Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

“I Am Getting Healthier”. Perceptions of Urban Aboriginal and Torres Strait Islander People in a Chronic Disease Self-Management and Rehabilitation Program

Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease self-management and rehabilitation which are designed specifically for urban Aboriginal and Torres Strait Islander people. This paper aims to explore client and staff perceptions of the Work It out Program, a chronic disease rehabilitation and self-management program designed for urban Aboriginal and Torres Strait Islander people. The study used a mixed methods approach to explore the success, barriers and self-reported outcomes of the program. Quantitative data were collected through a structured survey, comprising social and demographic data. Qualitative data were collected through interviews using Most Significant Change theory. Twenty-eight participants were recruited, 6 staff and 22 clients (M = 7, F = 21) with an age range between 21 and 79 years of age (Mean = 59.00, SD = 17.63). Interviews were completed in 2013 across four Work It out locations in Southeast Queensland. Semi-structured interviews were conducted either individually or in groups of two or three, depending on the participants’ preference. Thematic analysis of the data revealed six main themes;physical changes, lifestyle improvements, social and emotional well-being, perceptions about the successful features of the program, perceived barriers to the program and changes for the future. This exploratory study found that clients and staff involved in the Work It out Program perceived it as an effective self-management and rehabilitation program for urban Aboriginal and Torres Strait Islander Australians. Further evaluation with a larger sample size is warranted in order to establish further outcomes of the program.

The Effect of O2O Education Combined with Peer Education Management Model in Patients with Chronic Obstructive Pulmonary Disease

Objective:To explore the effect of online-to-offline(O2O)education combined with the peer education management model in patients with chronic obstructive pulmonary disease(COPD).Methods:Using convenience sampling,72 patients with COPD who were hospitalized in the respiratory medicine department of a tertiary-level hospital from March to December 2021 were selected as study subjects.Randomized grouping was carried out using the random number table method,the control group was given routine COPD health education in the department,and the intervention group applied O2O trinity health management combined with peer education on the basis of routine care.After 6 months of follow-up after discharge,the two groups were observed and compared for changes in pulmonary function,depression status,self-care ability,and quality of life.Results:At 3 and 6 months after the intervention,the lung function indexes and depression status of the two groups of patients improved significantly,and the improvement effect was more significant in the intervention group(P<0.05);after the intervention,the self-care ability scores of the patients in the intervention group were significantly higher than those of the control group(P<0.05);the quality-of-life scores of the two groups of patients decreased at 3 months after discharge,in which the quality-of-life scores in the intervention group was significantly lower than that of the control group(P<0.05).Conclusion:O2O education combined with the peer education management model can effectively improve the lung function of patients with COPD,depression,self-care ability,and quality of life.

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.

Effects of ginsenoside of stem and leaf combined with choline on learning and memory ability of rat models with Alzheimer diseases

BACKGROUND： Central adrenergic nerve and 5-serotonergic nerve can influence central cholinergic nerve on learning and memory and make easy for study; however, ginsenoside of stem and leaf （GSL） can improve functions of central adrenergic nerve; moreover, 5-serotonergic nerve and the combination with choline can produce synergistic effect and enhance learning and memory ability so as to improve learning and memory disorder of patients with Alzheimer disease （AD）. OBJECTIVE ： To observe the effects of GSL combining with choline on learning and memory of AD model rats DESIGN ： Randomized grouping design and controlled animal study SETIING ： Department of Pharmacology, Taishan Medical College MATERIALS ： The experiment was carried out in the Pharmacological Department of Medical College of Jilin University from October 1996 to January 1997. Forty healthy male Wistar rats of clean grade were randomly divided into 5 groups, including sham-injury group, model group, GSL group, choline group and combination group, with 8 rats in each group. Main medications： GSL with the volume more than 92.8% was provided by Department of Chemistry, Norman Bethune Medical College of Jilin University. Panaxatriol, the main component, was detected with thin layer scanning technique and regarded as the index of GSL quality [（55±1）%, CV= 2%, n = 5]. Choline was provided by the Third Shanghai Laboratory Factory. METHODS ： 150 nmol quinolinic acid was used to damage bilateral Meynert basal nuclei of adult rats so as to establish AD models. Rats in GSL, choline and combination groups were intragastric administrated with 400 mg/kg GSL, 200 mg/kg choline （20 mL/kg）, and both respectively last for 17 days starting from two days before operation. Rats in sham-injury group and model group were perfused with the same volume of distilled water once in each morning for the same days. （1） Passive avoidance step-down test： Five minutes later, rats jumped up safe platform when they were shocked with 36 V alternating current. If rats jumped down from the platform and the feet touched railings, the response was wrong. Numbers of wrong response were recorded within 3 minutes, and then the test was redone after 24 hours. （2） Morris water-maze spatial localization task： Swimming from jumping-off to platform directly was regarded as right response. Additionally, 4 successively right responses were regarded as the standard. Each rat was trained 10 times a day with 120 s per time for 3 successive days. The interval was 30 s. Three days later, numbers of right response were recorded. The training times were increased to 30 for unlearned rats. （3） Measurement of activity of choline acetylase in cerebral cortex： Rats were sacrificed at 17 days after operation to obtain cerebral cortex to measure activity of choline acetylase with radiochemistry technique. （4） Synergistic effect： It was expressed as Q value： Q value = factual incorporative effect/anticipant incorporative effect; Q ≥ 1 was regarded as synergistic effect. Anticipant incorporative effect = （EA＋EB-EA·EB）, EA and EB were single timing effect, respectively in GSL group and choline group. E（step-down test and Morris water maze test） = （x in model group - factual value in medicine groups）/x in model group; E （activity of choline acetylase） = （factual value in medicine groups -xin model group）/xin model group. MAIN OUTCOME MEASURES ： （1） Passive avoidance step-down test and Morris water-maze spatial localization task in the study of learning and memory; （2） activity of choline acetylase. RESULTS ： All 40 rats were involved in the final analysis. （1） Passive avoidance response： At learning phase on first day and retesting phase on the next day, numbers of wrong responses within 3 minutes were more in model group than sham operation group, and there was significant difference [（5.88±1.46）, （2.25±0.87） times; （2.63±1.06）, （0.50±0.53） times; P 〈 0.01]; numbers of wrong responses within 3 minutes were less in combination group than model group, and there was significant difference [learning phase： （1.12±0.83）, （5.88±1.46） times; retesting phase： （0.38±0.74）, （2.63±1.06）times, P 〈 0.01]; moreover, effect was stronger than that in GSL group and choline group. The Q value was 1.07 and 1.59, respectively and it showed synergistic effect. Spatial localization task： Training times were more in model group than sham operation group, and there was significant difference [（2.9±2.5）, （12.6±3.5） times; P 〈 0.01]. Training times were less in combination group than model group, and there was significant difference [（11.8±2.4）, （27.9±2.5） times, P 〈 0.01]; moreover, effect was stronger than that in GSL group and choline group. The Q value was 1.07 and it showed synergistic effect. （3） Activity of choline acetylase： Activity was lower in model group than sham operation group, and there was significant difference [（30.56±8.33）, （61.11 ±8.33） nkat/g; P 〈 0.01]. Activity was higher in combination group than model group and there was significant difference [（50.00±8.33）, （30.56±8.33） nkat/g, P 〈 0.01];moreover, effect was stronger than that in GSL group and choline group. The Q value was 1.5 and it showed synergistic effect. CONCLUSZON： GSL in combination with choline can synergically improve the disorder of learning and memory of AD model rats. Its mechanism may be involved in enhancing the function of central cholinergic system.

Analysis of Combining Ability for Resistance of Sugarcane Parents and Cross Combinations to Brown Stripe Disease

[Objectives] The paper was to screen resistant sugarcane varieties against brown stripe disease,and to breed disease-resistant germplasm resource.[Methods]The combining ability for resistance to sugarcane brown stripe disease was analyzed based on 23 female parents,21 male parents and 29 cross combinations. [Results]The average heritability of resistance to sugarcane brown stripe disease successively were female parents（ 95. 3%）,cross combinations（ 93. 0%）and male parents（ 79. 1%）. The general combining ability of 12 female parents showed negative effect,including Pma 98-40,Yacheng 93-26,Yunrui 05-283,Yuetang 91-976,Chuanzhe 19,ROC10,Yunzhe 06-80,ROC26,Zhanzhe 74-141,K86-110,Yunzhe 03-194 and ROC25. The general combining ability of 10 male parents showed negative effect,including Q 199,Yunrui 06-649,Yunrui 05-733,CP 84-1198,CP 88-1762,Yacheng 84-125,Yunrui 05-784,Yuetang 00-236,CP72-3591 and CP 94-110. The special combining ability of 16 cross combinations showed negative effect,including Pma 98-40 × Yunrui 05-649,Yacheng 93-26 ×Yunrui 05-733,Yunrui 05-283 × Q199,Yuetang 91-976 × CP 84-1198,Chuanzhe 19 × CP 88-1762 and ROC10 × Yuenong 73-204. [Conclusions] There were significant differences in combining ability among female parents,male parents and cross combinations,which were mainly controlled by additive and non-additive gene.

Diagnostic value of18F-FDG PET in the assessment of myocardial viability in coronary artery disease：A comparative study with99mTc SPECT and echocar-diography

ObjectiveTo 调查 18F-fluorodeoxyglucose 正电子排放断层摄影术的诊断的值( 18 F-FDG 宠物)在对在有已知的冠的动脉疾病( CAD )的病人的心肌的生存能力的评价什么时候与 99m Tc 单个光子排放计算了断层摄影术( SPECT )和 echocardiography ，与侵略冠的 angiography ，作为金 standard.MethodsThirty ，有诊断 CAD 的病人满足了选择标准，与他们中的 10 个一起( 9 个人，意味着年龄 59.5 ± ；10.5 年) 由 SPECT 和宠物组成的这些成像过程经历所有， echocardiography 和侵略 angiography。为心肌的生存能力的察觉的这些不太侵略的形式的诊断敏感与侵略冠的 angiography 相比。内部观察员并且 intra 观察员同意为 SPECT 和 PET.ResultsOf 的诊断性能被估计有证明 CAD 的所有病人， 50% 有的三倍的容器疾病。SPECT，宠物和 echocardiography 的诊断敏感是 90% ， 100% 并且 80% 在基于病人的评价分别地。优秀同意被完成在之间内部观察员并且在心肌的生存能力的 SPECT 和宠物的诊断的值的 intra 观察员同意(k = 0.9 ).Conclusion 18 F-FDG 宠物与已知的 CAD 在病人在对心肌的生存能力的评价有高诊断的价值什么时候与 SPECT 和 echocardiography 相比。与 18 进耐心的管理的 F-FDG 宠物被保证。

Assessment of a portfolio as an effective tool to promote self-management among patients with ischemic heart diseases: A preliminary trial

Portfolio has been used as an approach to promoting self-learning in the field of education and its effectiveness was reported in school education. The purpose of this study was to assess effectiveness of portfolio as a tool for educating patients with ischemic heart diseases as self-management behavior in terms of applicability and efficacy. Subjects of this study were seventeen patients who had myocardial infarction or angina. They were assigned to collect information about their themes chosen from diet, exercise, alcohol intake, smoking cessation, and stress management and gathered in files. Thirty minutes face-to-face educational interviews were conducted by a nurse for once per month over three months. Self-management, self-efficacy, and physiological data were evaluated for baseline and 3 months. Two participants dropped within two months (completion rate is 88.2%). The results showed that portfolio was effective as a self-management education tool on patients who were willing to participate, but did not improve physiological data if they did not continuously implement lifestyle change. Moreover it was dangerous when the patients acquired incorrect information on diseases. For these patients, health education by health professionals is required prior to conducting portfolio. Attributes fit for portfolio were assessed. Effectiveness of portfolio related to high self-efficacy and high self-management, but did not relate to living status, having job, educational background, and health locus of control.

Use of Social Cognitive Theory to Assess Salient Clinical Research in Chronic Disease Self-Management for Older Adults: An Integrative Review

The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.

A Study of Meta-cognitive Strategy to Improve College Students’ Self-management Ability in College English Learning

The ability of college students’English learning self-management plays an important role in English learning.To improve college students’self-management,this paper first analyzed the problems and necessity for.Then it mainly explored how to im prove their self-management ability thus to help student’s improve the efficiency of self-management in college English learning.

Telenutrition for the management of inflammatory bowel disease:Benefits,limits,and future perspectives

Patients with inflammatory bowel disease(IBD)require lifelong and personalized care by a multidisciplinary healthcare team.However,the traditional medical model is not ideal for patients who require continuous close monitoring and whose symptoms may dramatically worsen between regularly scheduled visits.Additionally,close dietary follow-up and monitoring of IBD in a traditional setting are challenging because of the disease complexity,high pressure on outpatient clinics with a small number of IBD specialist dietitians,and rising incidence.Given the significant burden of IBD,there is a need to develop effective dietary management strategies.The coronavirus disease 2019 pandemic caused an unprecedented shift from in-person care to delivering health care via technological remote devices.Traditional nutrition therapy and consultation can be provided by telenutrition through remote electronic communication applications that could greatly benefit patient care.Telenutrition might be useful,safe,and cost-effective compared with standard care.It is likely that virtual care for chronic diseases including IBD will continue in some form into the future.This review article summarizes the evidence about telenutrition applications in the management of IBD patients,and we gave an overview of the acceptance and impact of these interventions on health outcomes.

Chronic Obstructive Pulmonary Disease and Semantic Language Abilities

Objective: The main aim of the present study is to evaluate the semantic language abilities of patients with Chronic Obstructive Pulmonary Disease (COPD) compared to normal group. Secondly to examine the role of hypoxemia, hypercapnia and pulmonary parameters on language scores. Method: We assessed 100 COPD patients with the use of a comprehensive battery of neurocognitive tests standardized for the Greek population, examining semantic language abilities, namely the Boston Naming Test (BNT), the Picture Peabody Vocabulary Test (PPVT) and the Controlled Oral Word Fluency Test (COWAT). Results: The results revealed that although the overall performance of our group of patients was within normal range, it was statistically significant lower compared to normal distribution on all semantic language tests. Moreover, we found that the percentile of COPD patients that performed in the deficient range was significantly higher compared to normal distribution. Further analysis of pulmonary parameters showed that Forced Expiratory Volume in 1 sec (FEV1, FEV1%), Forced Vital Capacity (FVC, FVC%) and FEV1/FVC were not correlated with patients’ performance on the language tests. Low Partial Pressure of Oxygen in blood oxygen levels (PaO2) was found to be able to predict the performance of patients on BNT, PPVT and semantic verbal fluency test. Abnormally elevated Partial Pressure of Carbon Dioxide (PCaO2) in blood were not found to be related to language dysfunctions. Conclusions: Our findings indicate that our group of COPD patients is more prone to present semantic language impairments compared to normal group while low blood oxygen levels were associated with reduced performance on BNT, PPVT and semantic verbal fluency tests.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.

Effect of amino acid mutation at position 127 in 3A of a rabbitattenuated foot-and-mouth disease virus serotype Asia1 on viral replication and infection

An amino acid mutation(R127→I) in the 3A non-structural protein of an FMDV serotype Asia1 rabbit-attenuated ZB strain was previously found after attenuation of the virus. To explore the effects of this mutation on viral replication and infection, the amino acid residue isoleucine(I) was changed to arginine(R) in the infectious cDNA clone of the rabbit-attenuated ZB strain by sitedirected mutagenesis, and the R127-mutated virus was rescued. BHK monolayer cells and suckling mice were inoculated with the R127-mutated virus to test its growth property and pathogenicity, respectively. The effects of the R127 mutation on viral replication and virulence were analyzed. The data showed that there was a slight difference in plaque morphology between the R127-mutated and wild-type viruses. The growth rate of the mutated virus was lower in BHK-21 cells and its virulence in suckling mice was also attenuated. This study indicates that the R127 mutation in 3A may play an important role in FMDV replication in vitro and in pathogenicity in suckling mice.

Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice

AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.

Disease resistant and Growth promoting Effect of Nvhuang Fuzheng Oral Liquid on Chicks and Its Enhancement Effect on Infectious Bursal Disease Virus (IBDV) Vaccine

[Objective] The paper was to investigate the clinical effects of Nvhuang Fuzheng oral liquid on immunity enhancement,disease resistance and growth promotion of chicks. [Method] In the test,3-day-old Daninghe chicks were divided into normal control group,Nvhuang Fuzheng oral liquid group and positive control group. Chicks were administrated with drugs for 7 d before immunization. After vaccination,chicks were observed for 4 weeks,to statistically count the incidence state of chicks. Effects of Nvhuang Fuzheng oral liquid on growth performance,serum immunoglobulin,cytokine and infectious bursal disease virus( IBDV)antibody were studied. [Result] Compared to normal control group,Nvhuang Fuzheng oral liquid significantly improved the weight of chicks and reduced the feed gain ratio( P < 0. 05); significantly reduced the morbidity and mortality and increased the survival rate of chicks( P < 0. 05); continuously increased IgG,IgM and IL-2 content significantly in the serum of chicks( P < 0. 05); extremely improved IFN-γ content in the serum at 7 d post drug administration( P < 0. 01). After vaccination of IBDV vaccine for 1 and 2 weeks,Nvhuang Fuzheng oral liquid significantly improved IBDV antibody titer and positive rate of chicks compared to normal control group( P < 0. 05); at 3 weeks post immunization,the antibody positive rate reached 100%. [Conclusion]Nvhuang Fuzheng oral liquid improved immunoglobulin and cytokine levels of chicks,enhanced the immunity and reduced the occurrence of diseases( the morbidity was reduced by 15% and the mortality was reduced by 30%),enhanced disease-resistant ability and promoted the growth of chicks. Meantime,it improved the immune effect of IBDV vaccine.

Exploring the Influences of Continuous Self-Management Education on the Self-Care Skills and Health Behavior of Patients with PICC Intubation

Objective:To analyze the effects of continuous self-management education on the selfcare ability and health behavior of patients with tumor through peripherally inserted central venous catheters(PICC).Methods:The period from August 2018 to August 2020 was used as the research time range,and the random number table method was used as the basis for grouping.80 patients with malignant tumors who regularly performed fixed catheter maintenance care in the PICC clinic of our hospital were admitted in the experimental group(given PICC specialist nursing,and implemented continuous self-management education),and 80 patients with PICC tube malignant tumors discharged from the superior hospital during this time range served as the control group(return to the original catheterization hospital from time to time or perform catheter maintenance care in the nursing clinic of our hospital).The self-care ability scores,health behavior scores,and complications during intubation between both groups were analyzed.Results:(1)There was no significant difference in self-care ability score and healthy behavior score between groups before the intervention,P>0.05;the self-care ability score and health behavior score of the research group were better than the control group after intervention,P<0.05;(2)After investigation,the incidence of complications in the research group(2.50%)was lower than that of the control group(10.00%),but there was no difference between the groups,P>0.05.Conclusion:Continuous self-management education has good effects on improving the self-care ability of tumor patients with PICC intubation.It can urge patients to maintain good health behaviors and reduce complications.It is worthy of promotion.

有氧运动训练影响阿尔茨海默症小鼠海马Notch1、Caspase-3的表达

背景:β-淀粉样蛋白和Tau蛋白会对阿尔茨海默症患者的认知功能产生不良影响,研究发现Notch1及Caspase-3能够调控β-淀粉样蛋白和Tau蛋白的表达。Notch1及Caspase-3是否介导了有氧运动改善阿尔茨海默症患者认知能力的过程还不清楚,目前缺乏长期有氧运动影响阿尔茨海默症小鼠海马中Notch1及Caspase-3表达的研究。目的:观察长期有氧运动干预阿尔茨海默症小鼠的空间学习记忆情况及其海马中Notch1及Caspase-3的表达,探讨Notch1及Caspase-3对阿尔茨海默症小鼠的影响。方法:将3月龄野生型及APP/PS1双转基因阿尔茨海默症小鼠随机分为4组:野生对照组、野生运动组、阿尔茨海默症对照组、阿尔茨海默症运动组,每组20只。对照组小鼠不进行运动,运动组小鼠进行5个月的有氧运动干预。运动干预结束后,采用Morris水迷宫检测小鼠空间学习记忆能力;采用Real-timePCR、免疫荧光及Westernblot检测各组小鼠海马组织Aβ_(1-42)、Tau、Notch1及Caspase-3蛋白的表达。结果与结论:①阿尔茨海默症小鼠空间学习记忆能力显著差于野生组(P<0.05);运动组小鼠空间学习记忆能力显著优于对照组(P<0.05);②阿尔茨海默症对照组小鼠海马Aβ_(1-42)、Tau、Notch1及Caspase-3表达均显著高于野生对照组(P<0.05);阿尔茨海默症运动组小鼠海马Aβ_(1-42)、Tau、Notch1及Caspase-3表达显著低于阿尔茨海默症对照组(P<0.05);③提示:长期有氧运动干预能够改善阿尔茨海默症小鼠的空间学习记忆能力,而这可能与有氧运动降低阿尔茨海默症小鼠海马Notch1、Caspase-3、Aβ_(1-42)及Tau蛋白表达有关。

HDSMP结合CDSMP模式对老年高血压患者疾病应对和自我管理能力的影响

目的 探讨本土化的高血压、糖尿病自我管理教程(hypertension&diabetes self-management program, HDSMP)结合美国斯坦福大学首创的普适性慢性病自我管理项目(chronic disease self-management program, CDSMP)对老年高血压患者疾病应对和自我管理能力的影响。方法 选取2021年6-12月在郑州大学第一附属医院内科门诊就诊的符合纳入和排除标准的300例老年高血压患者作为研究对象,采用随机数字表法分为对照组150例和干预组150例。对照组患者接受以健康讲座和宣教手册为主的健康教育,干预组患者接受HDSMP结合CDSMP模式的慢性病自我管理,以自我管理小组的形式进行。两组患者的干预时间均为8周。评价并比较两组患者干预前后的疾病认知情况、生活质量、疾病应对能力、自我管理能力、血压控制效果。结果 干预组干预后对高血压知识(包括疾病诊断标准、高危因素、高血压危害、治疗方法)知晓率相比较干预前和对照组干预后均明显升高,差异有统计学意义(P<0.05)。干预组干预后健康调查简表(SF-36)各维度评分相比较干预前和对照组干预后均明显升高,差异有统计学意义(P<0.05)。干预组干预后医学应对方式问卷(medical coping modes questionnaire, MCMQ)中的面对得分相比较对照组干预后明显升高[(22.70±2.28)分vs.(20.95±2.62)分],屈服、回避得分相比较对照组干预后明显降低[(5.13±1.36)分vs.(5.96±1.65)分,(13.72±1.45)分vs.(15.10±1.49)分],差异有统计学意义(P<0.05)。干预组干预后自我管理各维度评分和总评分均显著高于对照组干预后(P<0.05)。两组患者干预后的舒张压和收缩压相比较干预前均显著降低,其中干预组相比较对照组降低更明显(P<0.05),干预后干预组的血压控制达标率相比较对照组明显升高(收缩压:88.67%vs. 76.00%,舒张压:93.33%vs. 78.67%,P<0.05)。结论 HDSMP结合CDSMP模式对提高和改善老年高血压患者的疾病应对能力、自我效能和自我管理能力的效果更佳,从而能进一步提高和改善患者的血压控制达标率及生活质量水平。

合理信念替代疗法对冠心病患者心理弹性和自护能力的影响

目的:分析合理信念替代疗法对冠心病患者心理弹性和自护能力的影响。方法:按照入院顺序将某院2021年8月-2022年8月收治的102例冠心病患者分为对照组(n=51,常规干预)和干预组(n=51,常规干预+合理信念替代疗法);对比两组患者干预前后心理弹性[心理弹性量表(CD-RISC)]、自护能力[自我护理能力量表(ESCA)]、健康行为[健康促进生活方式量表Ⅱ(HPLP-II)]、生活质量[西雅图心绞痛量表(SAQ)]及满意度。结果:干预后,两组CD-RISC量表坚韧、乐观、自强各维度得分及总分均升高(P<0.05),且干预组均高于对照组(t=4.371,5.404,3.883,6.574;P<0.05);干预后,两组ESCA量表中自我概念、健康知识水平、自我护理技能、自我护理责任感各维度得分及ESCA量表总分均高于干预前(P<0.05),且干预组均高于对照组(t=7.252,3.908,5.848,5.643,10.496;P<0.05);干预后,两组HPLP-Ⅱ量表人际关系、运动锻炼、自我实现、压力管理、健康责任、营养各维度得分及总分均高于干预前(P<0.05),且干预组均高于对照组(t=2.624,3.883,3.378,3.642,3.610,2.828;P<0.05);干预后,两组SAQ各维度评分均升高(P<0.05),且干预组心绞痛稳定状况、疾病认知程度、治疗满意度、心绞痛发作频率、躯体受限程度五大维度评分较对照组高(t=2.122,2.340,3.699,2.976,2.766;P<0.05);两组满意度比较,干预组为96.08%,高于对照组的84.31%(χ^(2)=3.991,P<0.05)。结论:对冠心病患者采用合理信念替代疗法效果显著,可增强患者心理弹性,提高自护能力、健康行为水平和生活质量,获得较高的满意度。