Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them f...Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them from conversion to diabetes mellitus（DM）. Methods： In total, 127 participants with IGT were randomly assigned to the control（63 cases, 3 lost to follow-up） and treatment groups（64 cases, 4 lost to follow-up） according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose（FPG）, 2-h postprandial plasma glucose（2h PG）, glycosylated hemoglobin（Hb A1c）, fasting insulin（FINS）, 2-h insulin（2hI NS）, homeostatic model assessment of insulin resistance（HOMA-IR）, blood lipid and patients＇ complains of Chinese medicine（CM） symptoms before and after treatment. Results： A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up（75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P〈0.05）. The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up（16.67% vs. 31.67%, P〈0.05）. Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride（TG）, total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups（P〉0.05）. After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group（P〈0.05）. CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group（P〈0.05）. No severe adverse events occurred. Conclusion： TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.展开更多
Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promi...Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.展开更多
Objective:To explore and analyze the effect of the Wet Lab combined with the PBL teaching mode in ophthalmology clinical practice teaching.Methods:Sixty interns who interned in the ophthalmology department of Daqing O...Objective:To explore and analyze the effect of the Wet Lab combined with the PBL teaching mode in ophthalmology clinical practice teaching.Methods:Sixty interns who interned in the ophthalmology department of Daqing Oilfield General Hospital from May 2024 to December 2024 were selected and randomly divided into a control group and a research group,with 30 students in each group.The learning outcomes and satisfaction levels of the two groups of students were compared.The interns in the control group used the traditional teaching mode,while those in the research group used the Wet Lab combined with the PBL teaching mode.The internship outcomes and satisfaction levels of the two groups of students were compared and analyzed.Results:Compared with the students in the control group,the students in the research group showed significantly better internship outcomes and satisfaction levels in ophthalmology clinical practice teaching(P<0.05).Conclusion:The teaching mode of the research group was superior to that of the control group in terms of intern satisfaction and internship outcomes in ophthalmology clinical practice teaching.展开更多
As a traditional medicinal and edible herb,Danggui(Angelicae Sinensis Radix)exhibits pharmacological activities closely associated with its characteristic chemical components,such as volatile oils(e.g.,ligustilide),or...As a traditional medicinal and edible herb,Danggui(Angelicae Sinensis Radix)exhibits pharmacological activities closely associated with its characteristic chemical components,such as volatile oils(e.g.,ligustilide),organic acids(e.g.,ferulic acid),and polysaccharides.It demonstrates a wide range of pharmacological effects,including anti-inflammatory and immunomodulatory properties,cardiovascular and cerebrovascular protection,neuroprotective functions,blood glucose regulation,antitumor activity,and hematopoietic promotion.Clinically,Danggui(Angelicae Sinensis Radix)is often combined with other Chinese herbs to treat immune-related disorders,cardiovascular and cerebrovascular diseases,neurodegenerative conditions,diabetes,and cancer.Although existing studies have identified some active components,the mechanisms and pharmacological roles of many others remain underexplored.Future research should focus on systematically analyzing diverse active constituents such as flavonoids,coumarins,amino acids,bioactive peptides,trace elements,and vitamins.Integrating multiomics and molecular docking technologies will help elucidate key targets and molecular mechanisms underlying its anti-inflammatory,antioxidant,and immunomodulatory effects,thereby facilitating the development of precise therapies based on multicomponent synergy.Additionally,in-depth investigation of herb-pairing effects and establishment of scientific quality control standards are essential to expand clinical applications and enhance the medicinal value of this traditional herb.展开更多
Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 wer...Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.展开更多
Objective:To investigate the application effect of the SECI theoretical model-based training program in enhancing clinical nursing teachers‘information-based teaching capabilities.Methods:A self-control study design ...Objective:To investigate the application effect of the SECI theoretical model-based training program in enhancing clinical nursing teachers‘information-based teaching capabilities.Methods:A self-control study design was adopted,with 124 clinical nursing teachers from a tertiary hospital participating in the SECI training program from January 2024 to June 2025.The program was implemented through four stages:“Establishing Teacher Community(Socialization)”,“Case Teaching(Extravagant)”,“Integration of Discipline and Research(Fusion)”,and“Routine Application of Teaching(Implicit)”.Self-designed questionnaires were used to assess teachers’information-based teaching capabilities before and after training,covering four dimensions:awareness and attitude towards information-based teaching,foundational skills,teaching practice,and professional practice.Data analysis was performed using SPSS 26.0.Results:Post-training,the total score of clinical nursing teachers’information-based teaching capabilities increased from(53.47±15.56)to(78.92±12.34),showing statistically significant differences(t=15.732,P<0.001).Scores in all dimensions also showed significant improvements(P<0.05).Multivariate linear regression analysis revealed that educational background(β=0.198,P=0.026)and professional title(β=0.184,P=0.040)were primary influencing factors for pre-training information-based teaching capabilities,while their impact weakened post-training.Conclusion:The training program based on SECI theory effectively enhances clinical nursing educators’digital teaching capabilities.Its structured,spiral-up knowledge transformation process helps bridge competency gaps among teachers from diverse backgrounds,facilitates the mutual conversion and deep integration of tacit and explicit knowledge,and provides a practical new model for developing digital teaching competencies in clinical nursing education.展开更多
Jing Fang granules(JFG)are a modern Chinese medicinal formulation derived from Jing Fang Defeating Toxin San(JFDS).JFG primarily contains bioactive compounds such as flavonoids/flavonoid glycosides,coumarins and other...Jing Fang granules(JFG)are a modern Chinese medicinal formulation derived from Jing Fang Defeating Toxin San(JFDS).JFG primarily contains bioactive compounds such as flavonoids/flavonoid glycosides,coumarins and other components,which have various activities:anti-inflammatory,immune system regulation,antiviral,anti-aging,detoxification,and protection of the liver,lungs,and kidneys.JFG has broad potential therapeutic applications.The mechanisms of JFG’s actions are primarily associated with signaling pathways such as TLR4/NF-κB,PI3K/AKT,and MAPK.This article reviews the research progress on JFG,including chemical composition,pharmacologic effects,mechanism of action,safety,clinical application,etc.,serving as a foundation for future research and clinical applications.展开更多
Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery...Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.展开更多
Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly ...Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.展开更多
BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE...BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.展开更多
Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effe...Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.展开更多
BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis an...BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.展开更多
Objective: To observe the clinical effect percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single lumbar disc herniation. Methods: From August 2017 to June 2019, 42 patients with low lumbar...Objective: To observe the clinical effect percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single lumbar disc herniation. Methods: From August 2017 to June 2019, 42 patients with low lumbar single segment lumbar disc herniation were treated with percutaneous transforaminal endoscopic discectomy surgery in our hospital. The operation time, incision size, bleeding volume and hospitalization time were recorded respectively. The patients were evaluated before operation, 1 month and 6 months after operation. Visual analogue scale (VAS) and assessment were used to evaluate the lumbocrural pain. The JOA score and the Oswestry disability index (ODI) were used to evaluate the lumbar function, and the modified macnab score was used to evaluate the clinical effect in the last follow-up. Results: All the 42 patients successfully completed the operation without any other operation. There were no severe complications such as dural injury and nerve root injury. The operation time was (76.98 ± 8.58) min, the incision size was (8.45 ± 1.2) mm, the bleeding volume was (20.14 ± 2.93) ml, and the hospitalization time was (4.55 ± 1.13) d. One month and six months after the operation, the visual analogue scale (VAS), the evaluation of lumbar function (Oswestry) and the disability index (ODI) were significantly improved compared with those before the operation (P Conclusion: The treatment of low lumbar but segmental lumbar disc herniation with percutaneous intervertebral foramen, with small incision, less bleeding and quick recovery, can improve the pain and dysfunction of patients.展开更多
Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce...Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce body resistance and tonifythe qi,alleviate the toxic side-effects of CT,thus strengthening the efficacy of organismagainst tumor.Shenqi Fuzheng(参芪扶正,展开更多
Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the ...Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the outpatients of AcupunctureMoxibustion,Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine,the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria.Using the random number table method,they were divided into a combined treatment group(acupuncture plus kinesiotherapy,23 cases) and a simple kinesiotherapy group(22 patients).Treatment for 4 weeks was one course,and two consecutive courses were required.The visual analog scale(VAS) score,the score of the assessment scale for cervical spondylosis,the value of surface electromyography(root mean square,RMS),and the cervical curvature value were used in the evaluation.The allocation scheme was concealed from the outcome assessors.Results:The data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed.Before treatment,the differences were not statistically significant in the general conditions,VAS score,assessment score of cervical spondylosis,cervical curvature value,and RMS in UCS patients between the two groups(all P> 0.05).After treatment,the VAS score was reduced compared with that before treatment in both groups(all P <0.05).In two courses of treatment,the VAS score decreased as compared with that in one course of treatment in both groups(both P <0.05),and the VAS score in the combined treatment group decreased more obviously after each course of treatment(both P <0.05).The RMS decreased compared with that before treatment in each group(both P <0.05),and the decrease in the combined treatment group was more obvious(P <0.05).After treatment of each course,the assessment score was all increased as compared with that before treatment in two groups(all P <0.05).In two courses of treatment,the assessment score was increased as compared with that in one course of treatment in both groups(both P <0.05),and the score in the combined treatment group was increased more obviously in the two courses of treatment(P <0.05).Regarding either the intra-group comparison or the inter-group comparison before and after treatment,the differences were not statistically significant(all P> 0.05),suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS.However,cervical curvature tended to improve in the combined treatment group.The total effective rate was significantly different between the two groups(P <0.05),indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.Conclusion:Combined treatment with acupuncture,kinesiotherapy,and kinesiotherapy alleviated pain,relieved the symptoms and physical signs,and improved the daily movement of the patients.However,the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.展开更多
Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects p...Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.展开更多
BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the...BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.展开更多
Objective: To observe the effect and mechanism of Garlicin in treating coronary heart disease (CHD) with angina pectoris. Methods: Clinical study: 55 patients were selected and randomized into the Garlicin group and t...Objective: To observe the effect and mechanism of Garlicin in treating coronary heart disease (CHD) with angina pectoris. Methods: Clinical study: 55 patients were selected and randomized into the Garlicin group and the nitroglycerin group. To Garlicin group, 60 mg of Garlicin was given by adding in 5% glucose solution for intravenous dripping once per day, the therapeutic course展开更多
Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, paralle...Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, parallel-group, randomized clinical trial of 216 sta- ble outpatients with HF, ejection fraction ≥ 50%, elevated N-terminal brain-type natriuretic peptide or elevat- ed invasively measured filling pressures, and reduced exercise capacity. Participants were randomized from October 2008 through February 2012 at 26 centers in North America. Follow-up was through August 30, 2012.展开更多
Clinical pathway (CP) is a medical management tool made by a group of medical specialists and specialized for certain diseases. It has been proved that CP was an efficient way to optimize the hospitalization managemen...Clinical pathway (CP) is a medical management tool made by a group of medical specialists and specialized for certain diseases. It has been proved that CP was an efficient way to optimize the hospitalization management and control medical cost. In this paper, we focused on the effect of CP in the patients with acute complicated appendicitis via total duration of hospitalization, hospitalization time before operation, total cost of hospitalization and drug expenditure. From March 2014 to March 2015, the patients with conditions of appendicitis in Three Gorges Central Hospital of Wanzhou, Chongqing, were divided into CP group and non path control group to analyze the effect of the application of CP. Our data showed that there were no significant differences between two groups of patients in total duration of hospitalization, hospitalization time before operation, total cost of hospitalization and drug expenditure. The implementation of CP neither decreased the time of patients in hospital nor the total hospitalization cost. Besides, application of CP for acute appendicitis patients should distinguish between simple appendicitis and complicated appendicitis, simple appendectomy patients implement CP is beneficial, and patients with complicated appendicitis did not come from the benefit.展开更多
基金Supported by Shandong Province Science and Technology Program for Public Wellbing(No.2014kjhm0106)Shandong Province Science and Technology Development Plan(No.2006GG3202011),China
文摘Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them from conversion to diabetes mellitus（DM）. Methods： In total, 127 participants with IGT were randomly assigned to the control（63 cases, 3 lost to follow-up） and treatment groups（64 cases, 4 lost to follow-up） according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose（FPG）, 2-h postprandial plasma glucose（2h PG）, glycosylated hemoglobin（Hb A1c）, fasting insulin（FINS）, 2-h insulin（2hI NS）, homeostatic model assessment of insulin resistance（HOMA-IR）, blood lipid and patients＇ complains of Chinese medicine（CM） symptoms before and after treatment. Results： A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up（75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P〈0.05）. The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up（16.67% vs. 31.67%, P〈0.05）. Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride（TG）, total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups（P〉0.05）. After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group（P〈0.05）. CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group（P〈0.05）. No severe adverse events occurred. Conclusion： TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.
基金Supported by the National Natural Science Foundation of China,No.82072537the General Project of Hunan Natural Science Foundation,No.2022JJ30412 and No.2021JJ30464.
文摘Exosomes(Exos)are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication.They play a pivotal role in the pathogenesis and progression of various diseases and offer promising avenues for therapeutic interventions.Exos derived from mesenchymal stem cells(MSCs)have significant immunomodulatory properties.They effectively regulate immune responses by modulating both innate and adaptive immunity.These Exos can inhibit excessive inflammatory responses and promote tissue repair.Moreover,they participate in antigen presentation,which is essential for activating immune responses.The cargo of these Exos,including ligands,proteins,and microRNAs,can suppress T cell activity or enhance the population of immunosuppressive cells to dampen the immune response.By inhibiting lymphocyte proliferation,acting on macrophages,and increasing the population of regulatory T cells,these Exos contribute to maintaining immune and metabolic homeostasis.Furthermore,they can activate immune-related signaling pathways or serve as vehicles to deliver microRNAs and other bioactive substances to target tumor cells,which holds potential for immunotherapy applications.Given the immense therapeutic potential of MSC-derived Exos,this review comprehensively explores their mechanisms of immune regulation and therapeutic applications in areas such as infection control,tumor suppression,and autoimmune disease management.This article aims to provide valuable insights into the mechanisms behind the actions of MSC-derived Exos,offering theoretical references for their future clinical utilization as cell-free drug preparations.
基金Higher Education Research Project of Heilongjiang Provincial Higher Education Society:Design and Effect Evaluation of Ophthalmology Clinical Practice Teaching Mode Based on Wet Lab Combined with PBL Teaching Method(23GJYBF110)。
文摘Objective:To explore and analyze the effect of the Wet Lab combined with the PBL teaching mode in ophthalmology clinical practice teaching.Methods:Sixty interns who interned in the ophthalmology department of Daqing Oilfield General Hospital from May 2024 to December 2024 were selected and randomly divided into a control group and a research group,with 30 students in each group.The learning outcomes and satisfaction levels of the two groups of students were compared.The interns in the control group used the traditional teaching mode,while those in the research group used the Wet Lab combined with the PBL teaching mode.The internship outcomes and satisfaction levels of the two groups of students were compared and analyzed.Results:Compared with the students in the control group,the students in the research group showed significantly better internship outcomes and satisfaction levels in ophthalmology clinical practice teaching(P<0.05).Conclusion:The teaching mode of the research group was superior to that of the control group in terms of intern satisfaction and internship outcomes in ophthalmology clinical practice teaching.
基金Key Scientific Research Projects of Henan Higher Education Institutions(21A320018).
文摘As a traditional medicinal and edible herb,Danggui(Angelicae Sinensis Radix)exhibits pharmacological activities closely associated with its characteristic chemical components,such as volatile oils(e.g.,ligustilide),organic acids(e.g.,ferulic acid),and polysaccharides.It demonstrates a wide range of pharmacological effects,including anti-inflammatory and immunomodulatory properties,cardiovascular and cerebrovascular protection,neuroprotective functions,blood glucose regulation,antitumor activity,and hematopoietic promotion.Clinically,Danggui(Angelicae Sinensis Radix)is often combined with other Chinese herbs to treat immune-related disorders,cardiovascular and cerebrovascular diseases,neurodegenerative conditions,diabetes,and cancer.Although existing studies have identified some active components,the mechanisms and pharmacological roles of many others remain underexplored.Future research should focus on systematically analyzing diverse active constituents such as flavonoids,coumarins,amino acids,bioactive peptides,trace elements,and vitamins.Integrating multiomics and molecular docking technologies will help elucidate key targets and molecular mechanisms underlying its anti-inflammatory,antioxidant,and immunomodulatory effects,thereby facilitating the development of precise therapies based on multicomponent synergy.Additionally,in-depth investigation of herb-pairing effects and establishment of scientific quality control standards are essential to expand clinical applications and enhance the medicinal value of this traditional herb.
文摘Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.
基金2023 Southwest Medical University Higher Education Teaching Reform and Research Project(Project No.:JG2023jdyb032)2023 Chengdu Medical College School-level Undergraduate Educational Reform Project(Project No.:JG2023057)-Context of“New Medical Science”。
文摘Objective:To investigate the application effect of the SECI theoretical model-based training program in enhancing clinical nursing teachers‘information-based teaching capabilities.Methods:A self-control study design was adopted,with 124 clinical nursing teachers from a tertiary hospital participating in the SECI training program from January 2024 to June 2025.The program was implemented through four stages:“Establishing Teacher Community(Socialization)”,“Case Teaching(Extravagant)”,“Integration of Discipline and Research(Fusion)”,and“Routine Application of Teaching(Implicit)”.Self-designed questionnaires were used to assess teachers’information-based teaching capabilities before and after training,covering four dimensions:awareness and attitude towards information-based teaching,foundational skills,teaching practice,and professional practice.Data analysis was performed using SPSS 26.0.Results:Post-training,the total score of clinical nursing teachers’information-based teaching capabilities increased from(53.47±15.56)to(78.92±12.34),showing statistically significant differences(t=15.732,P<0.001).Scores in all dimensions also showed significant improvements(P<0.05).Multivariate linear regression analysis revealed that educational background(β=0.198,P=0.026)and professional title(β=0.184,P=0.040)were primary influencing factors for pre-training information-based teaching capabilities,while their impact weakened post-training.Conclusion:The training program based on SECI theory effectively enhances clinical nursing educators’digital teaching capabilities.Its structured,spiral-up knowledge transformation process helps bridge competency gaps among teachers from diverse backgrounds,facilitates the mutual conversion and deep integration of tacit and explicit knowledge,and provides a practical new model for developing digital teaching competencies in clinical nursing education.
基金supported by the Key R&D Program of Shandong Province,China(No.2024TZXD067,2022SFGC0105)Natural Science Foundation of Shandong Province(No.ZR2023QB021)+2 种基金Young Taishan Scholarship to Xuekui Xia(No.tsqn202103100)Jinan Talent Project for Universities(No.2021GXRC062,202228088)Key innovation Project and Science,Education and Industry Integration Innovation Pilot Project of Qilu University of Technology(Shandong Academy of Sciences)(No.2022JBZ01-06,2024ZDZX03,2023RCKY214).
文摘Jing Fang granules(JFG)are a modern Chinese medicinal formulation derived from Jing Fang Defeating Toxin San(JFDS).JFG primarily contains bioactive compounds such as flavonoids/flavonoid glycosides,coumarins and other components,which have various activities:anti-inflammatory,immune system regulation,antiviral,anti-aging,detoxification,and protection of the liver,lungs,and kidneys.JFG has broad potential therapeutic applications.The mechanisms of JFG’s actions are primarily associated with signaling pathways such as TLR4/NF-κB,PI3K/AKT,and MAPK.This article reviews the research progress on JFG,including chemical composition,pharmacologic effects,mechanism of action,safety,clinical application,etc.,serving as a foundation for future research and clinical applications.
文摘Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.
文摘Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.
基金the Major State Basic Research and Development Pro-gram of China, No.2006CB504504
文摘BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.
文摘Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022 and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.2021-1-I2M-003+1 种基金Undergraduate Innovation Program,No.2023-zglc-06034National Key Clinical Specialty Construction Project,No.ZK108000。
文摘BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.
文摘Objective: To observe the clinical effect percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single lumbar disc herniation. Methods: From August 2017 to June 2019, 42 patients with low lumbar single segment lumbar disc herniation were treated with percutaneous transforaminal endoscopic discectomy surgery in our hospital. The operation time, incision size, bleeding volume and hospitalization time were recorded respectively. The patients were evaluated before operation, 1 month and 6 months after operation. Visual analogue scale (VAS) and assessment were used to evaluate the lumbocrural pain. The JOA score and the Oswestry disability index (ODI) were used to evaluate the lumbar function, and the modified macnab score was used to evaluate the clinical effect in the last follow-up. Results: All the 42 patients successfully completed the operation without any other operation. There were no severe complications such as dural injury and nerve root injury. The operation time was (76.98 ± 8.58) min, the incision size was (8.45 ± 1.2) mm, the bleeding volume was (20.14 ± 2.93) ml, and the hospitalization time was (4.55 ± 1.13) d. One month and six months after the operation, the visual analogue scale (VAS), the evaluation of lumbar function (Oswestry) and the disability index (ODI) were significantly improved compared with those before the operation (P Conclusion: The treatment of low lumbar but segmental lumbar disc herniation with percutaneous intervertebral foramen, with small incision, less bleeding and quick recovery, can improve the pain and dysfunction of patients.
文摘Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce body resistance and tonifythe qi,alleviate the toxic side-effects of CT,thus strengthening the efficacy of organismagainst tumor.Shenqi Fuzheng(参芪扶正,
基金Supported by Leading Talents Training Program of Hunan Province High-Level Health Talents 225 Project (Hunan Health-20N9-N9S)。
文摘Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the outpatients of AcupunctureMoxibustion,Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine,the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria.Using the random number table method,they were divided into a combined treatment group(acupuncture plus kinesiotherapy,23 cases) and a simple kinesiotherapy group(22 patients).Treatment for 4 weeks was one course,and two consecutive courses were required.The visual analog scale(VAS) score,the score of the assessment scale for cervical spondylosis,the value of surface electromyography(root mean square,RMS),and the cervical curvature value were used in the evaluation.The allocation scheme was concealed from the outcome assessors.Results:The data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed.Before treatment,the differences were not statistically significant in the general conditions,VAS score,assessment score of cervical spondylosis,cervical curvature value,and RMS in UCS patients between the two groups(all P> 0.05).After treatment,the VAS score was reduced compared with that before treatment in both groups(all P <0.05).In two courses of treatment,the VAS score decreased as compared with that in one course of treatment in both groups(both P <0.05),and the VAS score in the combined treatment group decreased more obviously after each course of treatment(both P <0.05).The RMS decreased compared with that before treatment in each group(both P <0.05),and the decrease in the combined treatment group was more obvious(P <0.05).After treatment of each course,the assessment score was all increased as compared with that before treatment in two groups(all P <0.05).In two courses of treatment,the assessment score was increased as compared with that in one course of treatment in both groups(both P <0.05),and the score in the combined treatment group was increased more obviously in the two courses of treatment(P <0.05).Regarding either the intra-group comparison or the inter-group comparison before and after treatment,the differences were not statistically significant(all P> 0.05),suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS.However,cervical curvature tended to improve in the combined treatment group.The total effective rate was significantly different between the two groups(P <0.05),indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.Conclusion:Combined treatment with acupuncture,kinesiotherapy,and kinesiotherapy alleviated pain,relieved the symptoms and physical signs,and improved the daily movement of the patients.However,the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.
文摘Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
文摘BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.
文摘Objective: To observe the effect and mechanism of Garlicin in treating coronary heart disease (CHD) with angina pectoris. Methods: Clinical study: 55 patients were selected and randomized into the Garlicin group and the nitroglycerin group. To Garlicin group, 60 mg of Garlicin was given by adding in 5% glucose solution for intravenous dripping once per day, the therapeutic course
文摘Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, parallel-group, randomized clinical trial of 216 sta- ble outpatients with HF, ejection fraction ≥ 50%, elevated N-terminal brain-type natriuretic peptide or elevat- ed invasively measured filling pressures, and reduced exercise capacity. Participants were randomized from October 2008 through February 2012 at 26 centers in North America. Follow-up was through August 30, 2012.
文摘Clinical pathway (CP) is a medical management tool made by a group of medical specialists and specialized for certain diseases. It has been proved that CP was an efficient way to optimize the hospitalization management and control medical cost. In this paper, we focused on the effect of CP in the patients with acute complicated appendicitis via total duration of hospitalization, hospitalization time before operation, total cost of hospitalization and drug expenditure. From March 2014 to March 2015, the patients with conditions of appendicitis in Three Gorges Central Hospital of Wanzhou, Chongqing, were divided into CP group and non path control group to analyze the effect of the application of CP. Our data showed that there were no significant differences between two groups of patients in total duration of hospitalization, hospitalization time before operation, total cost of hospitalization and drug expenditure. The implementation of CP neither decreased the time of patients in hospital nor the total hospitalization cost. Besides, application of CP for acute appendicitis patients should distinguish between simple appendicitis and complicated appendicitis, simple appendectomy patients implement CP is beneficial, and patients with complicated appendicitis did not come from the benefit.
