Curative Effect Observation of Burosumab for Children and Adults with X-Linked Hypophosphatemicrickets / 罕见病研究

We studied the patients diagnosed with X-linked hypophosphatemicrickets(XLH) and treated with burosumab in Peking Union Medical College Hospital from January 2021 to December 2022. In addition, we described the clinical characteristics of the patients, the changes of clinical indexes before and after burosumab treatment, and the adverse drug reactions during treatment. We also evaluated the efficacy and safety of burosumab for XLH. The results showed that three children XLH patients and one adult XLH patients received burosumab treatment. After treatment, the serum phosphorus level of all patients increased; the serum phosphorus of 3 children patients increased above the lower limit of the reference value range; the serum alkaline phosphatase(ALP) of all patients was lower than that of before treatment; the serum ALP of one adult patient was close to the normal range after 2.5 years of treatment. One child patient showed small crystals in kidney through ultrasound 48 weeks after treatment; one child and one adult showed increased serum parathyroid hormone(PTH)level before treatment and serum PTH continued increasing after treatment. Finally, it may be concluded that burosumab increased serum phosphorus levels in XLH patients, kept the level relatively stable, and reduced serum ALP levels. No serious adverse reactions occurred during treatment, in order to provide reference for the use of burosumab in patients with XLH.

Overview and Analysis of Rare Disease Drugs Approved for Market in China, the United States, the European Union, and Japan in 2023 / 罕见病研究

Objective To summarize and analyze what the listing in market of orphan drugs in China, the United States, the European Union, and Japan in 2023, and to provide empirical reference to Chinese pharmaceutical enterprises, pharmaceutical management, and new drug research and development departments. Methods Collect the 2023 drug market data released by official drug regulatory agencies in four countries and international organization-China, the United States, the European Union, and Japan categorize the market of rare disease drugs and and their indications, approval dates, R&D status in China, component therapeutic areas, and special review and approval pathways were analyzed. Results Findings in 2023, 28 orphan drugs were listed in the United States, mostly anti-tumor related, accounting for 32.1% (9 out of 28); 17 orphan drugs were listed in the European Union, anti-tumor related accounting for 47.0% (8 of 17); 22 listed in Japan; and 45 listed in China. In 2023, over 70% orphan drugs listed in the European Union and Japan entered the phase of clinical trials/marketing and applications/approved clinical applications in China (86.4% from Japan and 70.6% from European Union). Conclusions Currently, there is no qualification accreditation mechanism for orphan drugs in China. However, in 2023, the number of rare disease drugs listed in China was the greatest among the four countries/international organization. It reflects that China′s Catalog for Rare Diseases played a guiding role in drug research and development. Meanwhile, the reform of drug approval and review in China and the issue of rare disease catalogs took place in a short period of time, so the review and approval, as well as research and development of rare disease drugs are still in the catching up stage.

Curative Effect Observation of Burosumab for Children and Adults with X-Linked Hypophosphatemicrickets / 罕见病研究

We studied the patients diagnosed with X-linked hypophosphatemicrickets(XLH) and treated with burosumab in Peking Union Medical College Hospital from January 2021 to December 2022. In addition, we described the clinical characteristics of the patients, the changes of clinical indexes before and after burosumab treatment, and the adverse drug reactions during treatment. We also evaluated the efficacy and safety of burosumab for XLH. The results showed that three children XLH patients and one adult XLH patients received burosumab treatment. After treatment, the serum phosphorus level of all patients increased; the serum phosphorus of 3 children patients increased above the lower limit of the reference value range; the serum alkaline phosphatase(ALP) of all patients was lower than that of before treatment; the serum ALP of one adult patient was close to the normal range after 2.5 years of treatment. One child patient showed small crystals in kidney through ultrasound 48 weeks after treatment; one child and one adult showed increased serum parathyroid hormone(PTH)level before treatment and serum PTH continued increasing after treatment. Finally, it may be concluded that burosumab increased serum phosphorus levels in XLH patients, kept the level relatively stable, and reduced serum ALP levels. No serious adverse reactions occurred during treatment, in order to provide reference for the use of burosumab in patients with XLH.

Discussion on Building an Indicator System for Party Building Work Platform in National Public Hospitals / 中国医院管理

Objective To promote the construction of a national party building indicator system for public hospitals,provide reference for the development of system documents such as quality evaluation methods for party building work in public hospitals.Methods Conduct a comprehensive and systematic collection,organization,and analysis of policy documents related to party building in public hospitals in China since 2018,and organize expert discussions.Results The positive coefficients of the three rounds of expert discussions were all 100％,and the expert authority coefficient was 0.878.A party building indicator system was constructed with 7 primary indicators and 40 secondary indicators,including leadership system and decision-making mechanism,leadership team and cadre talent team construction,grassroots party organization construction,party member team construction,medical ethics and clean governance construction,party building work guarantee,and others.Conclusion The indicator system has been unanimously recognized by experts and is authoritative and feasible,laying the foundation for the refined party building work in public hospitals.

Exploration of the Effect and Mechanism of Shuangzhu Kangxian Prescription in Improving Carbon Tetrachloride-Induced Hepatitic Fibrosis in Rats Based on Wnt/β-catenin Signaling Pathway / 中药新药与临床药理

Objective To investigate the effect and mechanism of Shuangzhu Kangxian Prescription(Astragali Radix,bran-fried Atractylodis Macrocephalae Rhizoma,vinegar-prepared Rhizoma Curcumae,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,Litchi Semen)on improving hepatitic fibrosis induced by carbon tetrachloride(CCl4)in rats based on the Wnt/β-catenin signaling pathway.Methods The rat model of hepatitic fibrosis was replicated by subcutaneous injection of 3.0 mL·kg-1 40%CCl4 twice a week for 8 weeks.SD rats were randomly divided into blank control group(n=8),model group(n=7),positive control group(n=7,intragastric administration of 43.19 mg·kg-1 silymarin),low-dose Chinese medicine group(n=6,intragastric administration of 4.3 g·kg-1Shuangzhu Kangxian Prescription),medium-dose Chinese medicine group(n=6,intragastric administration of 8.6 g·kg-1Shuangzhu Kangxian Prescription),high-dose Chinese medicine group(n=7,intragastric administration of 17.2 g·kg-1Shuangzhu Kangxian Prescription).The continuous intragastric administration was given once a day for 4 consective weeks,in addition to the blank control group,the other groups continued to be subcutaneously injected with CCl4 at the same time.The pathological changes of liver tissue were observed by HE and Masson staining.The levels of serum type Ⅳ collagen(Col Ⅳ),type Ⅲ procollagen(PC Ⅲ),hyaluronic acid(HA)and laminin(LN)were detected by ELISA.The protein expression levels of Wnt1,β-catenin and PPAR-γ in liver tissue were detected by Western Blot.The mRNA expression levels of Wnt1,β-catenin and PPAR-γ in liver tissue were detected by qPCR.Results Compared with the blank control group,the liver of the model group showed partial necrosis of liver cells,the normal hepatic lobule structure was destroyed,the arrangement of liver cell cords was disordered,the central vein or portal area was enlarged,and a large number of inflammatory cells infiltrated to form bridging necrosis.The collagen fibers in the central vein or portal area of the liver proliferated significantly,forming fibrous septa,and the fibrosis score were significantly increased(P＜0.05).The levels of serum Col IV,PC Ⅲ,HA and LN were significantly increased(P＜0.05).The protein and mRNA expression levels of Wnt1 and β-catenin in liver tissue were significantly increased(P＜0.05),and the protein and mRNA expression levels of PPAR-γ were significantly decreased(P＜0.05).Compared with the model group,the steatosis of hepatocytes in the positive control group and the medium-and high-dose groups of Chinese medicine was improved,and the necrosis and inflammatory cell infiltration were reduced.The degree of hepatitic fibrosis was improved,the liver collagen fibers were reduced,and the fibrosis score was significantly reduced(P＜0.05).The levels of serum Col Ⅳ,PC Ⅲ,HA and LN were significantly decreased(P＜0.05).The protein and mRNA expression levels of Wnt1 and β-catenin in liver tissue were significantly decreased(P＜0.05),and the protein and mRNA expression levels of PPAR-γ were significantly increased(P＜0.05).Conclusion Shuangzhu Kangxian Prescription has the effect of anti CCl4-induced hepatitic fibrosis in rats,and its mechanism may be related to the inhibition of Wnt/β-catenin signaling pathway and up-regulation of PPAR-γ expression.

Spatiotemporal roles of AMPK in PARP-1- and autophagy-dependent retinal pigment epithelial cell death caused by UVA.

BACKGROUND: Although stimulating autophagy caused by UV has been widely demonstrated in skin cells to exert cell protection, it remains unknown the cellular events in UVA-treated retinal pigment epithelial (RPE) cells. METHODS: Human ARPE-19 cells were used to measure cell viability, mitochondrial reactive oxygen species (ROS), mitochondrial membrane potential (MMP), mitochondrial mass and lysosomal mass by flow cytometry. Mitochondrial oxygen consumption rate (OCR) was recorded using Seahorse XF flux analyzer. Confocal microscopic images were performed to indicate the mitochondrial dynamics, LC3 level, and AMPK translocation after UVA irradiation. RESULTS: We confirmed mitochondrial ROS production and DNA damage are two major features caused by UVA. We found the cell death is prevented by autophagy inhibitor 3-methyladenine and gene silencing of ATG5, and UVA induces ROS-dependent LC3II expression, LC3 punctate and TFEB expression, suggesting the autophagic death in the UVA-stressed RPE cells. Although PARP-1 inhibitor olaparib increases DNA damage, ROS production, and cell death, it also blocks AMPK activation caused by UVA. Interestingly we found a dramatic nuclear export of AMPK upon UVA irradiation which is blocked by N-acetylcysteine and olaparib. In addition, UVA exposure gradually decreases lysosomal mass and inhibits cathepsin B activity at late phase due to lysosomal dysfunction. Nevertheless, cathepsin B inhibitor, CA-074Me, reverses the death extent, suggesting the contribution of cathepsin B in the death pathway. When examining the role of EGFR in cellular events caused by UVA, we found that UVA can rapidly transactivate EGFR, and treatment with EGFR TKIs (gefitinib and afatinib) enhances the cell death accompanied by the increased LC3II formation, ROS production, loss of MMP and mass of mitochondria and lysosomes. Although AMPK activation by ROS-PARP-1 mediates autophagic cell death, we surprisingly found that pretreatment of cells with AMPK activators (A769662 and metformin) reverses cell death. Concomitantly, both agents block UVA-induced mitochondrial ROS production, autophagic flux, and mitochondrial fission without changing the inhibition of cathepsin B. CONCLUSION: UVA exposure rapidly induces ROS-PARP-1-AMPK-autophagic flux and late lysosomal dysfunction. Pre-inducing AMPK activation can prevent cellular events caused by UVA and provide a new protective strategy in photo-oxidative stress and photo-retinopathy.

Predictive value of red blood cell distribution width and platelet-to-lymphocyte ratio for acute kidney injury in critically ill patients.

OBJECTIVES: The purpose of this study was to explore the value of red blood cell distribution width (RDW) and platelet-to-lymphocyte ratio (PLR) in predicting the occurrence of acute kidney injury (AKI) in critically ill patients. MATERIALS AND METHODS: Among 1,500 adult patients in the intensive care unit (ICU) between January 2016 and December 2019, we examined the associations of baseline RDW and PLR with the risk of AKI development using logistical analysis. In addition, we explored the value of RDW and PLR in predicting in-hospital mortality. RESULTS: Overall, 615 (41%) patients were diagnosed with AKI. We divided the groups into two subgroups each; the high-RDW (≥ 14.045%) group had a high risk of developing AKI (OR = 5.189, 95% CI: 4.088 - 6.588), and the high-PLR (≥ 172.067) group had a risk of developing AKI too (OR = 9.11, 95% CI: 7.09 - 11.71). The areas under the receiver operating characteristic curves (AUCs) for the prediction of AKI incidence based on RDW and PLR were 0.780 (95% CI: 0.755 - 0.804) and 0.728 (95% CI: 0.702 - 0.754) (all p < 0.001), with cut-off values of 14.045 and 172.067, respectively. Moreover, a higher RDW was associated with a higher rate of hospital mortality (OR: 2.907, 2.190 - 3.858), and the risk of in-hospital mortality related to PLR was 1.534 (95% CI: 1.179 - 1.995). CONCLUSION: A higher RDW was related to a higher risk of AKI occurrence and in-hospital mortality in the ICU.

15 and 30 min of immobilization after IUI: a randomized control trial.

The purpose of this study is to provide evidence for better guidance related to bed rest after intrauterine insemination (IUI). We conducted a randomized trial to compare the effect of 15 min versus 30 min of bed rest after IUI on pregnancy rate. A total of 204 couples were recruited from May 2021 to December 2021 and randomized to remain in the supine position for either 15 or 30 min after the procedure. The outcomes were the clinical pregnancy rate and comfort level after IUI. Ultimately, 198 couples were included in the analysis. The 15-min immobilization group consisted of 100 couples (226 cycles), and the 30-min immobilization group consisted of 98 couples (225 cycles). The clinical pregnancy rate per couple in the 15-min immobilization group (26 of 100) was not different from that in the 30-min immobilization group (23 of 98). With the use of discrete-time survival analysis, the cumulative probability of clinical pregnancy also showed no difference between these two groups. Based on the literature and on our study, the possible beneficial effect of 30-min immobilization after IUI is at least questionable, and a shorter time could be implemented depending on the results of a systematic review and the individual patient data from the currently executed trials.

Membrane Protein Modification Modulates Big and Small Extracellular Vesicle Biodistribution and Tumorigenic Potential in Breast Cancers In Vivo.

Extracellular vesicles (EVs) are released by cells to mediate intercellular communication under pathological and physiological conditions. While small EVs (sEVs; <100-200 nm, exosomes) are intensely investigated, the properties and functions of medium and large EVs (big EVs (bEVs); >200 nm, microvesicles) are less well explored. Here, bEVs and sEVs are identified as distinct EV populations, and it is determined that bEVs are released in a greater bEV:sEV ratio in the aggressive human triple-negative breast cancer (TNBC) subtype. PalmGRET, bioluminescence-resonance-energy-transfer (BRET)-based EV reporter, reveals dose-dependent EV biodistribution at nonlethal and physiological EV dosages, as compared to lipophilic fluorescent dyes. Remarkably, the bEVs and sEVs exhibit unique biodistribution profiles, yet individually promote in vivo tumor growth in a syngeneic immunocompetent TNBC breast tumor murine model. The bEVs and sEVs share mass-spectrometry-identified tumor-progression-associated EV surface membrane proteins (tpEVSurfMEMs), which include solute carrier family 29 member 1, Cd9, and Cd44. tpEVSurfMEM depletion attenuates EV lung organotropism, alters biodistribution, and reduces protumorigenic potential. This study identifies distinct in vivo property and function of bEVs and sEVs in breast cancer, which suggest the significant role of bEVs in diseases, diagnostic and therapeutic applications.

Evaluating the behavior and principle of deep eutectic solvent on ephedrine-type alkaloid extraction from Ephedrae Herba.

In this study, deep eutectic solvent (DES), as a new green solvent, was used to extract bioactive alkaloids from Ephedrae Herba using supersonic extraction. In a variety of tested hydrophilic and hydrophobic DESs, DES composed of choline chloride and xylitol was proved to be the most efficient solvent. Factors affecting extraction efficiency, including the mole ratio of hydrogen bond acceptor/hydrogen bond donor, water contention, and solid/liquid ratio, were optimized individually. Under optimal conditions, the yield of ephedrine (EP) and pseudoephedrine obtained using this new method was 14.24 and 4.32 mg/g, respectively, which was higher than that using the traditional solvent (acidified water and methanol). Furthermore, the extraction mechanism of DES and EP was investigated using molecular dynamics simulation study. Structural properties such as radial distribution functions and average number of hydrogen bonds were then computed. The results showed that hydrogen bonds and van der Waals forces are important driving forces of extraction; in addition, the hydrogen bonds between the Cl atom of choline chloride and N atom of EP played a dominant part in the extraction process. Based on the extraction principle, the extraction method using choline chloride as extraction solvent was also discussed.

Prevalence, risk factors and characteristics of delirium in intensive care unit patients: a prospective observational study / 中华危重病急救医学

OBJECTIVE@#To investigate the prevalence, risk factors, duration and outcome of delirium in intensive care unit (ICU) patients.@*METHODS@#A prospective observational study was conducted for critically ill patients admitted to the department of critical care medicine, the Affiliated Hospital of Guizhou Medical University from September to November 2021. Delirium assessments were performed twice daily using the Richmond agitation-sedation scale (RASS) and confusion assessment method of ICU (CAM-ICU) for patients who met the inclusions and exclusion criteria. Patient's age, gender, body mass index (BMI), underlying disease, acute physiologic assessment and chronic health evaluation (APACHE) at ICU admission, sequential organ failure assessment (SOFA) at ICU admission, oxygenation index (PaO2/FiO2), diagnosis, type of delirium, duration of delirium, outcome, etc. were recorded. Patients were divided into delirium and non-delirium groups according to whether delirium occurred during the study period. The clinical characteristics of the patients in the two groups were compared, and risk factors for the development of delirium were screened using univariate analysis and multivariate Logistic regression analysis.@*RESULTS@#A total of 347 ICU patients were included, and delirium occurred in 57.6% (200/347) patients. The most common type was hypoactive delirium (73.0% of the total). Univariate analysis showed statistically significant differences in age, APACHE score and SOFA score at ICU admission, history of smoking, hypertension, history of cerebral infarction, immunosuppression, neurological disease, sepsis, shock, glucose (Glu), PaO2/FiO2 at ICU admission, length of ICU stay, and duration of mechanical ventilation between the two groups. Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.045, 95% confidence interval (95%CI) was 1.027-1.063, P < 0.001], APACHE score at ICU admission (OR = 1.049, 95%CI was 1.008-1.091, P = 0.018), neurological disease (OR = 5.275, 95%CI was 1.825-15.248, P = 0.002), sepsis (OR = 1.941, 95%CI was 1.117-3.374, P = 0.019), and duration of mechanical ventilation (OR = 1.005, 95%CI was 1.001-1.009, P = 0.012) were all independent risk factors for the development of delirium in ICU patients. The median duration of delirium in ICU patients was 2 (1, 3) days. Delirium was still present in 52% patients when they discharged from the ICU.@*CONCLUSIONS@#The prevalence of delirium in ICU patients is over 50%, with hypoactive delirium being the most common. Age, APACHE score at ICU admission, neurological disease, sepsis and duration of mechanical ventilation were all independent risk factors for the development of delirium in ICU patients. More than half of patients with delirium were still delirious when they discharged from the ICU.

FERM domain-containing protein FRMD6 activates the mTOR signaling pathway and promotes lung cancer progression / 医学前沿

FRMD6, a member of the 4.1 ezrin-radixin-moesin domain-containing protein family, has been reported to inhibit tumor progression in multiple cancers. Here, we demonstrate the involvement of FRMD6 in lung cancer progression. We find that FRMD6 is overexpressed in lung cancer tissues relative to in normal lung tissues. In addition, the enhanced expression of FRMD6 is associated with poor outcomes in patients with lung squamous cell carcinoma (n = 75, P = 0.0054) and lung adenocarcinoma (n = 94, P = 0.0330). Cell migration and proliferation in vitro and tumor formation in vivo are promoted by FRMD6 but are suppressed by the depletion of FRMD6. Mechanistically, FRMD6 interacts and colocalizes with mTOR and S6K, which are the key molecules of the mTOR signaling pathway. FRMD6 markedly enhances the interaction between mTOR and S6K, subsequently increasing the levels of endogenous pS6K and downstream pS6 in lung cancer cells. Furthermore, knocking out FRMD6 inhibits the activation of the mTOR signaling pathway in Frmd6-/- gene KO MEFs and mice. Altogether, our results show that FRMD6 contributes to lung cancer progression by activating the mTOR signaling pathway.

Advances in mechanism of traditional Chinese medicine in inhibiting angiogenesis in ovarian cancer / 中国中药杂志

Ovarian cancer is one of the three major cancers in gynecology. Ovarian cancer has insidious symptoms in its early stages and mostly has progressed to advanced stages when detected. Surgical treatment combined with chemotherapy is currently the main treatment, but the 5-year survival rate is still less than 45%. Angiogenesis is a key step in the growth and metastasis of ovarian cancer. The inhibition of ovarian cancer angiogenesis has become a new hotspot in anti-tumor targeted therapy, which has many advantages such as less drug resistance, high specificity, few side effects, and broad anti-tumor spectrum. Modern research has confirmed that traditional Chinese medicine(TCM) can inhibit tumor angiogenesis by inhibiting the expression of pro-angiogenic factors, up-regulating the expression of anti-angiogenic factors, inhibiting the proliferation of vascular endothelial cells, reducing the density of tumor microvessels, and regulating related signaling pathways, with unique advantages in the treatment of ovarian cancer. This paper presented a review of the role of TCM in inhibiting ovarian cancer angiogenesis in order to provide references for the optimization of clinical ovarian cancer treatment strategies.

Cross sectional, surveillance and longitudinal study of poor visual acuity in Gui an New Distinct of Guizhou Province / 中国学校卫生

Objective@#To understand the development trend of poor vision among primary students through cross sectional, surveillance and longitudinal analysis, so as to put forward some suggestions on adolescents growth and health.@*Methods@#Visual data of 3 753 pupils were inclucled for analysis from Gui an New Distinct, Guizhou Province in autumn semester 2021, and were compared with data collected during the year of 2016-2021. The curve, increment and contribution rate of poor vision from each grade of the three designs were contrasted.@*Results@#In 2021, poor vision rate among pupils in this town was 25.6%. The curve of poor vision rate in cross sectional data was U shaped with significant rise followed by decline which was different from monitoring and longitudinal tracking data, and the trend of poor vision rate of monitoring and longitudinal tracking data were linear with continued increases. The cross sectional data in 2021 showed that the highest contribution rate of poor vision rate of pupils was in grade 1(87.0% ), while other data showed that those were both in grade 4(45.0%, 33.9%).@*Conclusion@#The accuracy of the development trend of poor vision is lowest in cross sectional analysis and highest in longitudinal analysis. However, data acquisition and preservation is easy in cross sectional study and difficult in longitudinal study. It is necessary to improve the electronic information system based on cross sectional data to gradually form a complete monitoring and longitudinal tracking data, and combine different data to provide more accurate information.

Evaluation on the blocking effect of hepatitis B vaccine on mother-to-infant transmission in 302 cases and analysis of influencing factors / 公共卫生与预防医学

Objective To evaluate the effect of the current immunization strategy for hepatitis B virus (Hepatitis B) in blocking mother-to-infant transmission in Hubei Province, and to explore the mechanism and possible influencing factors of failure of mother-to-infant blockade. Methods A multi-stage random sampling method was used to select 2 counties or districts in Hubei Province. Through maternity hospital health handbook, neonatal health record or hospital medical record system, hepatitis B virus (HBV) surface antigen (HBsAg)-positive pregnant women in 2012-2018 years were included to retrospectively investigate their delivery status and the HBV infection status of their children. Results Among the 302 newborns, 32 were positive for HBsAg, and the success rate of blockade of mother-to-infant transmission of hepatitis B was 89.45%. Further analysis showed that 68.21% (206 / 302) of newborns were delivered in township hospitals, 66.23% (200 / 302) were delivered by caesarean section and 41.72% (126 / 302) were breastfed, while 16.89% (51/302) were positive for hepatitis B virus e antigen (HBeAg), and 41.06% (124/302) were positive for anti-HBe. The vaccination rate of hepatitis B immunoglobulin (HBIG) during pregnancy was 3.31% (10/302), and the newborn HBIG vaccination rate was 94.37% (285/302). There were 84.11% (254/302) of pregnant women taking protective measures in daily life. Logistic regression analysis showed that township hospitals (OR=2.82, P<0.05), HBeAg positivity during pregnancy (OR=8.68, P<0.05), and HBIG vaccination during pregnancy (OR=12.62 , P<0.05) were risk factors for failure of mother-to-infant blockade, while anti-HBe positivity during pregnancy (OR=0.22, P<0.05), vaccination of newborns with HBIG (OR=0.20, P<0.05), and protective measures taken in daily life (OR=0.28, P<0.05) were protective factors for mother-to-infant interruption. Conclusion Deliveries in township hospitals and HBeAg-positivity during pregnancy are more likely to fail in blocking of mother-to-infant transmission of hepatitis B. HBIG vaccination during pregnancy does not reduce the risk of blockade failure. Neonatal HBIG vaccination, anti-HBe positivity during pregnancy, and protective measures in daily life can reduce the risk of blockade failure of mother-to-infant transmission of hepatitis B.

Correlation analysis of self-esteem and imposter phenomenon among clinical nurses / 中国实用护理杂志

Objective:To investigate the correlation relationship between self-esteem and imposter phenomenon among nurses,and to provide reference for optimizing nurse team.Methods:A total of 836 nurses were selected from February to March 2023 in the Yongzhou Central Hospital of Hunan Province and the People′s Hospital of Longhua, Shenzhen. A cross-sectional survey was conducted on nurses using the General Data Questionnaire, Impostor Phenomenon Scale and Self-Esteem Scale.Results:The imposter phenomenon score of nurses was (48.97 ± 12.58) points and the self-esteem score was (28.93 ± 3.86) points. The total score of self-esteem was negatively correlated with the total score of imposter phenomenon ( r= -0.433, P<0.01). Multivariate linear regression analysis showed that with the increase of self-esteem score, the score of imposter phenomenon decreased ( B=-1.402, P<0.01). Self-esteem was an important factor affecting the imposter phenomenon among clinical nurses, accounting for 18.9% of the total variation. Conclusions:The self-esteem and imposter phenomenon of clinical nurses are both at a moderate level, the improvement of self-esteem is beneficial to decreased their imposter phenomenon.

Study on the value of Xiaozeng Qianggu tablet combined with Zhengshishuhuo tincture in treating knee osteoarthritis combined with osteoporosis:an assessment based on quantitative MRI and QCT / 中国医学装备

Objective:To assess the value of Xiaozeng Qianggu tablet combined with Zhengshishuhuo tincture in treating knee osteoarthritis(KOA)combined with osteoporosis(OP)on the basis of quantitative magnetic resonance imaging(MRI)and quantitative CT(QCT).Methods:A total of 80 patients with KOA combined with OP admitted to the hospital were selected,and they were divided into an observation group and a control group according to the random number table method,with 40 cases in each group.The observation group was treated with Xiaozeng Qianggu Tablets combined with Zhengshishuhuo tincture that coordinated local massage,while the control group was treated with Zhengshishuhuo tincture alone coordinated local massage.The visual analogue scale(VAS),Westerm Ontario and Mcmaster Universities Osteoarthritis Index(WOMAC)and short form-36(SF-36)scores before and after treatment of the two groups of patients were compared,as well as the changes of serum IL-1β,IL-6 and TNF-α levels of patients.Quantitative MRI and QCT were used to measure the imaging changes of the patients'knee joints before and after treatment,and whole organ magnetic resonance imaging score(WOMRIS)and bone mineral density(BMD)values of knee joint before and after treatment between two groups were further compared.Results:After treatment,the VAS and WOMAC scores of the patients in the observation group were significantly lower than those of the control group,and the SF-36 scores of that was significantly lower than that of the control group,the differences were statistically significant(t=2.518,t=2.017,t=2.262,P<0.05),respectively.The serum TNF-α,IL-1β,and IL-6 levels of the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=2.429,t=2.641,t=4.065,P<0.05).The scores of subchondral bone marrow edema,meniscal injury and degeneration and joint effusion of observation group were significantly lower than those of the control group,and the differences were statistically significant(t=2.641,t=2.216,t=2.262,P<0.05).The BMD values of the four parts included the femoral medial condyle,lateral condyle,tibial lateral platform and tibial medical platform of the observation group were respectively higher than those of control group,and the differences were statistically significant(t=2.864,t=3.985,t=4.276,t=2.714,P<0.05).Conclusion:Xiaozeng Qianggu Tablets combined with Zhengshishuhuo tincture that coordinated local massage can effectively relieve pain of patients with KOA combined with OP,and improve joint function,and delay osteoporosis of knee joint.

Combining electromyographic biofeedback with extracorporeal shockwave therapy can better relieve lower limb spasticity and improve the motor functioning of children with spastic cerebral palsy / 中华物理医学与康复杂志

Objective:To explore the effect of combining extracorporeal shockwave therapy (ESWT) with electromyographic biofeedback on the motor functioning of children with spastic cerebral palsy.Methods:Fifty children with spastic cerebral palsy (2-7 years old) were randomized into a control group and an experimental group, each of 25. Both groups received routine rehabilitation and electric stimulation therapy with electromyographic biofeedback, while the experimental group was additionally provided with ESWT. Before and after 8 weeks of treatment, integral electromyograms were recorded and the root mean square values of the electromyogram recorded from the tibialis anterior muscle were computed. Lower limb spasticity and motor ability were evaluated by using the Modified Ashworth Scale (MAS), the Modified Tardieu Scale (MTS), and the D and E regions of the Gross Motor Function Measurement Scale (GMFM-88).Results:After the treatment the results of both groups had improved significantly in terms of the surface electromyography of the tibialis anterior muscle, MAS scores, R1 in the MTS and the difference between R2 and R1, and the GMFM-88 regional scores. All of the improvements were significantly greater in the experimental group than in the control group, on average.Conclusions:Combining ESWT with EMG biofeedback can better relieve lower limb spasticity and improve the motor functioning of children with spastic cerebral palsy.

Comparison on the efficacy of Chinese-made novel-designed mechanical-locked and elastic self-locked transcatheter edge-to-edge repair system in the treatment of patients with functional mitral regurgitation / 中华心血管病杂志

Objective: To evaluate and compare the short-term efficacy of domestic mechanical-locked (Clip2Edge) and elastic self-locked (ValveClip) transcranial mitral valve edge-to-edge interventional repair (TEER) devices in the treatment of functional mitral regurgitant valves. Methods: In this retrospective non-randomized comparative study, patients underwent TEER procedure in Fuwai Yunnan Cardiovascular Disease Hospital from May 2022 to April 2023 for heart failure combined with moderate to severe or severe functional mitral valve were divided into Clip2Edge and ValveClip groups based on the TEER system used. Baseline, perioperative, and postoperative 30 d follow-up data were collected and compared between the two groups. The primary outcome was the success rate on the 30 d post operation, while secondary outcomes included immediate postoperative technical success rate and the incidence of all-cause mortality on the 30 d post operation, readmission rate of acute heart failure, cerebral infarction, severe bleeding, and other serious adverse events rates. Results: A total of 60 patients were enrolled, 34 patients were in the Clip2Edge group and 26 in the ValveClip group, mean age was (63.8±9.3) years, and 24 patients (40%) were female. There were no significant differences in baseline data of age, cardiac function, comorbidities, mitral regurgitation 4+(19(73%) vs. 29(85%)), the end-diastolic volume of left ventricle ((220.8±91.2) ml vs. (210.8±71.7) ml) between the two groups (all P>0.05). The technical success rate immediately after the procedure was 100%. There were no readmission of acute heart failure, death, cerebral infarction, severe bleeding, and other serious adverse events up to the 30 d follow-up. Device success rate was similar between the ValveClip group (24 cases (100%)) and the Clip2Edge group (27 cases (96%)) (P>0.05). Conclusion: Both types of novel domestic TEER devices are safe and feasible in treating patients with functional mitral regurgitation.

Comparison on the efficacy of Chinese-made novel-designed mechanical-locked and elastic self-locked transcatheter edge-to-edge repair system in the treatment of patients with functional mitral regurgitation / 中华心血管病杂志

Objective: To evaluate and compare the short-term efficacy of domestic mechanical-locked (Clip2Edge) and elastic self-locked (ValveClip) transcranial mitral valve edge-to-edge interventional repair (TEER) devices in the treatment of functional mitral regurgitant valves. Methods: In this retrospective non-randomized comparative study, patients underwent TEER procedure in Fuwai Yunnan Cardiovascular Disease Hospital from May 2022 to April 2023 for heart failure combined with moderate to severe or severe functional mitral valve were divided into Clip2Edge and ValveClip groups based on the TEER system used. Baseline, perioperative, and postoperative 30 d follow-up data were collected and compared between the two groups. The primary outcome was the success rate on the 30 d post operation, while secondary outcomes included immediate postoperative technical success rate and the incidence of all-cause mortality on the 30 d post operation, readmission rate of acute heart failure, cerebral infarction, severe bleeding, and other serious adverse events rates. Results: A total of 60 patients were enrolled, 34 patients were in the Clip2Edge group and 26 in the ValveClip group, mean age was (63.8±9.3) years, and 24 patients (40%) were female. There were no significant differences in baseline data of age, cardiac function, comorbidities, mitral regurgitation 4+(19(73%) vs. 29(85%)), the end-diastolic volume of left ventricle ((220.8±91.2) ml vs. (210.8±71.7) ml) between the two groups (all P>0.05). The technical success rate immediately after the procedure was 100%. There were no readmission of acute heart failure, death, cerebral infarction, severe bleeding, and other serious adverse events up to the 30 d follow-up. Device success rate was similar between the ValveClip group (24 cases (100%)) and the Clip2Edge group (27 cases (96%)) (P>0.05). Conclusion: Both types of novel domestic TEER devices are safe and feasible in treating patients with functional mitral regurgitation.