Quality of life and psychological distress in end-stage renal disease patients undergoing hemodialysis and transplantation

BACKGROUND Among diverse profound impacts on patients’quality of life(QoL),end-stage renal disease(ESRD)frequently results in increased levels of depression,anxiety,and stress.Renal replacement therapies such as hemodialysis(HD)and transplantation(TX)are intended to enhance QoL,although their ability to alleviate psychological distress remains uncertain.This research posits the existence of a significant correlation between negative emotional states and QoL among ESRD patients,with varying effects observed in HD and TX patients.AIM To examine the relationship between QoL and negative emotional states(depression,anxiety,and stress)and predicted QoL in various end-stage renal replacement therapy patients with ESRD.METHODS This cross-sectional study included HD or TX patients in the Eastern Region of Saudi Arabia.The 36-item Short Form Survey and Depression Anxiety Stress Scale(DASS)was used for data collection,and correlation and regression analyses were performed.RESULTS The HD and TX transplantation groups showed statistically significant inverse relationships between QoL and DASS scores.HD patients with high anxiety levels and less education scored low on the physical component summary(PCS).In addition,the results of the mental component summary(MCS)were associated with reduced depression.Compared with older transplant patients,TX patients’PCS scores were lower,and depression,stress,and negative working conditions were highly correlated with MCS scores.CONCLUSION The findings of this study revealed notable connections between well-being and mental turmoil experienced by individuals undergoing HD and TX.The PCS of HD patients is affected by heightened levels of anxiety and lower educational attainment,while the MCS of transplant patients is influenced by advancing age and elevated stress levels.These insights will contribute to a more comprehensive understanding of patient support.

Metabolic and cardiovascular benefits with combination therapy of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes

Both GLP-1 receptor agonists(GLP-1RA)and SGLT-2 inhibitors(SGLT-2I)are newer classes of anti-diabetic agents that lower HbA1c moderately and decrease body weight and systolic blood pressure(SBP)modestly.Combination therapy with GLP-1RA plus SGLT-2I have shown a greater reduction in HbA1c,body weight,and SBP compared to either agent alone without any significant increase in hypoglycemia or other side effects.Since several agents from each class of these drugs have shown an improvement in cardiovascular(CV)and renal outcomes in their respective cardiovascular outcome trials(CVOT),combination therapy is theoretically expected to have additional CV and renal benefits.In this comprehensive opinion review,we found HbA1c lowering with GLP-1RA plus SGLT-2I to be less than additive compared to the sum of HbA1c lowering with either agent alone,although body weight lowering was nearly additive and the SBP lowering was more than additive.Our additional meta-analysis of CV outcomes with GLP1RA plus SGLT-2I combination therapy from the pooled data of five CVOT found a similar reduction in three-point major adverse cardiovascular events compared to GLP-1RA or SGLT-2I alone,against placebo.Interestingly,a greater benefit in reduction of heart failure hospitalization with GLP-1RA plus SGLT-2I combination therapy was noted in the pooled meta-analysis of two randomized controlled trials.Future adequately powered trials can confirm whether additional CV or renal benefit is truly exerted by GLP-1RA plus SGLT-2I combination therapy.

White-light-driven fluorescence switch for super-resolution imaging guided photodynamic and photoacid therapy

Photocaged fluorophores with photoactivatable characteristics presented important applications in imaging the biological structures and processes.Taking advantage of their super-resolution imaging merits to manipulate and visualize anti-cancer treatment is always a goal of modern clinical medicine.Traditional photodynamic therapy(PDT) is a noninvasive treatment but limited in intracellular oxygen content.Type I PDT and photoacid therapy(PAT) are two effective supplements of traditional PDT especially in hypoxic condition.Herein,a novel white-light-driven fluorescence switch(7H-dibenzo[c,g]carbazol-7-yl)(2-iodophenyl)methanone(2IB) was designed and synthesized as an unprecedent “all in one” platform for stochastic optical reconstruction microscopy(STORM) imaging guided Type Ⅰ/Ⅱ PDT and PAT.The experimental and theoretical studies revealed that the working mechanism is based on two competing paths under excitation:photosensitization and photocyclization reaction.Efficient intersystem crossing(ISC) ensured the generation of reactive oxygen species(ROS) for PDT,while low energy barrier facilitated the photocyclization reaction that simultaneously yielded emissive fluorophores(2IBC) and H^(+) for super-resolution imaging and photoacid,respectively.Impressively,the fluorescent intensity of mitochondria-targeted 2IBC was positively correlated with treatment efficacy,which is beneficial to spatiotemporally visualized therapeutic process and outcome.As a result,superior anti-tumor performance was achieved in vitro and in vivo.This contribution provided a multifunctional nanodrug paradigm for multimode cancer diagnosis and treatment.

Effects of Prior Antiplatelet Therapy on the Prognosis of Primary Intracerebral Hemorrhage： A Meta-analysis

Background：Antiplatelet therapy （APT） was prevalently being used in the prevention of vascular disease,but the influence of prior APT on the prognosis of patients with intracerebral hemorrhage （ICH） remains controversial.This meta-analysis was to explore the effects of prior APT on the prognosis of patients with primary ICH.Methods：PubMed and Embase were searched to identify the eligible studies.The studies comparing the mortality of ICH patients with or without prior APT were included.The quality of these studies was evaluated by the Newcastle-Ottawa quality assessment scale.The adjusted or unadjusted odds ratio （OR） for mortality between ICH patients with and without prior APT were pooled with 95% confidence interval （95% CI） as the effect of this meta-analysis.Results：Twenty-two studies fulfilled the inclusion criteria and exhibited high qualities.The pooled OR was 1.37 （95% CI：1.13-1.66,P =0.001） for univariate analysis and 1.41 （95% CI：1.05-1.90,P =0.024） for multivariate analysis.The meta-regression indicated that for each 1-day increase in the time of assessment,the adjusted OR for the mortality of APT patients decreased by 0.0049 （95% CI：0.0006-0.0091,P =0.026） as compared to non-APT patients.Conclusion：Prior APT was associated with high mortality in patients with ICH that might be attributed primarily to its strong effect on early time.

Effectiveness of external Sanjierupi Gao on mastalgia caused by mammary gland hyperplasia: a placebo controlled trial

OBJECTIVE:To evaluate the curative effect of external application of the Chinese drug,Sanjierupi Gao,on mastalgia caused by mammary gland hyperplasia.METHODS:This randomized,double-blinded,and placebo controlled study enrolled 260 patients with mammary gland hyperplasia from five hospitals.Patients were randomly and equally divided in-to a Sanjierupi Gao treatment group and a placebo control group.An adhesive plaster was applied to the most painful area on either breast for 7 h a day.Treatment lasted for two menstrual cycles without application during menstruation.Mastalgia was used as the main index of curative effect.The change before and after treatment in days of mastalgia,the time to alleviate pain,pain extent,and severe pain scores were observed.RESULTS:Compared to the control group,the treatment group had significantly fewer days of mastalgia(P<0.01),a significantly lower severe pain score(P<0.01),and significantly less subjective pain and tenderness(P<0.05 and P<0.01,respectively).Three days before the follow-up visit,the pain score in the treatment group was significantly lower than that in the control group(P<0.05).A non-parametric test was used to compare the time to alleviate mastalgia between the two groups and found no statistical difference(Z=0.313,P=0.754).CONCLUSION:Application of Sanjierupi Gao can decrease mastalgia duration in patients with mammary gland hyperplasia during menstruation and alleviate the extent of mastalgia.The time to alleviate pain is psychologically influenced.

Curative effect of scraping therapies on lumbar muscle strain

OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hundred and ten patients with lumbar muscle strain were divided into five groups with 42 patients each.The "scraping therapy at acupoint until appearance of skin eruptions" and "scraping therapy along channel until appearance of skin eruptions" groups were treated with a 4-daycourse. The "scraping therapy at acupoint without appearance of skin eruptions", "scraping therapy along channel without appearance of skin eruptions", and acupuncture groups were treated with a 2-day course.The five groups were treated with seven courses. The visual analog scale (VAS), oswestry disability index (ODI), and lumbago scores were recorded in the five groups before treatment, after each treatment, and in follow-up visits one month and three months after treatment. RESULTS: VAS, ODI, and lumbago scores after treatment improved in the five groups (P<0.01). There was a statistical difference (P<0.01) in the change of VAS scores by appearance of skin eruptions and scraping site. CONCLUSION: Scraping therapy can effectively alleviate lumbago symptoms. The appearance of skin eruptions and scraping therapy along channels can enhance the curative effect of scraping therapy.

Research methods in complementary and alternative medicine： an integrative review

The scientific literature presents a modest amount ot evidence m the use or complementary ana al[erna- tire medicine （CAM）. On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important, Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.