2, CYP6B6 and CYP6B7 were induced by the four allelochemicals in the midguts and the fat bodies. In conclusion, the generalist H. armigera can take benefit of plant allelochemicals from its host plants to elaborate its defense against insecticides.

[Spectroscopic Characteristics of Minerals in Sliding Zone Soil in Motuo Landslides and Their Engineering Significance].

The sliding zone soil of Motuo and GelinLandslides were tested with X-ray diffraction, X-ray fluorescence, and infrared absorption spectra. Its compositins of main minerals and clay minerals, even the chemical compositions were comprehensively analyzed. The results show that the composition of the main minerals was controlled by alluvial fan composition, and the contents of clay minerals accounted for 9% and 10% respectively, with a large number of illitecontained in the sliding zone soilofMotuoLandslide, which reflects that the landslide had a high slip rate. There were no exotic corbonates minerals or secondary clay minerals contained corrosive substance with poor mechanical properties filled into theslidingplane because of the closed system, based on the infrared absorption spectrum with no peaks arising from CO2-3, HCO1-3 or C­H, as a positive affect result of the stability of these lamdsiles.The samples of sliding zone soil contain a certain amount of halloysite, reflecting that the landslides in the area of Motuo developed in a very humid and warm environment. With Na2O and CaO preserved in the closed system, a large number of illite/montmorillonite mixed layer formed in the sliding zone soilofGelinlandslide due to the strong water-rock interaction in thesliding plane with the decomposition of illite. The frictional strength of sliding zone was largely reduced due to the clay mineral assemblages, leading to the activity risk of landslide increasing.

[The design and baseline characteristics of a phase III study to evaluate the efficacy and safety of alogliptin versus placebo in type 2 diabetes mellitus in Mainland China].

OBJECTIVE: To assess the design and the Mainland China subgroup baseline characteristics of the study to evaluate the efficacy and safety of alogliptin versus placebo in subjects with type 2 diabetes (T2DM) as monotherapy, add-on to metformin or add-on to pioglitazone. METHODS: This was a multi-center, randomized, double-blind, placebo-controlled, 16-week study comparing alogliptin (ALO, 25 mg, 1/d) versus placebo (PLA) as monotherapy (A), add-on to metformin (B) or add-on to pioglitazone ± metformin (C). The T2DM subjects with glycosylated hemoglobin A1c(HbA1c) between 7% and 10% and aged between 18 years and 75 years were enrolled and randomized to the alogliptin group and the placebo group in 1: 1 ratio with 16 weeks treatment. All patients were followed up every 4 weeks. The safety endpoints consisted of the incidence of hypoglycemia and other adverse events. RESULTS: A total of 491 patients were enrolled in the Mainland China subgroup of the study (181 in group A, 186 in group B and 124 in group C). In each treatment group, the baseline characteristics including age, gender, body mass index, diabetes duration, HbA1c, fasting plasma glucose, body weight, daily dosage of metformin and daily dosage of pioglitazone were all well balanced. CONCLUSION: The demographic data, medical history, glycemic profile and treatment regimen at baseline in Mainland China subgroup are well balanced. The result of this study will provide the clinical evidence for the use of alogliptin in Chinese T2DM patients.

Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: a randomized controlled trial / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To compare the efficacy of a short messaging service (SMS) text messaging and phone reminder to improve attendance rates at a health promotion center.</p><p><b>METHODS</b>A total of 1 859 participants who had scheduled appointments in the health promotion center of our hospital from April 2007 to May 2007 were enrolled in the study and randomly assigned into 3 groups: control (no reminder) group, SMS text messaging reminder group and telephone reminder group. Attendance rates and costs of interventions were collected.</p><p><b>RESULTS</b>A total of 1848 participants were eligible for analysis. Attendance rates of control, SMS and telephone groups were 80.5%, 87.5% and 88.3%, respectively. The attendance rates were significantly higher in SMS and telephone groups than that in the control group, with odds ratio 1.698, 95% confidence interval 1.224 to 2.316, P=0.001 in the SMS group, and odds ratio 1.829, 95% confidence interval 1.333 to 2.509, P<0.001 in the telephone group. However, there was no difference between the SMS group and the telephone group (P=0.670). The cost effectiveness analysis showed that the cost per attendance for the SMS group (0.31 Yuan) was significantly lower than that for the telephone group (0.48 Yuan).</p><p><b>CONCLUSION</b>SMS and telephone are effective reminders for improving attendance rate at a health promotion center. SMS reminder may be more cost-effective compared with the telephone reminder.</p>

Relationship between alanine aminotransferase levels and metabolic syndrome in nonalcoholic fatty liver disease / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the relationship between alanine aminotransferase (ALT) levels and metabolic syndrome (MS) in nonalcoholic fatty liver disease (NAFLD).</p><p><b>METHODS</b>A total of 26527 subjects who received medical health checkup in our hospital from January 2005 to July 2007 were enrolled in the study. The diagnosis of fatty liver was based on ultrasound imaging. MS was defined according to the criteria of the Adult Treatment Panel III. ALT, triglyceride (TG), high density lipoprotein cholesterol (HDL-c), fasting plasma glucose (FPG), height, weight, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in each subject to analyze the relationship between MS and ALT activity.</p><p><b>RESULTS</b>(1) The prevalence of NAFLD in men (30.94%) was significantly higher than that in women (15.65%); (2) The incidence of MS in NAFLD (33.83%) was significantly greater than that in non-NAFLD (10.62%); (3) Of the 6470 subjects with NAFLD, in the age-adjusted partial correlation analysis, there were statistically significant correlations between the ALT levels and most metabolic risk factors in each sex (P<0.01), except that ALT levels had no correlation with HDL-c in women. Moreover, in the multiple stepwise regression analysis, SBP lost its significance, and WC, body mass index (BMI), age, DBP, TG and FPG were independently associated with ALT levels in both sexes (P<0.05). HDL-c remained significant and was independently related to ALT levels in men; (4) ALT levels were significantly higher in subjects with MS compared to those without MS (P<0.001). Mean ALT levels increased with the number of MS components in each sex (P<0.05 for trend).</p><p><b>CONCLUSION</b>We found a strong relationship between ALT levels and MS in NAFLD and revealed that the cluster of MS components might be the predictor for ALT elevations.</p>

Relationship between hyperuricemia and metabolic syndrome / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the relationship between metabolic syndrome and hyperuricemia.</p><p><b>METHODS</b>A total of 2 374 subjects who received health examination in our hospital from Jan. 2004 to Dec. 2006 were enrolled in our study. Hyperuricemia is defined as >or=7 mg/dl (in men) or >or=6.0 mg/dl (in women). Metabolic syndrome was defined using AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute) criteria.</p><p><b>RESULTS</b>(1) The overall prevalence of hyperuricemia was 13.10%. The condition was more common in men than in women (19.07% vs 3.42%). (2) Among men, uric acid concentration is statistically significantly positively correlated with waist circumference, blood pressure, and triglyceride. Uric acid is negatively correlated with serum high-density lipoprotein-cholesterol (HDL-C). Uric acid concentration is most strongly correlated with serum triglyceride (r=0.379) and waist circumference (r=0.297). Among women, statistically significant positive correlations were noted for the serum uric acid concentrations with waist circumference, triglyceride and fasting plasma glucose. Serum triglyceride (r=0.329) and waist circumference (r=0.234) are most strongly correlated with uric acid concentrations. (3) Men with hyperuricemia had a 1.634-fold increased risk of metabolic syndrome as compared with those without hyperuricemia [odds ratio (OR)=1.634, P=0.000]. Women with hyperuricemia had a 1.626-fold increased risk of metabolic syndrome (OR=1.626, P=0.000) as compared with those without hyperuricemia.</p><p><b>CONCLUSION</b>Hyperuricemia is prevalent among Chinese population. Additionally, serum uric acid is positively associated with metabolic syndrome.</p>