Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma

BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.AIM To explore the effects of nursing care in fast-track surgery on postoperative pain,psychological state,and patient satisfaction with nursing for glioma.METHODS From June 2018 to June 2020,138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected.They were categorized into groups according to different nursing care that they received.Of them,69 patients receiving nursing care in fast-track surgery were included in an experimental group,and 69 patients receiving conventional postoperative nursing were included in a control group.Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day.A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups.RESULTS Time to excretion,time to out-of-bed activities,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There was no significant difference in duration of operative time or intraoperative bleeding between the two groups(P>0.05).There was no significant difference in postoperative pain score between the two groups(P>0.05).The pain score was significantly lower in the observation group than in the control group at 3 d after the operation(P<0.05).There was no significant difference in postoperative SAS or SDS score between the two groups(P>0.05).SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation(P<0.05).The rate of patient satisfaction with nursing was 94.2%in the observation group,which was significantly higher than that(81.2%)of the control group(P<0.05).CONCLUSION Nursing care in fast-track surgery can relieve postoperative pain,anxiety,and depression,and improve patient satisfaction with nursing in patients with glioma,which is worthy of clinical application.

Excitation-Contraction Coupling Time is More Sensitive in Evaluating Cardiac Systolic Function

Background： Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation-contraction coupling occurs as early as the compensated stage of hypertrophy before the global decrease in left ventricular ejection fraction （LVEF）. This study was to evaluate the cardiac electromechanical coupling time in evaluating cardiac systolic function in the early stage of heart failure. Methods： Twenty-six patients with Stage B heart failure （SBHF） and 31 healthy controls （CONs） were enrolled in this study. M-mode echocardiography was performed to measure LVEF. Tissue Doppler imaging （TDI） combined with electrocardiography （ECG） was used to measure cardiac electromechanical coupling time. Results： There was no significant difference in LVEF between SBHF patients and CONs （64.23 ± 8.91% vs. 64.52 ± 5.90%; P= 0.886）. However, all four electromechanical coupling time courses （Qsb： onset of Q wave on ECG to beginning of S wave on TDI, Qst： onset of Q wave on ECG to top of S wave on TDI, Rsb： top of R wave on ECG to beginning orS wave on TDI, and Rst： top of R wave on ECG to top orS wave on TDI） of SBHF patients were significantly longer than those of CONs （Qsb： 119.19 ± 35.68 ms vs. 80.30 ± 14.81 ms, P 〈 0.001 ; Qst： 165.42 ± 60.93 ms vs. 129.04 ± 16.97 ms, P = 0.006; Rsb： 82.43 ± 33.66 ms vs. 48.30 ± 15.18 ms, P 〈 0.001; and Rst： 122.37 ± 36.66 ins vs. 93.25 ± 16.72 ms, P = 0.001 ）, and the Qsb, Rsb, and Rst time showed a significantly higher sensitivity than LVEF （Rst： P =0.032; Rsb： P = 0.003; and Qsb： P = 0.004）. Conclusions： The cardiac electromechanical coupling time is more sensitive than LVEF in evaluating cardiac systolic function.

Ca^(2+):a versatile master key for intracellular signaling cascades

Ca2+is one of the most ancient and versatile intracellular messengers in both animal and plant systems.Ca2+interacts with a huge array of signaling proteins,and coordinates the integration of non-signaling proteins into cellular communication systems.In doing so,Ca2+plays crucial roles

Role of FK506-binding protein in Ca^(2+) spark regulation

The elementary Ca^(2+) release events, Ca^(2+) sparks, has been found for a quarter of century. However, the molecular regulation of the spark generator, the ryanodine receptor(RyR) on the sarcoplasmic reticulum,remains obscure. Although each subunit of the RyR homotetramer has a site for FK506-binding protein(FKBP), the role of FKBPs in modifying RyR Ca^(2+) sparks has been debated for long. One of the reasons behind the controversy is that most previous studies detect spontaneous sparks, where the mixture with out-of-focus events and local wavelets prevents an accurate characterization of Ca^(2+) sparks. In the present study, we detected Ca^(2+) sparks triggered by single L-type Ca^(2+) channels(LCCs) under loose-seal patch clamp conditions in FK506-treated or FKBP12.6 knockout cardiomyocytes. We found that FKBP dissociation both by FK506 and by rapamycin decreased the Ca^(2+) spark amplitude in ventricular cardiomyocytes. This change was neither due to decreased releasable Ca^(2+) in the sarcoplasmic reticulum,nor explained by changed RyR sensitivity. Actually FK506 increased the LCC-RyR coupling probability and curtailed the latency for an LCC to trigger a RyR Ca^(2+) spark. FKBP12.6 knockout had similar effects as FK506/rapamycin treatment, indicating that the decreased spark amplitude was attributable to the dissociation of FKBP12.6 rather than FKBP12. We also explained how decreased amplitude of spontaneous sparks after FKBP dissociation sometimes appears to be increased or unchanged due to inappropriate data processing. Our results provided firm evidence that without the inter-RyR coordination by functional FKBP12.6, the RyR recruitment during a Ca^(2+) spark would be compromised despite the sensitization of individual RyRs.

Abnormal expression of miR-331 leads to impaired heart function

MicroRNAs (miRNAs) play important roles in maintaining normal heart function. Abnormal expression of miR-331 has been observed in the hearts of patients with atrial fibrillation and Marfan syndrome. However, whether miR-331 regulates cardiac function under physiological and pathological conditions still remains unknown. In the present study, we investigated the function and underlying mechanisms of miR-331 in a pressure overload-induced heart failure model and miR-331 transgenic rat model. First, we found that the expression of miR-331-3p exhibited a 1.7-fold increase in hypertrophy compared with that in the sham group (P<0.01), yet the expression of miR-331-5p remained unchanged. Furthermore, overexpression of miR-331 in cardiomyocytes and defective excitation-contraction (E-C) coupling efficiency were observed. Luciferase assays showed that miR-331-3p suppressed JPH2 expression by binding to the coding region of JPH2 mRNA. Finally, in the miR-331 transgenic rat model, JPH2 expression was suppressed at both the mRNA and protein levels in vivo, which resulted in impairment of both the E-C coupling efficiency of cardiomyocytes and systolic function of the heart. This finding mechanistically linked miR-331 to JPH2 downregulation and suggested an important role for the abnormal expression of miR-331 leading to the dysfunction of E-C coupling in heart failure.

2.3 μm nanosecond passive Q-switching of an LD-pumped Tm:YLF laser using gold nanorods as a saturable absorber

Developing new saturable absorbers for use in the mid-infrared region has practical significance for short-pulsed lasers and related scientific and industrial applications.The performance of gold nanorods(GNRs)as saturable absorbers at novel mid-infrared wavelengths needs to be evaluated even though these benefit from ultrafast nonlinear responses and broadband saturable absorption.Passive Q-switching of an LD-pumped 2.3μm Tm:YLF laser using GNRs was successfully realized in this study.Pulses with an 843 ns pulse width and a 6.67 kHz repetition rate were achieved using this Q-switched laser.Results showed that GNRs provide promising passive Q-switches for 2.3μm Tm-doped lasers.

The formation of Ca^(2+) gradients at the cleavage furrows during cytokinesis of Zebrafish embryos

In dividing embryos,a localized elevation in intracellular Ca^(2+)([Ca^(2+)]i)at the cleavage furrow has been shown to be essential for cytokinesis.However,the underlying mechanisms for generating and maintaining these[Ca^(2+)]_(i) gradients throughout cytokinesis are not fully understood.In the present study,we analyzed the role of inositol 1,4,5-trisphosphate receptors(IP3Rs)and endoplasmic reticulum(ER)distribution in determining the intracellular Ca^(2+) gradients in early zebrafish blastomeres.Application of the injected Ca^(2+) indicator,Indo-1,showed that during the first cell division a standing Ca^(2+) gradient was formed~35 min after fertilization,with the[Ca^(2+)]_(i) spatially decaying from 500–600 nmol/L at the cleavage furrow to 100–200 nmol/L around the nucleus.While the IP3R immunohistochemical fluorescence was relatively concentrated in the peri-furrow region,ER labeling was relatively enriched in both peri-furrow and peri-nuclear regions.Numeric simulation suggested that a divergence in the spatial distribution of IP3R and the locations of Ca^(2+) uptake within the ER was essential for the formation of a standing Ca^(2+) gradient,and the Ca^(2+) gradient could only be well-established under an optimal stoichiometry of Ca^(2+) uptake and release.Indeed,while inhibition of IP3R Ca^(2+) release blocked the generation of the Ca^(2+)gradient at a lower[Ca^(2+)]_(i) level,both Ca^(2+) release stimulation by inositol 1,4,5-trisphosphate(IP3)injection and ER Ca^(2+) pump inhibition by cyclopiazonic acid also eliminated the Ca^(2+) gradients at higher[Ca^(2+)]_(i) levels.Our results suggest a dynamic relationship between ER-mediated Ca^(2+) release and uptake that underlies the maintenance of the perifurrow Ca^(2+) gradient and is essential for cytokinesis of zebrafish embryos.