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.

高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的研究

目的探讨高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效,以及对炎症因子、心肌损伤标志物、microRNA-21(miR-21)、呼吸力学指标、肺功能指标的影响。方法选取南通市妇幼保健院2018年1月-2020年12月收治的新生儿呼吸窘迫综合征患儿150例,按照治疗方法分为对照组与干预组,每组75例。对照组实施常规通气联合肺表面活性物质治疗,干预组实施高频振荡通气联合肺表面活性物质治疗。采用放射免疫测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平;采用酶联免疫吸附试验(ELISA)检测肌酸磷酸激酶同工酶(CK-MB)、氨基末端B型脑钠肽前体(NT-proBNP)水平;采用实时荧光定量聚合酶链反应(qRT-PCR)检测miR-21 mRNA相对表达量;检测并比较两组的呼吸力学指标、肺功能指标,比较两组的临床疗效和并发症总发生率。结果干预组治疗后7 d的TNF-α、IL-6、IL-8、CK-MB、NT-proBNP水平、miR-21 mRNA相对表达量、PaCO_(2)低于对照组(P<0.05);干预组PaO_(2)、氧合指数、每千克体重潮气量(TV)、达峰容积比(TPEF/TE)、达峰时间比(VPEF/VE)高于对照组(P<0.05);两组治疗有效率比较,差异无统计学意义(P>0.05);干预组并发症总发生率(5.33%)低于对照组(16.00%)(P<0.05)。结论高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征疗效显著,改善患儿呼吸功能和肺功能,减轻炎症反应,保护心肌细胞,减少并发症。

Effects of alloy elements on ductility and thermal conductivity of compacted graphite iron

The infl uence of Si, Sn, Mo and Ni on the ductility and thermal conductivity of compacted graphite iron(CGI) was investigated. Metallographic observation and Differential Scanning Calorimetry(DSC) experiments were carried out to analyze the roles of various additions in the eutectoid reaction. The experimental results showed that the ductility of CGI is proportional to the ferrite fraction, so moderate Si content could dramatically improve the ductility by increasing the ferrite fraction. DSC measurements showed that Mo has moderate inhibition on eutectoid transformation during both the heating and cooling processes, while the sample without Sn obviously broadens the three-phase region. Vermicularity and ferrite are known to improve thermal conductivity, and the former plays a more important role. Besides, among the alloy elements investigated, Sn has the greatest negative effect on conductivity, followed by Ni and Mo having the smallest effects.

Effect of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease

Objective:To investigate the effects of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease, Methods:110 patients with coronary heart disease from June 2015 to June 2016 in our hospital were selected as the research objects, randomly divided into observation group 55 cases and control group 55 cases, The patients in both groups received conventional treatment of coronary heart disease, and the control group was given orally atorvastatin calcium capsules at the same time. The observation group was added with trimetazidine hydrochloride tablets on the basis of the control group. The left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end-diastolic diameter (LVESD), C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD) and MDA levels of two groups were compared respectively before and after treatment. Results: Before treatment, the LVESD, LVEDD and LVEF levels between observation group and the control group had no significant difference (P>0.05);Compared with before treatment, LVESD and LVEDD levels in the observation group and control group after treatment were significantly decreased, LVEF increased significantly, and there were significant differences (P<0.05);After treatment, the observation group LVESD and LVEDD were lower than the control group, LVEF in the observation group after treatment was higher than the control group, and the differences were statistically significant (P<0.05). Before treatment, SOD and MDA between the observation group and the control group had no significant difference (P>0.05);After treatment, SOD in the observation group and the control group were significantly increased, MDA decreased significantly, and the differences were statistically significant (P<0.05);After treatment, SOD in the observation group was higher than the control group, MDA in the observation group was lower than the control group, and the differences were statistically significant (P<0.05). Before treatment, CRP, TNF-α, and IL-6 between the observation group and the control group had no significant difference (P>0.05);compared with before treatment, the CRP, TNF-α, and IL-6 of observation group and control group after treatment were significantly decreased, and the differences were statistically significant (P<0.05);After treatment, CRP, TNF-α, and IL-6 of the observation group were lower than the control group, and the difference was statistically significant (P<0.05).Conclusions:Atorvastatin combined with trimetazidine can more significantly improve cardiac function in patients with coronary heart disease, reduce oxidative stress and inflammation.

An Improved Golden Jackal Optimization Algorithm Based on Multi-strategy Mixing for Solving Engineering Optimization Problems

Nowadays,optimization techniques are required in various engineering domains to find optimal solutions for complex problems.As a result,there is a growing tendency among scientists to enhance existing nature-inspired algorithms using various evolutionary strategies and to develop new nature-inspired optimization methods that can properly explore the feature space.The recently designed nature-inspired meta-heuristic,named the Golden Jackal Optimization(GJO),was inspired by the collaborative hunting actions of the golden jackal in nature to solve various challenging problems.However,like other approaches,the GJO has the limitations of poor exploitation ability,the ease of getting stuck in a local optimal region,and an improper balancing of exploration and exploitation.To overcome these limitations,this paper proposes an improved GJO algorithm based on multi-strategy mixing(LGJO).First,using a chaotic mapping strategy to initialize the population instead of using random parameters,this algorithm can generate initial solutions with good diversity in the search space.Second,a dynamic inertia weight based on cosine variation is proposed to make the search process more realistic and effectively balance the algorithm's global and local search capabilities.Finally,a position update strategy based on Gaussian mutation was introduced,fully utilizing the guidance role of the optimal individual to improve population diversity,effectively exploring unknown regions,and avoiding the algorithm falling into local optima.To evaluate the proposed algorithm,23 mathematical benchmark functions,CEC-2019 and CEC2021 tests are employed.The results are compared to high-quality,well-known optimization methods.The results of the proposed method are compared from different points of view,including the quality of the results,convergence behavior,and robustness.The superiority and high-quality performance of the proposed method are demonstrated by comparing the results.Furthermore,to demonstrate its applicability,it is employed to solve four constrained industrial applications.The outcomes of the experiment reveal that the proposed algorithm can solve challenging,constrained problems and is very competitive compared with other optimization algorithms.This article provides a new approach to solving real-world optimization problems.

Synthesis and properties of three novel rhodamine-based fluorescent sensors for Hg^(2+)

Three novel rhodamine-based Hg^2＋ fluorescent sensors were designed and synthesized. The sensors could work in semi-aqueous solutions with nearly neutral p H and showed high selectivity and sensitivity to Hg^2＋ with remarkable fluorescence enhancement. For these three sensors, the linear working range broadened（0–80, 0–100 and 0–140 μmol/L, respectively） and the sensitivity increased（7.7, 15.5 and 17.6 folds of the fluorescence enhancement and 512, 66.2 and 37.6 ppb of the detection limit） with the rising of the thiourea-unit numbers. Furthermore the sensors exhibited excellent interference immunity to multiple environmentally and biologically relevant metal ions. Pond and tap water assay showed good practicability of the sensors. The number of the bound Hg^（2＋） equaling to that of the thiourea units and the irreversible recognition process implied a new interaction way between Hg^（2＋） and the sensor.

2019 Chinese expert consensus statement on diagnosis and treatment of syphilis

Syphilis,caused by Treponema pallidum subsp pallidum(T.pallidum),is a chronic,systemic human disease transmitted through sexual contact.The incidence and prevalence of syphilis is still high in China.[1]To guide the prevention measures and management of this disease,we renew the guidelines on diagnosis and treatment of syphilis[Supplementary file,http://links.lww.com/CM9/A292].Manifestations and diagnosis of all stages of syphilis are presented in Table 1,and management in Table 2.

Conceptual model of real-time IoT systems

We address a special kind of Internet of Things (IoT) systems that are also real-time. We call them real-time IoT (RT-IoT) systems. An RT-IoT system needs to meet timing constraints of system delay, clock synchronization, deadline, and so on. The timing constraints turn to be more stringent as we get closer to the physical things. Based on the reference architecture of IoT (ISO/IEC 30141), the RT-IoT conceptual model is established. The idea of edge subsystem is introduced. The sensing & con-trolling domain is the basis of the edge subsystem, and the edge subsystem usually must meet the hard real-time constraints. The model includes four perspectives, the time view, computation view, communication view, and control view. Each view looks, from a different angle, at how the time parameters impact an RT-IoT system.

National Guidelines on Diagnosis and Treatment of Gonorrhea in China (2020)

Gonorrhea is one of the main sexually transmitted diseases in China.It mainly affects the genitourinary tract,and its clinical manifestations vary from asymptomatic to complicated types.The diagnosis of gonorrhea should be based on the patient's epidemiologicai history,clinical manifestations,and laboratory examination results.Treatment should be prompt and standardized and should involve the recommended treatment regimens.Patients should be appropriately followed up after treatment.The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern.In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers,the authors developed the guidelines based on the version of 2014,which will be of important in the standardizing medical care of gonorrhea,and further facilitating control and prevention of the disease.