CT-based radiomics research for discriminating the risk stratification of pheochromocytoma using different machine learning models: a multi-center study.

OBJECTIVES: The purpose of this study was to explore and verify the value of various machine learning models in preoperative risk stratification of pheochromocytoma. METHODS: A total of 155 patients diagnosed with pheochromocytoma through surgical pathology were included in this research (training cohort: n = 105; test cohort: n = 50); the risk stratification scoring system classified a PASS score of < 4 as low risk and a PASS score of ≥ 4 as high risk. From CT images captured during the non-enhanced, arterial, and portal venous phase, radiomic features were extracted. After reducing dimensions and selecting features, Logistic Regression (LR), Extra Trees, and K-Nearest Neighbor (KNN) were utilized to construct the radiomics models. By adopting ROC curve analysis, the optimal radiomics model was selected. Univariate and multivariate logistic regression analyses of clinical radiological features were used to determine the variables and establish a clinical model. The integration of radiomics and clinical features resulted in the creation of a combined model. ROC curve analysis was used to evaluate the performance of the model, while decision curve analysis (DCA) was employed to assess its clinical value. RESULTS: 3591 radiomics features were extracted from the region of interest in unenhanced and dual-phase (arterial and portal venous phase) CT images. 13 radiomics features were deemed to be valuable. The LR model demonstrated the highest prediction efficiency and robustness among the tested radiomics models, with an AUC of 0.877 in the training cohort and 0.857 in the test cohort. Ultimately, the composite of clinical features was utilized to formulate the clinical model. The combined model demonstrated the best discriminative ability (AUC, training cohort: 0.887; test cohort: 0.874). The DCA of the combined model showed the best clinical efficacy. CONCLUSION: The combined model integrating radiomics and clinical features had an outstanding performance in differentiating the risk of pheochromocytoma and could offer a non-intrusive and effective approach for making clinical decisions.

The prevalence, complications, and risk factors for infantile hemangioma: a systematic review and meta-analysis.

The epidemiological landscape of infantile hemangioma (IH) has been extensively explored through diverse data sources; however, a scarcity of systematically pooled and quantified evidence from comprehensive global studies persists. In this meta-analysis, we systematically review available literature to elucidate the prevalence, distribution of lesions, complications, and risk factors associated with IH. A meticulous search encompassing the Cochrane Library, PubMed, Embase, and Web of Science identified 3206 records, of which 55 studies met the inclusion criteria. We found that the overall prevalence of IH is 2.8% [95% confidence interval (CI): 1.5-4.4%] (31,274,396 infants), and IH was located more frequently in the head and neck with a prevalence of 47.4% (95% CI: 39.5-55.4%). The overall prevalence of complications of IH is 24.3% (95% CI: 18.6-30.5%), ulceration is 16.0% (95% CI: 10.4-21.2%), bleeding is 5.6% (95% CI: 3.3-8.5%), visual impairment is 5.6% (95% CI: 3.0-8.9%), infection is 2.8% (95% CI: 1.5-4.8%), subglottic obstruction is 1.5% (95% CI: 0.5-3.0%), respectively. Through 27 studies, we have evaluated 35 factors encompassing perinatal factors, socioeconomic factors, maternal complications, drug factors, and antepartum procedures, and identified 18 risk factors that increase the prevalence of IH. These findings can greatly assist clinicians and family members in effectively evaluating the risk of IH, and determining whether pregnant women should undergo intensified monitoring or preventive measures.

CT-Based Radiomics Analysis of Different Machine Learning Models for Discriminating the Risk Stratification of Pheochromocytoma and Paraganglioma: A Multicenter Study.

RATIONALE AND OBJECTIVES: Using different machine learning models CT-based radiomics to integrate clinical radiological features to discriminating the risk stratification of pheochromocytoma/paragangliomas (PPGLs). MATERIALS AND METHODS: The present study included 201 patients with PPGLs from three hospitals (training set: n = 125; external validation set: n = 45; external test set: n = 31). Patients were divided into low-risk and high-risk groups using a staging system for adrenal pheochromocytoma and paraganglioma (GAPP). We extracted and selected CT radiomics features, and built radiomics models using support vector machines (SVM), k-nearest neighbors, random forests, and multilayer perceptrons. Using receiver operating characteristic curve analysis to select the optimal radiomics model, a combined model was built using the output of the optimal radiomics model and clinical radiological features, and its accuracy and clinical applicability were evaluated using calibration curves and clinical decision curve analysis (DCA). RESULTS: Finally, 13 radiomics features were selected to construct machine learning models. In the radiomics model, the SVM model demonstrated higher accuracy and stability, with an AUC value of 0.915 in the training set, 0.846 in external validation set, and 0.857 in external test set. Combining the outputs of SVM models with two clinical radiological features, a combined model constructed has demonstrated optimal risk stratification ability for PPGLs with an AUC of 0.926 for the training set, 0.883 for the external validation set, and 0.899 for the external test set. The calibration curve and DCA show good calibration accuracy and clinical effectiveness for the combined model. CONCLUSION: Combined model that integrates radiomics and clinical radiological features can discriminate the risk stratification of PPGLs.

Acaricidal activities of paeonol from Moutan Cortex, dried bark of Paeonia × suffruticosa, against the grain pest mite Aleuroglyphus ovatus (Acari: Acaridae).

Aleuroglyphus ovatus (Acari: Acaridae) is a major pest mite of stored grains that is distributed worldwide. Paeonol, a phenolic component of the essential oil extracted from the Chinese herb Paeonia moutan, possesses a range of biological activities, including antiviral, antifungal and acaricidal activity. This study investigated the bioactivity of paeonol against A. ovatus and its effect on the activity of detoxification enzymes. The bioactivity of paeonol against A. ovatus was determined by contact, fumigation and repellency bioassays, and the mechanism was preliminarily explored via morphological observation of the color changes of mite epidermis and determination of the changing trend of some important enzymes associated with acaricidal efficacy in the mites. The results showed that the median lethal concentration (LC50) in the contact and fumigation bioassays was 9.832 µg/cm2 and 14.827 µg/cm3, respectively, and the acaricidal activity of paeonol was higher under direct contact than under fumigation. Dynamic symptomatology studies registered typical neurotoxicity symptoms including excitation, convulsion and paralysis in A. ovatus treated with paeonol. The enzyme activity of catalase (CAT), nitric oxide synthase (NOS) and glutathione-S-transferase (GST) was higher, whereas the activity of superoxide dismutase (SOD) and acetylcholinesterase (AChE) was lower, compared to the control group. CAT, NOS and GST were activated, whereas SOD and AChE activities were inhibited after paeonol intervention. Our findings suggest paeonol has potent acaricidal activity against A. ovatus and thus may be used as an agent to control the stored-product mite A. ovatus.

Rapid and visual detection of Toxoplasma gondii oocyst in cat feces using loop-mediated isothermal amplification (LAMP) assay.

Toxoplasma gondii is an obligate parasitic protozoon that transmits to animals and humans via ingested food. Cats that act as T. gondii's final hosts play a critical role in T. gondii transmission by shedding millions of oocysts. Timely diagnosis of infected cats is essential for preventing toxoplasmosis because oocysts are a putative T. gondii source in epidemiology. We developed a new visual LAMP assay targeting the B1 gene to analyze single oocysts in cat feces in this study. The amplification result could be visually estimated based on the color change. LAMP assay analytical sensitivity was 101 copies/µL for the B1 gene plasmid, which was tenfold better than the PCR reaction. There were no cross-reactions with other parasites. The LAMP assay can detect a single T. gondii oocyst in 200 mg of cat feces. The LAMP assay detected a single oocyst in 200 mg cat feces at a higher rate than the PCR assay (83.3% vs. 50.0%).

The complete mitochondrial genome of the chicken roundworm Ascaridia galli (Nematoda: Ascaridiidae).

Ascaridia galli (Nematoda: Ascaridiidae), infecting mainly the small intestine of chickens, is one of the most common nematodes in poultry worldwide. The complete mitochondrial genome sequence of A. galli was 13,981 bp in total length with 36 coding genes, namely, 12 protein-coding genes (PCGs), two ribosomal RNAs, and 22 transfer RNAs. All PCGs were transcribed in one direction. Phylogenetic analysis of the mitogenome of A. galli would further contribute to resolving its phylogenetic position and offer novel perspectives on phylogenetic studies of A. galli.

What Makes a Hospital Excellent? A Qualitative Study on the Organization and Management of Five Leading Public Hospitals in China.

Purpose: To summarize the organizational and management experiences and explore the organizational theoretical model of five leading public hospitals in China. Patients and Methods: Purposive sampling was used to select five leading hospitals in different regions of China under the National Health Commission and Provincial Health Commission as study hospitals for the study. From August 2021 to March 2022, 8 leaders and 39 managers from these hospitals were surveyed using semi-structured interviews. The data and information were analyzed in four dimensions using thematic analysis and grounded theory, focused on summarizing the experiences and practices of China's leading hospitals in organizational system, culture, operations and performance management, and employee development. This study complied with the COREQ guidelines for reporting qualitative research. Results: An organizational system model of the characteristics of hospital excellence was developed using four core attributes: organizational system, organizational culture, operations and performance management, and employee development; the model was named the System-Culture-Operation-Performance-Employee (SCOPE) model. Organization and management among leaders and managers in China's leading hospitals are based on the SCOPE process, resulting in employees' well-being, patients' positive outcomes, and organizational excellence. In terms of hospital culture, while adhering to the Hippocratic Oath, the hospital is deeply influenced by traditional Chinese culture, which emphasizes "benevolence" and "love", leading all staff to adhere to "patient-centered care and service." In terms of operations management, a separate operations management department is responsible for hospital operations and performance assessment. As for employee development, the staff's sense of reverence for their profession is emphasized and a reasonable salary system and good practice environment are established to promote staff motivation. Conclusion: The SCOPE model reveals the perspectives of leaders and managers in China's leading hospitals regarding organization and management under a Chinese cultural background. These findings can complement the existing literature on hospital management systems.

Learn from the best hospitals: a comparison of the mission, vision and values.

BACKGROUND: The hospital's mission, vision, and values are the core of the hospital's culture and the most profound expression of the hospital's culture. Although there have been many comparative studies on the mission, vision and values of organizations in the past, there have been few studies on the mission, vision and values of hospitals in the healthcare field. The purpose is to understand how the world's top hospitals develop the use of mission, vision and values in their "day-to-day management" and this may help other hospitals to develop their mission, vision and value effectively. METHODS: This paper collects and discusses the approaches of the world's top five hospitals in mission, vision and value through a qualitative analysis method. Documents for the study were collected from the publicly available information of the five hospitals, including their websites, annual reports, and relevant academic literature published in English on Google Scholar, PubMed, Medline, and Web of Science. RESULTS: These five hospitals have similarities and differences in the development of their missions, visions and values, which are worthy of study by other hospitals. The setting of a mission is a useful reflection of the hospital's focus and direction showing the social responsibility and sustainability of the hospital. The development of a vision has a guiding role in the equity and development of patients and employees and can improve the efficiency and effectiveness of hospital management and ensure the quality of services. The elaboration of values can greatly help hospitals to develop strategic plans and improve daily management. CONCLUSION: The top five hospitals in the world have several common valuable cultures in their missions, visions, and values, regardless of the properties of the hospitals or their management models. In addition, each hospital also has some enlightening descriptions that reflect their particularities.

Rapid visual detection of the allergen Dermatophagoides farinae in house dust by loop-mediated isothermal amplification.

Dermatophagoides farinae is considered to be an important factor causing some allergic diseases, such as urticaria, allergic rhinitis, asthma, and other interrelated diseases. Avoiding exposure to allergens is the most effective way to reduce allergic reactions. In this study, we successfully established a loop-mediated isothermal amplification (LAMP) method for the detection of D. farinae DNA target internal transcribed spacer (ITS) and D. farinae 1 allergen (Der f 1) genes. The turbidity-monitoring system and visual fluorescent reagents were used to verify the test results of LAMP assay. Following optimization of the primers and reaction temperatures, the amplification sensitivity, specificity, and efficiency of the method for detecting D. farinae were assessed. There was no cross-reaction with other arthropod species that are commonly found in indoor environmental dust, such as Dermatophagoides pteronyssinus, Alophagoides ovatus, Periplaneta americana, Anopheles sinensis, and Musca domestica. Furthermore, the sensitivity of LAMP assay for detecting D. farinae DNA was 10 times greater than that of conventional PCR. The positive detection rate by the LAMP method was greater than the conventional PCR for both single D. farinae mites and D. farinae mites in indoor dust. A new type of LAMP method for D. farinae based on the Der f 1 and ITS genes was, therefore, successfully established. This study is the first time to detect the D. farinae allergen using LAMP assay. This assay could be useful as a model for the rapid detection of allergens produced by other house dust mites in the future.

Assessing vaccine hesitancy using the WHO scale for caregivers of children under 3 years old in China.

Introduction: Vaccine hesitancy may increase infectious disease burden and impede disease control efforts, while few studies have measured such a phenomenon with a standardized tool in China. This study aimed to test the validation of the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group among caregivers and examine demographic characteristics associated with caregiver hesitancy in six provinces of China. Methods: Using a multistage sampling design, this study was conducted in 36 immunization clinics in six provinces from December 2019 to August 2020. Caregivers of children aged 0-3 years were included. The VHS was used to assess vaccine hesitancy. The construct validity and internal consistency of the scale were assessed. Associations between caregivers' characteristics and vaccine hesitancy were examined by simple and multiple linear regression models. Results: Of the 3,359 participants included, a two-factor structure within the scale was identified, consisting of "lack of confidence" (1.89 ± 0.53) and "risks" (3.20 ± 0.75). Caregivers engaged in medical work expressed more confidence and were less concerned about risks compared to those of non-medical staff (p < 0.05). Participants with higher income levels were more confident (p < 0.05), while those surveyed after the COVID-19 pandemic, who were mothers, who had an older child, or who were raising a second or above birth child, had less concern about risks (p < 0.05). Discussion: We found that the VHS had acceptable reliability and construct validity and caregivers' hesitancy was driven more by concerns about risks than by the lack of confidence. Countering these concerns will be particularly important among non-medical staff, lower income, child's fathers, having a younger child, or raising first-birth child groups.

Assessment of knowledge, attitude, and practice of sexual health among students in a Chinese medical college: a cross-sectional study.

Background: Sexual health is an essential part of overall well-being, and medical students' sexual education, level of sexual knowledge, and attitudes toward sexual health will affect their sexual behavior. Aim: To explore the correlation among medical decision tendency, sex education level, and sexual health KAP (knowledge, attitudes, and practices). Methods: We conducted a cross-sectional survey in March 2019. Data were collected via online surveys with a self-developed questionnaire covering sexual KAP and sexual education. We used Spearman correlation to assess the effect of sexual education on KAP after scoring the related questions. Outcomes: Outcomes included descriptive analysis and correlation of medical and nursing students' KAP and education regarding sexual health. Results: Medical and nursing students hold a high level of sexual knowledge (74.8%) and a positive attitude toward premarital sex (87.5%) and homosexuality (94.5%). By conducting the correlation analysis, we observed that medical and nursing students' tendency to support friends' homosexuality was positively correlated with the view that medical intervention for transgender or gay/lesbian people is unnecessary (P < .01). A positive correlation was also found between medical and nursing students who want more diverse sexual education and who would tend to provide patients with more humanistic care regarding their sexual needs (P < .01). Clinical Translation: Medical and nursing students who want more diverse sexual education and who had higher scores in the sexual knowledge test tend to provide their patients with more humanistic care regarding sexual needs. Strengths and Limitations: The research shows the current situation of medical and nursing students' sexual education experience and preference and sexual knowledge, attitudes, and behavior. Heat maps were used to more intuitively describe the correlation between medical students' characteristics and their sexual knowledge, attitudes, and behaviors and sex education. The results may not be generalizable across China, as the participants were from 1 medical school. Conclusion: It is essential to provide sexual education for medical and nursing students to ensure a more humanistic approach to patient care regarding sexual needs; therefore, we recommend that medical schools invest in sexual education for medical and nursing students throughout their education.

Clinical Characteristics of Six Patients with Chlamydia psittaci Infection Diagnosed by Metagenomic Next-Generation Sequencing: A Case Series.

The incidence of psittacosis infection has gradually increased in recent years. Metagenomic next-generation sequencing (mNGS) can be used to comprehensively identify the total DNA and RNA content of the microbiome, as well as identify both known and unexpected pathogens within 24 hours. We diagnosed and treated six patients with psittacosis infection using mNGS, two of whom developed severe disease and most of whom presented with pulmonary symptoms. One of the young female patients also presented with irregular vaginal bleeding and myocarditis. Patients with underlying gastric disorders first showed gastrointestinal symptoms, which is a rare manifestation in patients with psittacosis. Older patients with underlying disease usually showed more severe symptoms. However, rare complications can also occur in immunocompetent young people and develop into severe disease. All patients showed significant congestion at bronchial lumen lesions, which may be associated with a severe inflammatory response to mucosal Chlamydia psittaci (C. psittaci) infection. Overall, mNGS is a rapid and effective tool for the clinical diagnosis of psittacosis caused by C. psittaci, and early diagnosis and treatment can prevent psittacosis from developing into a serious illness.

Organisational Culture Research in Healthcare: A Big Data Bibliometric Study.

Across international healthcare, organisational culture and work environment have become central to all patient safety. However, there is a lack of comprehensive overview to assess and track the evolution of the literature on organisational culture in healthcare. This study aims to describe the current situation and global trends in organisational culture research in healthcare. The methodology is based on bibliometric mapping using scientific visualisation software (CiteSpace and VOSviewer). The big data were collected from the Web of Science core citation database. After applying the search criteria, we retrieved 1559 publications, which have steadily increased over the last two decades. In addition, 92 countries and regions have published studies on organisational culture in healthcare. The United States has made significant contributions to this field. In particular, organisational culture occupies an important position in the quality management of different types of care and caregiving. At the same time, organisational culture in healthcare may be inadequately researched in terms of theoretical underpinnings, which in turn leads to a lack of widespread dissemination of practice, and research on organisational culture in healthcare through evidence-based medicine may remain a significant focus and hot topic throughout the research field in the coming years.

Detection and assessment of dust mite allergens in an indoor environment in Anhui, China.

Dust in the home environment is thought to be a potential trigger for increasing allergic diseases, such as allergic rash, rhinitis, asthma, and other conditions, associated with dust mites. To verify the status of dust mite prevalence in indoor surroundings, we collected 189 dust samples from the air conditioner filters (n = 75) and floors (n = 114) of households, schools, and hotels in the Anhui area, China. All samples were measured for dust mite breeding rate and breeding density under light microscopy and analyzed for dust mite species Dermatophagoides farinae 1 (Der f 1) and Dermatophagoides pteronyssinus 1 (Der p 1) allergen using enzyme-linked immunosorbent assay (ELISA). The dust mite breeding rates were 34.67% (26/75) and 20.18% (23/114), respectively, in the dust samples from the floor and air conditioning filters. The breeding density was the highest in households (10/g), followed by schools (9/g) and hotels (4/g). ELISA indicated that the allergen threshold (2.0 µg/g dust) of Der f 1 was exceeded in only two samples and Der p 1 in one sample. Additionally, a questionnaire was used to investigate the health knowledge on allergic diseases involved in indoor facilities, finding that most allergy sufferers were aware that indoor dust might be responsible for their conditions. The findings suggest that regular maintenance of indoor hygiene and cleaning of air-conditioning filters should reduce the risks of exposure to indoor allergens.

Rapid and Visual Detection of Toxoplasma gondii in Blood Samples from Pet Cats and Dogs by Loop-Mediated Isothermal Amplification.

Background: Toxoplasma gondii is an obligate intracellular parasite that invades nearly all nucleated cells of a broad spectrum of vertebrate hosts, and which may cause serious disease in immunocompromised patients, as well as in the immunologically incompetent fetus. This study aimed to establish a loop-mediated isothermal amplification (LAMP) technique to rapidly detect T. gondii in the blood infection by targeting the 529 bp repeat element of T. gondii. Materials and Methods: A turbidity monitoring system, together with visual reagent, was used to test the amplification result of the LAMP assay. In addition, the specificity and sensitivity of the LAMP assay were measured. Results: The results suggest that the successfully established LAMP assay profile can detect the DNA of T. gondii at 67°C within 40 min. The limit of detection of the LAMP assay was 101 copies/µL. No cross reaction occurred with Plasmodium vivax, Toxocara cati, Clonorchis sinensi, Spirometra mansoni or Cryptosporidium parvum. We validated the developed LAMP assay by detecting T. gondii in DNA extracted from 353 blood samples collected from domestic cats and dogs. The percentages of positive results in detecting these blood samples by LAMP and conventional PCR were 5.38% and 2.83%, respectively. Conclusions: Our findings show that the developed LAMP assay offers higher analytical sensitivity than conventional PCR and good analytical specificity, minimizes aerosol contamination, and can be applied to on-site rapid detection of T. gondii.

Rapid and convenient detection of SARS-CoV-2 using a colorimetric triple-target reverse transcription loop-mediated isothermal amplification method.

Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 poses a significant threat to global public health. Early detection with reliable, fast, and simple assays is crucial to contain the spread of SARS-CoV-2. The real-time reverse transcription-polymerase chain reaction (RT-PCR) assay is currently the gold standard for SARS-CoV-2 detection; however, the reverse transcription loop-mediated isothermal amplification method (RT-LAMP) assay may allow for faster, simpler and cheaper screening of SARS-CoV-2. In this study, the triple-target RT-LAMP assay was first established to simultaneously detect three different target regions (ORF1ab, N and E genes) of SARS-CoV-2. The results revealed that the developed triplex RT-LAMP assay was able to detect down to 11 copies of SARS-CoV-2 RNA per 25 µL reaction, with greater sensitivity than singleplex or duplex RT-LAMP assays. Moreover, two different indicators, hydroxy naphthol blue (HNB) and cresol red, were studied in the colorimetric RT-LAMP assay; our results suggest that both indicators are suitable for RT-LAMP reactions with an obvious color change. In conclusion, our developed triplex colorimetric RT-LAMP assay may be useful for the screening of COVID-19 cases in limited-resource areas.

Glass transitions in frozen systems as influenced by molecular weight of food components.

Freezing is a frequently used way to expand the storage life of foods with high water content. Under suitable cooling rates, frozen systems attain a condition of maximum freeze concentration, which is characterized by the glass transition temperature (Tg '), end point of freezing or onset of melting (Tm '), and concentration of solids (Xs ') in the maximum-freeze-concentrated matrix. The value of Tg ', Tm ', and Xs ' depends on the chemical composition of frozen system. Below Tg ', the rates of deteriorative reactions are significantly reduced. In this article, the data for Tg ', Tm ', and Xs ' of different frozen systems including sugars, starches, proteins, and food are collected and compiled. The trends in Tg ' and Tm ' data of food are investigated using molecular weight (MW) of food components. The Tg ' and Tm ' of most starches (increased by 2.46% to 87.3% and 10.8% to 85.0%) and some protein-rich foods (increased by 5.00% to 53.4% and 25.0% to 52.9%) were higher than the maximum values of sugar-rich foods. Both Tg ' and Tm ' values increased with increasing MW of solids in frozen food, reaching an asymptotic value. Moreover, there were exponential relationships between Tg ' or Tm ' values and MW for sugar and starch-rich foods taken together. Some studies found that frozen storage below Tg ' maintains the higher quality of food that was achieved by fast freezing. However, other studies found that there was no significant difference in the quality of frozen foods between storage temperature below and above Tg '. Therefore, storage below Tg ' is not the only factor for predicting the stability of frozen foods.

Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update.

BACKGROUND: Diabetic foot (DF) is one of the most common and serious complications of diabetes mellitus (DM), which brings great psychological and economic pressure to patients. This study aimed to evaluate the efficacy of stem cells in the treatment of diabetic foot. METHODS: All relevant studies in Cochrane, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang databases were systematically searched for meta-analysis. The outcomes consisted of ulcer or wound healing rate, amputation rate, new vessels, ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), pain-free walking distance, and rest pain score. Dichotomous outcomes were described as risk ratios (RR) with 95% confidence intervals (CIs), while continuous data were presented as standardized mean differences (SMDs) with 95% CIs. Statistical analysis was performed with RevMan 5.3 software. RESULTS: A total of 14 studies with 683 participants were included in the meta-analysis. Meta-analysis showed that stem cell therapy was more effective than conventional therapy in terms of ulcer or wound healing rate [OR = 8.20 (5.33, 12.62)], improvement in lower extremity ischemia(new vessels) [OR = 16.48 (2.88, 94.18)], ABI [MD = 0.13 (0.04, 0.08)], TcO2[MD = 4.23 (1.82, 6.65)], pain-free walking distance [MD = 220.79 (82.10, 359.48)], and rest pain score [MD = - 1.94 (- 2.50, - 1.39)], while the amputation rate was significantly decreased [OR = 0.19 (0.10, 0.36)]. CONCLUSIONS: The meta-analysis of the current studies has shown that stem cells are significantly more effective than traditional methods in the treatment of diabetic foot and can improve the quality of life of patients after treatment. Future studies should conduct large-scale, randomized, double-blind, placebo-controlled, multicenter trials with high-quality long-term follow-up to demonstrate the most effective cell types and therapeutic parameters for the treatment of diabetic foot.

Medication Adherence and Perceived Social Support of Hypertensive Patients in China: A Community-Based Survey Study.

Purpose: Previous studies suggested perceived social support has impact on medication adherence among hypertensive patients, but did not simultaneously elucidate the different contents or key providers of social support that patients perceived. This study was to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China, which could prove important for targeted interventions. Patients and Methods: Following a multi-stage stratified sampling framework, a total of 903 hypertensive patients from 12 primary health institutions across a middle-income city were recruited from April to June 2021. Medication adherence was measured using the Chinese version of the Morisky, Green and Levine scale; perceived social support was determined using the name generator method. A binary logistic regression model was performed to identify the association between medication adherence and perceived social support. The contents of support included informational, emotional, and instrumental support (finances and caregiving). The support providers included spouse/partner, children, parents, siblings, other relatives, and friends. Results: A total of 506 (56.04%) patients optimally adhered to their antihypertensive medication. Female, older, urban patients, patients with shorter duration of hypertension and antihypertensive medications used showed better adherence (P<0.05). Optimal medication adherence was positively associated with the overall score of caregiving support (adjusted odds ratio [AOR] = 1.128; 95% confidence interval [CI] = [1.013-1.257]), informational support from the spouse/partner (AOR = 1.574; 95% CI = [1.112-2.227]), emotional support from the spouse/partner (AOR = 1.430; 95% CI = [1.032-1.981]), financial support from the spouse/partner (AOR = 1.439; 95% CI = [1.069-1.937]) and caregiving support from the spouse/partner (AOR = 1.652; 95% CI = [1.130-2.414]), whereas optimal medication adherence was negatively associated with caregiving support from friends (AOR = 0.499; 95% CI = [0.286-0.872]). Conclusion: Informational, emotional, financial and caregiving support from spouses/partners have positive impacts on optimal medication adherence of hypertensive patients of community-level. Community-based interventions designed to improve medication adherence of hypertensive patients should target both patients and their spouses/partners; spouses/partners could be encouraged to provide various support to improve the medication adherence of hypertensive patients.