BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequen...BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.展开更多
Atrial fibrillation(AF)is a growing global health burden,with a prevalence of over 52.55 million cases.Rising disability-adjusted life-years,increasing age,and disparities in care have contributed to the worsening sev...Atrial fibrillation(AF)is a growing global health burden,with a prevalence of over 52.55 million cases.Rising disability-adjusted life-years,increasing age,and disparities in care have contributed to the worsening severity and mortality of AF.Modifiable risk factors,such as hypertension,obesity,and diabetes mellitus,are associated with alterations in gut microbiota,making the gut-heart axis a potential therapeutic target.Gut dysbiosis influences AF pathogenesis through inflam-mation,metabolic disruption,and autonomic dysfunction.Key mechanisms include gut barrier dysfunction,short-chain fatty acid(SCFA)depletion,lipopoly-saccharides(LPS)-induced inflammation,and ferroptosis-mediated atrial remodeling.Trimethylamine N-oxide,bile acids,and tryptophan metabolites contribute to arrhythmogenic remodeling.Emerging evidence suggests that dietary interventions,including prebiotics and probiotics,as well as gut surveillance,may help mitigate AF progression.Clinical implications of gut modulation in AF include person-alized dietary strategies,microbiome assessment through metagenomic sequencing,and targeted interventions such as SCFA-based therapies and ferroptosis inhibition.Metabolite surveillance,including LPS and indoxyl sulfate monitoring,may influence the effectiveness of anticoagulant and antiarrhythmic therapy.Despite growing mechanistic evidence linking gut dysbiosis to AF,clinical applications remain unexplored.This review summarizes the current understanding of the gut microbiome's role in AF.展开更多
In this editorial,we commented on two articles published online in August and September 2024 in the World Journal of Diabetes,which focused on modifying the gut microbiota(GM)to prevent or delay the progression of dia...In this editorial,we commented on two articles published online in August and September 2024 in the World Journal of Diabetes,which focused on modifying the gut microbiota(GM)to prevent or delay the progression of diabetes mellitus(DM)and DM-related complications.Numerous studies,many of which are animal studies,have indicated the potential role of GM in the pathogenesis of DM.However,the detailed causality and mechanisms between GM and DM have not been fully clarified.Although there have been some reports of a potential role of modifying the GM in treating DM,most lack long-term observations and are not mechanistic.Additionally,the GM and its role in DM might vary among individuals;therefore,GM-targeted interventions should be individualized to realize their therapeutic potential.展开更多
BACKGROUND Myocardial infarction is a high-risk condition prevalent among the elderly population,often leading to adverse clinical manifestations such as reduced cardiopulmonary function,anxiety,and depression post-su...BACKGROUND Myocardial infarction is a high-risk condition prevalent among the elderly population,often leading to adverse clinical manifestations such as reduced cardiopulmonary function,anxiety,and depression post-surgery.Consequently,cardiac rehabilitation holds immense importance in mitigating these complications.AIM To evaluate the effect of individualized cardiac rehabilitation on blood pressure variability(BPV)and baroreflex sensitivity(BRS)in elderly patients with myocardial infarction.METHODS A cohort of 74 elderly patients diagnosed with myocardial infarction and admitted to our hospital between January 2021 and January 2022 were subjected to random selection.Subsequently,all patients were divided into two groups,namely the research group(n=37)and the control group(n=37),utilizing the number table method.The control group received conventional drug treatment and nursing guidance intervention,while the study group underwent individualized cardiac rehabilitation in addition to the interventions received by the control group.All patients were continuously intervened for 12 wk,and the BPV of these two groups in the 1st wk(T0),the 4th wk(T1)and the 12th wk(T2)were compared,BRS,changes in cardiopulmonary function measures,and adverse cardiovascular events.RESULTS Of 24 h diastolic BPV,24 h systolic BPV,carbon dioxide ventilation equivalent slope of the research group were lower than those of the control group at T1 and T2,BRS,peak heart rate and systolic blood pressure product,1 min heart rate recovery were higher than those of the control group,and the incidence of adverse events in the research group was lower than that of the control group,the difference was statistically significant(P<0.05).CONCLUSION In this study,we found that after individualized cardiac rehabilitation in elderly patients with myocardial infarction,BPV and BRS can be effectively improved,cardiac function is significantly enhanced,and a better prognosis is obtained.展开更多
Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily dep...Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.展开更多
Splenic artery aneurysm has a hidden onset and atypical symptoms.There are various diagnostic methods for splenic aneurysms,among which ultrasound is the first choice for aneurysm screening.The diagnostic rate of CTA ...Splenic artery aneurysm has a hidden onset and atypical symptoms.There are various diagnostic methods for splenic aneurysms,among which ultrasound is the first choice for aneurysm screening.The diagnostic rate of CTA and DSA reaches 100%.In clinical practice,it is necessary to integrate medical history,symptoms and signs,and multiple imaging results to improve the diagnostic rate.In terms of treatment plans,both intervention and surgical procedures have their strengths,and the application of intervention will be more extensive.We need to adhere to the principle of individualization and choose a reasonable treatment plan for patients.At present,there are many reports on pregnant women with large splenic aneurysms both domestically and internationally.Some scholars believe that large splenic aneurysms may be related to hormonal imbalances during pregnancy,and the specific pathogenic mechanism will become a hot topic in future research.展开更多
Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map ...Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map the factors that interfere with the individualization of nursing care,in acute medical and perioperative settings.Scoping review was conducted according to the Joanna Briggs Institute guidelines.The MEDLINE,CINAHL,Cochrane,SciELO,Scientific Repository of Open Access,and LILACS databases were searched for publications from January 2017 up to March 2023.Of the 124 articles selected,17 met the inclusion criteria.The individualization of nursing care is complex and shaped by multiple variables in the care environment,nursing,and patient characteristics.The institutional organization,the nurses’expertise,and the patient’s attributes were identified as variables that interfere with the individualization of nursing care.Individualized nursing care is responsible for better quality of care and health outcomes.The identification of the variables that affect individualized care contributes to planning programs to improve individualization,during hospitalization and the discharge.展开更多
Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attenti...Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attention has been paid to the management of VVS and POTS in children and adolescents.A number of potential mechanisms are involved in their pathophysiology,but the leading cause of symptoms varies among patients.A few studies thus have focused on the individualized treatment of VVS or POTS based on selected hemodynamic parameters or biomarkers that can predict the therapeutic effect of certain therapies and improve their effectiveness.This review summarizes the latest developments in individualized treatment of VVS and POTS in children and indicates directions for further research in this field.展开更多
BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the pr...BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.展开更多
Objective： Experimental evidence suggests that the overexpression of breast cancer-specific tumor suppressor protein 1 （BRCA1） gene enhances sensitivity to docetaxel and resistance to cisplatin and ribonucleotide r...Objective： Experimental evidence suggests that the overexpression of breast cancer-specific tumor suppressor protein 1 （BRCA1） gene enhances sensitivity to docetaxel and resistance to cisplatin and ribonucleotide reductase M1 （RRM1） gene overexpression enhances resistance to gemcitabine. To further examine the effect of BRCA1 and RRM1 mRNA levels on outcome in advanced non-small cell lung cancer （NSCLC）, we performed this non-randomized phase II clinical trial which tested the hypothesis that customized therapy would confer improved outcome over non-customized therapy. Methods： RNA was isolated from fresh tumor tissue. Patients received chemotherapy regimen based on their BRCA1 and RRM1 mRNA levels： both low-cisplatin plus gemcitabine （GP）; both high-vinorelbine plus cisplatin （NP）; BRCA1 low and RRM1 high-cisplatin plus docetaxel （TP）; BRCA1 high and RRM1 low-vinorelbine plus gemcitabine （GN）. Results： From Dec 2005 to Nov 2008, 94 metastatic and locally advanced NSCLC patients from our institute were enrolled in this study. The median age was 58 years old. Among them, 21 patients received GP, 30 patients received TP and 43 patients received NP chemotherapy. GP group had a higher response rate, and longer median time to progression （TTP） and median overall survival （OS） time than the other 2 groups. The response rates in the GP, TP and NP groups were 42.9%, 36.7% and 27.9%, respectively （P=0.568）. The median TTP was 5.6, 5.0, 4.8 months （P=0.975）, respectively, and the median OS time was 12.5, 11.0, 9.7 months （P=0.808）, respectively. Conclusion： Chemotherapy customized according to BRCA1 and RRM1 expression levels is associated with higher response rate and longer TTP and OS time in the GP group. This suggests that BRCA1 and RRM1 mRNA levels could be used as biomarkers in individual therapy in NSCLC.展开更多
OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese pa...OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese patients with schizophrenia was built based on therapeu⁃tic drug monitoring data to guide individualized therapy.METHODS Plasma concentration data(330 measurements from 121 patients)were ana⁃lyzed using a nonlinear mixed-effects model⁃ing approach with first-order conditional estima⁃tion with interaction(FOCE I).The concentra⁃tions of amisulpride were detected by HPLC-MS/MS.Age,weight,sex,combination medication history and renal function status were evaluated as main covariates.The model was internally val⁃idated using goodness-of-fit,bootstrap and nor⁃malized prediction distribution error.Recom⁃mended dosage regimens for patients with key covariates were estimated on the basis of Monte Carlo simulations and the established model.RESULTS A one-compartment model with first-order absorption and elimination was found to adequately characterize amisulpride concentra⁃tion in Chinese patients with schizophrenia.The population estimates of the apparent volume of distribution(V/F)and apparent clearance(CL/F)were 12.7 L and 1.12 L·h-1,respectively.Age sig⁃nificantly affected the clearance of amisulpride and the final model was as follow:CL/F=1.04×(AGE/32)-0.624(L·h-1).To avoid exceeding the lab⁃oratory alert level(640μg·L-1),the model-based simulation results showed that the recommended dose of amisulpride was no more than 600 mg per day for patients aged 60 years,800 mg per day for those aged 40 years and 1200 mg per day for those aged 20 years,respectively.CON⁃CLUSION Dosage optimization of amisulpride can be carried out according to age to reduce the risk of adverse reactions.The model can be used as a suitable tool for designing individual⁃ized therapy for Chinese patients with schizo⁃phrenia.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)can lead to excessive pregnancy weight gain(PWG),abnormal glucolipid metabolism,and delayed lactation.Therefore,it is necessary to provide appropriate and effective interve...BACKGROUND Gestational diabetes mellitus(GDM)can lead to excessive pregnancy weight gain(PWG),abnormal glucolipid metabolism,and delayed lactation.Therefore,it is necessary to provide appropriate and effective interventions for pregnant women with GDM.AIM To clarify the effects of individualized nutrition interventions on PWG,glucolipid metabolism,and lactation in pregnant women with GDM.METHODS The study population consisted of 410 pregnant women with GDM who received treatment at the Northern Jiangsu People's Hospital of Jiangsu Provinceand Yangzhou Maternal and Child Health Hospital between December 2020 and December 2022,including 200 who received routine in-terventions[control(Con)group]and 210 who received individualized nutrition interventions[research(Res)group].Data on PWG,glucolipid metabolism[total cholesterol,(TC);triglycerides(TGs);fasting blood glucose(FPG);glycosylated hemoglobin(HbA1c)],lactation time,perinatal complications(cesarean section,premature rupture of membranes,postpartum hemorrhage,and pregnancy-induced hypertension),and neonatal adverse events(premature infants,fetal macrosomia,hypo-glycemia,and respiratory distress syndrome)were collected for comparative analysis.RESULTS The data revealed markedly lower PWG in the Res group vs the Con group,as well as markedly reduced TG,TC,FPG and HbA1c levels after the intervention that were lower than those in the Con group.In addition,obviously earlier lactation and statistically lower incidences of perinatal complications and neonatal adverse events were observed in the Res group.CONCLUSION Individualized nutrition interventions can reduce PWG in pregnant women with GDM,improve their glucolipid metabolism,and promote early lactation,which deserves clinical promotion.展开更多
OBJECTIVE:To evaluate the differences in the efficacy of stationary treatment and individualized treatment for patients with nonproliferative diabetic retinopathy(NPDR).METHODS:This study was a randomized,controlled,m...OBJECTIVE:To evaluate the differences in the efficacy of stationary treatment and individualized treatment for patients with nonproliferative diabetic retinopathy(NPDR).METHODS:This study was a randomized,controlled,multicenter clinical trial.Participants with NPDR were randomized into the stationary treatment group or the individualized treatment group.The stationary treatment group was given the basic treatment and Qiming granules,and the individualized treatment group was given the basic treatment,Qiming granules,and individualized Chinese herbal medicines over a 12-week period.The individualized therapeutic formula was also changed over time to adjust to the changes in the clinical presentation of the patient.We conducted observations of fundus retinal exudation and hemorrhage,visual acuity,Traditional Chinese Medicine symptom scores and other indicators.RESULTS:A total of 140 participants with NPDR were randomized into the stationary treatment group or the individualized treatment group,and 132 participants completed this study.Following the 12-week treatment,significant improvements in both primary and secondary outcomes were observed in the stationary and individualized treatment groups.No remarkable difference in the primary outcomes between the two groups was observed.However,there was a significant difference in the Traditional Chinese Medicine symptom scores(18±7 vs 15±6;P<0.05).There were no severe adverse effects.CONCLUSION:Compared with stationary treatment,individualized treatment is more effective at relieving the Traditional Chinese Medicine symptoms and improving vision and fundus lesions at 12 weeks post treatment.展开更多
The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded versio...The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for apicture book intended for children and their families(in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research.展开更多
Background:Patients with pancreatic ductal adenocarcinoma(PDAC)who undergo surgical resection and receive effective chemotherapy have the best chance for longterm survival.Unfortunately,because of the heterogeneity of...Background:Patients with pancreatic ductal adenocarcinoma(PDAC)who undergo surgical resection and receive effective chemotherapy have the best chance for longterm survival.Unfortunately,because of the heterogeneity of pancreatic cancer,it is difficult to find a personalized treatment strategy for patients.Organoids are ideal preclinical models for personalized medicine.Therefore,we explore the cultivation conditions and construction methods of PDAC organoid models to screen the individualized therapy strategy.Methods:Fresh PDAC tissues from surgical resection were collected and digested with digestive enzymes;then the tumor cells were embedded in Matrigel with a suitable medium to establish the PDAC organoid models.The genetic stability of the organoids was analyzed using whole exon sequencing;hematoxylin and eosin staining and immunohistochemistry of organoids were performed to analyze their consistency with the pathological morphology of the patient's tumor tissue;After 2 days of organoid culture,we selected four commonly used clinical chemotherapy drugs for single or combined treatment to analyze drug sensitivity.Results:Two cases of PDAC organoid models were successfully established,and the results of their pathological characteristics and exome sequencing were consistent with those of the patient's tumor tissue.Both PDAC organoids showed more sensitivity to gemcitabine and cisplatin,and the combined treatment was more effective than monotherapy.Conclusion:Both organoids better retained the pathological characteristics,genomic stability,and heterogeneity with the original tumor.Individual PDAC organoids exhibited different sensitivities to the same drugs.Thus,this study provided ideal experimental models for screening individualized therapy strategy for patients with PDAC.展开更多
BACKGROUND： Early diagnosis of gallbladder cancer（GBC） can remarkably improve the prognosis of patients. This study aimed to develop a nomogram for individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystit...BACKGROUND： Early diagnosis of gallbladder cancer（GBC） can remarkably improve the prognosis of patients. This study aimed to develop a nomogram for individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening.METHODS： The nomogram was developed using logistic regression analyses based on a retrospective cohort consisting of 89 consecutive patients with stage Ⅰ-Ⅱ GBC and 1240 patients with gallbladder wall thickening treated at one biliary surgery center in Shanghai between January 2009 and December 2011. The accuracy of the nomogram was validated by discrimination, calibration and a prospective cohort treated at another center between January 2012 and December 2014（n=928）.RESULTS： Factors included in the nomogram were advanced age, hazardous alcohol consumption, long-standing diagnosed gallstones, atrophic gallbladder, gallbladder wall calcification, intraluminal polypoid lesion, higher wall thickness ratio and mucosal line disruption. The nomogram had concordance indices of 0.889 and 0.856 for the two cohorts, respectively. Internal and external calibration curves fitted well. The area under the receiver-operating characteristic curves of the nomogram was higher than that of multidetector row computed tomography in diagnosis of stage Ⅰ-Ⅱ GBC（P〈0.001）.CONCLUSION： The proposed nomogram improves individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening, especially for those the imaging features alone do not allow to confirm the diagnosis.展开更多
Objective:To evaluate the clinical therapeutic effect and safety of individualized moxibustion in treatment of postpartum pantalgia.Methods:A total of 99 patients with postpartum pantalgia were divided into three grou...Objective:To evaluate the clinical therapeutic effect and safety of individualized moxibustion in treatment of postpartum pantalgia.Methods:A total of 99 patients with postpartum pantalgia were divided into three group at the ratio of 1:1:1 according to random number table,i.e.an individualized moxibustion group,a quantitative moxibustion group and a voltaren group.The same acupoints were selected in the individualized moxibustion group and the quantitative moxibustion group.With the patient in supine,Zhongwǎn(中脘CV12),Guānyuán(关元CV4),bilateral Tiānshū(天枢ST25),bilateral Xuèhǎi(血海SP10),bilateral Yanglingquan(阳陵泉GB34),bilateral Zúsānlǐ(足三里ST36) and bilateral Sānyīnjiāo(三阴交SP6) were selected.With the patient in prone,Dàzhuī(大椎GV14),bilateral Géshū(膈俞BL17),bilateral Píshū(脾俞BL20),bilateral Shènshū(肾俞BL23),Mìngmén 命门(GV4),bilateral Wěizhōng(委中BL40) and bilateral Yǒngquán(涌泉KI1) were selected.In the individualized moxibustion group,the moxibusion dose was determined by patient’s constitution and conditions as well as no occurrence of dry throat,thirst and local skin lesion.In the quantitative moxibustion group,the moxibustion dose was fixed as 1 cone at each acupoint in treatment.In these two groups,the treatment was given once every two days,three times a week and the treatment for 2 weeks was as 1 course.Totally,2 courses of treatment were required.In the voltaren group,voltaren ointment was used externally at the pain area,once a day,for 4 weeks totally.Separately,before treatment,at the end of treatment course and in follow-up,the symptom score of traditional Chinese medicine(TCM),pain score of visual analogue scale(VAS) and patient’s treatment satisfaction score were observed in the patients of the three groups.Results:In comparison within group,TCM symptom score,VAS score and the treatment satisfaction score at the end of treatment were all reduced obviously as compared with those before treatment in each of the three groups(P <0.05).In 4,12 and 24 weeks of followup after treatment,the differences in these data were not significant as compared with those at the end of treatment in the individualized moxibustion group and the quantitative moxibustion group respectively(all P> 0.05).In the voltaren group,these data were not different as compared with those at the end of treatment in 4 weeks of follow-up(all P> 0.05),but these data were all increased as compared with those at the end of treatment in 12 and 24 weeks of follow-up(all P <0.05).In comparison among three groups,at the end of treatment and in 4,12 and 24 weeks of followup,the above-mentioned three therapeutic effect indicators were all different significantly(all P <0.05).In comparison between two groups,in the individualized moxibustion group,TCM symptom score,VAS score and the patient’s treatment satisfaction score were all lower than those in the quantitative moxibustion group at the end of treatment and at each time point of follow-up successively,indicating the significant differences(all P <0.05).Conclusion:Individualized moxibustion and quantitative moxibustion improve the short-term and longterm therapeutic effect on postpartum pantalgia as compared with the external application of voltaren ointment.The therapeutic effect and patient’s satisfaction of individualized moxibustion for replenishing kidney and nourishing blood are better than the quantitative moxibustion.The individualized moxibustion therapy for replenishing kidney and nourishing blood achieves a satisfactory effect on postpartum pantalgia and is excelled to voltaren ointment that is strongly recommended in modern medicine.Individualized moxibustion is an external therapy of TCM with optimal short-term and long-term therapeutic effect and reliable safety.Hence,it deserves to be promoted in practice.展开更多
With the massive increase of digital resource based on the network,it becomes very important that how to help readers acquire the information needed according to the individualized requirement and interest in an accur...With the massive increase of digital resource based on the network,it becomes very important that how to help readers acquire the information needed according to the individualized requirement and interest in an accurate,convenient and prompt method. Therefore,it is very urgent to investigate individualized information service of library. In this paper,based on the development of the individualized information service for the reader in the college library,the individualized information service is clarified by using three perspectives,including establishment of individualized information demand model,integration of internal and external resource and protection of the reader privacy. Finally,the corresponding strategy and related measure are presented.展开更多
Background Hypertensive cerebral hemorrhage （HCH） is an important cerebrovascular disease that poses significant threat to the health of human being, with high incidence and mortality. With the development of mini- ...Background Hypertensive cerebral hemorrhage （HCH） is an important cerebrovascular disease that poses significant threat to the health of human being, with high incidence and mortality. With the development of mini- mally invasive techniques, individualized surgical treatment of HCH is very common. Method During 2003- 2012, according to the condition of using craniotomy, hematoma in small bone window craniotomy and hematoma for treatment of 162 cases of hypertensive cerebral hemorrhage patients. Results Among 162 patients with HCH in our study, 24 had recurrent hemorrhage after surgery, with an incidence of recurrent hemorrhage of 14.8%. Among the 24 recurrent hemorrhages, 22 had hemorrhage in primary hematoma site and two subdural hematomas. Among these patients, 16 died, with a mortality of 9.8%. Death rate and recurrent hemorrhage in the small bone window group were lower than that in the craniotomy group, and ＂the difference reached statistical significance （P 〈 0.05）. Conclusions Individuation in treatment of hypertension must be correctly estimated based on disease condition, comprehensive judgment, selection of appropriate treatment options. Even if that we would reduce mortality, improve the success rate of operation and living quality.展开更多
A Streetcar Named Desire which describes Blanche's tortuous tragedy is a influential drama.With the evolution of the human civilization such as psychology,psychological analysis has become an important approach of...A Streetcar Named Desire which describes Blanche's tortuous tragedy is a influential drama.With the evolution of the human civilization such as psychology,psychological analysis has become an important approach of analyzing the literary works in literary criticism.Some critics analyze Blanche by means of Freudian psychoanalysis and Jungian psychology while this thesis analyzes Blanche's Inferiority Complex and Compensation by Adler's individualized psychology from the perspectives of Blanche's childhood and Blanche's broken marriage.展开更多
文摘BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.
文摘Atrial fibrillation(AF)is a growing global health burden,with a prevalence of over 52.55 million cases.Rising disability-adjusted life-years,increasing age,and disparities in care have contributed to the worsening severity and mortality of AF.Modifiable risk factors,such as hypertension,obesity,and diabetes mellitus,are associated with alterations in gut microbiota,making the gut-heart axis a potential therapeutic target.Gut dysbiosis influences AF pathogenesis through inflam-mation,metabolic disruption,and autonomic dysfunction.Key mechanisms include gut barrier dysfunction,short-chain fatty acid(SCFA)depletion,lipopoly-saccharides(LPS)-induced inflammation,and ferroptosis-mediated atrial remodeling.Trimethylamine N-oxide,bile acids,and tryptophan metabolites contribute to arrhythmogenic remodeling.Emerging evidence suggests that dietary interventions,including prebiotics and probiotics,as well as gut surveillance,may help mitigate AF progression.Clinical implications of gut modulation in AF include person-alized dietary strategies,microbiome assessment through metagenomic sequencing,and targeted interventions such as SCFA-based therapies and ferroptosis inhibition.Metabolite surveillance,including LPS and indoxyl sulfate monitoring,may influence the effectiveness of anticoagulant and antiarrhythmic therapy.Despite growing mechanistic evidence linking gut dysbiosis to AF,clinical applications remain unexplored.This review summarizes the current understanding of the gut microbiome's role in AF.
基金Supported by Medical Education Collaborative Innovation Fund of Jiangsu University,No.JDYY2023101.
文摘In this editorial,we commented on two articles published online in August and September 2024 in the World Journal of Diabetes,which focused on modifying the gut microbiota(GM)to prevent or delay the progression of diabetes mellitus(DM)and DM-related complications.Numerous studies,many of which are animal studies,have indicated the potential role of GM in the pathogenesis of DM.However,the detailed causality and mechanisms between GM and DM have not been fully clarified.Although there have been some reports of a potential role of modifying the GM in treating DM,most lack long-term observations and are not mechanistic.Additionally,the GM and its role in DM might vary among individuals;therefore,GM-targeted interventions should be individualized to realize their therapeutic potential.
文摘BACKGROUND Myocardial infarction is a high-risk condition prevalent among the elderly population,often leading to adverse clinical manifestations such as reduced cardiopulmonary function,anxiety,and depression post-surgery.Consequently,cardiac rehabilitation holds immense importance in mitigating these complications.AIM To evaluate the effect of individualized cardiac rehabilitation on blood pressure variability(BPV)and baroreflex sensitivity(BRS)in elderly patients with myocardial infarction.METHODS A cohort of 74 elderly patients diagnosed with myocardial infarction and admitted to our hospital between January 2021 and January 2022 were subjected to random selection.Subsequently,all patients were divided into two groups,namely the research group(n=37)and the control group(n=37),utilizing the number table method.The control group received conventional drug treatment and nursing guidance intervention,while the study group underwent individualized cardiac rehabilitation in addition to the interventions received by the control group.All patients were continuously intervened for 12 wk,and the BPV of these two groups in the 1st wk(T0),the 4th wk(T1)and the 12th wk(T2)were compared,BRS,changes in cardiopulmonary function measures,and adverse cardiovascular events.RESULTS Of 24 h diastolic BPV,24 h systolic BPV,carbon dioxide ventilation equivalent slope of the research group were lower than those of the control group at T1 and T2,BRS,peak heart rate and systolic blood pressure product,1 min heart rate recovery were higher than those of the control group,and the incidence of adverse events in the research group was lower than that of the control group,the difference was statistically significant(P<0.05).CONCLUSION In this study,we found that after individualized cardiac rehabilitation in elderly patients with myocardial infarction,BPV and BRS can be effectively improved,cardiac function is significantly enhanced,and a better prognosis is obtained.
基金funded by the National Social Science Fund Project—Research on the Construction Strategy of Community Home-Based Elderly Care Service Ecological Chain from the Perspective of Stakeholders(Grant Number,22BSH137).
文摘Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.
文摘Splenic artery aneurysm has a hidden onset and atypical symptoms.There are various diagnostic methods for splenic aneurysms,among which ultrasound is the first choice for aneurysm screening.The diagnostic rate of CTA and DSA reaches 100%.In clinical practice,it is necessary to integrate medical history,symptoms and signs,and multiple imaging results to improve the diagnostic rate.In terms of treatment plans,both intervention and surgical procedures have their strengths,and the application of intervention will be more extensive.We need to adhere to the principle of individualization and choose a reasonable treatment plan for patients.At present,there are many reports on pregnant women with large splenic aneurysms both domestically and internationally.Some scholars believe that large splenic aneurysms may be related to hormonal imbalances during pregnancy,and the specific pathogenic mechanism will become a hot topic in future research.
文摘Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map the factors that interfere with the individualization of nursing care,in acute medical and perioperative settings.Scoping review was conducted according to the Joanna Briggs Institute guidelines.The MEDLINE,CINAHL,Cochrane,SciELO,Scientific Repository of Open Access,and LILACS databases were searched for publications from January 2017 up to March 2023.Of the 124 articles selected,17 met the inclusion criteria.The individualization of nursing care is complex and shaped by multiple variables in the care environment,nursing,and patient characteristics.The institutional organization,the nurses’expertise,and the patient’s attributes were identified as variables that interfere with the individualization of nursing care.Individualized nursing care is responsible for better quality of care and health outcomes.The identification of the variables that affect individualized care contributes to planning programs to improve individualization,during hospitalization and the discharge.
基金supported by Peking University Clinical Scientist Program (BMU2019LCKXJ001,Beijing)Fundamental Research Funds for the Central Universities of China.
文摘Vasovagal syncope(VVS) and postural tachycardia syndrome(POTS) are the main forms of orthostatic intolerance in pediatrics and both are underlying causes of neurally-mediated syncope.In recent years,increasing attention has been paid to the management of VVS and POTS in children and adolescents.A number of potential mechanisms are involved in their pathophysiology,but the leading cause of symptoms varies among patients.A few studies thus have focused on the individualized treatment of VVS or POTS based on selected hemodynamic parameters or biomarkers that can predict the therapeutic effect of certain therapies and improve their effectiveness.This review summarizes the latest developments in individualized treatment of VVS and POTS in children and indicates directions for further research in this field.
基金Supported by the Program of Qiqihar Science and Technology Plan,No.SFGG-201534
文摘BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.
基金supported by grants from the key project of the Science and Technology Commission of Shanghai Municipality (No.06DZ19502)the project of the Science and Technology Commission of Shanghai Municipality (04DZ19109)
文摘Objective： Experimental evidence suggests that the overexpression of breast cancer-specific tumor suppressor protein 1 （BRCA1） gene enhances sensitivity to docetaxel and resistance to cisplatin and ribonucleotide reductase M1 （RRM1） gene overexpression enhances resistance to gemcitabine. To further examine the effect of BRCA1 and RRM1 mRNA levels on outcome in advanced non-small cell lung cancer （NSCLC）, we performed this non-randomized phase II clinical trial which tested the hypothesis that customized therapy would confer improved outcome over non-customized therapy. Methods： RNA was isolated from fresh tumor tissue. Patients received chemotherapy regimen based on their BRCA1 and RRM1 mRNA levels： both low-cisplatin plus gemcitabine （GP）; both high-vinorelbine plus cisplatin （NP）; BRCA1 low and RRM1 high-cisplatin plus docetaxel （TP）; BRCA1 high and RRM1 low-vinorelbine plus gemcitabine （GN）. Results： From Dec 2005 to Nov 2008, 94 metastatic and locally advanced NSCLC patients from our institute were enrolled in this study. The median age was 58 years old. Among them, 21 patients received GP, 30 patients received TP and 43 patients received NP chemotherapy. GP group had a higher response rate, and longer median time to progression （TTP） and median overall survival （OS） time than the other 2 groups. The response rates in the GP, TP and NP groups were 42.9%, 36.7% and 27.9%, respectively （P=0.568）. The median TTP was 5.6, 5.0, 4.8 months （P=0.975）, respectively, and the median OS time was 12.5, 11.0, 9.7 months （P=0.808）, respectively. Conclusion： Chemotherapy customized according to BRCA1 and RRM1 expression levels is associated with higher response rate and longer TTP and OS time in the GP group. This suggests that BRCA1 and RRM1 mRNA levels could be used as biomarkers in individual therapy in NSCLC.
文摘OBJECTIVE To explain the high inter-individual variability and the frequency of exceeding the therapeutic reference range and the laboratory alert level of amisulpride,a popula⁃tion pharmacokinetic model in Chinese patients with schizophrenia was built based on therapeu⁃tic drug monitoring data to guide individualized therapy.METHODS Plasma concentration data(330 measurements from 121 patients)were ana⁃lyzed using a nonlinear mixed-effects model⁃ing approach with first-order conditional estima⁃tion with interaction(FOCE I).The concentra⁃tions of amisulpride were detected by HPLC-MS/MS.Age,weight,sex,combination medication history and renal function status were evaluated as main covariates.The model was internally val⁃idated using goodness-of-fit,bootstrap and nor⁃malized prediction distribution error.Recom⁃mended dosage regimens for patients with key covariates were estimated on the basis of Monte Carlo simulations and the established model.RESULTS A one-compartment model with first-order absorption and elimination was found to adequately characterize amisulpride concentra⁃tion in Chinese patients with schizophrenia.The population estimates of the apparent volume of distribution(V/F)and apparent clearance(CL/F)were 12.7 L and 1.12 L·h-1,respectively.Age sig⁃nificantly affected the clearance of amisulpride and the final model was as follow:CL/F=1.04×(AGE/32)-0.624(L·h-1).To avoid exceeding the lab⁃oratory alert level(640μg·L-1),the model-based simulation results showed that the recommended dose of amisulpride was no more than 600 mg per day for patients aged 60 years,800 mg per day for those aged 40 years and 1200 mg per day for those aged 20 years,respectively.CON⁃CLUSION Dosage optimization of amisulpride can be carried out according to age to reduce the risk of adverse reactions.The model can be used as a suitable tool for designing individual⁃ized therapy for Chinese patients with schizo⁃phrenia.
基金The study was reviewed and approved by the Medical Ethics Committee of Northern Jiangsu People's Hospital of Jiangsu Province(Approval No.2023ky150).
文摘BACKGROUND Gestational diabetes mellitus(GDM)can lead to excessive pregnancy weight gain(PWG),abnormal glucolipid metabolism,and delayed lactation.Therefore,it is necessary to provide appropriate and effective interventions for pregnant women with GDM.AIM To clarify the effects of individualized nutrition interventions on PWG,glucolipid metabolism,and lactation in pregnant women with GDM.METHODS The study population consisted of 410 pregnant women with GDM who received treatment at the Northern Jiangsu People's Hospital of Jiangsu Provinceand Yangzhou Maternal and Child Health Hospital between December 2020 and December 2022,including 200 who received routine in-terventions[control(Con)group]and 210 who received individualized nutrition interventions[research(Res)group].Data on PWG,glucolipid metabolism[total cholesterol,(TC);triglycerides(TGs);fasting blood glucose(FPG);glycosylated hemoglobin(HbA1c)],lactation time,perinatal complications(cesarean section,premature rupture of membranes,postpartum hemorrhage,and pregnancy-induced hypertension),and neonatal adverse events(premature infants,fetal macrosomia,hypo-glycemia,and respiratory distress syndrome)were collected for comparative analysis.RESULTS The data revealed markedly lower PWG in the Res group vs the Con group,as well as markedly reduced TG,TC,FPG and HbA1c levels after the intervention that were lower than those in the Con group.In addition,obviously earlier lactation and statistically lower incidences of perinatal complications and neonatal adverse events were observed in the Res group.CONCLUSION Individualized nutrition interventions can reduce PWG in pregnant women with GDM,improve their glucolipid metabolism,and promote early lactation,which deserves clinical promotion.
基金Supported by the National Key Technology Support Program of China and the State Administration of Traditional Medicine of China(Project No.2014BAI10B03)。
文摘OBJECTIVE:To evaluate the differences in the efficacy of stationary treatment and individualized treatment for patients with nonproliferative diabetic retinopathy(NPDR).METHODS:This study was a randomized,controlled,multicenter clinical trial.Participants with NPDR were randomized into the stationary treatment group or the individualized treatment group.The stationary treatment group was given the basic treatment and Qiming granules,and the individualized treatment group was given the basic treatment,Qiming granules,and individualized Chinese herbal medicines over a 12-week period.The individualized therapeutic formula was also changed over time to adjust to the changes in the clinical presentation of the patient.We conducted observations of fundus retinal exudation and hemorrhage,visual acuity,Traditional Chinese Medicine symptom scores and other indicators.RESULTS:A total of 140 participants with NPDR were randomized into the stationary treatment group or the individualized treatment group,and 132 participants completed this study.Following the 12-week treatment,significant improvements in both primary and secondary outcomes were observed in the stationary and individualized treatment groups.No remarkable difference in the primary outcomes between the two groups was observed.However,there was a significant difference in the Traditional Chinese Medicine symptom scores(18±7 vs 15±6;P<0.05).There were no severe adverse effects.CONCLUSION:Compared with stationary treatment,individualized treatment is more effective at relieving the Traditional Chinese Medicine symptoms and improving vision and fundus lesions at 12 weeks post treatment.
文摘The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for apicture book intended for children and their families(in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research.
基金Laboratory Animal Foundation Program,Grant/Award Number:SYDW_KY 2021-14National Natural Science Foundation of China,Grant/Award Number:32070532 and 32270566+1 种基金Promotion Plan of the Air Force Medical University,Grant/Award Number:2020SWAQ11the Ethics Committee of Xijing Hospital of FMMU(ethics approval number:KY20203128-1).
文摘Background:Patients with pancreatic ductal adenocarcinoma(PDAC)who undergo surgical resection and receive effective chemotherapy have the best chance for longterm survival.Unfortunately,because of the heterogeneity of pancreatic cancer,it is difficult to find a personalized treatment strategy for patients.Organoids are ideal preclinical models for personalized medicine.Therefore,we explore the cultivation conditions and construction methods of PDAC organoid models to screen the individualized therapy strategy.Methods:Fresh PDAC tissues from surgical resection were collected and digested with digestive enzymes;then the tumor cells were embedded in Matrigel with a suitable medium to establish the PDAC organoid models.The genetic stability of the organoids was analyzed using whole exon sequencing;hematoxylin and eosin staining and immunohistochemistry of organoids were performed to analyze their consistency with the pathological morphology of the patient's tumor tissue;After 2 days of organoid culture,we selected four commonly used clinical chemotherapy drugs for single or combined treatment to analyze drug sensitivity.Results:Two cases of PDAC organoid models were successfully established,and the results of their pathological characteristics and exome sequencing were consistent with those of the patient's tumor tissue.Both PDAC organoids showed more sensitivity to gemcitabine and cisplatin,and the combined treatment was more effective than monotherapy.Conclusion:Both organoids better retained the pathological characteristics,genomic stability,and heterogeneity with the original tumor.Individual PDAC organoids exhibited different sensitivities to the same drugs.Thus,this study provided ideal experimental models for screening individualized therapy strategy for patients with PDAC.
基金supported by grants from the National Natural Science Foundation of China(81401932,81272747 and 81372642)
文摘BACKGROUND： Early diagnosis of gallbladder cancer（GBC） can remarkably improve the prognosis of patients. This study aimed to develop a nomogram for individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening.METHODS： The nomogram was developed using logistic regression analyses based on a retrospective cohort consisting of 89 consecutive patients with stage Ⅰ-Ⅱ GBC and 1240 patients with gallbladder wall thickening treated at one biliary surgery center in Shanghai between January 2009 and December 2011. The accuracy of the nomogram was validated by discrimination, calibration and a prospective cohort treated at another center between January 2012 and December 2014（n=928）.RESULTS： Factors included in the nomogram were advanced age, hazardous alcohol consumption, long-standing diagnosed gallstones, atrophic gallbladder, gallbladder wall calcification, intraluminal polypoid lesion, higher wall thickness ratio and mucosal line disruption. The nomogram had concordance indices of 0.889 and 0.856 for the two cohorts, respectively. Internal and external calibration curves fitted well. The area under the receiver-operating characteristic curves of the nomogram was higher than that of multidetector row computed tomography in diagnosis of stage Ⅰ-Ⅱ GBC（P〈0.001）.CONCLUSION： The proposed nomogram improves individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening, especially for those the imaging features alone do not allow to confirm the diagnosis.
基金Supported by Shenzhen Pingshan District Health Research Project:201854.
文摘Objective:To evaluate the clinical therapeutic effect and safety of individualized moxibustion in treatment of postpartum pantalgia.Methods:A total of 99 patients with postpartum pantalgia were divided into three group at the ratio of 1:1:1 according to random number table,i.e.an individualized moxibustion group,a quantitative moxibustion group and a voltaren group.The same acupoints were selected in the individualized moxibustion group and the quantitative moxibustion group.With the patient in supine,Zhongwǎn(中脘CV12),Guānyuán(关元CV4),bilateral Tiānshū(天枢ST25),bilateral Xuèhǎi(血海SP10),bilateral Yanglingquan(阳陵泉GB34),bilateral Zúsānlǐ(足三里ST36) and bilateral Sānyīnjiāo(三阴交SP6) were selected.With the patient in prone,Dàzhuī(大椎GV14),bilateral Géshū(膈俞BL17),bilateral Píshū(脾俞BL20),bilateral Shènshū(肾俞BL23),Mìngmén 命门(GV4),bilateral Wěizhōng(委中BL40) and bilateral Yǒngquán(涌泉KI1) were selected.In the individualized moxibustion group,the moxibusion dose was determined by patient’s constitution and conditions as well as no occurrence of dry throat,thirst and local skin lesion.In the quantitative moxibustion group,the moxibustion dose was fixed as 1 cone at each acupoint in treatment.In these two groups,the treatment was given once every two days,three times a week and the treatment for 2 weeks was as 1 course.Totally,2 courses of treatment were required.In the voltaren group,voltaren ointment was used externally at the pain area,once a day,for 4 weeks totally.Separately,before treatment,at the end of treatment course and in follow-up,the symptom score of traditional Chinese medicine(TCM),pain score of visual analogue scale(VAS) and patient’s treatment satisfaction score were observed in the patients of the three groups.Results:In comparison within group,TCM symptom score,VAS score and the treatment satisfaction score at the end of treatment were all reduced obviously as compared with those before treatment in each of the three groups(P <0.05).In 4,12 and 24 weeks of followup after treatment,the differences in these data were not significant as compared with those at the end of treatment in the individualized moxibustion group and the quantitative moxibustion group respectively(all P> 0.05).In the voltaren group,these data were not different as compared with those at the end of treatment in 4 weeks of follow-up(all P> 0.05),but these data were all increased as compared with those at the end of treatment in 12 and 24 weeks of follow-up(all P <0.05).In comparison among three groups,at the end of treatment and in 4,12 and 24 weeks of followup,the above-mentioned three therapeutic effect indicators were all different significantly(all P <0.05).In comparison between two groups,in the individualized moxibustion group,TCM symptom score,VAS score and the patient’s treatment satisfaction score were all lower than those in the quantitative moxibustion group at the end of treatment and at each time point of follow-up successively,indicating the significant differences(all P <0.05).Conclusion:Individualized moxibustion and quantitative moxibustion improve the short-term and longterm therapeutic effect on postpartum pantalgia as compared with the external application of voltaren ointment.The therapeutic effect and patient’s satisfaction of individualized moxibustion for replenishing kidney and nourishing blood are better than the quantitative moxibustion.The individualized moxibustion therapy for replenishing kidney and nourishing blood achieves a satisfactory effect on postpartum pantalgia and is excelled to voltaren ointment that is strongly recommended in modern medicine.Individualized moxibustion is an external therapy of TCM with optimal short-term and long-term therapeutic effect and reliable safety.Hence,it deserves to be promoted in practice.
文摘With the massive increase of digital resource based on the network,it becomes very important that how to help readers acquire the information needed according to the individualized requirement and interest in an accurate,convenient and prompt method. Therefore,it is very urgent to investigate individualized information service of library. In this paper,based on the development of the individualized information service for the reader in the college library,the individualized information service is clarified by using three perspectives,including establishment of individualized information demand model,integration of internal and external resource and protection of the reader privacy. Finally,the corresponding strategy and related measure are presented.
文摘Background Hypertensive cerebral hemorrhage （HCH） is an important cerebrovascular disease that poses significant threat to the health of human being, with high incidence and mortality. With the development of mini- mally invasive techniques, individualized surgical treatment of HCH is very common. Method During 2003- 2012, according to the condition of using craniotomy, hematoma in small bone window craniotomy and hematoma for treatment of 162 cases of hypertensive cerebral hemorrhage patients. Results Among 162 patients with HCH in our study, 24 had recurrent hemorrhage after surgery, with an incidence of recurrent hemorrhage of 14.8%. Among the 24 recurrent hemorrhages, 22 had hemorrhage in primary hematoma site and two subdural hematomas. Among these patients, 16 died, with a mortality of 9.8%. Death rate and recurrent hemorrhage in the small bone window group were lower than that in the craniotomy group, and ＂the difference reached statistical significance （P 〈 0.05）. Conclusions Individuation in treatment of hypertension must be correctly estimated based on disease condition, comprehensive judgment, selection of appropriate treatment options. Even if that we would reduce mortality, improve the success rate of operation and living quality.
文摘A Streetcar Named Desire which describes Blanche's tortuous tragedy is a influential drama.With the evolution of the human civilization such as psychology,psychological analysis has become an important approach of analyzing the literary works in literary criticism.Some critics analyze Blanche by means of Freudian psychoanalysis and Jungian psychology while this thesis analyzes Blanche's Inferiority Complex and Compensation by Adler's individualized psychology from the perspectives of Blanche's childhood and Blanche's broken marriage.
