Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor dete...Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.展开更多
Background:Theory of Mind(ToM)and empathy are crucial cognitive and emotional capacities that influence social interactions.While their role in promoting prosocial behavior has been established,the potential moderatin...Background:Theory of Mind(ToM)and empathy are crucial cognitive and emotional capacities that influence social interactions.While their role in promoting prosocial behavior has been established,the potential moderating effect of mindfulness on this relationship remains unexplored.Understanding these complex interactions is vital for developing effective interventions to foster prosocial behavior among college students.This study examines the influence of ToM on college students’prosocial behavior and explores the moderating role of mindfulness in this relationship.Methods:A mixed-methods approach combining questionnaires and experimental design was employed.Study 1:A survey of 759 college students(mean age 22.03 years;477 females)was conducted using the ToM Scale,Interpersonal Reactivity Index,Prosocial Behavior Tendency Scale,and Mindfulness Awareness Scale.Data were analyzed using correlation and moderated mediation analyses.Study 2:An 8-week mindfulness attention training program was implemented for the intervention group and compared with a control group.Mindfulness training served as a moderating variable to validate Model 59 from Study 1.Results:1.Study 1 found:(a)ToM was significantly positively correlated with prosocial behavior(r=0.31,p<0.01).(b)Empathy partially mediated the relationship between ToM and prosocial behavior(β=0.10,p<0.001,95%CI[0.06,0.14]).(c)Mindfulness negatively moderated the direct path between ToM and three dimensions of prosocial behavior,as well as the indirect path between empathy and kin altruism and reciprocal altruism.Specifically,high levels of mindfulness weakened the direct impact of ToM on prosocial behavior.High levels of mindfulness also weakened the indirect influence of ToM on prosocial behavior through empathy.2.Study 2 results showed:(a)The intervention group had significantly higher levels of trait mindfulness compared to the control group(t=2.56,p<0.05).(b)The validity of the moderated mediation model 59 from Study 1 was verified.Conclusion:While ToM and empathy play crucial roles in fostering prosocial behavior,mindfulness exhibits a more complex influence than anticipated,potentially inhibiting prosocial behavior under certain circumstances.These findings offer novel insights into the psychological mechanisms underlying prosocial behavior and underscore the importance of considering multiple interacting factors in its promotion.展开更多
Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 case...Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 cases of mechanically ventilated patients who were admitted to the ICU of our hospital from March 2022 to March 2023 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each of the two groups.The control group was given routine care in ICU,and the observation group was given stratified nursing interventions based on the background of the risk of aspiration assessment on the basis of the control group,and both groups were cared for until they were transferred out of the ICU,and the mechanical ventilation time,ICU stay time,muscle strength score,complication rate,adherence,and satisfaction were observed and compared between the two groups.Results:The mechanical ventilation time and ICU stay time of the observation group were shorter than that of the control group after the intervention;the muscle strength score,compliance and satisfaction of the observation group were higher than that of the control group after the intervention;and the complication rate of the observation group was lower than that of the control group after the intervention,all of which were P<0.05.Conclusion:The application of stratified nursing intervention based on the background of misaspiration risk assessment in ICU mechanically ventilated patients can improve the patient's muscle strength,shorten the time of mechanical ventilation,promote the patient's recovery,reduce the occurrence of complications,and improve the patient's compliance and satisfaction.展开更多
Parkinson’s disease(PD)is the second neurodegenerative disease in the world.The pathological characteristics of PD are degeneration,loss and death of dopaminergic neurons in the substantia nigra of the midbrain.At pr...Parkinson’s disease(PD)is the second neurodegenerative disease in the world.The pathological characteristics of PD are degeneration,loss and death of dopaminergic neurons in the substantia nigra of the midbrain.At present,most scholars believe that the main pathogenesis of PD is α-synuclein aggregation,oxidative stress,mitochondrial dysfunction and neuroinflammatory reaction.More and more studies have demonstrated that ferroptosis plays an important role in the occurrence and development of PD.Ferroptosis is a new type of cell death that is significantly different from traditional apoptosis,scorching and necrosis.Its main feature is iron-dependent lipid peroxidation.Some studies have found that the efficacy of acupuncture and moxibustion in the treatment of PD may be related to the regulation of ferroptosis.Therefore,this study mainly discusses the occurrence and development mechanism of ferroptosis and its role in PD,and the possible mechanism of acupuncture and moxibustion in the treatment of PD dopaminergic neurons,so as to provide theoretical basis for acupuncture and moxibustion in the treatment of PD.展开更多
BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as c...BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approve...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.展开更多
The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and tempora...The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and temporal damage mechanism of hard siltstone. The uniaxial compression tests, coupled with acoustic emission(AE) and infrared radiation temperature(IRT) were conducted on siltstones with different stratification effects. The results revealed that the stratigraphic structure significantly affects the stress-strain response and strength degradation characteristics. The mechanical parameters exhibit anisotropy characteristics, and the stratification effect exhibits a negative correlation with the cracking stress and peak stress. The failure modes caused by the stratification effect show remarkable anisotropic features, including splitting failure(Ⅰ: 0°-22.50°, Ⅱ: 90°), composite failure(45°), and shearing failure(67.50°). The AE temporal sequences demonstrate a stepwise response characteristic to the loading stress level. The AE intensity indicates that the stress sensitivity of shearing failure and composite failure is generally greater than that of splitting failure. The IRT field has spatiotemporal migration and progressive dissimilation with stress loading and its dissimilation degree increases under higher stress levels. The stronger the stratification effect, the greater the dissimilation degree of the IRT field. The abnormal characteristic points of average infrared radiation temperature(AIRT) variance at local stress drop and peak stress can be used as early and late precursors to identify fracture instability. Theoretical analysis shows that the competitive relationship between compaction strengthening and fracturing damage intensifies the dissimilation of the infrared thermal field for an increasing stress level. The present study provides a theoretical reference for disaster warnings in hard sedimentary rock mass.展开更多
Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar formation.These changes reduce cardiac contractility,resulting in heart failure,which causes a huge public hea...Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar formation.These changes reduce cardiac contractility,resulting in heart failure,which causes a huge public health burden.Military personnel,compared with civilians,is exposed to more stress,a risk factor for heart diseases,making cardiovascular health management and treatment innovation an important topic for military medicine.So far,medical intervention can slow down cardiovascular disease progression,but not yet induce heart regeneration.In the past decades,studies have focused on mechanisms underlying the regenerative capability of the heart and applicable approaches to reverse heart injury.Insights have emerged from studies in animal models and early clinical trials.Clinical interventions show the potential to reduce scar formation and enhance cardiomyocyte proliferation that counteracts the pathogenesis of heart disease.In this review,we discuss the signaling events controlling the regeneration of heart tissue and summarize current therapeutic approaches to promote heart regeneration after injury.展开更多
BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between fr...BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.展开更多
Agronomic measures are the key to promote the sustainable development of ratoon rice by reducing the damage from mechanical crushing to the residual stubble of the main crop, thereby mitigating the impact on axillary ...Agronomic measures are the key to promote the sustainable development of ratoon rice by reducing the damage from mechanical crushing to the residual stubble of the main crop, thereby mitigating the impact on axillary bud sprouting and yield formation in ratoon rice. This study used widely recommended conventional rice Jiafuzhan and hybrid rice Yongyou 2640 as the test materials to conduct a four-factor block design field experiment in a greenhouse of the experimental farm of Fujian Agricultural and Forestry University, China from 2018 to 2019.The treatments included fertilization and no fertilization, alternate wetting and drying irrigation and continuous water flooding irrigation, and plots with and without artificial crushing damage on the rice stubble. At the same time, a 13C stable isotope in-situ detection technology was used to fertilize the pot experiment. The results showed significant interactions among varieties, water management, nitrogen application and stubble status.Relative to the long-term water flooding treatment, the treatment with sequential application of nitrogen fertilizer coupled with moderate field drought for root-vigor and tiller promotion before and after harvesting of the main crop, significantly improved the effective tillers from low position nodes. This in turn increased the effective panicles per plant and grains per panicle by reducing the influence of artificial crushing damage on rice stubble and achieving a high yield of the regenerated rice. Furthermore, the partitioning of 13C assimilates to the residual stubble and its axillary buds were significantly improved at the mature stage of the main crop, while the translocation rate to roots and rhizosphere soil was reduced at the later growth stage of ratooning season rice. This was triggered by the metabolism of hormones and polyamines at the stem base regulated by the interaction of water and fertilizer at this time. We therefore suggest that to achieve a high yield of ratoon rice with low stubble height under mechanized harvesting, the timely application of nitrogen fertilizer is fundamental,coupled with moderate field drying for root-vigor preservation and tiller promotion before and after the mechanical harvesting of the main crop.展开更多
BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considere...BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents.However,our understanding of the global performance and progress of psychological interventions for depression in children and adolescents(PIDCA)research is limited.AIM To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics.METHODS Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database.The Charticulator website,CiteSpace and VOSviewer software were used to visualize the trends in publications and citations,the collaborative research networks(countries,institutions,and authors),and the current research status and hotspots.RESULTS Until April 16,2023,1482 publications were identified.The number of documents published each year and citations had increased rapidly in this field.The United States had the highest productivity in this field.The most prolific institution was the University of London.Pim Cuijpers was the most prolific author.In the context of research related to PIDCA,both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots,including thirdwave cognitive behavior therapy,short-term psychoanalytic psychotherapy,cognitive behavioral analysis system of psychotherapy,family element in psychotherapy,modular treatment,mobile-health,emotion-regulation-based transdiagnostic intervention program,dementia risk in later life,predictors of the efficacy of psychological intervention,and risks of psychological intervention.CONCLUSION This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present.Psychological intervention characterized as psychological-process-focused,short,family-involved,modular,internet-based,emotionregulation-based,and personalized may benefit more young people.展开更多
BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM ...BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.展开更多
BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually....BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually.Metal drug-eluting stent unloading is one of the most common clinical complications.Comparatively,BRS detachment is more concealed and harmful,but has yet to be reported in clinical research.In this study,we report a case of BRS unloading and successful rescue.This is a case of a 59-year-old male with the following medical history:“Type 2 diabetes mellitus”for 2 years,maintained with metformin extended-release tablets,1 g PO BID;“hypertension”for 20 years,with long-term use of metoprolol sustained-release tablets,47.5 mg PO QD;“hyperlipidemia”for 20 years,without regular medication.He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours,on February 20,2022 at 15:35.Electrocardiogram results showed sinus rhythm,ST-segment elevation in leads I and avL,and poor R-wave progression in leads V1–3.High-sensitivity troponin I level was 4.59 ng/mL,indicating an acute high lateral wall myocardial infarction.The patient’s family requested treatment with BRS,without implanta-tion.During PCI,the BRS became unloaded but was successfully rescued.The patient was followed up for 2 years;he had no episodes of angina pectoris and was in generally good condition.CONCLUSION We describe a case of a 59-year-old male experienced BRS unloading and successful rescue.By analyzing images,the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations.We discuss preventive measures for BRS unloading.展开更多
For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein th...For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.展开更多
Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve ...Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.展开更多
One of the quintessential challenges in cancer treatment is drug resistance.Several mechanisms of drug resistance have been described to date,and new modes of drug resistance continue to be discovered.The phenomenon o...One of the quintessential challenges in cancer treatment is drug resistance.Several mechanisms of drug resistance have been described to date,and new modes of drug resistance continue to be discovered.The phenomenon of cancer drug resistance is now widespread,with approximately 90% of cancer-related deaths associated with drug resistance.Despite significant advances in the drug discovery process,the emergence of innate and acquired mechanisms of drug resistance has impeded the progress in cancer therapy.Therefore,understanding the mechanisms of drug resistance and the various pathways involved is integral to treatment modalities.In the present review,I discuss the different mechanisms of drug resistance in cancer cells,including DNA damage repair,epithelial to mesenchymal transition,inhibition of cell death,alteration of drug targets,inactivation of drugs,deregulation of cellular energetics,immune evasion,tumor-promoting inflammation,genome instability,and other contributing epigenetic factors.Furthermore,I highlight available treatment options and conclude with future directions.展开更多
Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Curren...Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.展开更多
BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improvin...BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.展开更多
BACKGROUND Yigong San(YGS)is a representative prescription for the treatment of digestive disorders,which has been used in clinic for more than 1000 years.However,the mechanism of its anti-gastric cancer and regulate ...BACKGROUND Yigong San(YGS)is a representative prescription for the treatment of digestive disorders,which has been used in clinic for more than 1000 years.However,the mechanism of its anti-gastric cancer and regulate immunity are still remains unclear.AIM To explore the mechanism of YGS anti-gastric cancer and immune regulation.METHODS Firstly,collect the active ingredients and targets of YGS,and the differentially expressed genes of gastric cancer.Secondly,constructed a protein-protein interaction network between the targets of drugs and diseases,and screened hub genes.Then the clinical relevance,mutation and repair,tumor microenvironment and drug sensitivity of the hub gene were analyzed.Finally,molecular docking was used to verify the binding ability of YGS active ingredient and hub genes.RESULTS Firstly,obtained 55 common targets of gastric cancer and YGS.The Kyoto Encyclopedia of Genes and Genomes screened the microtubule-associated protein kinase signaling axis as the key pathway and IL6,EGFR,MMP2,MMP9 and TGFB1 as the hub genes.The 5 hub genes were involved in gastric carcinogenesis,staging,typing and prognosis,and their mutations promote gastric cancer progression.Finally,molecular docking results confirmed that the components of YGS can effectively bind to therapeutic targets.CONCLUSION YGS has the effect of anti-gastric cancer and immune regulation.展开更多
Since the discovery of enzyme-like activity of Fe3O4 nanoparticles in 2007,nanozymes are becoming the promising substitutes for natural enzymes due to their advantages of high catalytic activity,low cost,mild reaction...Since the discovery of enzyme-like activity of Fe3O4 nanoparticles in 2007,nanozymes are becoming the promising substitutes for natural enzymes due to their advantages of high catalytic activity,low cost,mild reaction conditions,good stability,and suitable for large-scale production.Recently,with the cross fusion of nanomedicine and nanocatalysis,nanozyme-based theranostic strategies attract great attention,since the enzymatic reactions can be triggered in the tumor microenvironment to achieve good curative effect with substrate specificity and low side effects.Thus,various nanozymes have been developed and used for tumor therapy.In this review,more than 270 research articles are discussed systematically to present progress in the past five years.First,the discovery and development of nanozymes are summarized.Second,classification and catalytic mechanism of nanozymes are discussed.Third,activity prediction and rational design of nanozymes are focused by highlighting the methods of density functional theory,machine learning,biomimetic and chemical design.Then,synergistic theranostic strategy of nanozymes are introduced.Finally,current challenges and future prospects of nanozymes used for tumor theranostic are outlined,including selectivity,biosafety,repeatability and stability,in-depth catalytic mechanism,predicting and evaluating activities.展开更多
基金Supported by the National Natural Science Foundation of China,No.82100883the Research Project of Educational Commission of Jilin Province of China,No.JJKH20231214KJ.
文摘Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.
基金supported by the 2023 School Level Scientific Research Project of Hechi University(No.2023XJPT004).
文摘Background:Theory of Mind(ToM)and empathy are crucial cognitive and emotional capacities that influence social interactions.While their role in promoting prosocial behavior has been established,the potential moderating effect of mindfulness on this relationship remains unexplored.Understanding these complex interactions is vital for developing effective interventions to foster prosocial behavior among college students.This study examines the influence of ToM on college students’prosocial behavior and explores the moderating role of mindfulness in this relationship.Methods:A mixed-methods approach combining questionnaires and experimental design was employed.Study 1:A survey of 759 college students(mean age 22.03 years;477 females)was conducted using the ToM Scale,Interpersonal Reactivity Index,Prosocial Behavior Tendency Scale,and Mindfulness Awareness Scale.Data were analyzed using correlation and moderated mediation analyses.Study 2:An 8-week mindfulness attention training program was implemented for the intervention group and compared with a control group.Mindfulness training served as a moderating variable to validate Model 59 from Study 1.Results:1.Study 1 found:(a)ToM was significantly positively correlated with prosocial behavior(r=0.31,p<0.01).(b)Empathy partially mediated the relationship between ToM and prosocial behavior(β=0.10,p<0.001,95%CI[0.06,0.14]).(c)Mindfulness negatively moderated the direct path between ToM and three dimensions of prosocial behavior,as well as the indirect path between empathy and kin altruism and reciprocal altruism.Specifically,high levels of mindfulness weakened the direct impact of ToM on prosocial behavior.High levels of mindfulness also weakened the indirect influence of ToM on prosocial behavior through empathy.2.Study 2 results showed:(a)The intervention group had significantly higher levels of trait mindfulness compared to the control group(t=2.56,p<0.05).(b)The validity of the moderated mediation model 59 from Study 1 was verified.Conclusion:While ToM and empathy play crucial roles in fostering prosocial behavior,mindfulness exhibits a more complex influence than anticipated,potentially inhibiting prosocial behavior under certain circumstances.These findings offer novel insights into the psychological mechanisms underlying prosocial behavior and underscore the importance of considering multiple interacting factors in its promotion.
文摘Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 cases of mechanically ventilated patients who were admitted to the ICU of our hospital from March 2022 to March 2023 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each of the two groups.The control group was given routine care in ICU,and the observation group was given stratified nursing interventions based on the background of the risk of aspiration assessment on the basis of the control group,and both groups were cared for until they were transferred out of the ICU,and the mechanical ventilation time,ICU stay time,muscle strength score,complication rate,adherence,and satisfaction were observed and compared between the two groups.Results:The mechanical ventilation time and ICU stay time of the observation group were shorter than that of the control group after the intervention;the muscle strength score,compliance and satisfaction of the observation group were higher than that of the control group after the intervention;and the complication rate of the observation group was lower than that of the control group after the intervention,all of which were P<0.05.Conclusion:The application of stratified nursing intervention based on the background of misaspiration risk assessment in ICU mechanically ventilated patients can improve the patient's muscle strength,shorten the time of mechanical ventilation,promote the patient's recovery,reduce the occurrence of complications,and improve the patient's compliance and satisfaction.
基金This work was supported by,the Shenzhen Science and Technology Program(JCYJ20210324123614040)the Guangdong Basic and Applied Basic Research Foundation(Grant No.2022A151510450)+3 种基金the Medical Scientific Research Foundation of Guangdong Province(No.B2023087)the Sanming Project of Medicine in Shenzhen(Grant No.SZZYSM202106009)the Bao’an TCM Development Foundation(Grant No.2022KJCX-ZJZL-7)National Administration of Traditional Chinese Medicine(GZY-FJS-2022-59).
文摘Parkinson’s disease(PD)is the second neurodegenerative disease in the world.The pathological characteristics of PD are degeneration,loss and death of dopaminergic neurons in the substantia nigra of the midbrain.At present,most scholars believe that the main pathogenesis of PD is α-synuclein aggregation,oxidative stress,mitochondrial dysfunction and neuroinflammatory reaction.More and more studies have demonstrated that ferroptosis plays an important role in the occurrence and development of PD.Ferroptosis is a new type of cell death that is significantly different from traditional apoptosis,scorching and necrosis.Its main feature is iron-dependent lipid peroxidation.Some studies have found that the efficacy of acupuncture and moxibustion in the treatment of PD may be related to the regulation of ferroptosis.Therefore,this study mainly discusses the occurrence and development mechanism of ferroptosis and its role in PD,and the possible mechanism of acupuncture and moxibustion in the treatment of PD dopaminergic neurons,so as to provide theoretical basis for acupuncture and moxibustion in the treatment of PD.
基金Wuxi Municipal Health Commission Maternal and Child Health Research Project,No.FYKY202206.
文摘BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.
基金the Science and Technology Foundation of Tianjin Municipal Health Bureau,No.12KG119Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-059B+1 种基金Tianjin Health Science and Technology Project key discipline special,No.TJWJ2022XK034Research project of Chinese traditional medicine and Chinese traditional medicine combined with Western medicine of Tianjin municipal health and Family Planning Commission,No.2021022.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.
基金National Natural Science Foundation of China(No.52178393)2023 High-level Talent Research Project from Yancheng Institute of Technology(No.xjr2023019)+1 种基金Open Fund Project of Shaanxi Key Laboratory of Geotechnical and Underground Space Engineering(Grant No.YT202302)Science and Technology Innovation Team of Shaanxi Innovation Capability Support Plan(No.2020TD005).
文摘The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and temporal damage mechanism of hard siltstone. The uniaxial compression tests, coupled with acoustic emission(AE) and infrared radiation temperature(IRT) were conducted on siltstones with different stratification effects. The results revealed that the stratigraphic structure significantly affects the stress-strain response and strength degradation characteristics. The mechanical parameters exhibit anisotropy characteristics, and the stratification effect exhibits a negative correlation with the cracking stress and peak stress. The failure modes caused by the stratification effect show remarkable anisotropic features, including splitting failure(Ⅰ: 0°-22.50°, Ⅱ: 90°), composite failure(45°), and shearing failure(67.50°). The AE temporal sequences demonstrate a stepwise response characteristic to the loading stress level. The AE intensity indicates that the stress sensitivity of shearing failure and composite failure is generally greater than that of splitting failure. The IRT field has spatiotemporal migration and progressive dissimilation with stress loading and its dissimilation degree increases under higher stress levels. The stronger the stratification effect, the greater the dissimilation degree of the IRT field. The abnormal characteristic points of average infrared radiation temperature(AIRT) variance at local stress drop and peak stress can be used as early and late precursors to identify fracture instability. Theoretical analysis shows that the competitive relationship between compaction strengthening and fracturing damage intensifies the dissimilation of the infrared thermal field for an increasing stress level. The present study provides a theoretical reference for disaster warnings in hard sedimentary rock mass.
基金supported by the Natural Science Foundation of Beijing,China(7214223,7212027)the Beijing Hospitals Authority Youth Programme(QML20210601)+3 种基金the Chinese Scholarship Council(CSC)scholarship(201706210415)the National Key Research and Development Program of China(2017YFC0908800)the Beijing Municipal Health Commission(PXM2020_026272_000002,PXM2020_026272_000014)the National Natural Science Foundation of China(82070293).
文摘Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar formation.These changes reduce cardiac contractility,resulting in heart failure,which causes a huge public health burden.Military personnel,compared with civilians,is exposed to more stress,a risk factor for heart diseases,making cardiovascular health management and treatment innovation an important topic for military medicine.So far,medical intervention can slow down cardiovascular disease progression,but not yet induce heart regeneration.In the past decades,studies have focused on mechanisms underlying the regenerative capability of the heart and applicable approaches to reverse heart injury.Insights have emerged from studies in animal models and early clinical trials.Clinical interventions show the potential to reduce scar formation and enhance cardiomyocyte proliferation that counteracts the pathogenesis of heart disease.In this review,we discuss the signaling events controlling the regeneration of heart tissue and summarize current therapeutic approaches to promote heart regeneration after injury.
文摘BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.
基金supported by the National Nature Science Foundation of China,the National Key Research and Development Program of China(302001109,2016YFD0300508,2017YFD0301602,2018YFD0301105)the Fujian and Taiwan Cultivation Resources Development and Green Cultivation Coordination Innovation Center,China(Fujian 2011 Project,2015-75)the Natural Science Foundation of Fujian Province,China(2022J01142)。
文摘Agronomic measures are the key to promote the sustainable development of ratoon rice by reducing the damage from mechanical crushing to the residual stubble of the main crop, thereby mitigating the impact on axillary bud sprouting and yield formation in ratoon rice. This study used widely recommended conventional rice Jiafuzhan and hybrid rice Yongyou 2640 as the test materials to conduct a four-factor block design field experiment in a greenhouse of the experimental farm of Fujian Agricultural and Forestry University, China from 2018 to 2019.The treatments included fertilization and no fertilization, alternate wetting and drying irrigation and continuous water flooding irrigation, and plots with and without artificial crushing damage on the rice stubble. At the same time, a 13C stable isotope in-situ detection technology was used to fertilize the pot experiment. The results showed significant interactions among varieties, water management, nitrogen application and stubble status.Relative to the long-term water flooding treatment, the treatment with sequential application of nitrogen fertilizer coupled with moderate field drought for root-vigor and tiller promotion before and after harvesting of the main crop, significantly improved the effective tillers from low position nodes. This in turn increased the effective panicles per plant and grains per panicle by reducing the influence of artificial crushing damage on rice stubble and achieving a high yield of the regenerated rice. Furthermore, the partitioning of 13C assimilates to the residual stubble and its axillary buds were significantly improved at the mature stage of the main crop, while the translocation rate to roots and rhizosphere soil was reduced at the later growth stage of ratooning season rice. This was triggered by the metabolism of hormones and polyamines at the stem base regulated by the interaction of water and fertilizer at this time. We therefore suggest that to achieve a high yield of ratoon rice with low stubble height under mechanized harvesting, the timely application of nitrogen fertilizer is fundamental,coupled with moderate field drying for root-vigor preservation and tiller promotion before and after the mechanical harvesting of the main crop.
文摘BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents.Depression in children and adolescents affects their physical and mental development.Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents.However,our understanding of the global performance and progress of psychological interventions for depression in children and adolescents(PIDCA)research is limited.AIM To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics.METHODS Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database.The Charticulator website,CiteSpace and VOSviewer software were used to visualize the trends in publications and citations,the collaborative research networks(countries,institutions,and authors),and the current research status and hotspots.RESULTS Until April 16,2023,1482 publications were identified.The number of documents published each year and citations had increased rapidly in this field.The United States had the highest productivity in this field.The most prolific institution was the University of London.Pim Cuijpers was the most prolific author.In the context of research related to PIDCA,both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots,including thirdwave cognitive behavior therapy,short-term psychoanalytic psychotherapy,cognitive behavioral analysis system of psychotherapy,family element in psychotherapy,modular treatment,mobile-health,emotion-regulation-based transdiagnostic intervention program,dementia risk in later life,predictors of the efficacy of psychological intervention,and risks of psychological intervention.CONCLUSION This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present.Psychological intervention characterized as psychological-process-focused,short,family-involved,modular,internet-based,emotionregulation-based,and personalized may benefit more young people.
文摘BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.
基金Supported by Health Commission of Hunan Province,No.202203014389Chinese Medicine Research Project of Hunan Province,No.A2023051the Natural Science Foundation of Hunan Province,No.2024JJ9414.
文摘BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually.Metal drug-eluting stent unloading is one of the most common clinical complications.Comparatively,BRS detachment is more concealed and harmful,but has yet to be reported in clinical research.In this study,we report a case of BRS unloading and successful rescue.This is a case of a 59-year-old male with the following medical history:“Type 2 diabetes mellitus”for 2 years,maintained with metformin extended-release tablets,1 g PO BID;“hypertension”for 20 years,with long-term use of metoprolol sustained-release tablets,47.5 mg PO QD;“hyperlipidemia”for 20 years,without regular medication.He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours,on February 20,2022 at 15:35.Electrocardiogram results showed sinus rhythm,ST-segment elevation in leads I and avL,and poor R-wave progression in leads V1–3.High-sensitivity troponin I level was 4.59 ng/mL,indicating an acute high lateral wall myocardial infarction.The patient’s family requested treatment with BRS,without implanta-tion.During PCI,the BRS became unloaded but was successfully rescued.The patient was followed up for 2 years;he had no episodes of angina pectoris and was in generally good condition.CONCLUSION We describe a case of a 59-year-old male experienced BRS unloading and successful rescue.By analyzing images,the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations.We discuss preventive measures for BRS unloading.
基金supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。
文摘For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
基金supported by Key Project of China Rehabilitation Research Center,Nos.2022ZX-05,2018ZX-08(both to JB)。
文摘Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.
文摘One of the quintessential challenges in cancer treatment is drug resistance.Several mechanisms of drug resistance have been described to date,and new modes of drug resistance continue to be discovered.The phenomenon of cancer drug resistance is now widespread,with approximately 90% of cancer-related deaths associated with drug resistance.Despite significant advances in the drug discovery process,the emergence of innate and acquired mechanisms of drug resistance has impeded the progress in cancer therapy.Therefore,understanding the mechanisms of drug resistance and the various pathways involved is integral to treatment modalities.In the present review,I discuss the different mechanisms of drug resistance in cancer cells,including DNA damage repair,epithelial to mesenchymal transition,inhibition of cell death,alteration of drug targets,inactivation of drugs,deregulation of cellular energetics,immune evasion,tumor-promoting inflammation,genome instability,and other contributing epigenetic factors.Furthermore,I highlight available treatment options and conclude with future directions.
文摘Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.
文摘BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.
基金Supported by Ningxia Key Research and Development Program,No.2023BEG02015Ningxia Science and Technology Benefiting People Program,No.2022CMG03064+1 种基金Ningxia Natural Science Foundation,No.2022AAC02039National Natural Science Foundation of China,No.82260879 and No.82374261.
文摘BACKGROUND Yigong San(YGS)is a representative prescription for the treatment of digestive disorders,which has been used in clinic for more than 1000 years.However,the mechanism of its anti-gastric cancer and regulate immunity are still remains unclear.AIM To explore the mechanism of YGS anti-gastric cancer and immune regulation.METHODS Firstly,collect the active ingredients and targets of YGS,and the differentially expressed genes of gastric cancer.Secondly,constructed a protein-protein interaction network between the targets of drugs and diseases,and screened hub genes.Then the clinical relevance,mutation and repair,tumor microenvironment and drug sensitivity of the hub gene were analyzed.Finally,molecular docking was used to verify the binding ability of YGS active ingredient and hub genes.RESULTS Firstly,obtained 55 common targets of gastric cancer and YGS.The Kyoto Encyclopedia of Genes and Genomes screened the microtubule-associated protein kinase signaling axis as the key pathway and IL6,EGFR,MMP2,MMP9 and TGFB1 as the hub genes.The 5 hub genes were involved in gastric carcinogenesis,staging,typing and prognosis,and their mutations promote gastric cancer progression.Finally,molecular docking results confirmed that the components of YGS can effectively bind to therapeutic targets.CONCLUSION YGS has the effect of anti-gastric cancer and immune regulation.
基金S.G.acknowledges the financial support from the National Natural Science Foundation of China(NSFC 52272144,51972076)the Heilongjiang Provincial Natural Science Foundation of China(JQ2022E001)+4 种基金the Natural Science Foundation of Shandong Province(ZR2020ZD42)the Fundamental Research Funds for the Central Universities.H.D.acknowledges the financial support from the National Natural Science Foundation of China(NSFC 22205048)China Postdoctoral Science Foundation(2022M710931 and 2023T160154)Heilongjiang Postdoctoral Science Foundation(LBH-Z22010)G.Y.acknowledges the financial support from the National Science Foundation of Heilongjiang Education Department(324022075).
文摘Since the discovery of enzyme-like activity of Fe3O4 nanoparticles in 2007,nanozymes are becoming the promising substitutes for natural enzymes due to their advantages of high catalytic activity,low cost,mild reaction conditions,good stability,and suitable for large-scale production.Recently,with the cross fusion of nanomedicine and nanocatalysis,nanozyme-based theranostic strategies attract great attention,since the enzymatic reactions can be triggered in the tumor microenvironment to achieve good curative effect with substrate specificity and low side effects.Thus,various nanozymes have been developed and used for tumor therapy.In this review,more than 270 research articles are discussed systematically to present progress in the past five years.First,the discovery and development of nanozymes are summarized.Second,classification and catalytic mechanism of nanozymes are discussed.Third,activity prediction and rational design of nanozymes are focused by highlighting the methods of density functional theory,machine learning,biomimetic and chemical design.Then,synergistic theranostic strategy of nanozymes are introduced.Finally,current challenges and future prospects of nanozymes used for tumor theranostic are outlined,including selectivity,biosafety,repeatability and stability,in-depth catalytic mechanism,predicting and evaluating activities.