Impacts of continuous quality improvement on wound pain in the puncture site of arteriovenous fistula in haemodialysis patient.

This study analyses the effects of a continuous quality improvement nursing model on wound pain at the arteriovenous fistula (AVF) puncture site in patients undergoing haemodialysis. Forty haemodialysis patients from the First Affiliated Hospital of Chongqing Medical University, from September 2020 to December 2022, were selected as study subjects. They were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group was treated with a continuous quality improvement nursing model. The study compared the impact of these nursing approaches on pain intensity post-AVF puncture, wound visual analogue scale scores, self-rating anxiety scale, self-rating depression scale, quality of life scores and patient satisfaction with nursing care. In the observation group, the proportion of patients experiencing moderate to severe pain during AVF puncture was lower than that in the control group, whereas the proportion of patients with no pain or mild pain was higher (P = 0.008). After nursing, the observation group exhibited significantly lower wound visual analogue scale scores, self-rating anxiety scale scores, and self-rating depression scale scores compared to the control group (P < 0.001), with a significantly higher quality of life score (P < 0.05). The nursing satisfaction rate was 95.00% in the observation group, significantly higher than the 65.00% in the control group (P = 0.018). The continuous quality improvement nursing model significantly reduces wound pain at the AVF puncture site in haemodialysis patients, alleviates negative emotions, enhances the quality of life, and achieves high patient satisfaction. It is thus a highly recommendable approach in nursing practice.

Roles of Wnt/ß-catenin signaling pathway related microRNAs in esophageal cancer.

MicroRNAs (miRNAs) are endogenous, noncoding, single-stranded small RNAs that regulate expression of tumor suppressor genes and oncogenes and are involved in almost all tumor-related processes. MiRNA dysregulation plays an important role in the occurrence and development of esophageal cancer through specific signal pathways, including the Wnt/ß-catenin signaling pathway, and is closely related to the malignant characteristics of esophageal cancer. The interaction between miRNAs and the Wnt/ß-catenin signaling pathway, which is specifically expressed in esophageal cancer tissues, shows potential as a new biomarker and therapeutic target. This article reviews the role of miRNAs related to the Wnt pathway in the carcinogenesis of esophageal carcinoma and its role in Wnt signal transduction. The content of this review can be used as the basis for formulating or improving the treatment strategy of esophageal cancer.

Endovascular stent-graft treatment for aortoesophageal fistula induced by an esophageal fishbone: Two cases report.

BACKGROUND: Aortoesophageal fistula (AEF) induced by esophageal fishbones is a rare complication of esophageal foreign bodies and is very difficult to treat. Although the current view suggests that endovascular stent-graft treatment is useful for AEF, whether a subsequent thoracic operation is necessary remains controversial. The purpose of this report is to describe our experience using endovascular stent-graft treatment without combined thoracic operations for the treatment of AEF in two specific cases. CASE SUMMARY: We presented two cases of patients complaining of retrosternal discomfort treated in our department for an aortoesophageal fistula caused by the accidental ingestion of a fishbone. The two patients were effectively managed with combined means of endoscopic, medical (broad-spectrum antibiotic therapy, fasting, gastrointestinal decompression, etc.) and endovascular stent-graft treatment. The main difference in treatment was that the first patient presented with hematemesis after endoscopic removal of the fishbone. Subsequently, the patient underwent endovascular stent-graft treatment. The second case was managed with endoscopic removal of the fishbone with simultaneous endovascular stent-graft treatment, without any signs of hematemesis or melena. Both patients had successful postoperative management and were discharged home. Long-term follow-up is ongoing. CONCLUSION: The treatment decision-making process should depend on the patients' specific situations. Our practice indicates that endovascular stent-graft treatment without combined thoracic operations could be a valuable alternative in selected patients.

Electrosprayed Ultra-Thin Coating of Ethyl Cellulose on Drug Nanoparticles for Improved Sustained Release.

In nanopharmaceutics, polymeric coating is a popular strategy for modifying the drug release kinetics and, thus, new methods for implementing the nanocoating processes are highly desired. In the present study, a modified coaxial electrospraying process was developed to formulate an ultra-thin layer of ethyl cellulose (EC) on a medicated composite core consisting of tamoxifen citrate (TAM) and EC. A traditional single-fluid blending electrospraying and its monolithic EC-TAM nanoparticles (NPs) were exploited to compare. The modified coaxial processes were demonstrated to be more continuous and robust. The created NPs with EC coating had a higher quality than the monolithic ones in terms of the shape, surface smoothness, and the uniform size distribution, as verified by the SEM and TEM results. XRD patterns suggested that TAM presented in all the NPs in an amorphous state thanks to the fine compatibility between EC and TAM, as indicated by the attenuated total reflection (ATR)-FTIR spectra. In vitro dissolution tests demonstrated that the NPs with EC coating required a time period of 7.58 h, 12.79 h, and 28.74 h for an accumulative release of 30%, 50%, and 90% of the loaded drug, respectively. The protocols reported here open a new way for developing novel medicated nanoparticles with functional coating.

The Process⁻Property⁻Performance Relationship of Medicated Nanoparticles Prepared by Modified Coaxial Electrospraying.

In pharmaceutical nanotechnology, the intentional manipulation of working processes to fabricate nanoproducts with suitable properties for achieving the desired functional performances is highly sought after. The following paper aims to detail how a modified coaxial electrospraying has been developed to create ibuprofen-loaded hydroxypropyl methylcellulose nanoparticles for improving the drug dissolution rate. During the working processes, a key parameter, i.e., the spreading angle of atomization region (θ, °), could provide a linkage among the working process, the property of generated nanoparticles and their functional performance. Compared with the applied voltage (V, kV; D = 2713 - 82V with RθV2 = 0.9623), θ could provide a better correlation with the diameter of resultant nanoparticles (D, nm; D = 1096 - 5θ with RDθ2 = 0.9905), suggesting a usefulness of accurately predicting the nanoparticle diameter. The drug released from the electrosprayed nanoparticles involved both erosion and diffusion mechanisms. A univariate quadratic equation between the time of releasing 95% of the loaded drug (t, min) and D (t = 38.7 + 0.097D - 4.838 × 105D2 with a R2 value of 0.9976) suggests that the nanoparticle diameter has a profound influence on the drug release performance. The clear process-property-performance relationship should be useful for optimizing the electrospraying process, and in turn for achieving the desired medicated nanoparticles.

Fast Dissolving of Ferulic Acid via Electrospun Ternary Amorphous Composites Produced by a Coaxial Process.

Enhancing the dissolution of insoluble active ingredients comprises one of the most important issues in the pharmaceutical and biomaterial fields. Here, a third generation solid dispersion (3rd SD) of ferulic acid was designed and fabricated by a modified coaxial electrospinning process. A traditional second generation SD (2nd SD) was also prepared by common one-fluid blending electrospinning and was used as a control. With poly(vinyl alcohol) as the fiber matrix and polyvinylpyrrolidone K10 as an additive in the 3rd SDs, the two electrospinning processes were investigated. The prepared 2nd and 3rd SDs were subjected to a series of characterizations, including X-ray diffraction (XRD), scanning electron microscope (SEM), hydrophilicity and in vitro drug dissolving experiments. The results demonstrate that both SDs were monolithic nanocomposites and that the drugs were amorphously distributed within the matrix. However, the 3rd SDs had better morphology with smaller size, narrower size distribution, and smaller water contact angles than the 2nd SDs. Dissolution tests verified that the 3rd SDs could release their loaded cargoes within 60 s, which was over three times faster than the 2nd SDs. Therefore, a combined strategy based on the modified coaxial electrospinning and the logical selections of drug carriers is demonstrated for creating advanced biomaterials.

[Pollution Characteristics and Risk Assessment of Heavy Metals in Water and Sediment from Daye Lake].

The surface water and surface sediments were collected from Daye Lake in April 2014. The concentrations of heavy metals were determined by atomic absorption spectroscopy. The pollution potential health risk and ecological risk of heavy metals in water and sediment were assessed by the health risk assessment model and the potential ecological risk index method. The results showed that the concentrations of the heavy metals (Ni, Cd, Cu and Pb) was 49.27 µg·L-1, 2.19 µg·L-1, 12.18 µg·L-1, 12.13 µg·L-1(water) and 78.46 mg·kg-1, 77.13 mg·kg-1, 650.13 mg·kg-1 and 134.22 mg·kg-1 (sediment). Enrichment coefficient indicated that the enrichment of Cd, Cu and Pb was more serious, especially the accumulation of Cd was the most obvious. Compared to typical lakes in China, the contents of heavy metals in water and sediment were relatively high. The spatial pollutant distribution of the heavy metals in water and sediment all presented that the concentrations of the heavy metals were relatively higher in east and west of Daye Lake, relatively more uniform in the middle, and their origins were mainly from human activities. The results of environmental risk indicated that the carcinogens and chemical non-carcinogens health risk values of heavy metals by drinking water pathway were 9.77E-08~1.63E-05a-1. Therefore, the pollution of Ni and Cd should be the primary control target for environmental health risk management. The descending order of pollution degree of four metals in sediment was Cd> Cu> Pb> Ni, and Cd was the main contributor of the potential ecological risk elements.

[Characteristics and Sources of Elements of a PM10 Measurements from a Typical Industrial City in Eastern Hubei Province].

In order to investigate the characteristics and sources of elements in atmospheric aerosols (PM10) measurements, samples were collected between April 2012 and February 2013 in Huangshi, a typical industrial city in the east of Hubei province, China. These samples were analyzed for seventeen elements using wavelength dispersive X-ray fluorescence spectrometry. In addition, the pollution characteristics of fourteen elements were analyzed by an enrichment factor (EF) method, and the sources of these elements were studied by a principal component analysis (PCA) and positive matrix factorization (PMF) method. The result from the EF indicated that the concentration of the seventeen elements in the PM10 measurements varied from 0.01-9.83 µg·m-3. The elemental concentration of S was the highest and Ni and V was the lowest during the monitoring period in Huangshi. Daily levels of Pb and Cd exceeded the annual reference values set by the National Ambient Air Quality Standard (GB3095-2012) by 36.4% and 89.1%, respectively. An analysis of EF showed that Ti, V, Mn, and Ni elements were mildly enriched, indicating they were affected by both natural and anthropogenic sources. Ca, Cr, and Ba elements were moderately enriched and Cu, Zn, Pb, Sn, Sb, and Fe were highly enriched or hyper accumulated, suggesting they are mainly sourced from human activities. There were four sources significantly contributing to the elements in the PM10measurement, which were determined using PCA and PMF analysis. These were soil and fugitive dust, coal combustion, industry exhausts, and motor vehicle emissions. The results of the two models supported each other and had good consistency.

Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials.

BACKGROUND: Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes. METHODS: Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2. RESULTS: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02-0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40-2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12-0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90-1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11-0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10-0.33; P < 0.05), CD3 + (MD: 3.71; 95% CI: 2.57-4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12-0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05). CONCLUSIONS: Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

[Influence of recombined human growth hormone on sIgA and EGF in rats with obstructive jaundice].

AIM: To study the effect of the recombined human growth hormone(rhGH) on secretory immunoglobulin A (sIgA), epidermal growth factor (EGF) in rats with obstructive jaundice. METHODS: Sixty Wistar rats were randomly divided into four groups, sham-operated (group A), common biliary duct-ligated (group B), biliary duct-ligated plus rhGH-treat for one week (group C), biliary duct-ligated plus rhGH-treat for two weeks (group D), each group had 15 rats. Except group A, the rats of other groups were operated with biliary duct-ligated. Until two weeks after operation, the rats of group A and B were killed. After operation, the rats of group C were treated with rhGH hypodermic injection (0.75 U x kg(-1) x d(-1)) for one week, and then killed. The rats of D group were treated with rhGH hypodermic injection (0.75 U x kg(-1) x d(-1)) for two weeks, and then killed. All procedures were performed aseptically. Total bilirubin (TB), alkaline phosphatase (ALP), prealbumin(PA), insulin-like growth factor (IGF-1), sIgA, EGF were measured. RESULTS: Compared with group A, in group B, C, D, serum level of PA, IGF-1 and sIgA, EGF level of gastric and intestinal juice were lower, but TB, ALP were higher, there were significant difference. Compared with group B, the rats with treatment of rhGH in group C and D had higher sIgA and EGF and lower intestinal bacterial translocation. CONCLUSION: In objective jaundice rats, rhGH can protect their hepatic function, intestinal physical-barrier function and immune-barrier function, and reduce intestinal bacterial translocation.

Speciation analysis and the assessment of bioavailability of manganese in phytomedicines by extraction with octanol and determination by flame atomic absorption spectrometry.

Trace elements in phytomedicines are present in the form of metallic complexes. Since n-octanol, a long-chain alkanol, presents a configuration similar to that of carbohydrates and lipids, the lipophilicity and absorptivity of organic medicines may be assessed from their distribution coefficients between octanol and water. This strategy has been used in order to define the species of manganese in a number of phytomedicines and to study the distribution of manganese in decoctions of phytomedicines in the stomach and the intestine. The concentrations of manganese in the original herbal materials and in octanol- and water-soluble fractions were determined by flame atomic absorption spectrometry following mixed acid digestion. The acidities of gastric and intestinal juices, the phytomedical composition and the compatibility of phytomedicines, i.e. the combination of single phytomedicines, greatly affected the manganese complexing ligands and determined the species and bioavailability of manganese. It is concluded that a knowledge of the level of octanol-soluble manganese in a phytomedicine could form the basis of dosage design in order to avoid manganese overload.

Photocatalytic degradation of p-nitrophenol on nanometer size titanium dioxide surface modified with 5-sulfosalicylic acid.

The surface of nanometer size TiO(2) was simply and fast modified by chemical adsorption in saturated solution of 5-sulfosalicylic acid. After surface modification, a stable, yellow surface complex was formed quickly, the wavelength response range of TiO(2) was expanded, it has obvious absorption in the region from 320 to 450 nm; the adsorption efficiency of p-nitrophenol (PNP) by TiO(2) was enhanced from 42% to 84%. The photocatalytic activity was tested on the degradation of PNP. The influences of catalyst and its dosage, pH value, and PNP concentration on the degradation were investigated. On optimal photodegradation conditions, including initial pH 4.0, PNP 5 mg l(-1), catalyst 100 mg, irradiation time 120 min with 160 W high-pressure mercury lamp, the degradation efficiency of PNP was increased from 40% to 88% after surface modification. Surface modification led not only to an increase in the light utilization, but also improved the surface coverage of PNP in comparison with the pure TiO(2). Both of these factors are crucial for the photocatalytic activity of heterogeneous photocatalysis, especially for photodegradation of benzenoid pollutants.