BACKGROUNDPostoperative ileus is a common complication after colorectal cancer surgery,affecting recovery quality and hospital stay duration.Early activity intervention,as an important component of enhanced recovery a...BACKGROUNDPostoperative ileus is a common complication after colorectal cancer surgery,affecting recovery quality and hospital stay duration.Early activity intervention,as an important component of enhanced recovery after surgery,requires systematicevaluation of its exact effects on intestinal motility recovery and multidimensionalimpact.AIMTo comprehensively investigate the effects of early activity intervention onintestinal motility recovery and related indicators in patients after colorectalcancer surgery.METHODSUsing a retrospective comparative study design,80 patients who underwentcolorectal cancer surgery in our hospital from August 2023 to December 2024were retrospectively analyzed and divided into experimental and control groupswith 40 patients each based on the postoperative care protocols they received.Thecontrol group had received routine postoperative care,while the experimentalgroup had additionally received a systematic early activity intervention program,including bed-based passive activities within 6 hours post-surgery,active bed exercises from 6-24 hours,bedside activities from 24-48 hours,and in-ward walking after 48 hours.Assessmentindicators were retrospectively collected from medical records and included intestinal motility recovery,inflammatorystress response,postoperative complications,enteral nutrition tolerance,pain scores,nursing workload,patient psychological state,sleep quality,and nursing satisfaction.RESULTSThe experimental group demonstrated significantly shorter time to first flatus(48.2±10.6 hours vs 67.5±12.3hours,P<0.001)and first defecation(72.4±13.8 hours vs 94.6±15.7 hours,P<0.001);lower abdominal distensionscores at 72 hours post-surgery(2.1±0.6 vs 3.4±0.8,P<0.001);and reduced overall complication rates(7.5%vs20.0%,P=0.039).Inflammatory markers including C-reactive protein,interleukin-6,and tumor necrosis factor-αwere significantly lower in the experimental group(P<0.001).Pain scores at 72 hours post-surgery(1.8±0.5 vs 3.2±0.8,P<0.001)and additional analgesic requests(2.3±1.1 times vs 4.8±1.6 times,P<0.001)were markedlyreduced.Good enteral nutrition tolerance was higher(90.0%vs 72.5%,P=0.045),with earlier initiation of liquiddiet(62.3±9.6 hours vs 83.7±12.4 hours,P<0.001).Daily nursing time from postoperative day 3-7(78.3±15.6minutes vs 96.2±20.3 minutes,P<0.001)and extra interventions for complications(1.2±1.0 times/patient vs 2.8±1.5 times/patient,P<0.001)were reduced.Anxiety and depression scores were lower,sleep quality improved(Pittsburgh Sleep Quality Index:6.3±1.4 vs 9.2±2.1,P<0.001),and nursing satisfaction was significantly higher(92.6±5.8 vs 85.3±7.2,P<0.001).CONCLUSIONEarly activity intervention is a safe and effective non-pharmacological measure that not only significantly promotesintestinal motility recovery in patients after colorectal cancer surgery but also reduces inflammatory response andpostoperative pain,improves enteral nutrition tolerance,decreases postoperative complication rates,reducesnursing workload,improves patient psychological state and sleep quality,increases nursing satisfaction,andshortens hospital stay.This comprehensive intervention,being easy to implement and cost-effective,is worthy ofwidespread application in clinical practice.展开更多
BACKGROUND Direct cardiac surgery often necessitates intensive post-operative care,and the intensive care unit(ICU)activity scale represents a crucial metric in assessing and guiding early rehabilitation efforts to en...BACKGROUND Direct cardiac surgery often necessitates intensive post-operative care,and the intensive care unit(ICU)activity scale represents a crucial metric in assessing and guiding early rehabilitation efforts to enhance patient recovery.AIM To clarify the clinical application value of the ICU activity scale in the early recovery of patients after cardiac surgery.METHODS One hundred and twenty patients who underwent cardiac surgery between September 2020 and October 2021 were selected and divided into two groups using the random number table method.The observation group was rated using the ICU activity scale and the corresponding graded rehabilitation interventions were conducted based on the ICU activity scale.The control group was assessed in accordance with the routine rehabilitation activities,and the postoperative rehabilitation indexes of the patients in both groups were compared(time of tracheal intubation,time of ICU admission,occurrence of complications,and activity scores before ICU transfer).The two groups were compared according to postoperative rehabilitation indicators(time of tracheal intubation,length of ICU stay,and occurrence of complications)and activity scores before ICU transfer.RESULTS In the observation group,tracheal intubation time lasted for 18.30±3.28 h and ICU admission time was 4.04±0.83 d,which were significantly shorter than the control group(t-values:2.97 and 2.038,respectively,P<0.05).The observation group also had a significantly lower number of complications and adverse events compared to the control group(P<0.05).Before ICU transfer,the observation group(6.7%)had few complications and adverse events than the control group(30.0%),and this difference was statistically significant(P<0.05).Additionally,the activity score was significantly higher in the observation(26.89±0.97)compared to the control groups(22.63±1.12 points)(t-value;-17.83,P<0.05).CONCLUSION Implementation of early goal-directed activities in patients who underwent cardiac surgery using the ICU activity scale can promote the recovery of cardiac function.展开更多
Background:Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture.Although early passive mobilization limits rupture,it often compromises the functional recovery.Recent appr...Background:Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture.Although early passive mobilization limits rupture,it often compromises the functional recovery.Recent approaches favor early active mobilization with strong,multi-stranded core sutures to enhance outcomes.This study evaluated early active mobilization after eight-strand core repair in a tertiary care setting.Methods:In this prospective study,143 tendons from 30 patients who underwent surgery were followed up.The injured tendons were repaired using an eight-strand cross-locked cruciate technique with a double-stranded 4-0 suture,providing the tensile strength of eight strands with the same number of suture passes as in traditional four-core repairs,thereby reducing operative time without increasing bulk.Early active mobilization was initiated on postoperative day 2.The patients underwent digitally supervised physiotherapy and were monitored using a dedicated WhatsApp group,which enabled real-time guidance and compliance monitoring.The outcomes were measured in terms of total active motion,grip strength,pinch strength,time to return to work,postoperative pain,and complications.Results:Of the 30 patients,28(93.3%)had fair-to-excellent outcomes,whereas only 2(6.7%)had poor outcomes.Most patients(93.3%)returned to work within 12 weeks postoperatively.Four(13.3%)patients had complications,such as wound infection and skin necrosis.The patients showed significant changes in grip strength(45.2%)and pinch strength(70.7%)between weeks 8 and 12.No tendon ruptures were observed.Conclusion:The eight-core suturing technique used for flexor tendon repair withstood the forces of early active mobilization,which began on the second day after surgery,resulting in fair-to-excellent outcomes.It supports digitally supervised physiotherapy through app-based monitoring,enhancing patient compliance,and reducing reliance on in-person therapy sessions.This combination led to excellent functional recovery with minimal complications.展开更多
Early activity has a positive effect on the rehabilitation process of patients after cardiac intervention. This paper summarizes the concept and significance of early activity after cardiac intervention, the best time...Early activity has a positive effect on the rehabilitation process of patients after cardiac intervention. This paper summarizes the concept and significance of early activity after cardiac intervention, the best time and mode of different types of early activity after cardiac intervention, and the factors affecting early activity, aiming to provide a basis for clinical medical staff to provide safe and effective guidance of early activity after cardiac intervention.展开更多
Objective:To retrieve,evaluate,and summarize the best evidence for puncture management during the early initiation stage of autologous arteriovenous fistula(AVF)in hemodialysis patients,providing a reference for clini...Objective:To retrieve,evaluate,and summarize the best evidence for puncture management during the early initiation stage of autologous arteriovenous fistula(AVF)in hemodialysis patients,providing a reference for clinical nursing practice.Method:Following the“6S”pyramid model system,evidence on puncture management during the initiation stage of AVF in hemodialysis patients was retrieved from domestic and international databases.The search included clinical decision-making tools,guidelines,evidence summaries,systematic reviews,and expert consensus.The retrieval period spanned from database inception to January 2023.Four researchers screened the literature,performed quality evaluations,and extracted and integrated the evidence.Results:A total of nine articles were included,comprising one clinical decision,five guidelines,one evidence summary,one systematic review,and one expert consensus.The evidence encompassed 18 key points across six areas:team building and personnel training,timing of initial puncture,pre-puncture evaluation,puncture methods,post-puncture pressure management,and management of puncture-related complications.Conclusion:Blood purification nursing staff should combine clinical scenarios with evidence-based medicine to adopt scientific,effective,and feasible puncture management strategies during the early initiation stage of AVF.This approach aims to better safeguard the patient’s vascular access and overall treatment outcomes.展开更多
BMP2 plays crucial roles in vertebrate developmental process and acts as a bone inducer during osteogenesis. We present here the molecular cloning of bmp2 cDNA from the marine flatfish Cynoglossus semilaevis, and the ...BMP2 plays crucial roles in vertebrate developmental process and acts as a bone inducer during osteogenesis. We present here the molecular cloning of bmp2 cDNA from the marine flatfish Cynoglossus semilaevis, and the analysis of bmp2 expression profiling and promoter function. The full length of bmp2 cDNA sequence is 2 048 bp,which encodes a protein of 422 amino acids. Tissue expression distribution of bmp2 was examined in 14 tissues of mature individuals by quantitative real time PCR（qRT-PCR）. The results revealed that bmp2 was expressed ubiquitously, and the highest expression level was detected in the spinal cord. Moreover, bmp2 expression levels were detected at 15 sampling time points of early developmental stages（egg, larva, juvenile and fingerling stages）.The highest expression level of bmp2 was observed at the gastrula stage, which was about ten times higher than those at the other three embryo stages. Whole-mount in situ hybridization showed that the bmp2 signal was strongly detected at the location of the crown-like larval fin, heart and liver, and slightly expressed in the notochord at one day post hatch（dph）; then the expression of bmp2 started to be concentrated in notochord at three dph. Subsequently, we characterized the 5′-flanking region of bmp2 by testing the promoter activity by Luciferase reporter assays. Positive regulatory region was detected at the location of –179 to ＋109. The predicted transcription factor binding sites（E-box binding factors, zinc finger transcription factor, etc.） in this region might participate in the transcriptional regulation of the bmp2 gene.展开更多
文摘BACKGROUNDPostoperative ileus is a common complication after colorectal cancer surgery,affecting recovery quality and hospital stay duration.Early activity intervention,as an important component of enhanced recovery after surgery,requires systematicevaluation of its exact effects on intestinal motility recovery and multidimensionalimpact.AIMTo comprehensively investigate the effects of early activity intervention onintestinal motility recovery and related indicators in patients after colorectalcancer surgery.METHODSUsing a retrospective comparative study design,80 patients who underwentcolorectal cancer surgery in our hospital from August 2023 to December 2024were retrospectively analyzed and divided into experimental and control groupswith 40 patients each based on the postoperative care protocols they received.Thecontrol group had received routine postoperative care,while the experimentalgroup had additionally received a systematic early activity intervention program,including bed-based passive activities within 6 hours post-surgery,active bed exercises from 6-24 hours,bedside activities from 24-48 hours,and in-ward walking after 48 hours.Assessmentindicators were retrospectively collected from medical records and included intestinal motility recovery,inflammatorystress response,postoperative complications,enteral nutrition tolerance,pain scores,nursing workload,patient psychological state,sleep quality,and nursing satisfaction.RESULTSThe experimental group demonstrated significantly shorter time to first flatus(48.2±10.6 hours vs 67.5±12.3hours,P<0.001)and first defecation(72.4±13.8 hours vs 94.6±15.7 hours,P<0.001);lower abdominal distensionscores at 72 hours post-surgery(2.1±0.6 vs 3.4±0.8,P<0.001);and reduced overall complication rates(7.5%vs20.0%,P=0.039).Inflammatory markers including C-reactive protein,interleukin-6,and tumor necrosis factor-αwere significantly lower in the experimental group(P<0.001).Pain scores at 72 hours post-surgery(1.8±0.5 vs 3.2±0.8,P<0.001)and additional analgesic requests(2.3±1.1 times vs 4.8±1.6 times,P<0.001)were markedlyreduced.Good enteral nutrition tolerance was higher(90.0%vs 72.5%,P=0.045),with earlier initiation of liquiddiet(62.3±9.6 hours vs 83.7±12.4 hours,P<0.001).Daily nursing time from postoperative day 3-7(78.3±15.6minutes vs 96.2±20.3 minutes,P<0.001)and extra interventions for complications(1.2±1.0 times/patient vs 2.8±1.5 times/patient,P<0.001)were reduced.Anxiety and depression scores were lower,sleep quality improved(Pittsburgh Sleep Quality Index:6.3±1.4 vs 9.2±2.1,P<0.001),and nursing satisfaction was significantly higher(92.6±5.8 vs 85.3±7.2,P<0.001).CONCLUSIONEarly activity intervention is a safe and effective non-pharmacological measure that not only significantly promotesintestinal motility recovery in patients after colorectal cancer surgery but also reduces inflammatory response andpostoperative pain,improves enteral nutrition tolerance,decreases postoperative complication rates,reducesnursing workload,improves patient psychological state and sleep quality,increases nursing satisfaction,andshortens hospital stay.This comprehensive intervention,being easy to implement and cost-effective,is worthy ofwidespread application in clinical practice.
基金Supported by Zhejiang Provincial Medical and Health Technology Plan,No.2019KY762.
文摘BACKGROUND Direct cardiac surgery often necessitates intensive post-operative care,and the intensive care unit(ICU)activity scale represents a crucial metric in assessing and guiding early rehabilitation efforts to enhance patient recovery.AIM To clarify the clinical application value of the ICU activity scale in the early recovery of patients after cardiac surgery.METHODS One hundred and twenty patients who underwent cardiac surgery between September 2020 and October 2021 were selected and divided into two groups using the random number table method.The observation group was rated using the ICU activity scale and the corresponding graded rehabilitation interventions were conducted based on the ICU activity scale.The control group was assessed in accordance with the routine rehabilitation activities,and the postoperative rehabilitation indexes of the patients in both groups were compared(time of tracheal intubation,time of ICU admission,occurrence of complications,and activity scores before ICU transfer).The two groups were compared according to postoperative rehabilitation indicators(time of tracheal intubation,length of ICU stay,and occurrence of complications)and activity scores before ICU transfer.RESULTS In the observation group,tracheal intubation time lasted for 18.30±3.28 h and ICU admission time was 4.04±0.83 d,which were significantly shorter than the control group(t-values:2.97 and 2.038,respectively,P<0.05).The observation group also had a significantly lower number of complications and adverse events compared to the control group(P<0.05).Before ICU transfer,the observation group(6.7%)had few complications and adverse events than the control group(30.0%),and this difference was statistically significant(P<0.05).Additionally,the activity score was significantly higher in the observation(26.89±0.97)compared to the control groups(22.63±1.12 points)(t-value;-17.83,P<0.05).CONCLUSION Implementation of early goal-directed activities in patients who underwent cardiac surgery using the ICU activity scale can promote the recovery of cardiac function.
文摘Background:Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture.Although early passive mobilization limits rupture,it often compromises the functional recovery.Recent approaches favor early active mobilization with strong,multi-stranded core sutures to enhance outcomes.This study evaluated early active mobilization after eight-strand core repair in a tertiary care setting.Methods:In this prospective study,143 tendons from 30 patients who underwent surgery were followed up.The injured tendons were repaired using an eight-strand cross-locked cruciate technique with a double-stranded 4-0 suture,providing the tensile strength of eight strands with the same number of suture passes as in traditional four-core repairs,thereby reducing operative time without increasing bulk.Early active mobilization was initiated on postoperative day 2.The patients underwent digitally supervised physiotherapy and were monitored using a dedicated WhatsApp group,which enabled real-time guidance and compliance monitoring.The outcomes were measured in terms of total active motion,grip strength,pinch strength,time to return to work,postoperative pain,and complications.Results:Of the 30 patients,28(93.3%)had fair-to-excellent outcomes,whereas only 2(6.7%)had poor outcomes.Most patients(93.3%)returned to work within 12 weeks postoperatively.Four(13.3%)patients had complications,such as wound infection and skin necrosis.The patients showed significant changes in grip strength(45.2%)and pinch strength(70.7%)between weeks 8 and 12.No tendon ruptures were observed.Conclusion:The eight-core suturing technique used for flexor tendon repair withstood the forces of early active mobilization,which began on the second day after surgery,resulting in fair-to-excellent outcomes.It supports digitally supervised physiotherapy through app-based monitoring,enhancing patient compliance,and reducing reliance on in-person therapy sessions.This combination led to excellent functional recovery with minimal complications.
文摘Early activity has a positive effect on the rehabilitation process of patients after cardiac intervention. This paper summarizes the concept and significance of early activity after cardiac intervention, the best time and mode of different types of early activity after cardiac intervention, and the factors affecting early activity, aiming to provide a basis for clinical medical staff to provide safe and effective guidance of early activity after cardiac intervention.
基金Guiding Project No.79 of Jingzhou Science and Technology Bureau,Hubei Province。
文摘Objective:To retrieve,evaluate,and summarize the best evidence for puncture management during the early initiation stage of autologous arteriovenous fistula(AVF)in hemodialysis patients,providing a reference for clinical nursing practice.Method:Following the“6S”pyramid model system,evidence on puncture management during the initiation stage of AVF in hemodialysis patients was retrieved from domestic and international databases.The search included clinical decision-making tools,guidelines,evidence summaries,systematic reviews,and expert consensus.The retrieval period spanned from database inception to January 2023.Four researchers screened the literature,performed quality evaluations,and extracted and integrated the evidence.Results:A total of nine articles were included,comprising one clinical decision,five guidelines,one evidence summary,one systematic review,and one expert consensus.The evidence encompassed 18 key points across six areas:team building and personnel training,timing of initial puncture,pre-puncture evaluation,puncture methods,post-puncture pressure management,and management of puncture-related complications.Conclusion:Blood purification nursing staff should combine clinical scenarios with evidence-based medicine to adopt scientific,effective,and feasible puncture management strategies during the early initiation stage of AVF.This approach aims to better safeguard the patient’s vascular access and overall treatment outcomes.
基金The Special Scientific Research Funds for Central Non-profit Institutes,Chinese Academy of Fishery Sciences under contract No.2016RC-LX02the National Natural Science Foundation of China under contract No.31201981
文摘BMP2 plays crucial roles in vertebrate developmental process and acts as a bone inducer during osteogenesis. We present here the molecular cloning of bmp2 cDNA from the marine flatfish Cynoglossus semilaevis, and the analysis of bmp2 expression profiling and promoter function. The full length of bmp2 cDNA sequence is 2 048 bp,which encodes a protein of 422 amino acids. Tissue expression distribution of bmp2 was examined in 14 tissues of mature individuals by quantitative real time PCR（qRT-PCR）. The results revealed that bmp2 was expressed ubiquitously, and the highest expression level was detected in the spinal cord. Moreover, bmp2 expression levels were detected at 15 sampling time points of early developmental stages（egg, larva, juvenile and fingerling stages）.The highest expression level of bmp2 was observed at the gastrula stage, which was about ten times higher than those at the other three embryo stages. Whole-mount in situ hybridization showed that the bmp2 signal was strongly detected at the location of the crown-like larval fin, heart and liver, and slightly expressed in the notochord at one day post hatch（dph）; then the expression of bmp2 started to be concentrated in notochord at three dph. Subsequently, we characterized the 5′-flanking region of bmp2 by testing the promoter activity by Luciferase reporter assays. Positive regulatory region was detected at the location of –179 to ＋109. The predicted transcription factor binding sites（E-box binding factors, zinc finger transcription factor, etc.） in this region might participate in the transcriptional regulation of the bmp2 gene.
