Establishment of a safe disposal management program for home used sharp wastes from insulin injection among diabetic patients / 现代临床护理

Objective To establish a safe disposal management program for home used sharps waste of insulin injection so as to provide a reference for the standardised management of sharps waste after insulin.injection.Methods Based on the model of information-motivation-behavioural skills,the safe disposal management program for insulin needles used at home was developed by literature reviews and semi-structured interviews to investigate the perceptions and requirements of patients.The program was then modified and refined by two rounds of expert consultation with Delphi method.Results The effective retrieval rates of questionnaire for two rounds of expert consultations were 88.89%and 93.75%,with an expert authority coefficient at 0.93.In the second round,the mean importance scores of the items were 4.40 to 5.00,with a coefficient of variation ranged from 0 to 0.168.The established program consisted of three primary items,six secondary items,and 20 tertiary items.Conclusion The safe disposal management program for home used sharps waste of insulin injection established from the perspectives of information,motivation and behavioural skills was scientific and practical,which offered a guidance to healthcare professionals in the clinical practices.

Evidence summary for the management of insulin injection-related sharps waste disposal in patients with diabetes mellitus / 中国实用护理杂志

Objective:To retrieve and summarize the best evidence related to the management of insulin injection-related sharps waste disposal in diabetic patients at home and abroad, so as to provide reference for clinical healthcare professionals.Methods:This was a evidence-based research. Evidence on insulin injection-related sharps waste management in patients with diabetes, including guidelines, expert consensus, evidence summaries, best practice information sheet, recommended practices, clinical decisions and systematic reviews was systematically searched from domestic and international databases and professional websites, and the search time frame was from the establishment of the database to December 2021. Evidence was extracted and summarized following a quality evaluation of the literature that met the criteria.Results:A total of 15 papers were included, summarizing 25 pieces of best evidence on four areas including risk assessment and management of sharps waste associated with insulin injections, education and training, and the use of safe devices and sharps containers.Conclusions:Best evidence on the management of insulin injection-related sharps waste disposal provides evidence to support clinical practice for healthcare professionals to standardized sharps waste disposal practices in patients with diabetes.

Associations between serum GDF15 and glycolipid metabolism disorder in metabolic associated fatty liver patients / 中华内科杂志

Objective:To investigate relationships between serum growth differentiation factor 15 (GDF15) and glycolipid metabolism in patients with metabolic associated fatty liver disease (MAFLD).Methods:The current investigation was a cross-sectional study. A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021. There were 107 patients with MAFLD and type 2 diabetes mellitus (T2DM), including 54 males and 53 females with a mean age of (57±11) years. There were 65 patients with simple MAFLD only, including 32 men and 33 women with a mean age of (49±5) years. There were 105 patients with T2DM only, including 53 men and 52 women, with a mean age of (56±10) years. A control group of 56 people without MAFLD or diabetes,28 male, 28 female, mean age (48±6) years, was also included in the study. Serum GDF15 was measured via enzyme-linked immunosorbent assays. IBM SPSS 26.0 was used for statistical analysis. Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients.Results:GDF15 progressively increased in the control [385 (296, 484) ng/L], nonobese MAFLD [388 (319, 435) ng/L], obese MAFLD [426 (354, 527) ng/L], T2DM [664 (483, 900) ng/L], and MAFLD+T2DM groups [770 (560, 1 074) ng/L]( H=113.82, P=0.001). There was no significant difference in serum GDF15 between the simple MAFLD [406 (339, 524) ng/L] and control group ( U=1 505.50, P=0.132). GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group ( U=4 573.50, P=0.019). In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD [odds ratio ( OR)=2.202], T2DM ( OR=29.656), and MAFLD+T2DM( OR=58.197). In patients with MAFLD, serum GDF15 was higher in the FIB4 index>1.45 group [773 (534, 1 162) ng/L] than in the FIB4 index<1.45 group [527 (389, 787) ng/L] ( U=1 709.50, P<0.001). Increased GDF15 was associated with an increased risk of advanced liver fibrosis ( OR=2.388). Conclusion:In patients with simple MAFLD, GDF15 level was not significantly higher than in the control group. In the T2DM-only group and the MAFLD+T2DM group GDF15 was significantly higher than in the control group. Increased serum GDF15 was associated with increased risk and severity of MAFLD complicated with abnormal glucose and lipid metabolism. High GDF15 increased the risk of advanced fibrosis in MAFLD patients.

Relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion / 中国现代医生

Objective To investigate the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion.Methods A total of 60 patients with end-stage renal disease who underwent hemodialysis combined with hemoperfusion treatment in Ganzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2021 were selected.Thirty patients with atrial fibrillation were included in observation group,and thirty patients without atrial fibrillation were included in control group.The left heart structure indexes of two groups were compared,and the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion was analyzed.Results Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),interventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT)in observation group were higher than those in control group,and left ventricular ejection fraction(LVEF)was lower than that in control group(P<0.05).Logistic regression analysis showed that the decrease of LVEF and the increase of LVEDD,LVESD,LAD,IVST and LVPWT were associated with atrial fibrillation in patients with hemodialysis combined with hemoperfusion(P<0.05).The results of receiver operating characteristic curve showed that area under the curve of LVEDD,LVESD,LAD,LVEF,IVST and LVPWT in diagnosing atrial fibrillation in patients with hemodialysis combined with hemoperfusion were 0.724,0.708,0.760,0.761,0.762 and 0.758,respectively,which had certain diagnostic value.Conclusion Atrial fibrillation in patients with hemodialysis combined with hemoperfusion is related to the change of left heart structure,and the left heart structure indexes are helpful to assist the diagnosis of atrial fibrillation.

Qualitative study on the causes of improper disposal of discarded insulin pen needles in diabetic patients at home / 中国实用护理杂志

Objective:To understand the causes of improper disposal of discarded insulin pen needles at home in diabetic patients.Methods:Using descriptive phenomenological research method, semi-structured interviews were conducted in November 2021 with 18 patients with diabetes from the outpatient department of Shanghai University of Medicine & Health Sciences Affiliated Sixth Peoples Hospital South Campus (Shanghai Fengxian District Central Hospital), and Colaizzi seven-step analysis method was used to extract the themes.Results:The reasons for improper disposal of discarded insulin pen needles at home by diabetic patients included misconceptions about methods for safe disposal of needles, low awareness of safe disposal of needles, fear of needle stick injuries, lack of social support, time and distance conflict and economic burden.Conclusions:Medical staff should pay attention to health education to increase patients′ knowledge about safe disposal of needles. The collection program was optimized to alleviate patients′ fear of safe disposal of needle. At the same time, multiple support should be given to improve patients′ compliance with safe disposal of needle.

Study on effect of dendrobium nobile polysaccharides on expression of WT1 gene in myeloid leukemia cells / 重庆医学

Objective To explore the effect of dendrobium nobile polysaccharides on the expression of the WT 1 gene in my-eloid leukemia cells.Methods The CCK8 assay was used to detect the half maximal inhibitory concentration(IC50 )of dendrobium nobile polysaccharides in 3 kinds of leukemia cells;the each kind of leukemia cells were divided into the treatment group and the control group.The cells in the control group maintained the normal growth,while which in the treatment group were given the den-drobium nobile polysaccharides stimulation.The Hoechst33258 staining was used to detect the apoptosis situation of the cells in the two groups.The WT l gene expression level was detected by the real-time PCR and the protein expression levels of WT1,53 and BAX were detect the Western blot.Results Dendrobium nobile polysaccharides had the similar IC50 values in 3 kinds of myeloid leukemia cells,which were (110.71±6.49),(104±48.50),(96.66±5.10)mg/mL respectively,the difference among them had no statistical significance (P >0.05);the apoptosis rate of the treatment group was higher than that of the control group (P <0.05);the expression levels of WT1 gene and protein in the treatment group were decreased compared with the control group(P <0.05), while the expression of P53 and BAX protein was increased.Conclusion Dendrobium nobile polysaccharides can obviously decrease the expression level of WT1 protein,and has a certain killing effect on myeloid leukemia cells.