Application of Chinese Medicine Nursing Techniques in the Sequelae of Pelvic Inflammatory Diseases: A Review

Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.

Cardiovascular Disease Risk Associated to Chronic Inflammatory Rheumatic Diseases in Patients Seen in Rheumatology Unit in Yaounde, Cameroon

Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the Yaounde Central Hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08);high BMI OR 1.89, 95% CI (1.1 - 3.24);diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovascular risk in both study groups, highlighting the need to pursue research for definite conclusions on their reliability.

Chronic Inflammatory Rheumatic Diseases in Rheumatological Practice in Lomé(Togo)

Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, laboratory, radiological, therapeutic and evolutive features of chronic inflammatory rheumatic diseases in rheumatological practice in Togo. Patients and Methods: This was a multicenter cross-sectional study conducted from January 2011 to December 2019 on patients examined in the three rheumatology departments in Lomé (Togo). Patients 18 years old and above who have presented joint pain with or without synovitis, and/or rachialgia (back pain) for at least three months were included. The diagnosis of chronic inflammatory rheumatic diseases was made according to international consensus criteria. Results: Out of the 20333 patients whose files were collected during our study period, 290 (1.43%) suffered from chronic inflammatory rheumatic diseases. There were 226 (77.93%) females and 64 (22.07%) males. The mean age of the patients was 42.79 ± 15.18 years. The mean duration of symptoms was 40.80 ± 54.09 months. Arthritis (67.24%) was the main reason for consultation, followed by joint pain (31.38%). rheumatoid arthritis (41.03%), unclassified chronic inflammatory rheumatic diseases (38.62%), spondyloarthropathies (15.17%) and systemic lupus erythematosus (2.41%) were the major clinical forms. The immunological tests performed in 13.79% of cases were positive in 52.94% of cases. Carpitis (57.55%) and diffuse osteoporosis (45.28%) were the commonest radiographic features of the hands. 289 patients (99.66%) received symptomatic treatments such as NSAIDs (73.36%) and corticosteroids (51.90%) and 90 patients (31.03%) were treated with synthetic DMARDs such as methotrexate (88.89%). The outcome was favorable in 27.93% of cases. Conclusion: Chronic inflammatory rheumatic diseases are common diseases in rheumatological practice in Togo that deserve special attention. The establishment of a specialized immunology laboratory could be very useful for the diagnosis and early management of these diseases.

Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases

AIM To investigate whether immune mediated diseases(IMD) are more frequent in patients with inflammatory bowel disease(IBD).METHODS In this population based registry study,a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16,2013. Controls were randomly selected from the Danish Civil Registration System(CRS) and matched for sex,age,and municipality. We used ICD 10 codes to identify the diagnoses of the included patients. The IBD population was divided into three subgroups: Ulcerative colitis(UC),Crohn's disease(CD) and Both the latter referring to those registered with both diagnoses. Subsequently,odds-ratios(OR) and 95%CI were obtained separately for each group and their respective controls. The use of Bonferoni post-test correction adjusted the significance level to P < 0.00125. P-values were estimated using Fisher's exact test.RESULTS There were significantly more women than men in the registry,and a greater percentage of comorbidity in the IBD groups(P < 0.05). Twenty different IMDs were all significantly more frequent in the IBD group. Sixteen were associated with UC versus twelve with CD. In both UC and CD ORs were significantly increased(P < 0.00125) for primary sclerosing cholangitis(PSC),celiac disease,type 1 diabetes(T1D),sarcoidosis,asthma,iridocyclitis,psoriasis,pyoderma gangrenosum,rheumatoid arthritis,and ankylosing spondylitis. Restricted to UC(P < 0.00125) were autoimmune hepatitis,primary biliary cholangitis,Grave's disease,polymyalgia rheumatica,temporal arteritis,and atrophic gastritis. Restricted to CD(P < 0.00125) were psoriatic arthritis and episcleritis. Restricted to women with UC(P < 0.00125) were atrophic gastritis,rheumatoid arthritis,temporal arteritis,and polymyalgia rheumatica. Restricted to women with CD were episcleritis,rheumatoid arthritis,and psoriatic arthritis. The only disease restricted to men(P < 0.00125) was sarcoidosis. CONCLUSION Immune mediated diseases were significantly more frequent in patients with IBD. Our results strengthen the hypothesis that some IMDs and IBD may have overlapping pathogenic pathways.

Effect of Zhuang Yi Liu Fang Teng Fang on the Expression of TNF-αand NF-κB in Chronic Pelvic Inflammatory Disease(CPID)Model Rats

Objecrive:To investigate the expression of TNF-αand NF-κB in the uterus of chronic pelvic inflammatory disease(CPID)model rats.Methods:40 female rats that adaptive fed for 5 days were randomly divided into normal group,model group,high dose group,medium dose group and low dosegroup.In addition to the normal group:the rats in each group were made chronic pelvic inflammatory model by mechanical injuuy combined with implantation of bacteria.The rats in each group were administrated by gavage for 20days.After the last administration,the level of TNF-αand NF-κB in serum was measured by ELASA method.Results:(1)after the establishment of the model,the uterus of the chronic pelvic inflammatory model rats showed the pathological damage of chroic infilammation;the levels of lNF-αand NF-κB inserum were higher than those in the normal group,the difference was statistically significant(P<0.05).(2)After the drug intervention,the uterine tissue morphology of the rats in the Zhuang Yi Liu Fang Teng Fang Group was basically restored to normal,with only a small amount of inflammatory cell infiltration and other pathological changes;compared with the rats in the model group,the TNF-αin serum of the rats in each treatment group was lower,the difference was statistically significant(P<0.05).The expression of NF-κB in serum of each treatment group was lower fthan that of the model group(P<0.05).Conclusion:Zhuang Yi Liu Teng Fang can efectively improve the endometrial histomorphology of CPID model rats,and regulate the levels of TNF-αand NF-κB in the uterus of chronic pelvic inflammatory model rats.

Spondyloarthritis Associated with Inflammatory Bowel Disease: Study of 15 Observations in Guinea

Objective: Rheumatologic disorders of chronic inflammatory bowel disease (IBD) and reactive arthritis with a digestive origin are part of the spondyloarthritis family. In black Africa, the prevalence of SpA associated with IBD is not clearly established. Thus the objective of our study was to describe the clinical and radiological characteristics of spondyloarthritis associated with IBD. Patients and Method: We carried out a prospective study in the rheumatology department of CHU Ignace Deen between January and December 2019. The diagnosis of SpA was based on clinical and biological arguments in accordance with the criteria of Amor and ASAS. Results: Fifteen observations of spondyloarthritis associated with IBD were collected in patients mean age 52 years with extremes of 32 and 65 years. 9 (53.33%) were female. Ten patients had Crohn’s disease (CD) and 5 had ulcerative colitis (UC). The mean number of pushes was 2.5 ± 1.2. The average diagnostic time was 46 months. Sacroiliitis was present in 73.3% of cases and the mean mSASSS score at diagnosis was 32.11/72. In total, corticosteroids were used in 9 (60%) of patients, NSAIDs in 26.6% while DMARDs salazopyrine and methotrexate in 33.3% and 20% of patients, respectively. Conclusion: The MICI and SpA association is undoubtedly underestimated in our regions. Better collaboration between rheumatologists and gastroenterologists could facilitate diagnosis and improve care.

A case of bowel schitosomiasis not adhering to endoscopic findings

Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schistosomes mansonicharacterized by nausea, meteorism, abdominal pain, bloody diarrhea,rectal tenesmus, and hepatosplenomegaly. These infections represent a major health issue in Africa,Asia, and South America, but recently S mansoni has increased its prevalence in other countries, such as Europe countries and USA, due to international travelers and immigrants, with several diagnostic and prevention problems. We report a case of a 24-yearold patient without HIV infection, originated from Ghana, admitted for an afebrile dysenteric syndrome.All microbiologic studies were negative and colonoscopy revealed macroscopic lesions suggestive of a bowel inflammatory chronic disease. Since symptoms became worse, a therapy with mesalazine (2 g/d) was started,depending on the results of a bowel biopsy, but without any resolution. The therapy was stopped after 2 wk when the following result was available: a diagnosis of"intestinal schistosomiasis" was done (two Schistosoma eggs were detected in the colonic mucosa) and this was confirmed by the detection of Schistosoma eggs in the feces. Therapy was therefore changed to praziquantel(40 mg/kg, single dose), a specific anti-parasitic agent,with complete recovery. Schistosomiasis shows some peculiar difficulties in terms of differential diagnosis from the bowel inflammatory chronic disease, as the two disorders may show similar colonoscopic patterns.Since this infection has recently increased its prevalence worldwide, it was considered in the differential diagnosis of our patient with gastrointestinal symptoms.

Effect of Psychological Intervention on Emotion of Patients with Tumor Radiotherapy

Objective:To explore the emotional impact of psychological nursing intervention on patients with malignant tumor radiotherapy,and further verify the specific application value of this nursing model in the oncology department.Methods:A total of 129 patients with tumor radiotherapy admitted to our hospital from June 2018 to June 2021 were selected as subjects,and they were divided into control group and observation group by random number method.Among them,64 cases in the control group received routine clinical nursing.65 cases in the observation group received psychological nursing intervention.Then,the clinical nursing effect,self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,immune function level change condition and clinical nursing satisfaction were compared under the two nursing modes,in order to fully verify the clinical application value of psychological nursing intervention mode for patients with cancer radiotherapy.Results:Comparing the clinical indexes of the two groups,SDS and SAS scores of the observation group were significantly lower than those of the control group.In terms of nursing satisfaction,the observation group is 96.92%and the control group is 90.62%,the difference was significant,and had clinical statistical significance(P<0.05);After the comprehensive evaluation of the immune function of the two groups,it was found that the observation group was significantly better than the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:In the mode of psychological nursing,medical staff can carry out precise psychological nursing intervention and nutritional nursing for patients according to the specific conditions and treatment process of patients,which can greatly promote the psychological stability of patients,significantly reduce patients5 negative emotions.In addition,the scientific implementation of psychological nursing intervention in the treatment of tumor radiotherapy patients can effectively strengthen the improvement of the immune function of patients,which has a very important application value to improve the physical function of patients,promotes the patienfs body rehabilitation,and is worth in the field of widespread application.

Interventional pulmonology for chronic inflammatory airway diseases

Chronic inflammatory airway diseases,such as chronic bronchitis,chronic obstructive pulmonary disease,emphysema,and bronchial asthma,pose significant healthcare challenges.Interventional treatments offer promise as valuable complements to the optimal medical therapy recommended by the Global Initiative for Chronic Obstructive Lung Disease guideline and the Global Initiative for Asthma guideline.By directly accessing the airways,these minimally invasive procedures enable precise interventions.They encompass a wide range of techniques including bronchial thermoplasty and targeted lung denervation for both chronic obstructive pulmonary disease and severe asthma,bronchoscopic lung volume reduction(including the use of endobronchial valves,coils,and bronchoscopic thermal vapor ablation),airway bypass and peripheral stent placement for emphysema,bronchial rheoplasty and spray cryotherapy for chronic bronchitis,and other emerging methods.These interventional treatments aim to improve patients’symptoms by reducing lung volume,alleviating hyperinflation,eliminating vagal innervation,disrupting hyperplastic goblet cells and thus reducing excessive mucus secretion,and weakening submucosal smooth muscles.This review highlights the potential advantages of interventional treatments for chronic inflammatory airway diseases and discusses relevant techniques tailored to specific disease subtypes.The overall aim is to assist interventional pulmonologists in selecting the most appropriate techniques for individual patients.