Impacts of Evidence-based Nursing on Quality of Life and Anxiety in Patients with Liver Injury.

Background: Plasma exchange is the most commonly applied method for treating severe hepatitis. As a kind of invasive treatment, plasma exchange may have various complications during treatment. Therefore, effective nursing should be implemented during plasma exchange treatment to prevent the incidence of complications. Objective: To compare the effects of traditional nursing methods versus evidence-based nursing practices on the quality of life and anxiety of patients with liver injury. Design: This was a retrospective study. Patient data were obtained from patient records. Setting: This study was carried out in the Department of Gastroenterology, Second Hospital of Hebei Medical University. Participants: One hundred and twenty severe hepatitis patients with 89 cases of early hepatic failure and 31 cases of middle hepatic failure admitted to our department from January 2020 to December 2022 were chosen, followed by randomly separating into a control group and an observation group. Interventions: The control group adopted nursing, while the observation group received evidence-based nursing including psychological nursing, nursing during treatment and post-treatment nursing. Primary Outcome Measures: (1) liver function (2) emotional state assessed by Self-rating Anxiety Scale (SAS) along with Self-rating Depression Scale (SDS) (3) coagulation function, (4) quality of life assessed by Short-Form 36 (SF-36) scale (5) nursing satisfaction, and (6) incidence of complications. Results: In contrast to the control group, the occurrence of complications in the observation group was significantly lower (P < .05). At 1-month review, the quality of life score in the observation group was higher in contrast to the control group (P < .05). In contrast to the control group, the nursing satisfaction of patients in the observation group was better (P < .05), alanine aminotransferase and total bilirubin levels in the observation group were lower, while albumin levels were higher (P < .05), the anxiety and depression scores of the observation group were lessened (P < .05), and the required time of coagulation function indexes in the observation group was shorter (P < .05). Conclusion: The application of evidence-based nursing to artificial liver therapy in patients with liver failure can effectively promote the liver function and coagulation index of patients, help to relieve negative emotions, and promote the quality of life of patients. This study may provide clinical reference for the nursing of artificial liver therapy in patients with liver failure.

Influence of Dynamic and Static Obstructive Renal Artery on Early Prognosis in Stanford Type A Aortic Dissection.

BACKGROUND: Acute kidney injury (AKI) after acute Stanford type A aortic dissection (STAAD) surgery has a high mortality rate. Clarifying what type of renal artery problem (dynamic obstructive renal artery, DORA, or static obstructive renal artery, SORA) secondary to STAAD benefits from true lumen opening is helpful in providing a reference for the indication of renal artery intervention. METHODS: From May 2018 to December 2019, 292 acute STAAD patients who underwent aortic surgery were enrolled in this study. DORA, SORA, and renal malperfusion were diagnosed according to preoperative aortic enhanced computed tomography (CTA). Renal artery problems secondary to STAAD were divided into three types: type 1, normal renal artery; type 2, DORA; and type 3, SORA. Acute kidney injury was divided into three stages: Stage 1, Stage 2, and Stage 3, according to 2012 Kidney Disease: Improving Global Outcomes (KDIGO). The primary endpoint was all-cause 30-day in-hospital death, and the secondary endpoint was postoperative dialysis requirement. Univariate and multivariate analyses were performed to assess the difference among the three types. RESULTS: Postoperative AKI occurred in 154 of 292 (52.7%) patients, and postoperative dialysis was present in 27 of 292 (9.2%) patients with STAAD. Postoperative AKI and dialysis were significantly more prevalent in the SORA group (AKI: 71% in SORA group vs 51.5% in DORA group vs 22.2% in normal group; postoperative dialysis: 22.2% in SORA group vs 5.4% in DORA group vs 6.1 in normal group). Thirty-day (30-day) mortality was also significantly higher in the SORA group (Log-rank test, p=0.012). Preoperative acute myocardial infarction and body mass index were the independent risk factors for 30-day mortality. Static obstructive renal artery, cardiopulmonary bypass time, and renal blood cell transfusion >3 units were the independent risk factors for postoperative dialysis requirement. CONCLUSION: Static obstructive renal artery led to higher 30-day in-hospital mortality and more postoperative dialysis. Open surgery reduced renal ischaemia injury caused by DORA, but it could not reduce renal ischaemia injury caused by SORA.

Experimental and Numerical Investigation of Polymer-Based 3D-Printed Lattice Structures with Largely Tunable Mechanical Properties Based on Triply Periodic Minimal Surface.

Triply periodic minimal surfaces (TPMSs) have demonstrated significant potential in lattice structure design and have been successfully applied across multiple industrial fields. In this work, a novel lattice structure with tunable anisotropic properties is proposed based on two typical TPMS types, and their mechanical performances are studied both experimentally and numerically after being fabricated using a polymer 3D printing process. Initially, adjustments are made to the original TPMS lattice structures to obtain honeycomb lattice structures, which are found to possess significant anisotropy, by utilizing numerical homogenization methods. Based on this, a continuous self-twisting deformation is proposed to change the topology of the honeycomb lattice structures to largely tune the mechanical properties. Quasi-static compression experiments are conducted with different twisting angles, and the results indicate that self-twisting can affect the mechanical properties in specific directions of the structure, and also enhance the energy absorption capacity. Additionally, it mitigates the risk of structural collapse and failure during compression while diminishing structural anisotropy. The proposed self-twisting strategy, based on honeycomb lattice structures, has been proven valuable in advancing the investigation of lattice structures with largely tunable mechanical properties.

M6A RNA Methylation Mediates NOD1/NF-kB Signaling Activation in the Liver of Piglets Challenged with Lipopolysaccharide.

N6-methyladenosine (m6A) is the most abundant internal modification that widely participates in various immune and inflammatory responses; however, its regulatory mechanisms in the inflammation of liver induced by lipopolysaccharide in piglets remain largely unknown. In the present study, piglets were intraperitoneally injected with 80 µg/kg LPS or an equal dose of sterile saline. Results indicated that LPS administration increased activities of serum alanine aminotransferase (ALT), induced M1 macrophage polarization and promoted secretion of inflammatory cytokines, and finally led to hepatic lesions in piglets. The NOD1/NF-κB signaling pathway was activated in the livers of the LPS group. Moreover, the total m6A level was significantly elevated after LPS treatment. MeRIP-seq showed that 1166 and 1344 transcripts contained m6A methylation in control and LPS groups, respectively. The m6A methylation sites of these transcripts mainly distributes in the 5' untranslated region (5'UTR), the coding sequence (CDS), and the 3' untranslated region (3'UTR). Interestingly, these genes were mostly enriched in the NF-κB signaling pathway, and LPS treatment significantly changed the m6A modification in NOD1, RIPK2, NFKBIA, NFKBIB, and TNFAIP3 mRNAs. In addition, knockdown of METTL3 or overexpression of FTO both changed gene levels in the NOD1/NF-κB pathway, suggesting that activation of this pathway was regulated by m6A RNA methylation. Moreover, the alteration of m6A RNA methylation profile may be associated with the increase of reactive oxygen species (ROS), HIF-1α, and MAT2A. In conclusion, LPS activated the NOD1/NF-κB pathway at post-transcriptional regulation through changing m6A RNA methylation, and then promoted the overproduction of proinflammatory cytokines, ultimately resulting in liver inflammation and damage.

Acute-Onset Visual Impairment in Wilson's Disease: A Case Report and Literature Review.

Objective: We reported the case of a patient with Wilson's disease (WD) with acute-onset visual impairment and summarized previously reported cases to make physicians aware of the complicated clinical expressions of WD and improve diagnosis efficiency. Methods: The patient was recruited from the Second Affiliated Hospital of Zhejiang University School of Medicine. Clinical data, including cranial images, laboratory tests, and ophthalmic findings were obtained. The PubMed database was searched for published cases of WD with visual impairment. Results: We reported a 22-year-old male who presented with hand tremor, personality change, and acute-onset binocular vision blurring. WD was considered to be closely correlated with neuropsychiatric and ocular involvements. After low-copper diet and regular copper-chelation therapy, the related symptoms improved compared to before. Six WD cases of optic neuropathy have been reported, including ours. The patients usually had neurological and/or hepatic symptoms for a period without any treatment. All the reported cases manifested as acute episodes of visual changes, and the ocular manifestations improved after copper-chelation treatment. Conclusions: Excess copper accumulation may be a rare cause of visual impairment in patients with WD. While the etiology behind patients' acute-onset visual impairment remained uncertain, the possibility of WD should be considered through neuropsychiatric and hepatic symptoms, corneal K-F rings, decreased serum ceruloplasmin, and low likelihood or exclusion of other causes. Clinicians need to recognize this rare manifestation and give appropriate treatment to avoid misdiagnosis and unnecessary overtreatment.

The regulatory role of N6 -methyladenosine modification in the interaction between host and microbes.

N6 -methyladenosine (m6 A) is the most prevalent posttranscriptional modification in eukaryotic mRNAs. Dynamic and reversible m6 A modification regulates gene expression to control cellular processes and diverse biological functions. Growing evidence indicated that m6 A modification is involved in the homeostasis of host and microbes (mostly viruses and bacteria). Disturbance of m6 A modification affects the life cycles of viruses and bacteria, however, these microbes could in turn change host m6 A modification leading to human disease including autoimmune diseases and cancer. Thus, we raise the concept that m6 A could be a "messenger" molecule to participate in the interactions between host and microbes. In this review, we summarize the regulatory mechanisms of m6 A modification on viruses and commensal microbiota, highlight the roles of m6 A methylation in the interaction of host and microbes, and finally discuss drugs development targeting m6 A modification. This article is categorized under: RNA in Disease and Development > RNA in Disease.

A cross-sectional study of the interaction between night shift frequency and age on hypertension prevalence among female nurses.

Night shift is a common work schedule. This study aimed to analyze the interaction between age and frequency of night shift on the hypertension prevalence. A census questionnaire was conducted in 512 medical institutions in 11 cities of Hebei Province. One lakh twenty-one thousand nine hundred three female nurses were included in this study. Binary Logistic regression analysis was done by SPSS Version 26.0. The youngest age group without night shift was used as the reference group. The odds ratio was calculated by different combinations of interaction items. Interaction coefficients were calculated by an Excel table designed by Andersson. Compared with the 18-25 year old ones without night shift, there existed an additive interaction between the age of 36-45 and more than 5-10 night shifts per month on hypertension prevalence. Odds ratio, the relative excess risk of interaction, the attributable proportion of interaction, and the synergy index and their 95% confidence intervals were 2.923(2.292-3.727), 0.631(0.309-0.954), 0.216(0.109-0.323), 1.488(1.158-1.913). Additive interaction was also found between the age of 36-45 and more than 10 night shifts per month. OR, RERI, API, SI, and their 95% confidence intervals were 3.430(2.273-5.175) 1.037(0.061-2.013), 0.303(0.089-0.516), and 1.746(1.093-2.788). There also existed an additive interaction between the age of 46-65 and more than 5-10 night shifts per month on hypertension prevalence. OR, RERI, API, SI, and their 95% confidence intervals were 7.398(5.595-9.781) 1.809(0.880-2.739), 0.245(0.148-0.341), and 1.394(1.199-1.622).There existed interaction between specific age groups and night shift frequency on the prevalence of hypertension among female nurses.

Effects of initial stress on band gap of Love waves in a layered domain-inverted phononic crystal structure.

Love wave propagation in periodically domain-inverted lithium niobate substrate with a homogeneous zinc oxide waveguide layer is theoretically investigated. Much attention is devoted to the effect of initial stress on the band gap and dispersion behavior of Love wave in the layered structure. The results reveal a strong dependency of the band structure on the waveguide layer. In particular, as the waveguide layer gradually thickens, the band gap shifts into a lower frequency range remarkably. Additionally, the initial stress has a significant influence on the location of the band gap, but a small effect on the bandgap width. This separate effect provides the potential to actively tune the surface acoustic waves by the stress.

Hypertension prevalence alteration in 92 815 nurses based on the new standard by 2017 ACC/AHA hypertension guideline: observational cross-sectional study from China.

OBJECTIVES: This study aimed to elucidate the status of hypertension and to analyse the hypertension changes in prevalence, awareness, treatment and control rate among the portion of Chinese nursing staff based on the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline and the 2010 Chinese Guideline for the Management of Hypertension. DESIGN: Cross-sectional study. SETTING: 512 medical institutions in 13 cities in Hebei Province. PARTICIPANTS: The candidates of registered nurses from 512 medical institutions in 13 cities in Hebei Province (N=143 772) were invited to participate in the survey, and few of them who refused to participate were excluded from the research group based on the reasons that 93 603 incumbent nurses at the age of 18-65 accepted to the survey and submitted questionnaires online. Undoubtedly, a response rate of 65.11% was achieved. After excluding 788 individuals with incomplete information in the questionnaires, 92 815 participants were included in the final analysis. MAIN OUTCOME MEASURES: The prevalence, awareness, treatment and control rates of hypertension. RESULTS: 92 815 participants were included in the final analysis, among which consisted of 3677 men (3.96%) and 89 138 women (96.04%). The mean age of the participants was 31.65 (SD=7.47) years.We demonstrated that 26 875 nursing staff were diagnosed as having hypertension according to the new standard by the 2017 ACC/AHA guideline, more than 20 551 cases compared with the previous threshold on the 2010 Chinese guideline. The prevalence of hypertension among nursing staff was 28.96% in the context of the 2017 ACC/AHA guideline, 3.25 times higher than that (6.81%) evaluated by the criteria of the 2010 Chinese guideline. However, the awareness, treatment and control rate (13.50%, 10.73% and 0.81%) were 3.25, 3.22 and 17.48 times lower than those (57.37%, 45.30% and 14.97%) based on the 2010 Chinese guideline, respectively. CONCLUSIONS: This research illustrated that it was crucial to improve the awareness rate, drug treatment rate and control rate of hypertension for nurses. Meanwhile, according to the 2017 ACC/AHA guideline, the prevalence of hypertension in China will increase significantly, which poses a more severe challenge to the management of hypertension in China.