Clinical effects of detailed nursing management interventions on medication adherence and disease perception in patients with drugresistant tuberculosis

BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.

新生儿眼底病变筛查及视网膜出血的影响因素

目的:筛查统计新生儿眼底病变的基本情况,并探讨新生儿视网膜出血的影响因素。方法:收集2016-01-01/2018-05-31于我院产科病房及新生儿重症监护病房采用儿童数字化广域成像系统(RetcamⅢ)进行眼底筛查的新生儿,记录其性别、胎龄、分娩方式、窒息史、母孕史等临床资料,并对筛查结果进行统计分析。结果:本研究纳入新生儿289例,其中早产儿97例,足月儿192例。检出眼底病变者64例(22. 1%),其中视网膜出血者34例(11. 8%)、早产儿视网膜病变者23例(8. 0%)。单因素分析发现,胎龄、分娩方式、经阴产情况、有无窒息史、有无母孕期妊高征史、分娩史是新生儿视网膜出血的影响因素。多因素Logistic回归分析显示,早产儿、经阴道分娩、有窒息史、母孕期妊高征史是新生儿视网膜出血的高危因素。结论:新生儿视网膜出血发生率较高,其与胎龄、分娩方式、窒息史、母孕期妊高征史等多种因素相关,临床诊疗中应高度重视新生儿眼底病变的筛查。

糖尿病视网膜病变患者的生活质量及其影响因素

目的:分析糖尿病视网膜病变(diabetic retinopathy,DR)患者的生活质量(quality of life,QOL)及其影响因素。方法:分别采用一般情况问卷、视功能损害眼病患者生活质量量表(scale of quality of life in patients with visual impairment,SQQL-VI)和社会支持评定量表对103例DR患者进行问卷调查。采用向后逐步多重线性回归分析法分析年龄、性别、文化程度及社会支持度等因素对DR患者生活质量的影响。结果:DR患者的SQQL-VI量表中总生活质量评分为63.59±9.58分,症状与视功能评分为53.13±8.51分,身体机能评分为28.39±3.86分,社会活动评分为27.95±3.63分,精神心理方面评分为27.78±3.85分。单因素分析结果显示,不同年龄、文化程度、职业、家庭月收入、医疗费用负担方式、糖尿病病程和社会支持度DR患者的生活质量评分的差异有统计学意义(P<0.05)。多重线性回归分析显示,年龄、文化程度、医疗费用负担方式、糖尿病病程及社会支持度是DR患者生活质量的独立影响因素。结论:DR患者的生活质量较差,年龄、文化程度、医疗费用负担方式、糖尿病病程及社会支持是其主要影响因素,可通过减少经济负担、增加社会支持改善DR患者的生活质量。

卡培他滨节拍化疗联合三维适形放疗对晚期老年食管癌患者血清肿瘤标志物、VEGF、CRP及基质金属蛋白酶水平的影响

目的观察在晚期老年食管癌患者中,应用卡培他滨节拍化疗联合三维适形放疗的方案对其临床疗效、不良反应及对血清肿瘤标志物、血管内皮生长因子(vascular endothelial growth factor,VEGF)、C反应蛋白(c-reactionprotein,CRP)及基质金属蛋白酶水平的影响.方法回顾性分析2011-04/2016-04温州医科大学附属第一医院收治的130例晚期老年食管癌的临床资料,其中60例患者给予PF化疗方案(顺铂75 mg/m^2,d1,5-氟尿嘧啶1 g/m^2,d1-d4;每28 d一个化疗疗程,共二个疗程)联合同期三维适形放疗,将其作为对照组,70例患者给予卡培他滨节拍化疗方案(0.6 g/m^2,bid,早晚餐后口服,每28 d 1个化疗疗程,共2个疗程)联合同期三维适形放疗,将其作为观察组.然后将两组患者的临床疗效、不良反应及血清肿瘤标志物、VEGF、CRP及基质金属蛋白酶水平等指标进行比较.结果经过治疗后,观察组患者的治疗总有效率明显高于对照组(82.86%vs 65.0%),差异有统计学意义(P<0.05);在治疗前,两组患者的CA125、CA19-9、CEA、VEGF、CRP、MMP-2、MMP-9水平无明显差异,无统计学意义(P>0.05);在治疗后,观察组患者的CA125、CA19-9、CEA、VEGF、CRP、MMP-2、MMP-9水平明显低于对照组,差异有统计学意义(P<0.05);观察组患者的白细胞减少、消化道反应、肝功能损害发生率明显低于对照组.结论在晚期老年食管癌患者中应用卡培他滨节拍化疗联合三维适形放疗的治疗方案,能够显著提高临床疗效,有效降低其血清肿瘤标志物、VEGF、CRP及基质金属蛋白酶水平,且具有较高的用药安全性.

酸性溶液中苯并三氮唑和3-巯基-1-丙烷磺酸钠在铜电极表面的电化学SERS研究

利用原位电化学表面增强拉曼光谱技术(EC-SERS)研究了酸性溶液中苯并三氮唑(BTAH)、3-巯基-1-丙烷磺酸钠(MPS)及Cl-在铜电极表面的竞争吸附行为。在较正电位区间,BTAH分子在铜电极表面的吸附主要是通过三唑环在铜电极表面形成[Cu(BTA)]_(n)聚合物膜;随着电位负移,聚合物膜逐渐转化为BTAH分子形式吸附在铜电极表面。而MPS主要是以巯基端吸附在铜电极表面,其吸附方向的改变使得其在铜表面的拉曼信号呈现出先强后弱的趋势。Cl-主要是以Cu-Cl的形式存在,占据电极表面的活性位点与MPS产生协同作用。当三者复配时是以BTAH在电极表面的强吸附性为主导,且随着电位的负移,BTAH的拉曼信号呈现出先增强再减弱的趋势,相较于BTAH的强吸附作用,MPS与Cl-在电极表面的吸附强度较弱但依旧可以监测到两者参与竞争吸附的过程。

Role of neutrophil chemoattractant CXCL5 in SARS-CoV-2 infection-induced lung inflammatory innate immune response in an in vivo hACE2 transfection mouse model

Understanding the pathogenesis of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and clarifying antiviral immunity in hosts are critical aspects for the development of vaccines and antivirals.Mice are frequently used to generate animal models of infectious diseases due to their convenience and ability to undergo genetic manipulation.However,normal adult mice are not susceptible to SARS-CoV-2.Here,we developed a viral receptor(human angiotensin-converting enzyme 2,hACE2)pulmonary transfection mouse model to establish SARS-CoV-2 infection rapidly in the mouse lung.Based on the model,the virus successfully infected the mouse lung 2 days after transfection.Viral RNA/protein,innate immune cell infiltration,inflammatory cytokine expression,and pathological changes in the infected lungs were observed after infection.Further studies indicated that neutrophils were the first and most abundant leukocytes to infiltrate the infected lungs after viral infection.In addition,using infected CXCL5-knockout mice,chemokine CXCL5 was responsible for neutrophil recruitment.CXCL5 knockout decreased lung inflammation without diminishing viral clearance,suggesting a potential target for controlling pneumonia.

Meta-analysis of neostigmine injections given at the Zusanli （ST 36） acupoint in thetreatment of postpartum urinary retention

Objective： We aimed to determine the effect of neostigmine injections given at the Zusanli （ST 36） acupoint whentreating postpartum urinary retention. Methods： We conducted a systematic review to identify randomized controlledtrials （RCTs） involving neostigmine injections given at the Zusanli （ST 36） acupoint for treating postpartum urinaryretention. We searched the Cochrane Library, Pubmed, Web of Science, Chinese National Knowledge Infrastructure, VipDatabase, and Chinese Biomedical Literature Database from the creation of the database to December 30, 2016. Bias riskassessment was performed using Revman 5.3 software from Cochrane based on the criteria set out in the CochraneHandbook for Systematic Reviews of Interventions, version 5.1.0. Results： Thirteen studies were included with 627participants in the treatment group and 584 participants in the control group. （1） Overall response rate： neostigmineinjections given at the Zusanli （ST 36） acupoint have a better curative effect than injections given in muscle, odds ratio（OR） = 8.74, 95% confidence interval （CI） [5.83, 13.10], Z = 10.49 （P 〈 0.001）; （2） Comparison of effects at differentdosages： （i） 0.5 mg of neostigmine Zusanli （ST 36） acupoint injection group has better effect than 1 mg of neostigmineintramuscular injection group, OR = 15.84, 95% CI [5.74, 43.72],Z = 5.34 （P 〈 0.001）, （ii） 0.5 mg of neostigmineinjection given at the Zusanli acupoint has a better curative effect than 0.5 mg of neostigmine injection given in muscle ,OR = 7.30, 95% CI [3.47, 15.34], Z = 5.24 （P 〈 0.001）; （iii） 1 mg of neostigmine injection at the Zusanli （ST 36）acupoint has better efficacy than 1 mg of neostigmine injection in muscle, OR = 7.76, 95% CI [4.46, 13.52], Z = 7.25 （P〈 0.001）. Conclusion： Neostigmine injections at the Zusanli （ST 36） acupoint have beneficial effects in treatingpostpartum urinary retention. However, the low quality of the studies included in the meta-analysis raises questions overthe reliability of the results. Further studies are still needed.

Universal paradigm of ternary metacomposites with tunable epsilon-negative and epsilon-near-zero response for perfect electromagnetic shielding

CaCu_(3)Ti_(4)O_(12)(CCTO)ceramic nanocomposites incorporating graphene–carbon black(GRCB)fillers were fabricated by spark plasma sintering process.The percolative effects of conductive GRCB fillers on dielectric response of GRCB/CCTO ternary metacomposites were systematically investigated.The weakly real permittivity(ε′)-negative response(ε′~−1×10^(2))was achieved which originated from weakly low-frequency plasmonic state of free carriers within constructed GRCB networks.With enhancing three-dimensional GRCB network,the plasma frequency of metacomposites increased while the damping factor decreased.Herein,theε′-negative values of metacomposites were tuned from−10^(2) to−10^(4) orders of magnitude andε′-near-zero(ENZ)frequencies from~142 to~340 MHz which substantially benefited from the moderate carrier concentration of GRCB dual fillers.The Drude model and equivalent circuit models were adopted to demonstrate dielectric and electrical characteristics.The obtained metacomposites show strong EM shielding effect along with enhanced plasmonic oscillation and even better achieving perfect EM shielding effect in ENZ media.This work achieves the tunableε′-negative andε′-near-zero response and more importantly clarifies its regulation mechanism in ceramic-based ternary metacomposites,which opens up the possibility of designing high-performance EM shielding materials based on metacomposites.

Carbon nanotube-carbon black/CaCu_(3)Ti_(4)O_(12) ternary metacomposites with tunable negative permittivity and thermal conductivity fabricated by spark plasma sintering

Metacomposites with negative permittivity usually possess huge dielectric loss,showing potential for micro-wave attenuation devices where huge heat would generate.Herein,carbon nanotube-carbon black/CaCu_(3-)Ti_(4)O_(12)(CNT-CB/CCTO)ternary metacomposites were fabricated by spark plasma sintering.The CNT-CB dualphase filler was pre-pared through electrostatic selfassembly process in order to construct an effective 3-dimensional(3D)carbon network in CCTO matrix.The percolation threshold of CNT-CB/CCTO composites was identified at filler content of 12.52 wt%which accompanied with an essential change of conduction mechanism.The negative permittivity was derived from low-frequency plasmonic state of the 3D carbon network,described by Drude model.The problem of heat transport,generally occurring in negative permittivity materials,has been solved and optimized in obtained ternary metacomposites beneftting from the substantially high thermal conductivity(9.49-2.00 W·m^(-1)·K^(-1))and diffusivity(2.74-1.22mm^(2)·s^(-1)).This work could spark significant development of practical application of metacomposites on novel electronic devices and electromagnetic apparatus.