Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emoti...BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.展开更多
The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 ...The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.展开更多
BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials e...BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.CASE SUMMARY We present the case of a 27-year-old Chinese man who simultaneously experie-nced acute concomitant cerebrocardiac infarction(CCI)and painless ST-elevation myocardial infarction.The patient was successfully treated with elective percu-taneous coronary intervention(PCI)after receiving urgent systemic thrombolysis at the standard dose for AIS.CONCLUSION Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.展开更多
Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visite...Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into groups.The observation group received rehabilitation nursing based on the mind mapping model combined with psychological intervention,while the control group received routine intervention.The differences in emotional scores,self-care ability scores,compliance,and complications were compared between the two groups.Results:The anxiety(SAS)and depression(SDS)scores of the observation group were lower than those of the control group,while the self-care ability scale(ESCA)score was higher than that of the control group(P<0.05).The compliance rate of the observation group was higher than that of the control group(P<0.05).The complication rate of NS in the observation group was lower than that in the control group(P<0.05).Conclusion:Rehabilitation nursing based on the mind mapping model combined with psychological intervention can enhance self-care ability,reduce negative emotions,and reduce complications in NS nursing,which is efficient and feasible.展开更多
Liver transplantation,as an effective therapy for patients with liver cancer,plays an important role in improving the quality of life of patients.However,the com-plexity and trauma of liver transplantation can easily ...Liver transplantation,as an effective therapy for patients with liver cancer,plays an important role in improving the quality of life of patients.However,the com-plexity and trauma of liver transplantation can easily lead to the occurrence of malnutrition in patients,and then increase the risk of postoperative complica-tions,which has aroused widespread clinical attention.Reasonable nutritional support can not only maintain the stability of the body’s internal environment,reduce the occurrence of complications,but also promote the recovery of liver and other organ functions.In recent years,with the in-depth understanding of nut-ritional metabolism after liver transplantation,the application of enteral nutrition and parenteral nutrition in nutritional support after liver transplantation has been increasingly extensive and achieved remarkable results.This paper discusses the effect of early postoperative nutritional intervention on patients with liver cancer and liver transplantation,and combined with its mechanism of action,can better understand the effectiveness of intervention,and provide reference for the deve-lopment of scientific and reasonable nutritional support programs in clinical pra-ctice.展开更多
Background:Parenting exerts a profound influence on children’s mental health and behavioral development.Despite the high prevalence of children’s emotional and behavioral problems(CEBP)in China,evidence-based parent...Background:Parenting exerts a profound influence on children’s mental health and behavioral development.Despite the high prevalence of children’s emotional and behavioral problems(CEBP)in China,evidence-based parenting interventions remain scarcely investigated as preventive public health strategies.This pilot study evaluated a school-based intervention for preventing CEBP.Methods:We employed a quasi-experimental design with propensity score matching(PSM)to select 28 families(intervention:n=13;control:n=15)from two matched urban primary schools.Quantitative data from seven validated scales were analyzed using t-tests and ANCOVA.Qualitative insights were derived from 10 semi-structured interviews via thematic analysis.Results:Compared to the control group,the intervention group demonstrated significantly greater improvements in CEBP(p=0.020,Cohen’s d=0.92),parental adjustment(p=0.031,Cohen’s d=0.80),parenting confidence(p=0.003,Cohen’s d=1.04),and parentchild relationships(p=0.001,Cohen’s d=1.46).Non-significant effects were observed for parenting style,parental relationship,and parenting conflict(p>0.05).Qualitative analysis corroborated these findings and further identified contributing factors for non-significant outcomes,including challengeswithmeasurement adaptability and inconsistent co-parenting practices.Conclusions:This pilot study suggests that an authoritative parenting style may be effective and culturally adaptable in China.Positive parenting interventions appear to mitigate CEBP by reducing risk factors and enhancing protective factors.However,improving parental relationships and parenting conflict may require targeted strategies.Given the pilot nature of this PSM-matched study(n=28),the findings should be interpreted as exploratory and used primarily for intervention refinement.展开更多
This study aims to explore the characteristics of novice teachers’inappropriate behaviors in classroom teaching and their intervention strategies.With the continuous improvement of education quality,novice teachers f...This study aims to explore the characteristics of novice teachers’inappropriate behaviors in classroom teaching and their intervention strategies.With the continuous improvement of education quality,novice teachers face increasing challenges in teaching practice.Their inappropriate behaviors not only affect the classroom atmosphere but may also negatively impact students’learning outcomes.Therefore,researching the characteristics of novice teachers’inappropriate behaviors and their intervention strategies holds significant scientific and social value.This study employs a combination of quantitative and qualitative methods to analyze the behavioral patterns of novice teachers in classroom teaching and proposes corresponding intervention strategies.The results indicate that novice teachers’inappropriate behaviors mainly manifest as poor classroom management,monotonous teaching methods,and insufficient interaction with students.Based on these findings,the study proposes a series of effective intervention strategies,including enhancing teacher training,optimizing teaching design,and promoting positive interactions between teachers and students.The conclusions of the study not only provide practical guidance for educational practice but also point out directions for future research,emphasizing the crucial role of teacher professional development in improving teaching quality.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological interve...In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.展开更多
Background:Alzheimer's disease(AD)is a degenerative disease that occurs in the central nervous system and is characterized by progressive cognitive dysfunction and behavioral impairment.The main pathological mecha...Background:Alzheimer's disease(AD)is a degenerative disease that occurs in the central nervous system and is characterized by progressive cognitive dysfunction and behavioral impairment.The main pathological mechanisms are amyloid-βaccumulation(Aβ)and hyperphosphorylation of tau protein(P-TAU).Objective:however,there are no effective drugs for the treatment of AD,so the intervention and treatment of AD still need further research.Methods:We did a search and summary some of the new potential drugs and other interventions for the treatment of AD.Results:We found relevant anti-Aβ,anti-tau,anti-aging,the Apolipoprotein(APOE)control drugs and intervention in AD through exercise and diet.Conclusions:because most of these drugs are in clinical trials,more effort is needed to develop anti-AD drugs.展开更多
BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise lev...BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.展开更多
Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outco...Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outcomes,there is growing interest in sarcopenia as a marker of frailty and its potential role in long-term prognosis.The prognostic value of the psoas muscle index(PMI),a sarcopenia metric,remains underexplored in PCI populations regarding long term survival.Methods This single-center retrospective cohort study evaluated 177 patients undergoing PCI from 2015 to 2019.PMI was calculated from computed tomography(CT)imaging at the L3 vertebral level using the formula:(left psoas area+right psoas area)/height2 and expressed in cm^(2)/m^(2).Sarcopenia was defined as the lowest sex-specific PMI quartile.Primary outcomes included 5-year all-cause mortality and 3-point major adverse cardiovascular events(MACE:non-fatal myocardial infarction,ischemic stroke,and cardiac death).Binary linear regression and Cox proportional hazards models were utilized to determine associations between PMI and outcomes Results Sarcopenic patients exhibited significantly higher 5-year all-cause mortality compared to non-sarcopenic counterparts(64.4%vs.35.6%,P<0.001),while no significant difference was observed in 3-point MACE incidence(55.6%vs.51.4%,P=0.520).Sarcopenia was independently associated with all-cause mortality on binary logistic regression(OR=3.49;95%CI:1.69–7.19;P=0.0007),but not MACE(OR=1.00;95%CI:0.50–1.98;P=0.99).In a multivariable Cox regression model,sarcopenia was associated with increased hazard of mortality(HR=1.60;95%CI:0.96–2.66;P=0.071),though this did not reach statistical significance.Kaplan-Meier analysis demonstrated significantly reduced survival among sarcopenic patients(χ^(2)=6.13,P=0.0133).Conclusions PMI is a significant independent predictor of 5-year all-cause mortality in PCI patients,underscoring the prognostic importance of assessing skeletal muscle mass in this population.展开更多
Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifes...Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifest through physiological symptoms,cognitive distortions,behavioral avoidance,and cardiacspecific concerns and typically emerge within 1-2 weeks post-procedure.Key risk factors include female sex,younger age(<55 years),psychiatric history,procedural complexity,and poor social support.Anxiety negatively affects cardiovascular outcomes when left untreated,leading to higher readmission rates(HR=1.47)and recurrent cardiovascular events(HR=1.31),as well as lower medication adherence and quality of life.Screening is optimally conducted 7-10 days postprocedure via validated tools such as the Hospital Anxiety and Depr-ession Scale,Anxiety.Heart-specific cognitive behavioral therapy(SMD=-0.72),selective serotonin reuptake inhibitors(especially sertraline),and integrated cardiac rehabilitation programs that incorporate both psychological and physical elements are among the beneficial interventions that have been supported by evidence.These all-encompassing strategies show long-term improvements in cardiovascular outcomes,functional ability,and healthcare expenses in addition to immediate benefits in lowering anxiety.Digital initiatives have the potential to increase access,especially in underprivileged areas.Early identification of highrisk patients and implementation of timely,targeted interventions represent crucial strategies for improving both psychological and cardiovascular outcomes in this vulnerable population.展开更多
Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revasculariz...Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization.Whether this benefit is consistent across different age groups still needs further investigation.Methods In this prespecified subgroup study of FAVORⅢChina trial,we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects.The primary endpoint was major adverse cardiac events(MACEs),a composite of all-cause death,myocardial infarction,and ischemia-driven revascularization.Results Of the 3825 patients,1717(44.9%)were aged≥65 years.At baseline,patients≥65 had higher rates of hypertension,hyperlipidaemia,stroke history(P<0.0001),and peripheral vascular disease(P=0.024)and had higher SYNTAX scores(P=0.0095).Compared with standard angiography guidance,the QFR-guided strategy consistently reduced the 1-year(≥65 years,6.04%vs.9.19%,HR=0.65,95%CI:0.46–0.92;<65 years,5.53%vs.8.43%,HR=0.65,95%CI:0.47–0.91)and 3-year MACE rates in both age groups(≥65 years,11.8%vs.15.2%,HR:0.75,95%CI:0.58–0.98;<65 years,9.5%vs.14.6%,HR=0.63;95%CI:0.49–0.81),without a significant interaction(Pinteraction=0.99).Within the QFR-guided group,the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged≥65 years than in those aged<65 years(8.3%vs.3.0%,P=0.10).Conclusions Although with higher rate of comorbidities and more complex coronary anatomy,the long-term benefit of the QFR-guided PCI strategy remained consistent in patients≥65 years,compared with those<65 years.展开更多
Objective:This randomized controlled trial aimed to assess the impact of a targeted educational intervention on the awareness and practice of genetic screening and counseling among young adults in Calabar Municipality...Objective:This randomized controlled trial aimed to assess the impact of a targeted educational intervention on the awareness and practice of genetic screening and counseling among young adults in Calabar Municipality,Cross River State.Materials and Methods:Participants(aged 18-45)were randomly assigned to either an intervention group receiving structured health education or a control group receiving general health information.Stratified randomization was used between the groups.A sample size of 340 participants was recruited to detect a 20%difference in outcomes with 80%power.Data were collected using prevalidated questionnaires at baseline,immediately after the intervention,and at a 3-month follow-up.The intervention consisted of three weekly 90-min educational sessions covering genetics,the benefits of screening,and practical guidance on accessing genetic services.The primary outcomes were changes in awareness and practices related to genetic screening,with secondary outcomes focusing on attitudes and intentions toward genetic counseling.Results:Findings revealed that awareness of genetic screening was higher in the intervention group,with 65.9%of participants aware of early detection,compared to 59.4%in the control group,although the difference was not statistically significant(P=0.23).In terms of practice,42.9%of the intervention group and 40.0%of the control group engaged in genetic screening programs,with no significant difference(P=0.57).Logistic regression analysis highlighted that age,educational level,and knowledge of teratogens were significant predictors of genetic screening awareness.Participants aged 36 years and above were 1.52 times more likely to be aware(odds ratio[OR]=1.52,P=0.003),and those with tertiary education had nearly double the likelihood of awareness(OR=1.96,P<0.001).Conclusion:The study underscores the importance of targeted education in improving genetic screening awareness.展开更多
Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, espe...Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.展开更多
BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutri...BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.展开更多
BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,an...BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.展开更多
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
文摘BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.
文摘The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.
文摘BACKGROUND Simultaneous acute ischemic stroke(AIS)and myocardial infarction(cardio-cerebral ischemic attack)have rarely been reported in the literature.Currently,no clear evidence-based guidelines or clinical trials exist to determine the optimal therapeutic strategy for these patients.CASE SUMMARY We present the case of a 27-year-old Chinese man who simultaneously experie-nced acute concomitant cerebrocardiac infarction(CCI)and painless ST-elevation myocardial infarction.The patient was successfully treated with elective percu-taneous coronary intervention(PCI)after receiving urgent systemic thrombolysis at the standard dose for AIS.CONCLUSION Urgent thrombolysis followed by elective PCI was an appropriate strategy for the management of simultaneous CCI.
文摘Objective:To evaluate the value of rehabilitation nursing based on mind mapping model combined with psychological intervention for patients with nephrotic syndrome(NS).Methods:A total of 60 patients with NS who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into groups.The observation group received rehabilitation nursing based on the mind mapping model combined with psychological intervention,while the control group received routine intervention.The differences in emotional scores,self-care ability scores,compliance,and complications were compared between the two groups.Results:The anxiety(SAS)and depression(SDS)scores of the observation group were lower than those of the control group,while the self-care ability scale(ESCA)score was higher than that of the control group(P<0.05).The compliance rate of the observation group was higher than that of the control group(P<0.05).The complication rate of NS in the observation group was lower than that in the control group(P<0.05).Conclusion:Rehabilitation nursing based on the mind mapping model combined with psychological intervention can enhance self-care ability,reduce negative emotions,and reduce complications in NS nursing,which is efficient and feasible.
文摘Liver transplantation,as an effective therapy for patients with liver cancer,plays an important role in improving the quality of life of patients.However,the com-plexity and trauma of liver transplantation can easily lead to the occurrence of malnutrition in patients,and then increase the risk of postoperative complica-tions,which has aroused widespread clinical attention.Reasonable nutritional support can not only maintain the stability of the body’s internal environment,reduce the occurrence of complications,but also promote the recovery of liver and other organ functions.In recent years,with the in-depth understanding of nut-ritional metabolism after liver transplantation,the application of enteral nutrition and parenteral nutrition in nutritional support after liver transplantation has been increasingly extensive and achieved remarkable results.This paper discusses the effect of early postoperative nutritional intervention on patients with liver cancer and liver transplantation,and combined with its mechanism of action,can better understand the effectiveness of intervention,and provide reference for the deve-lopment of scientific and reasonable nutritional support programs in clinical pra-ctice.
基金supported by the National Social Science Fund of China[18BSH146].
文摘Background:Parenting exerts a profound influence on children’s mental health and behavioral development.Despite the high prevalence of children’s emotional and behavioral problems(CEBP)in China,evidence-based parenting interventions remain scarcely investigated as preventive public health strategies.This pilot study evaluated a school-based intervention for preventing CEBP.Methods:We employed a quasi-experimental design with propensity score matching(PSM)to select 28 families(intervention:n=13;control:n=15)from two matched urban primary schools.Quantitative data from seven validated scales were analyzed using t-tests and ANCOVA.Qualitative insights were derived from 10 semi-structured interviews via thematic analysis.Results:Compared to the control group,the intervention group demonstrated significantly greater improvements in CEBP(p=0.020,Cohen’s d=0.92),parental adjustment(p=0.031,Cohen’s d=0.80),parenting confidence(p=0.003,Cohen’s d=1.04),and parentchild relationships(p=0.001,Cohen’s d=1.46).Non-significant effects were observed for parenting style,parental relationship,and parenting conflict(p>0.05).Qualitative analysis corroborated these findings and further identified contributing factors for non-significant outcomes,including challengeswithmeasurement adaptability and inconsistent co-parenting practices.Conclusions:This pilot study suggests that an authoritative parenting style may be effective and culturally adaptable in China.Positive parenting interventions appear to mitigate CEBP by reducing risk factors and enhancing protective factors.However,improving parental relationships and parenting conflict may require targeted strategies.Given the pilot nature of this PSM-matched study(n=28),the findings should be interpreted as exploratory and used primarily for intervention refinement.
文摘This study aims to explore the characteristics of novice teachers’inappropriate behaviors in classroom teaching and their intervention strategies.With the continuous improvement of education quality,novice teachers face increasing challenges in teaching practice.Their inappropriate behaviors not only affect the classroom atmosphere but may also negatively impact students’learning outcomes.Therefore,researching the characteristics of novice teachers’inappropriate behaviors and their intervention strategies holds significant scientific and social value.This study employs a combination of quantitative and qualitative methods to analyze the behavioral patterns of novice teachers in classroom teaching and proposes corresponding intervention strategies.The results indicate that novice teachers’inappropriate behaviors mainly manifest as poor classroom management,monotonous teaching methods,and insufficient interaction with students.Based on these findings,the study proposes a series of effective intervention strategies,including enhancing teacher training,optimizing teaching design,and promoting positive interactions between teachers and students.The conclusions of the study not only provide practical guidance for educational practice but also point out directions for future research,emphasizing the crucial role of teacher professional development in improving teaching quality.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
基金Supported by the National Natural Science Foundation of China(71774049).
文摘In recent years,gratitude intervention,as an application method of positive psychology,has gradually attracted the attention of researchers.Gratitude intervention is considered to be an effective psychological intervention,especially in patients with malignant tumors.This study reviews the research progress of gratitude intervention in patients with malignant tumors,focusing on the mechanism,implementation methods,effect evaluation and challenges in clinical application of gratitude intervention,in the hope of providing a theoretical support and practical guideline for future research and practice.
基金National Natural Science Foundation of China Regional Fund Project(Protective effect and mechanism of new antibiotic zunyimycins on Alzheimer's disease model,82060654).
文摘Background:Alzheimer's disease(AD)is a degenerative disease that occurs in the central nervous system and is characterized by progressive cognitive dysfunction and behavioral impairment.The main pathological mechanisms are amyloid-βaccumulation(Aβ)and hyperphosphorylation of tau protein(P-TAU).Objective:however,there are no effective drugs for the treatment of AD,so the intervention and treatment of AD still need further research.Methods:We did a search and summary some of the new potential drugs and other interventions for the treatment of AD.Results:We found relevant anti-Aβ,anti-tau,anti-aging,the Apolipoprotein(APOE)control drugs and intervention in AD through exercise and diet.Conclusions:because most of these drugs are in clinical trials,more effort is needed to develop anti-AD drugs.
文摘BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.
文摘Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outcomes,there is growing interest in sarcopenia as a marker of frailty and its potential role in long-term prognosis.The prognostic value of the psoas muscle index(PMI),a sarcopenia metric,remains underexplored in PCI populations regarding long term survival.Methods This single-center retrospective cohort study evaluated 177 patients undergoing PCI from 2015 to 2019.PMI was calculated from computed tomography(CT)imaging at the L3 vertebral level using the formula:(left psoas area+right psoas area)/height2 and expressed in cm^(2)/m^(2).Sarcopenia was defined as the lowest sex-specific PMI quartile.Primary outcomes included 5-year all-cause mortality and 3-point major adverse cardiovascular events(MACE:non-fatal myocardial infarction,ischemic stroke,and cardiac death).Binary linear regression and Cox proportional hazards models were utilized to determine associations between PMI and outcomes Results Sarcopenic patients exhibited significantly higher 5-year all-cause mortality compared to non-sarcopenic counterparts(64.4%vs.35.6%,P<0.001),while no significant difference was observed in 3-point MACE incidence(55.6%vs.51.4%,P=0.520).Sarcopenia was independently associated with all-cause mortality on binary logistic regression(OR=3.49;95%CI:1.69–7.19;P=0.0007),but not MACE(OR=1.00;95%CI:0.50–1.98;P=0.99).In a multivariable Cox regression model,sarcopenia was associated with increased hazard of mortality(HR=1.60;95%CI:0.96–2.66;P=0.071),though this did not reach statistical significance.Kaplan-Meier analysis demonstrated significantly reduced survival among sarcopenic patients(χ^(2)=6.13,P=0.0133).Conclusions PMI is a significant independent predictor of 5-year all-cause mortality in PCI patients,underscoring the prognostic importance of assessing skeletal muscle mass in this population.
文摘Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifest through physiological symptoms,cognitive distortions,behavioral avoidance,and cardiacspecific concerns and typically emerge within 1-2 weeks post-procedure.Key risk factors include female sex,younger age(<55 years),psychiatric history,procedural complexity,and poor social support.Anxiety negatively affects cardiovascular outcomes when left untreated,leading to higher readmission rates(HR=1.47)and recurrent cardiovascular events(HR=1.31),as well as lower medication adherence and quality of life.Screening is optimally conducted 7-10 days postprocedure via validated tools such as the Hospital Anxiety and Depr-ession Scale,Anxiety.Heart-specific cognitive behavioral therapy(SMD=-0.72),selective serotonin reuptake inhibitors(especially sertraline),and integrated cardiac rehabilitation programs that incorporate both psychological and physical elements are among the beneficial interventions that have been supported by evidence.These all-encompassing strategies show long-term improvements in cardiovascular outcomes,functional ability,and healthcare expenses in addition to immediate benefits in lowering anxiety.Digital initiatives have the potential to increase access,especially in underprivileged areas.Early identification of highrisk patients and implementation of timely,targeted interventions represent crucial strategies for improving both psychological and cardiovascular outcomes in this vulnerable population.
文摘Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization.Whether this benefit is consistent across different age groups still needs further investigation.Methods In this prespecified subgroup study of FAVORⅢChina trial,we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects.The primary endpoint was major adverse cardiac events(MACEs),a composite of all-cause death,myocardial infarction,and ischemia-driven revascularization.Results Of the 3825 patients,1717(44.9%)were aged≥65 years.At baseline,patients≥65 had higher rates of hypertension,hyperlipidaemia,stroke history(P<0.0001),and peripheral vascular disease(P=0.024)and had higher SYNTAX scores(P=0.0095).Compared with standard angiography guidance,the QFR-guided strategy consistently reduced the 1-year(≥65 years,6.04%vs.9.19%,HR=0.65,95%CI:0.46–0.92;<65 years,5.53%vs.8.43%,HR=0.65,95%CI:0.47–0.91)and 3-year MACE rates in both age groups(≥65 years,11.8%vs.15.2%,HR:0.75,95%CI:0.58–0.98;<65 years,9.5%vs.14.6%,HR=0.63;95%CI:0.49–0.81),without a significant interaction(Pinteraction=0.99).Within the QFR-guided group,the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged≥65 years than in those aged<65 years(8.3%vs.3.0%,P=0.10).Conclusions Although with higher rate of comorbidities and more complex coronary anatomy,the long-term benefit of the QFR-guided PCI strategy remained consistent in patients≥65 years,compared with those<65 years.
文摘Objective:This randomized controlled trial aimed to assess the impact of a targeted educational intervention on the awareness and practice of genetic screening and counseling among young adults in Calabar Municipality,Cross River State.Materials and Methods:Participants(aged 18-45)were randomly assigned to either an intervention group receiving structured health education or a control group receiving general health information.Stratified randomization was used between the groups.A sample size of 340 participants was recruited to detect a 20%difference in outcomes with 80%power.Data were collected using prevalidated questionnaires at baseline,immediately after the intervention,and at a 3-month follow-up.The intervention consisted of three weekly 90-min educational sessions covering genetics,the benefits of screening,and practical guidance on accessing genetic services.The primary outcomes were changes in awareness and practices related to genetic screening,with secondary outcomes focusing on attitudes and intentions toward genetic counseling.Results:Findings revealed that awareness of genetic screening was higher in the intervention group,with 65.9%of participants aware of early detection,compared to 59.4%in the control group,although the difference was not statistically significant(P=0.23).In terms of practice,42.9%of the intervention group and 40.0%of the control group engaged in genetic screening programs,with no significant difference(P=0.57).Logistic regression analysis highlighted that age,educational level,and knowledge of teratogens were significant predictors of genetic screening awareness.Participants aged 36 years and above were 1.52 times more likely to be aware(odds ratio[OR]=1.52,P=0.003),and those with tertiary education had nearly double the likelihood of awareness(OR=1.96,P<0.001).Conclusion:The study underscores the importance of targeted education in improving genetic screening awareness.
文摘Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.
基金Supported by the Special Project on Intravenous Therapy of Shanghai Nursing Society,No.2023JL-B08Naval Medical University Nursing“Zhuyuan”Talent Program.
文摘BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.
文摘BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.
