Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

History of chronic gastritis:How our perceptions have changed

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular patient.Modern classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a patient.However,this attitude to the patient suffering from CG was far from always.The present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

Development of a Decision Aid for Family Surrogate Decision Makers of Critically Ill Patients Requiring Renal Replacement Therapy in ICU:A User-Centered Design for Rapid Prototyping

Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.

Preparation of Laser Cladding Coating Undercooling Cu-based Alloy and Co on Non-equilibrium Solidification Structure

The effect of the gradient content of Co element on the solidification process of Cu-based alloy under deep under cooling conditions was explored.The non-equilibrium solidification structure of the under cooled alloy samples were analyzed.It is found that the rapidly solidified alloy has undergone twice grain refinement during the undercooling process.Characterization and significance of the maximum undercooling refinement structure of Cu60Ni35Co5 at T=253 K were analyzed.High-density defects were observed,such as dislocations,stacking faults networks,and twinning structures.The standard FCC diffraction pattern represents that it is still a single-phase structure.Based on the metallographic diagram,EBSD and TEM data analysis,it is illustrated that the occurrence of grain refinement under high undercooling is due to stress induced recrystallization.In addition,the laser cladding technology is used to coat Co-based alloy(Stellite12) coating on 304 stainless steel substrate;the microstructure of the coating cross-section was analyzed.It was found that the microstructure of the cross-section is presented as columnar crystals,planar crystals,and disordered growth direction,so that the coating has better hardness and wear resistance.By electrochemical corrosion of the substrate and coating,it can be seen that the Co and Cr elements present in the coating are more likely to form a dense passivation film,which improved the corrosion resistance of the coating.

Advances in the diagnosis and treatment of heterotopic pancreas

Heterotopic pancreas,a rare congenital malformation,manifests outside the normal pancreas.Research suggests that abnormal embryonic development is linked to the presence of heterotopic pancreas.Three prevailing theories explain its mechanism:Dislocation theory,metaplasia theory,and totipotent stem cell theory.Clinical presentations of heterotopic pancreas are often nonspecific,with most patients being asymptomatic and incidentally discovered during unrelated surgeries or examinations.Endoscopic ultrasound,computed tomography,and magnetic resonance imaging are commonly employed diagnostic tools for heterotopic pancreas.However,the accuracy of diagnosis based on these methods is not consistently high,necessitating histopathological confirmation in many cases.Treatment options for heterotopic pancreas typically involve endoscopic resection,surgical resection,or observation through follow-up.

Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction

BACKGROUND Pelvic floor dysfunction(PFD)is related to muscle fiber tearing during childbirth,negatively impacting postpartum quality of life of parturient.Appropriate and effective intervention is necessary to promote PFD recovery.AIM To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD.METHODS A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups:Control group(n=27)received comprehensive rehabilitation therapy and observation group(n=32)received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy.The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment.Intervention for both groups was started 6 weeks postpartum,and rehabilitation lasted for 3 months.Pelvic floor muscle voltage,pelvic floor muscle strength,vaginal muscle voltage,vaginal muscle tone,pelvic floor function,quality of life,and incidence of postpartum PFD were compared between the two groups.RESULTS Before comprehensive rehabilitation treatment,basic data and pelvic floor function were not significantly different between the two groups.After treatment,the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles,contraction time of type I and type II fibers,pelvic floor muscle strength,vaginal muscle tone,vaginal muscle voltage,and quality of life(GQOLI-74 reports),compared with the control group.The observation group had lower scores on the pelvic floor distress inventory(PFDI-20)and a lower incidence of postpartum PFD,indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function.CONCLUSION The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength,promote the recovery of vaginal muscle tone,and improve pelvic floor function and quality of life.The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.

Efficiency and safety of laparoscopic left hemihepatectomy: A study of intrathecal vs extrathecal Glissonean pedicle techniques

BACKGROUND Selective hemihepatic vascular occlusion is utilized in both right and left hemihepatectomies to preserve blood supply to the intact lobe,maintain hemo-dynamic stability,and mitigate surgical risks.While this technique encompasses both intrathecal and extrathecal Glissonean pedicle transection methods,there is a lack of systematic comparative reports on these two approaches.AIM To retrospectively analyze the clinical data of patients with hepatocellular carcinoma(HCC)undergoing laparoscopic anatomical hepatectomy in our hospital to explore the feasibility,safety,and short-and long-term efficacy of extrathecal and intrathecal Glissonean pedicle transection methods in laparo-scopic left hemihepatectomy.METHODS A retrospective study was performed to analyze the clinical data of 49 HCC patients who underwent laparoscopic left hemihepatectomy from January 2019 to December 2022 in our hospital.These patients were divided into extrathecal Glissonean pedicle transection(EGP)group(n=24)and intrathecal Glissonean pedicle transection(IGP)group(n=25)according to the different approaches used for selective hemihepatic vascular occlusion.The perioperative indicators,liver function indexes,complications,and follow-up findings were compared between these two groups.RESULTS The surgeries were smooth in both groups,and no perioperative death was noted.The hepatic pedicle transection time and the operation time were(16.1±2.3)minutes and(129.6±19.0)minutes,respectively,in the EGP group,which were significantly shorter than those in the IGP group[(25.5±2.4)minutes and(184.8±26.0)minutes,respectively],both P<0.01.There were no significant differences in intraoperative blood loss,time to anal exhaust,hospital stay,drain indwelling time,and postoperative liver function between the two groups(all P>0.05).The incidence of postoperative complications showed no significant difference[16.67%(4/24)vs 16.0%(4/25),P>0.05].All the 49 HCC patients were followed up after surgery(range:11.2-53.3 months;median:36.4 months).The overall survival rate and disease-free survival rate were not significantly different(both P>0.05).CONCLUSION Both extrathecal and intrathecal Glissonean pedicle approaches are effective and safe hepatic inflow occlusion techniques in laparoscopic left hemihepatectomy for HCC.However,the extrathecal approach simplifies the hepatic pedicle transection,shortens the operation time,and increases the surgical efficiency,making it a more feasible technique.

Mechanism underlying the effects of exercise against type 2 diabetes:A review on research progress

Exercise has emerged as one of the important and effective non-drug therapies used for management of type 2 diabetes(T2D)in certain nations.The present report summarizes the latest findings from the research on the beneficial effect of exercise on T2D.The objectives were to provide references for the theoretical study and the clinical practice of exercise-based management of T2D,in addition to identify the limitations of the existing literature,thereby provide direction for future research in this field.

Application of psychological intervention in intensive care unit nursing for patients with severe acute pancreatitis

BACKGROUND Severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine nursing,more attention needs be paid to the patient’s psychological changes.AIM To investigate the effects of psychological intervention in ICU patients with SAP.METHODS One hundred ICU patients with SAP were hospitalized in the authors’hospital between 2020 and 2023 were selected,and divided into observation and control groups per the hospitalization order.The control and observation groups received routine nursing and psychological interventions,respectively.Two groups are being compared,using the Self-rating Anxiety Scale(SAS),Self-Determination Scale(SDS),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,and 36-item Short Form Health Survey(SF-36)scores;nursing satisfaction of patients;ICU care duration;length of stay;hospitalization expenses;and the incidence of complications.RESULTS After nursing,the SDS,SAS,and APACHEⅡ scores in the experimental group were significantly lower than in the control group(P<0.05).The SF-36 scores in the observation group were significantly higher than those in the control group(P<0.05).The nursing satisfaction of patients in the experimental group was 94.5%,considerably higher than that of 75.6% in the control group(P<0.05).The ICU care duration,length of stay,and hospitalization expenses in the observation group were significantly lower than those in the control group,and the incidence of complications was lower(P<0.05).CONCLUSION For patients with SAP,the implementation of standardized psychological intervention measures can effectively alleviate adverse psychological conditions.

Personalized treatment of perihilar cholangiocarcinoma based on tumor genetic and molecular characteristics

This editorial discusses the article written by Tchilikidi et al that was published in the latest edition of the World Journal of Gastrointestinal Surgery.Genetic and molecular profiling of perihilar cholangiocarcinoma(pCCA)has identified a number of key abnormalities that drive tumor growth and spread,including pyruvate kinase M2,proline rich 11,and transcription factor 7,etc.pCCA has specific genetic and molecular features that can be used to develop personalized treatment plans.Personalized treatment approaches offer new opportunities for effectively targeting the underlying drivers of tumor growth and progression.The findings based on tumor genetic and molecular characteristics highlight the importance of developing personalized treatment strategies.

Research on the Construction Status of the Beijing-Tianjin-Hebei Medical Talent Community and the Countermeasures for Its Realization

In April 2015,the Political Bureau of the CPC Central Committee adopted the“Outline of the Plan for the Coordinated Development of Beijing,Tianjin,and Hebei.”In July 2017,the“Plan for the Integrated Development of Beijing,Tianjin,and Hebei Talents(2017–2030),”jointly prepared by the leading groups of the three regions,was officially released.The core of the coordinated development of these three regions is the orderly removal of non-capital functions from Beijing.Talents,especially medical talents,are integral to this transition.The construction of a medical talent community across these three regions promotes the further development of a healthier China,meets the growing needs of the people for a better life,and embodies the concept of putting people first.This paper begins by examining the current situation of the construction of the Beijing-Tianjin-Hebei medical talent community,reviewing the progress made,analyzing existing problems,and proposing targeted countermeasures and suggestions.

Effects of exercise by type and duration on quality of life in patients with digestive system cancers:A systematic review and network meta-analysis

Background:There is scant evidence regarding the effects of exercise type and duration on quality of life(QoL)in digestive system cancer(DSC)survivors.We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.Methods:A systematic literature search of PubMed,Embase,and Web of Science was performed.Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs,and the comparator was in standard care or other types of exercise.The primary outcome was QoL,including general health,physical health,mental health,and role function.Secondary outcomes included cancer-related symptoms such as fatigue,insomnia,depression,anxiety,and duration of hospital stay.The network meta-analyses were performed using a random-effect model.Results:The analysis included 32 eligible articles and a total of 2558 participants.Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health(standardized mean difference(SMD)=0.66,95%credible intervals(Crls):0.05 to 1.30),and also contributed to a better mental health(SMD=0.38,95%CrI:-0.05 to 0.81)and role function(SMD=0.48,95%CrI:-0.27 to 1.20).Although without significant changes,short-term resistance exercise tended to increase the physical health of patients with DSCs(SM=0.69,95%CrI:-0.07 to 1.50)and effective in alleviating fatigue(SMD=-0.77,95%CrI:-1.50 to 0.01).Short-term aerobic exercise was related to a lower score of insomnia(SMD=-1.20,95%CrI:-2.40 to 0.06),depression(SMD=-0.51,95%CrI:-1.50 to 0.45),and anxiety(SMD=-0.45,95%CrI:-1.30 to 0.34).All types of exercise related to a trend of declined hospital stays(-0.87 to-5.00 day).Long-term resistance exercise,however,was negatively associated with general health(SMD=-0.33,95%CrI:-1.70 to 1.00),physical health(SMD=-0.18,95%CrI:-1.30to 0.90),and role function(SMD=-1.20,95%CrI:-2.50 to 0.11).Conclusion:This study suggests that short-term aerobic exercise,with or without resistance exercise programs,enhances QoL(especially for general health)as well as relieves cancer-related symptoms for DSC survivors,while long-term resistance exercise may have negative effects,and thus should be adopted cautiously.These results provide important evidence for the management of DSCs.

Construction of clinical research nurse training program based on position competence

BACKGROUND As one of the most important members in clinical trials,the number of clinical research nurses(CRN)can't keep up with the growth of experimental projects,so it is urgent to build clinical research training and strengthen the background knowledge of nurses.AIM To construct CRN training program based on position competence,accelerate the construction of CRN talent pool,and provide scientific guidance significance for CRN training.METHODS Based on the position competence model,combined with literature research and qualitative interview results,the first draft was prepared of the CRN training program.Two rounds of correspondence with 16 experts were conducted using the Delphi method to determine the training program.RESULTS The effective recovery rate of the expert correspondence questionnaire was 100%and the authority coefficients of the 2 rounds of experts were 0.826 and 0.895.Finally,4 first-level indicators and determine 15 s-level indicators of training objectives.The training program included 4 first-level indicators,training requirements,content,methods,assessment and evaluation,15 s-level indicators,and 74 third-level indicators.CONCLUSION The CRN training program based on position competence is scientific and extendable,providing a basis for participation in CRN training.

Efficacy of lidocaine wet compress combined with red-light irradiation for chronic wounds

BACKGROUND Chronic wounds that fail to progress through normal phases of healing present a significant healthcare burden owing to prolonged treatment and associated costs.Traditional wound care typically involves regular dressing changes,which can be painful.Recent approaches have explored the use of lidocaine to manage pain and red-light irradiation(RLI),known for its anti-inflammatory and cell proliferation effects,to potentially enhance wound healing.AIM To investigate the therapeutic efficacy of lidocaine wet compression(LWC)combined with RLI for chronic wounds.METHODS We enrolled 150 patients with chronic wounds from the Wound and Ostomy Outpatient Clinic of the Second Hospital of Anhui Medical University from April to September 2022.The wounds were treated with dressing changes.The patients were randomly assigned to the control and experimental groups using a random number table and given the same first dressing change(2%LWC for 5 min and routine dressing change).From the second dressing change,in addition to 2%LWC for 5 min and routine dressing change,the experimental group received RLI,whereas the control group continued to receive the same LWC and dressing change.The first and second dressing changes were performed on days 1 and 2,respectively.The third dressing change was performed 3 d after the second change.The frequency of subsequent dressing changes was determined based on wound exudation and pain.Pain during the first three dressing changes was evaluated in both groups.The average number of dressing changes within 28 d and the degree of wound healing on day 28 were also recorded.RESULTS During the initial dressing change,no noticeable differences were observed in the pain levels experienced by the two groups,indicating similar pain tolerance.However,during the second and third dressing changes,the experimental group reported significantly less pain than the control group.Furthermore,over 28 d,the experimental group required fewer dressing changes than the control group.CONCLUSION Notably,the effectiveness of wound healing on the 28th day was significantly higher in the experimental group than that of in the control group.The combination of LWC and RLI was effective in reducing early-stage pain,promoting wound healing,decreasing the frequency of dressing changes,and enhancing patients’overall quality of life with chronic wounds.

Magnetic resonance-guided focused ultrasound for essential tremor:a prospective,single center,single-arm study

The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA General Hospital.This prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(ClinicalTrials.gov Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local population.From 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm study.The treatment efficacy was determined using the Clinical Rating Scale for Tremor.Safety was evaluated according to the incidence and severity of adverse events.All of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate nucleus.At the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as serious.The most common intraoperative adverse events were nausea and headache.The most frequent postoperative adverse events were paresthesia and equilibrium disorder.Most of the adverse events were mild and usually disappeared within a few days.Our findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.

An artificial intelligence diabetes management architecture based on 5G

Along with the development of 5G network and Internet of Things technologies,there has been an explosion in personalized healthcare systems.When the 5G and Artificial Intelligence(Al)is introduced into diabetes management architecture,it can increase the efficiency of existing systems and complications of diabetes can be handled more effectively by taking advantage of 5G.In this article,we propose a 5G-based Artificial Intelligence Diabetes Management architecture(AIDM),which can help physicians and patients to manage both acute complications and chronic complications.The AIDM contains five layers:the sensing layer,the transmission layer,the storage layer,the computing layer,and the application layer.We build a test bed for the transmission and application layers.Specifically,we apply a delay-aware RA optimization based on a double-queue model to improve access efficiency in smart hospital wards in the transmission layer.In application layer,we build a prediction model using a deep forest algorithm.Results on real-world data show that our AIDM can enhance the efficiency of diabetes management and improve the screening rate of diabetes as well.

Circulating glycated albumin levels and gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is characterized by glucose intolerance that is first diagnosed during pregnancy,making it the most common complication associated with this period.Early detection and targeted treatment of GDM can minimize foetal exposure to maternal hyperglycaemia and subsequently reduce the associated adverse pregnancy outcomes.Previous studies have inconsistently suggested that the level of glycated albumin(GA)might predict GDM.AIM To review and synthesize existing evidence to evaluate the relationship between GA levels and the development of GDM.METHODS We sought to compare GA levels between GDM and control groups in this metaanalysis by systematically searching the Web of Science,PubMed,Cochrane Library,and Embase databases for articles published up to June 2023.The analysis utilized the weighted mean difference(WMD)as the primary metric.The data were meticulously extracted,and the quality of the included studies was assessed.Additionally,we conducted a subgroup analysis based on study region and sample size.We assessed heterogeneity using I2 statistics and evaluated publication bias through funnel plots.Additionally,trim-and-fill analysis was employed to detect and address any potential publication bias.RESULTS The meta-analysis included a total of 11 studies involving 5477 participants,comprising 1900 patients with GDM and 3577 control individuals.The synthesized results revealed a notable correlation between elevated GA levels and increased susceptibility to GDM.The calculated WMD was 0.42,with a 95%confidence interval(95%CI)ranging from 0.11 to 0.74,yielding a P value less than 0.001.Concerning specific GA levels,the mean GA level in the GDM group was 12.6,while for the control group,it was lower,at 11.6.This discrepancy underscores the potential of GA as a biomarker for assessing GDM risk.Moreover,we explored the levels of glycated haemoglobin(HbA1c)in both cohorts.The WMD for HbA1c was 0.19,with a 95%CI ranging from 0.15 to 0.22 and a P value less than 0.001.This observation suggested that both GA and HbA1c levels were elevated in individuals in the GDM group compared to those in the control group.CONCLUSION Our meta-analysis revealed a substantial correlation between elevated GA levels and increased GDM risk.Furthermore,our findings revealed elevated levels of HbA1c in GDM patients,emphasizing the significance of monitoring both GA and HbA1c levels for early GDM detection and effective management.

Dapagliflozin in heart failure and type 2 diabetes:Efficacy,cardiac and renal effects,safety

BACKGROUND Heart failure(HF),especially HF with reduced ejection fraction(HFrEF),presents complex challenges,particularly in the aging population where it often coexists with type 2 diabetes mellitus(T2DM).AIM To analyze the effect of dapagliflozin treatment on cardiac,renal function,and safety in patients with HFrEF combined with T2DM.METHODS Patients with T2DM complicated with HFrEF who underwent treatment in our hospital from February 2018 to March 2023 were retrospectively analyzed as the subjects of this study.The propensity score matching method was used,and a total of 102 eligible samples were scaled.The clinical efficacy of the two groups was evaluated at the end of the treatment,comparing the results of blood glucose,insulin,cardiac function,markers of myocardial injury,renal function indexes,and 6-min walk test(6MWT)before and after the treatment.We compared the occurrence of adverse effects on the treatment process of the two groups of patients.The incidence of adverse outcomes in patients within six months of treatment was counted.RESULTS The overall clinical efficacy rate of patients in the study group was significantly higher than that of patients in the control group(P=0.013).After treatment,the pancreatic beta-cell function index,left ventricular ejection fraction,and glomerular filtration rate of patients in the study group were significantly higher than control group(P<0.001),while their fasting plasma glucose,2-h postprandial glucose,glycosylated hemoglobin,insulin resistance index,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,cardiac troponin I,creatine kinase-MB,N-terminal pro b-type natriuretic peptide,serum creatinine,and blood urea nitrogen were significantly lower than those of the control group.After treatment,patients in the study group had a significantly higher 6MWT than those in the control group(P<0.001).Hypoglycemic reaction(P=0.647),urinary tract infection(P=0.558),gastrointestinal adverse effect(P=0.307),respiratory disturbance(P=0.558),and angioedema(P=0.647)were not statistically different.There was no significant difference between the incidence of adverse outcomes between the two groups(P=0.250).CONCLUSION Dapagliflozin significantly enhances clinical efficacy,cardiac and renal function,and ambulatory capacity in patients with HFrEF and T2DM without an increased risk of adverse effects or outcomes.

Research progress on insomnia treated by traditional Chinese medicine and acupuncture based on microbial-gut-brain axis theory

Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.

Relationship between postoperative rehabilitation style, gastrointestinal function, and inflammatory factor levels in children with intussusception

BACKGROUND Intussusception occurs in children and progresses rapidly.If not treated in time,it may lead to secondary complications such as intestinal perforation,which affect the quality of life and health of children.Surgery is the most common clinical treatment and has a good effect.However,the postoperative prognosis of children with intussusception has a correlation with the postoperative rehabilitation method.Therefore,in this study,we explored the relationship between postopera-tive rehabilitation,gastrointestinal function,and the expression of inflammatory factors in children with intussusception.The medical records of 18 children who were admitted to our hospital for intussusception surgery between October 2022 and May 2024 were retrospectively reviewed.The patients were divided into the routine nursing group(n=6)and rehabilitation training group(n=12)according to the postoperative rehabilitation method.The general data,gastrointestinal function,and inflammatory factor levels of the two groups were statistically analyzed.Pearson correlation analysis of gastrointestinal function,inflammatory factors,and postoperative rehabil-itation was performed.RESULTS We found no significant intergroup differences in sex,age,or disease course(P>0.05).The times to first defecation,bowel sound recovery,and anal exhaust were shorter and inflammatory factor levels were lower in the rehabilitation training group than in the routine nursing group(P<0.05).Pearson correlation analysis showed that gastrin and motilin levels were positively correlated with postoperative rehabilitation(P<0.05).Interleukin(IL)-2,IL-4,IL-6,IL-10,high-sensitivity C-reactive protein,and tumor necrosis factor-αlevels were negatively correlated with postoperative rehabilitation(P<0.05).Gastrointestinal function was positively correlated(P<0.05),and levels of inflammatory factors were negatively correlated with postoperative recovery time(P<0.05).CONCLUSION We found a positive correlation between gastrointestinal function and postoperative rehabilitation training,and a negative correlation between inflammatory factor levels and rehabilitation training in children with intussus-ception.