Background:To achieve successful management of infants with congenital heart disease(CHD)together with pulmonary hypertension(PH),postoperative care,especially feeding care is vital in addition to surgery.Postoperativ...Background:To achieve successful management of infants with congenital heart disease(CHD)together with pulmonary hypertension(PH),postoperative care,especially feeding care is vital in addition to surgery.Postoperative feeding is comprised of three stages:feeding in the intensive care unit,feeding in the general ward and family feeding,in which the general ward is considered as the“transitional stage”.At present,there is little research on the optimal mode of feeding care for the transitional stage,and there is no universally recognized and accepted protocol.Methods:We retrospectively analyzed 114 CHD infants with PH who underwent family-centered(FC)feeding care from July 2017 to December 2018,and prospectively studied 122 CHD infants with the same baseline level who adopted the improved mode,nurse-parent-driven(NPD)feeding mode from January 2019 to June 2020.The feasibility and efficacy of NPD as a“transitional”feeding nursing mode in CHD infants with PH were compared with the FC cohort by observing and analyzing the stress of family caregivers,feedingrelated complications,the proportion of breastfeeding,improvement of nutritional status,acquisition of knowledge and skills of feeding care,inpatient’s satisfaction rating and prognosis.Results:When compared with the FC feeding care,the NPD mode significantly reduced the burden of family caregivers,improved the rate of feeding care knowledge and skills and inpatient’s satisfaction rating,reduced the incidence of improper feeding-related complications,and enhanced the proportion of breastfeeding and nutritional status of infants at the“transitional stage”(all P<0.05).The self-assessment score of care ability of family caregivers and weight gain of children in the NPD group were significantly higher than those in the FC group(all P<0.05)during the follow-up.Conclusions:As a transitional mode of feeding in CHD infants with PH,NPD feeding care is superior to the conventional FC mode,which therefore can be adopted as a standard protocol in clinical practice.展开更多
Due to the high risk of tearing and rupture,vulnerable atherosclerotic plaques would induce serious cardiovascular and cerebrovascular diseases.Despite the available clinical methods can evaluate the vulnerability of ...Due to the high risk of tearing and rupture,vulnerable atherosclerotic plaques would induce serious cardiovascular and cerebrovascular diseases.Despite the available clinical methods can evaluate the vulnerability of plaques and specifically treat vulnerable plaques before a cardiovascular event,but the efficiency is still low and undesirable.Herein,we rationally design and engineer the low-intensity focused ultrasound(LIFU)-responsive FPD@CD nanomedicine for the highly efficient treatment of vulnerable plaques by facilely loading phase transition agent perfluorohexane(PFH)into biocompatible PLGA-PEG-PLGA nanoparticles(PPP NPs)and then attaching dextran sulphate(DS)onto the surface of PPP NPs for targeting delivery.DS,as a typical macrophages-targeted molecule,can achieve the precise vaporization of NPs and subsequently controllable apoptosis of RAW 264.7 macrophages as induced by acoustic droplet vaporization(ADV)effect.In addition,the introduction of DiR and Fe3O4 endows nanomedicine with near-infrared fluorescence(NIRF)and magnetic resonance(MR)imaging capabilities.The engineered FPD@CD nanomedicine that uses macrophages as therapeutic targets achieve the conspicuous therapeutic effect of shrinking vulnerable plaques based on in vivo and in vitro evaluation outcomes.A reduction of 49.4%of vascular stenosis degree in gross pathology specimens were achieved throughout the treatment period.This specific,efficient and biosafe treatment modality potentiates the biomedical application in patients with cardiovascular and cerebrovascular diseases based on the relief of the plaque rupture concerns.展开更多
基金This work was supported by the Science and Technology Project of Science and Technology Bureau of Wenzhou(Y20170467)the Science and Technology Project of Medical and Health of Zhejiang Province(2017RC021)+1 种基金Key Discipline Program of Pediatric Surgery of Health Bureau of Zhejiang Province(No.11-ZC27)Research Center for diagnosis and treatment of cardiac and vascular disease of Zhejiang,China(JBZX-202001).
文摘Background:To achieve successful management of infants with congenital heart disease(CHD)together with pulmonary hypertension(PH),postoperative care,especially feeding care is vital in addition to surgery.Postoperative feeding is comprised of three stages:feeding in the intensive care unit,feeding in the general ward and family feeding,in which the general ward is considered as the“transitional stage”.At present,there is little research on the optimal mode of feeding care for the transitional stage,and there is no universally recognized and accepted protocol.Methods:We retrospectively analyzed 114 CHD infants with PH who underwent family-centered(FC)feeding care from July 2017 to December 2018,and prospectively studied 122 CHD infants with the same baseline level who adopted the improved mode,nurse-parent-driven(NPD)feeding mode from January 2019 to June 2020.The feasibility and efficacy of NPD as a“transitional”feeding nursing mode in CHD infants with PH were compared with the FC cohort by observing and analyzing the stress of family caregivers,feedingrelated complications,the proportion of breastfeeding,improvement of nutritional status,acquisition of knowledge and skills of feeding care,inpatient’s satisfaction rating and prognosis.Results:When compared with the FC feeding care,the NPD mode significantly reduced the burden of family caregivers,improved the rate of feeding care knowledge and skills and inpatient’s satisfaction rating,reduced the incidence of improper feeding-related complications,and enhanced the proportion of breastfeeding and nutritional status of infants at the“transitional stage”(all P<0.05).The self-assessment score of care ability of family caregivers and weight gain of children in the NPD group were significantly higher than those in the FC group(all P<0.05)during the follow-up.Conclusions:As a transitional mode of feeding in CHD infants with PH,NPD feeding care is superior to the conventional FC mode,which therefore can be adopted as a standard protocol in clinical practice.
基金support from the National Natural Science Foundation of China(Grant Nos.81701650,81971608,and 82172092)the Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University(Grant No.2020-7)the Science&Technology Commission Foundation of Chongqing(Grant No.cstc2017jcyjAX0444).
文摘Due to the high risk of tearing and rupture,vulnerable atherosclerotic plaques would induce serious cardiovascular and cerebrovascular diseases.Despite the available clinical methods can evaluate the vulnerability of plaques and specifically treat vulnerable plaques before a cardiovascular event,but the efficiency is still low and undesirable.Herein,we rationally design and engineer the low-intensity focused ultrasound(LIFU)-responsive FPD@CD nanomedicine for the highly efficient treatment of vulnerable plaques by facilely loading phase transition agent perfluorohexane(PFH)into biocompatible PLGA-PEG-PLGA nanoparticles(PPP NPs)and then attaching dextran sulphate(DS)onto the surface of PPP NPs for targeting delivery.DS,as a typical macrophages-targeted molecule,can achieve the precise vaporization of NPs and subsequently controllable apoptosis of RAW 264.7 macrophages as induced by acoustic droplet vaporization(ADV)effect.In addition,the introduction of DiR and Fe3O4 endows nanomedicine with near-infrared fluorescence(NIRF)and magnetic resonance(MR)imaging capabilities.The engineered FPD@CD nanomedicine that uses macrophages as therapeutic targets achieve the conspicuous therapeutic effect of shrinking vulnerable plaques based on in vivo and in vitro evaluation outcomes.A reduction of 49.4%of vascular stenosis degree in gross pathology specimens were achieved throughout the treatment period.This specific,efficient and biosafe treatment modality potentiates the biomedical application in patients with cardiovascular and cerebrovascular diseases based on the relief of the plaque rupture concerns.
