Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effect...Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effective model of elderly hypertension management and the most effective and lowest cost management crowd. According to the randomized controlled design of trial, 105 old hypertensive patients participated in the study voluntarily in the Qingdao Municipal Hospital were randomly divided into the experimental group (75 cases) and control group (30 cases). Experimental group is divided into geriatric specialist group (25 cases), general practitioner group (25 cases) and nurse group (25 cases). Blood pressure was administered in experimental (with the new model) and control groups (with the traditional model) for 2 months to compare their blood pressure and the decrease of them. Results: Blood pressure was compared between the two groups before and after administration. The systolic blood pressure (SBP) of experimental group is 162.44 ± 13.970 mmHg before administration. SBP of experimental group is 147.69 ± 13.509 mmHg after administration, the difference is statistically significant (P = 0.000). The diastolic blood pressure (DBP) of experimental group is 91.58 ± 10.822 mmHg before administration. DBP of experimental group is 84.64 ± 10.412 mmHg after administration, P = 0.003. SBP of control group is 159.93 ± 15.238 mmHg before administration. The systolic blood pressure of control group is 152.33 ± 14.115 (mmHg) after administration. P is 0.167 (P > 0.05). The difference was not statistically significant. DBP of control group is 94.73 ± 12.401 (mmHg) before administration. DBP of control group is 90.60 ± 11.115 (mmHg) after administration. P is 0.345 (P > 0.05). The difference was not statistically significant. The decrease of SBP of geriatric specialist group, general practitioner group and nurse group is 18.40 ± 11.764 mmHg, 14.47 ± 9.44 mmHg, 10.80 ± 6.026 mmHg. The difference was not statistically significant (P > 0.05). The decrease of DBP of geriatric specialist group, general practitioner group and nurse group is 9.33 ± 7.451 mmHg vs. 5.33 ± 6.287 mmHg vs. 6.13 ± 5.069 mmHg (P > 0.05). Conclusion: The new model is effective and it works well for controlling blood pressure of elderly hypertensive patients. Especially with the doctors and patients’ families, the management effect has been obviously improved. Medical interventions make the new model more scientific. The management of geriatric specialists, general practitioners and nurses is equally valid.展开更多
Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of...Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of the present study is to investigate the feasibility of TQM model and the attitude of the managers of health field of Yazd medical sciences university towards it. The present study was a descriptive and analytical one which was cross-section ally conducted from 2010 to 2011. The population under study consisted of the managers of the unit of staff vice-chancellor for health and treatment, the managers of health system and centers of cities and also the managers of Yazd’s public hospitals. 64 people were chosen using the formula for calculating the number of samples. A questionnaire with 48 questions was used. The questionnaire’s validity was approved by the faculty members whose major is management and its reliability by using α-cronbach 87%. To analyze the data, the software SPSS V.17 was used. Scoring method was based on likert. The findings of the study show that, considering feasibility of TQM, there is a significant relation between the awareness and attitude of the managers of health and treatment field on one side and the variables, age and University degree, on the other side p = 0.001. Considering binary logistic regression and the results obtained in the form of inter and backward stepwise, the most important factors affecting the feasibility of TQM among the managers of health and treatment field are the level of awareness and attitude with the predicted accuracy 79.3% and 87.9% respectively.展开更多
Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contami...Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contamination all around the world, therefore helping to endanger public health on an unintentional process. Although, the main mission of the hospital is to promote human health, it cannot be assumed as an island apart from its urban environment. “Green Hospital”, as an approach to address environmental challenges and to meet communities need in health issues, has emerged recently as a try to improve the health, in line with its main mission. In this approach, all the environmental aspects of waste management are important and to be addressed. Hospitals’ administrators can manage wastes disposal through composting, recycling and better supplying methods (downsizing packaging, using reusable products instead of disposables and using recycled products). This article is a review of the subject matter, in nature, using many library and online sources;it discusses about the need to move towards the green hospital approach, the administration and leadership role in its establishment, the environmental impact of hospital operations and assessment of the effects, wastes management and control, and also the methods in wastes disposal and treatment.展开更多
BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitutio...BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.展开更多
This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technol...This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.展开更多
The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not ...The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.展开更多
Establishing a culture of patient safety can be effective in reducing the incidence of medical errors and solving concerns of safety inadequacy in health systems. The purpose of this study was to assess the culture of...Establishing a culture of patient safety can be effective in reducing the incidence of medical errors and solving concerns of safety inadequacy in health systems. The purpose of this study was to assess the culture of patient safety in the selected hospitals, and compare the results with published reports of AHRQ. This study was approved by the Ethical Committee of BPUMS. The subjects signed the informed consent form to participle in the study. Confidentiality was maintained throughout the study reports. Cross-sectional study was conducted in 2012;the study sample was composed of 364 staffs working at two selected hospitals affiliated to Bushehr University of Medical Sciences. Hospital Survey on Patient Safety Culture was used to collect data. Descriptive statistical analysis was used to analyze the data. No reports of events in both studied hospitals and benchmark were accounted for the most of the reported errors, although this indicator in studied hospitals was nearly 23% higher than that of the benchmark report. The highest patient safety grade in studied hospitals and benchmark was “acceptable” and “very good”, respectively. The highest percentage of positive response to patient safety dimension was organization learning and then teamwork within units in studied hospitals. Teamwork within units also was the highest average percent in benchmark report. Non-punitive response to errors had the lowest positive percentage of participant responses in both studies. To achieve the patient safety culture, we do not need to blame individual and apply punitive approach when errors occur. This makes person accept responsibility for their actions honestly and report errors in a timely manner to prevent reoccurrence of similar errors.展开更多
1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countr...1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countries,varying definitions and standards for digital solutions,and a lack of coordination in digital health investments[1].展开更多
The general goal of the management of communication and information technology (MCIT) in the health sector, is to accelerate collecting, achieving and supporting the health system processes, and effective decision-mak...The general goal of the management of communication and information technology (MCIT) in the health sector, is to accelerate collecting, achieving and supporting the health system processes, and effective decision-making for managing this system;because preparing and providing health care services for society is very complex, and highly dependent on the information system. The aim of this investigation is to determine the mean scores of the possibility of implementing the MCIT standards in Khorasan Razavi hospitals, from the perspective of managers. This was a cross sectional descriptive-analytic study conducted in two steps in all hospitals. In the first step, the applicability of the standards in hospitals was studied. In the second step, the current status of hospitals was compared with international standards MCIT. In order to determine the validity of the questionnaires, opinions of professors and experts were acquired. Regarding the reliability, the SPSS V. 12 calculated the value of Cronbach’s to be 0.95 for the first questionnaire and 0.86 for the second questionnaire. Data were analyzed using statistic tests of one way ANOVA and t-test. The level of significance was fixed at 0.5. In the 16 hospitals studied, the mean and standard deviation of MCIT were (57.25 ± 13.74). The MCIT standards are applicable in hospitals of Khorasan Razavi according to half (49.4%) of managers;nonetheless, their application requires greater efforts by the hospitals.展开更多
Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The obje...Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.展开更多
Background: EPI is one of the most cost-effective public health interventions that have already been identified. Mass vaccination is one of the most effective public health strategies that lead to a dramatic reduction...Background: EPI is one of the most cost-effective public health interventions that have already been identified. Mass vaccination is one of the most effective public health strategies that lead to a dramatic reduction in the incidence of many infectious diseases. This is a descriptive study (eco-logical exploratory) where data about the status of routine immunization of children under 6 years in 6 selected countries in terms of the routine immunization programs in each country, the coverage and reported cases of vaccine-preventable diseases from 2006 to 2008 were collected assuming that each country is a representative of a Continent;data about the status of Iran were also collected and a comparative study was performed in the next step. It is worth mentioning that selecting these countries was according to health experts to consolidate the data. Collection tools are data of international (WHO and UNICEF) and national organizations of the above countries. In all countries surveyed, triple vaccine, vaccines of polio, hepatitis B, measles, rubella and mumps are part of the routine immunization program for children under the age of 6 years, with the explanation that in South Africa only measles vaccine is injected instead of measles, rubella and mumps vaccines. The coverage rate of the vaccine and other vaccines in Iran was the best compared to other countries. This represents the widespread activity of health care systems of the country in the field of vaccination and tireless efforts of healthcare workers and health centers.展开更多
Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut...Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.展开更多
Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enh...Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enhance healthcare delivery and efficiency, there are still uncertainties surrounding its effectiveness, value, and broader adoption. This comprehensive literature review aims to explore and synthesize existing knowledge on the economic impact of AI in healthcare. The primary objective of this review is to understand the potential cost savings and efficiency improvements associated with the deployment of AI in healthcare settings. By highlighting the economic implications of AI, this review seeks to offer insights into the value proposition of investing in AI technologies for stakeholders such as healthcare providers, payers, and policymakers. Methods: To conduct this review, we conducted a search of literature from 2020 to 2023 across three databases: PubMed, Scopus and Google Scholar. We specifically focused on studies that discuss the impacts of AI in healthcare and include cost evaluations, using combinations of keywords related to AI, economics, healthcare, and cost evaluation. The inclusion criteria were studies that conducted some form of economic evaluation related to AI in healthcare settings, while exclusion criteria were studies without a cost evaluation component. Data extraction and quality assessment using the CASP checklist were undertaken on the final set of included studies. Results: After screening studies, we identified 10 out of a total of 28 studies and reports that met our criteria of outlining any form of economic impact and evaluation of AI in healthcare settings. Based on our findings, implementing AI in healthcare could potentially lead to cost savings. Several studies suggest savings ranging from $200 billion to $360 billion in the United States alone. The use of AI in healthcare sectors such as ophthalmology, radiology and disease screening has shown positive economic impacts. Conclusion: While AI has potential for cost savings and efficiency improvements, in healthcare settings, it’s crucial to conduct detailed context specific cost evaluations to optimize the adoption and implementation strategies of AI.展开更多
BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We r...BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis ...BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods...Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.展开更多
Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are kno...Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are known to play crucial roles during seed dormancy and germination in P.koraiensis,it remains unclear whether these metabolic pathways function differentially across tissues.P.koraiensis seeds that had undergone different durations of moist chilling in their natural environment,yielding seeds with relatively deeper primary physiological dormancy(DDS)and seeds with released primary physiological dormancy(RDS).A non-targeted metabolomic analysis was conducted on the radicle and hypocotyl-cotyledon portions of both DDS and RDS,before and after a two-week incubation under favorable conditions.Under germination conditions,RDS and DDS showed divergent metabolic profiles,especially regarding carbohydrate metabolism.Specifically,RDS seeds showed significantly reduced substrates of respiratory metabolic pathways in both radicles and hypocotyl-cotyledons.Conversely,the intermediates of the carbohydrate metabolism pathway(particularly the tricarboxylic acid cycle)accumulating in radicles of DDS seeds under germination conditions.Moreover,in RDS,the carbohydrate metabolic pathways were more prevalent in the hypocotyl-cotyledon,while lysine degradation and ascorbate and aldarate metabolism were the dominant metabolic pathways in radicles.In contrast,the tricarboxylic acid cycle showed higher activity in DDS radicles compared to hypocotyl-cotyledons.We further demonstrated that carbohydratemetabolic pathways continue to play a dominant role in both dormancy maintenance and germination processes of P.koraiensis seeds.Notably,the carbohydratemetabolism in radicles likely exerts more critical regulatory functions in these two physiological processes compared to that in cotyledon and hypocotyl tissues.展开更多
Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data ...Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data for the diagnosis,treatment and management of SHS.A 60-year-old female with incidentally detected splenic mass(6.0 cm×5.7 cm)underwent splenectomy,confirmed as SHS in 2020.Post-op imatinib therapy was given.In 2022,hepatic metastases(2.4 cm×2.9 cm)with pancytopenia led to supportive care.Lesions enlarged to 4.3 cm×2.7 cm,leading to multi-organ failure and death at 33 months.The case was categorized into three distinct stages based on the pathophysiology of SHS:Early-stage splenic tumor growth,mid-stage liver metastasis with hematological abnormalities,and late-stage tumor infiltration leading to multiorgan failure.For SHS,this case highlights the pivotal role of early intervention and the value of personalized treatment strategies.展开更多
文摘Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effective model of elderly hypertension management and the most effective and lowest cost management crowd. According to the randomized controlled design of trial, 105 old hypertensive patients participated in the study voluntarily in the Qingdao Municipal Hospital were randomly divided into the experimental group (75 cases) and control group (30 cases). Experimental group is divided into geriatric specialist group (25 cases), general practitioner group (25 cases) and nurse group (25 cases). Blood pressure was administered in experimental (with the new model) and control groups (with the traditional model) for 2 months to compare their blood pressure and the decrease of them. Results: Blood pressure was compared between the two groups before and after administration. The systolic blood pressure (SBP) of experimental group is 162.44 ± 13.970 mmHg before administration. SBP of experimental group is 147.69 ± 13.509 mmHg after administration, the difference is statistically significant (P = 0.000). The diastolic blood pressure (DBP) of experimental group is 91.58 ± 10.822 mmHg before administration. DBP of experimental group is 84.64 ± 10.412 mmHg after administration, P = 0.003. SBP of control group is 159.93 ± 15.238 mmHg before administration. The systolic blood pressure of control group is 152.33 ± 14.115 (mmHg) after administration. P is 0.167 (P > 0.05). The difference was not statistically significant. DBP of control group is 94.73 ± 12.401 (mmHg) before administration. DBP of control group is 90.60 ± 11.115 (mmHg) after administration. P is 0.345 (P > 0.05). The difference was not statistically significant. The decrease of SBP of geriatric specialist group, general practitioner group and nurse group is 18.40 ± 11.764 mmHg, 14.47 ± 9.44 mmHg, 10.80 ± 6.026 mmHg. The difference was not statistically significant (P > 0.05). The decrease of DBP of geriatric specialist group, general practitioner group and nurse group is 9.33 ± 7.451 mmHg vs. 5.33 ± 6.287 mmHg vs. 6.13 ± 5.069 mmHg (P > 0.05). Conclusion: The new model is effective and it works well for controlling blood pressure of elderly hypertensive patients. Especially with the doctors and patients’ families, the management effect has been obviously improved. Medical interventions make the new model more scientific. The management of geriatric specialists, general practitioners and nurses is equally valid.
文摘Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of the present study is to investigate the feasibility of TQM model and the attitude of the managers of health field of Yazd medical sciences university towards it. The present study was a descriptive and analytical one which was cross-section ally conducted from 2010 to 2011. The population under study consisted of the managers of the unit of staff vice-chancellor for health and treatment, the managers of health system and centers of cities and also the managers of Yazd’s public hospitals. 64 people were chosen using the formula for calculating the number of samples. A questionnaire with 48 questions was used. The questionnaire’s validity was approved by the faculty members whose major is management and its reliability by using α-cronbach 87%. To analyze the data, the software SPSS V.17 was used. Scoring method was based on likert. The findings of the study show that, considering feasibility of TQM, there is a significant relation between the awareness and attitude of the managers of health and treatment field on one side and the variables, age and University degree, on the other side p = 0.001. Considering binary logistic regression and the results obtained in the form of inter and backward stepwise, the most important factors affecting the feasibility of TQM among the managers of health and treatment field are the level of awareness and attitude with the predicted accuracy 79.3% and 87.9% respectively.
文摘Hospitals have always been the focal point of social systems identity. Thus, they acte as the mirror of the community and should be responsible for it. Hospitals have been recognized as a significant source of contamination all around the world, therefore helping to endanger public health on an unintentional process. Although, the main mission of the hospital is to promote human health, it cannot be assumed as an island apart from its urban environment. “Green Hospital”, as an approach to address environmental challenges and to meet communities need in health issues, has emerged recently as a try to improve the health, in line with its main mission. In this approach, all the environmental aspects of waste management are important and to be addressed. Hospitals’ administrators can manage wastes disposal through composting, recycling and better supplying methods (downsizing packaging, using reusable products instead of disposables and using recycled products). This article is a review of the subject matter, in nature, using many library and online sources;it discusses about the need to move towards the green hospital approach, the administration and leadership role in its establishment, the environmental impact of hospital operations and assessment of the effects, wastes management and control, and also the methods in wastes disposal and treatment.
基金Supported by the National Natural Science Foundation of China,No.82103022the Science Foundation of the Second Affiliated Hospital of Xi’an Jiaotong University,No.RC(XM)202012.
文摘BACKGROUND Traditional Chinese medicine(TCM)body constitution is a key factor in determining and influencing the occurrence,development,and variation of diseases.As the mind interact with the body,TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.AIM To investigate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.METHODS A total of 2441 participants were enrolled in our study.TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire,sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index,and psychopathological symptoms were evaluated using Symptom Checklist-90.Logistic regression was used to estimate the interrelationship between TCM body constitution,psychiatric disorders and sleep quality.RESULTS The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution,Qi-stagnation constitution,and blood-stasis constitution were significantly higher in the psychiatric symptoms group.Additionally,psychiatric symptoms were considerably associated with sleep quality,Qi-deficiency constitution,and Qi-stagnation constitution,but were inversely associated with male sex.Obsessive–compulsive symptoms were considerably associated with sleep quality,Qi-deficiency constitution and Qi-stagnation constitution.Depression was considerably associated with sleep quality,hyperuricemia,and Qi-stagnation constitution.Anxiety was considerably associated with sleep quality,diabetes,and Qi-stagnation constitution.Finally,poor sleep quality was considerably associated with Qi-deficiency constitution,Qi-stagnation constitution,dampness-heat constitution,phlegm-dampness constitution,and blood-stasis constitution but was inversely associated with male sex and body mass index>23.9.CONCLUSION TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality.Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.
基金funded by the Scientific ResearchDeanship at theUniversity ofHa’il-Saudi Arabia through project number-RG-23251.
文摘This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.
文摘The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.
文摘Establishing a culture of patient safety can be effective in reducing the incidence of medical errors and solving concerns of safety inadequacy in health systems. The purpose of this study was to assess the culture of patient safety in the selected hospitals, and compare the results with published reports of AHRQ. This study was approved by the Ethical Committee of BPUMS. The subjects signed the informed consent form to participle in the study. Confidentiality was maintained throughout the study reports. Cross-sectional study was conducted in 2012;the study sample was composed of 364 staffs working at two selected hospitals affiliated to Bushehr University of Medical Sciences. Hospital Survey on Patient Safety Culture was used to collect data. Descriptive statistical analysis was used to analyze the data. No reports of events in both studied hospitals and benchmark were accounted for the most of the reported errors, although this indicator in studied hospitals was nearly 23% higher than that of the benchmark report. The highest patient safety grade in studied hospitals and benchmark was “acceptable” and “very good”, respectively. The highest percentage of positive response to patient safety dimension was organization learning and then teamwork within units in studied hospitals. Teamwork within units also was the highest average percent in benchmark report. Non-punitive response to errors had the lowest positive percentage of participant responses in both studies. To achieve the patient safety culture, we do not need to blame individual and apply punitive approach when errors occur. This makes person accept responsibility for their actions honestly and report errors in a timely manner to prevent reoccurrence of similar errors.
基金The Science and Technology Innovation 2030 Major Project,Grant/Award Number:2023ZD0508506National Key Research and Development Program of China,Grant/Award Numbers:2022YFC2705001,2023YFC2706305。
文摘1|THE FUTURE OF HEALTH IS DIGITAL.Digital health has shown significant promise in improving health outcomes.However,its transformation faces various challenges,including resource distribution disparities across countries,varying definitions and standards for digital solutions,and a lack of coordination in digital health investments[1].
文摘The general goal of the management of communication and information technology (MCIT) in the health sector, is to accelerate collecting, achieving and supporting the health system processes, and effective decision-making for managing this system;because preparing and providing health care services for society is very complex, and highly dependent on the information system. The aim of this investigation is to determine the mean scores of the possibility of implementing the MCIT standards in Khorasan Razavi hospitals, from the perspective of managers. This was a cross sectional descriptive-analytic study conducted in two steps in all hospitals. In the first step, the applicability of the standards in hospitals was studied. In the second step, the current status of hospitals was compared with international standards MCIT. In order to determine the validity of the questionnaires, opinions of professors and experts were acquired. Regarding the reliability, the SPSS V. 12 calculated the value of Cronbach’s to be 0.95 for the first questionnaire and 0.86 for the second questionnaire. Data were analyzed using statistic tests of one way ANOVA and t-test. The level of significance was fixed at 0.5. In the 16 hospitals studied, the mean and standard deviation of MCIT were (57.25 ± 13.74). The MCIT standards are applicable in hospitals of Khorasan Razavi according to half (49.4%) of managers;nonetheless, their application requires greater efforts by the hospitals.
文摘Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.
文摘Background: EPI is one of the most cost-effective public health interventions that have already been identified. Mass vaccination is one of the most effective public health strategies that lead to a dramatic reduction in the incidence of many infectious diseases. This is a descriptive study (eco-logical exploratory) where data about the status of routine immunization of children under 6 years in 6 selected countries in terms of the routine immunization programs in each country, the coverage and reported cases of vaccine-preventable diseases from 2006 to 2008 were collected assuming that each country is a representative of a Continent;data about the status of Iran were also collected and a comparative study was performed in the next step. It is worth mentioning that selecting these countries was according to health experts to consolidate the data. Collection tools are data of international (WHO and UNICEF) and national organizations of the above countries. In all countries surveyed, triple vaccine, vaccines of polio, hepatitis B, measles, rubella and mumps are part of the routine immunization program for children under the age of 6 years, with the explanation that in South Africa only measles vaccine is injected instead of measles, rubella and mumps vaccines. The coverage rate of the vaccine and other vaccines in Iran was the best compared to other countries. This represents the widespread activity of health care systems of the country in the field of vaccination and tireless efforts of healthcare workers and health centers.
文摘Background: The practice of female genital cutting as a cultural obligation is widespread in Kenya but there is little consensus about its effects on health. Some of the health risks associated with female genital cut range from minor and short-term to major and long-term effects including pain, bleeding, infections, and, in the extreme, death. Female genital cut is widespread among the Kisii but there is no adequate information about how it is currently practised and the value people attach to it. Objective: The objective was to establish the value of female genital cut as well as the health risks associated with the practice among the Kisii community of western Kenya. Methods: This was a cross-sectional study, which employed a mixed method approach to generate both quantitative and qualitative data. The quantitative data were obtained from a randomly selected sample of 373 respondents while quantitative data were generated from focus group discussions as well as key informants interviews. Results: The Kisii consider female genital cut a cultural identifier inherited from past generations and whose main value is a rite of passage from girlhood to womanhood. Majority (63%) had heard of the health risks associated with female genital cut including transmission of infections, excessive bleeding and pain. But most of the community did not seem to know the long-term health consequences associated with female genital cut. Even though knowledge on the campaigns to eradicate the practice was found to be wide spread, the community’s response toward the campaigns was less than positive. Conclusions: The authors conclude that female genital cut continues to persist in this community because of its value as a rite of passage, which currently has no substitute. This cultural demand by far outweighs the health risks associated with female genital cut, which are being mitigated through medicalization of the practice. For intervention programmes to succeed a more culturally sensitive campaign that is acceptable or appropriate alternative rite of passage is required.
文摘Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enhance healthcare delivery and efficiency, there are still uncertainties surrounding its effectiveness, value, and broader adoption. This comprehensive literature review aims to explore and synthesize existing knowledge on the economic impact of AI in healthcare. The primary objective of this review is to understand the potential cost savings and efficiency improvements associated with the deployment of AI in healthcare settings. By highlighting the economic implications of AI, this review seeks to offer insights into the value proposition of investing in AI technologies for stakeholders such as healthcare providers, payers, and policymakers. Methods: To conduct this review, we conducted a search of literature from 2020 to 2023 across three databases: PubMed, Scopus and Google Scholar. We specifically focused on studies that discuss the impacts of AI in healthcare and include cost evaluations, using combinations of keywords related to AI, economics, healthcare, and cost evaluation. The inclusion criteria were studies that conducted some form of economic evaluation related to AI in healthcare settings, while exclusion criteria were studies without a cost evaluation component. Data extraction and quality assessment using the CASP checklist were undertaken on the final set of included studies. Results: After screening studies, we identified 10 out of a total of 28 studies and reports that met our criteria of outlining any form of economic impact and evaluation of AI in healthcare settings. Based on our findings, implementing AI in healthcare could potentially lead to cost savings. Several studies suggest savings ranging from $200 billion to $360 billion in the United States alone. The use of AI in healthcare sectors such as ophthalmology, radiology and disease screening has shown positive economic impacts. Conclusion: While AI has potential for cost savings and efficiency improvements, in healthcare settings, it’s crucial to conduct detailed context specific cost evaluations to optimize the adoption and implementation strategies of AI.
基金Supported by Special TCM Innovation Project of Hebei Provincial Department of Science and Technology,No.223777130DScientific Research Project of Hebei Province Administration of Traditional Chinese Medicine,No.2024215.
文摘BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
文摘Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.
基金supported by the National Natural Science Foundation of China(31901300).
文摘Pinus koraiensis is the dominant and constructive species of the zonal vegetation in Northeast China,known as the mixed broadleaf-Korean pine forest.Although carbohydrate metabolism pathways in the seed embryo are known to play crucial roles during seed dormancy and germination in P.koraiensis,it remains unclear whether these metabolic pathways function differentially across tissues.P.koraiensis seeds that had undergone different durations of moist chilling in their natural environment,yielding seeds with relatively deeper primary physiological dormancy(DDS)and seeds with released primary physiological dormancy(RDS).A non-targeted metabolomic analysis was conducted on the radicle and hypocotyl-cotyledon portions of both DDS and RDS,before and after a two-week incubation under favorable conditions.Under germination conditions,RDS and DDS showed divergent metabolic profiles,especially regarding carbohydrate metabolism.Specifically,RDS seeds showed significantly reduced substrates of respiratory metabolic pathways in both radicles and hypocotyl-cotyledons.Conversely,the intermediates of the carbohydrate metabolism pathway(particularly the tricarboxylic acid cycle)accumulating in radicles of DDS seeds under germination conditions.Moreover,in RDS,the carbohydrate metabolic pathways were more prevalent in the hypocotyl-cotyledon,while lysine degradation and ascorbate and aldarate metabolism were the dominant metabolic pathways in radicles.In contrast,the tricarboxylic acid cycle showed higher activity in DDS radicles compared to hypocotyl-cotyledons.We further demonstrated that carbohydratemetabolic pathways continue to play a dominant role in both dormancy maintenance and germination processes of P.koraiensis seeds.Notably,the carbohydratemetabolism in radicles likely exerts more critical regulatory functions in these two physiological processes compared to that in cotyledon and hypocotyl tissues.
基金Supported by the Program of General Hospital of Western Theater,No.2021-XZYG-C33.
文摘Splenic histiocytic sarcoma(SHS)is a rare,aggressive hematological malignancy with unclear progression and management.Our case illustrates the progression and pathophysiological processes of SHS and provides key data for the diagnosis,treatment and management of SHS.A 60-year-old female with incidentally detected splenic mass(6.0 cm×5.7 cm)underwent splenectomy,confirmed as SHS in 2020.Post-op imatinib therapy was given.In 2022,hepatic metastases(2.4 cm×2.9 cm)with pancytopenia led to supportive care.Lesions enlarged to 4.3 cm×2.7 cm,leading to multi-organ failure and death at 33 months.The case was categorized into three distinct stages based on the pathophysiology of SHS:Early-stage splenic tumor growth,mid-stage liver metastasis with hematological abnormalities,and late-stage tumor infiltration leading to multiorgan failure.For SHS,this case highlights the pivotal role of early intervention and the value of personalized treatment strategies.
