Objective To explore the clinical pathway of operable and evaluable psychological nursing for elderly patients so as to improve the psychological nursing competence of duty nurses.Methods Sixty elderly patients were randomly divided into control group( n =30 cases) which received traditional psychological nursing and pathway group( n =30 cases) which received psychological nursing in clinical pathway.Then,patients' satisfaction to psychological nursing service and the effect of psychological nursing pathway on competence of duty nurses were compared.Results The rate of emotional attention in nurses,psychological nursing content,mastery of relax skill,mental support feeling and patients' satisfaction in pathway group was 96.67％,86.67％,93.33％,100％,respectively,which were higher than 63.33％,36.67％,6％,36.67％,80％in control group,and difference was statistically significant (x2 =10.42,15.86,45.06,27.80,4.04,respectively;P ＜0.05 or P ＜0.01 ).The score of health education,assessment and intervention,communication and cooperation of nurses after clinical pathway application of psychological nursing respectively was (94.00 ±0.42),(87.61 ±7.09),(98.40 ±0.69) significantly higher than (92.80 ±0.49),(61.3.0 ±9.50),(93.70 ±1.24) before application (t =11.76,14.04,20.95,respectively; P ＜ 0.05 ).Conclusions Application of psychological nursing pathway is good for improving competence of nurses and promoting psychological nursing service in geriatric internal medicine wards.

Objective:To observe the effect of acupuncture in regulating ubiquitin-proteasome pathway (UPP),and discuss the action of acupuncture in intervening heroin-induced brain damage.Methods:Thirty male Sprague-Dawley (SD) rats were divided into a control group,a model group and an acupuncture group by using the random number table.Rats in the model and acupuncture groups received intramuscular heroin injection for successive 8 d at a progressively increased dose.Afterwards,the injection was suspended for 5 d for withdrawal.The heroin relapse rat model was established by repeating the drug addiction and withdrawal process for 3 times.The control group followed the step of the model establishment,but was given intramuscular injection of normal saline at the stage of addiction and no intervention at the stage of withdrawal;the model group was given intramuscular heroin injection at a progressively increased dose at the addiction stage and no intervention at the withdrawal stage;the acupuncture group was dealt in the same way as the model group at the addiction stage,but received acupuncture at Baihui (GV 20) and Dazhui (GV 14) at the withdrawal stage,with the needles retained for 30 min each time,1 session a day,for successive 5 d.On the 39th day,brain tissues were extracted from the hippocampus and ventral tegmental area (VTA) of the three groups of rats.The apoptosis of brain nerve cells was detected by using terminal deoxynucleotidyl transferase-mediated nick and labeling (TUNEL).The mRNA and protein expressions of ubiquitin (Ub),ubiquitin protein ligase (E3) and 26S were examined by immunohistochemistry and quantitative real-time polymerase chain reaction (RT-qPCR).Results:Compared with the model group,rat's hippocampus and VTA in the acupuncture group showed significantly fewer cells positively stained by TUNEL staining (P＜0.01),and its mRNA and protein expressions of Ub,E3,26S were significantly lower (P＜0.01).Conclusion:Reducing nerve cell apoptosis and regulating the mRNA and protein expressions of Ub,E3 and 26S in rat's hippocampus and VTA are possibly one of the action mechanisms of acupuncture in intervening heroin-induced brain damage.

Objective To analyze the correlation between internal iliac artery calcification and delayed graft function (DGF) and short-term prognosis of kidney transplant recipients. Methods Clinical data of 222 kidney transplant recipients were retrospectively analyzed. According to the recovery of renal function, all recipients were divided into the DGF group (n=50) and immediate graft function (IGF) group (n=172). According to whether the recipients were complicated with severe internal iliac artery calcification, DGF and IGF groups were further divided into the high-risk DGF (n=22), low-risk DGF (n=28), high-risk IGF (n=41) and low-risk IGF(n=131) subgroups, respectively. Clinical data of donors and recipients were statistically compared between two groups. The incidences of postoperative DGF and internal iliac artery calcification were recorded. The risk factors of DGF after kidney transplantation, and the correlation between internal iliac artery calcification and clinical parameters were analyzed. Short-term prognosis of recipients with DGF complicated with severe internal iliac artery calcification was evaluated. Results The incidence of DGF was 22.5% (50/222). Among all recipients, 28.4% (63/222) were complicated with severe internal iliac artery calcification. In the DGF group, 44% (22/50) of the recipients were complicated with severe internal iliac artery calcification, higher than 23.8% (41/172) in the IGF group (P < 0.05). Univariate analysis showed that high serum creatinine (Scr) level of donors, male donor, high triglyceride level and severe internal iliac artery calcification of recipients were the risk factors for DGF after kidney transplantation (all P < 0.05). Multivariate logistic regression analysis revealed that Scr≥143 μmol/L of donors and severe internal iliac artery calcification of recipients were the independent risk factors for DGF after kidney transplantation (both P < 0.05). Correlation analysis indicated that internal iliac artery calcification was weakly correlated with the age of recipients and renal artery anastomosis (both P < 0.05). In the DGF group, the Scr level at postoperative 1 month was significantly higher, whereas the estimated glomerular filtration rate (eGFR) was significantly lower than those in the IGF group (both P < 0.05). The eGFR at postoperative 12 months in the high-risk DGF subgroup was significantly lower than those in the low-risk DGF, high-risk IGF and low-risk IGF subgroups (all P < 0.05). Conclusions Internal iliac artery calcification is not only a risk factor for recovery of renal allograft function, but also negatively affects short-term prognosis of renal allograft function.

OBJECTIVETo compare the penetration abilities of resin infiltration into proximal lesions in primary molars with those of adhesive in vitro.

METHODSThirty-two extracted or exfoliated primary molars showing proximal white spot lesions were selected. Roots of the teeth were removed, and the crowns were cut across the white spot lesions perpendicular to the surface. Cut surfaces were examined (by stereo microscopy) and classified with respect to histological lesion extension (C1-C4): lesions confined to the outer half on enamel (C1), lesions confined to the inner half on enamel (C2), lesions confined to the outer half on dentin (C3), lesions extending into the inner half of dentin (C4). Corresponding lesion halves were etched for 120 s with 15% hydrochloric acid gel and were subsequently treated with either adhesive or resin infiltration. Specimens were observed with laser scanning confocal microscope (LSCM) in dual fluorescence mode. In confocal microscopic images, lesion depth and penetration depth of the resin infiltration or the adhesive in corresponding halves were measured, and penetration percentages were calculated respectively. Differences of the data between two groups were analyzed by Wilcoxon signed rank test. Variations of histological caries extensions were detected with Kruskal-Wallis H test.

RESULTSAt the same grading level (C1-C3) in histological caries extension, penetration depths of the resin infiltration group and the adhesive group were 240 (230, 260) µm vs 190 (150, 210) µm, 405 (300, 523) µm vs 180 (160, 200) µm, and 590 (430, 640) µm vs 180 (160, 200) µm respectively. There was significant statistical difference in the data between two groups (P < 0.05). Statistically significant difference in penetration depths of the resin infiltration group (at C1-C3) were found (P < 0.01). At the same grading level (C1-C3) in histological caries extension, percentage penetrations of the resin infiltration group and the adhesive group were [100.0% (96.2%, 100.0%)], [99.1% (95.7%, 100.0%)], [82.0% (81.1%, 92.2%)] and [79.2% (68.4%, 87.5%)], [41.8% (29.1%, 74.5%)], [30.2% (29.2%, 39.6%)], respectively. The difference between the above data was also significant (P < 0.05). Percentage penetrations of the resin infiltration group at C1 and C2 level was higher than those at C3 level (P < 0.05).

CONCLUSIONSThe resin infiltration is capable of penetrating almost completely into proximal lesions in primary molars.

Acid Etching, Dental ; methods ; Composite Resins ; chemistry ; Dental Caries ; pathology ; therapy ; Dental Cements ; chemistry ; Dental Enamel ; pathology ; Dental Enamel Permeability ; Humans ; Hydrochloric Acid ; pharmacology ; Molar ; pathology ; Surface Properties ; Tooth, Deciduous ; pathology

OBJECTIVETo explore the clinical application of high-frequency ultrasound in the diagnosis and treatment of epididymal stasis after vasectomy.

METHODSWe retrospectively studied the sonographic characteristics of 23 cases of epididymal stasis treated by vasectomy, which were divided into a mild (n = 5), a moderate (n = 11) and a severe group (n = 7) according to the results of color Doppler flow imaging. We analyzed the significance of high-frequency ultrasonography in the treatment of epididymal stasis after vasectomy.

RESULTSHigh-frequency ultrasonography revealed 14 cases of increased bilateral epididymal volume, 6 cases of left epididymal thickening and 3 cases of right epididymal thickening, mainly the thickening of the epididymal body and tail. After conservative treatment, 18 of the epididymal stasis cases (5 mild, 11 moderate and 2 severe) were improved, and the other 5 severe cases significantly relieved and discharged from hospital following conservative treatment combined with vasectomy reversal.

CONCLUSIONPost-vasectomy epididymal stasis has typical sonographic characteristics, and high-frequency ultrasonography has an extremely important application value in the clinical classification, diagnosis and treatment of the disease.

Adult ; Aged ; Epididymis ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ultrasonography ; methods ; Vasectomy ; adverse effects

OBJECTIVETo compare the clinical efficacies of humeral head prosthesis and internal fixation in the treatment of comminuted proximal humeral fractures.

METHODSThe clinical data were analyzed for the patients with comminuted proximal humeral fractures undergoing surgeries for humeral head replacement or open reduction plus internal fixation in our hospital between January 2002 and January 2009. Constant scores were used to determine the excellent clinical outcome rates in the two groups, and the operating time, blood loss and postoperative motor scores of the shoulder were compared.

RESULTSForty patients in the humeral head replacement group were evaluated. According to the Constant scores, excellent outcomes were achieved in 16 patients, good outcomes in 18 patients, moderate in 3 patients, and poor in 3 patients, with an excellent outcome rate of 85%. In the 40 cases receiving open reduction plus internal fixation, excellent outcomes were achieved in 11 cases, good in 13 cases, moderate in 8 cases, and poor in 8 cases, with an excellent clinical outcome rate of 60%. Compared with open reduction plus internal fixation, humeral head replacement was associated with shortened operating time, reduced blood loss and better motor function recovery of the shoulder.

CONCLUSIONSReplacement of humeral head prosthesis produces better clinical outcomes than open reduction and internal fixation in patients with comminuted proximal humeral fractures, and can promote the short-term functional recovery of the shoulder with minimal surgical complications.

Aged ; Arthroplasty, Replacement ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; physiology ; Fractures, Comminuted ; etiology ; surgery ; Humans ; Humerus ; surgery ; Joint Prosthesis ; Male ; Middle Aged ; Prosthesis Implantation ; Shoulder Fractures ; surgery

BACKGROUNDPneumonia is the most common cause of morbidity and mortality in lung transplant (LT) recipients. The aim of the present study was to evaluate the incidence, etiology, risk factors and prognosis of pneumonia in LT recipients.

METHODSThe LT cohort consisted of 28 recipients receiving LT in Beijing Chao-Yang Hospital from August 2005 to April 2011. Data collected included demographic data, underlying disorders, time and type of transplant, follow-up information, date of last follow-up, and patient status. A retrospective analysis was made of observational data that were prospectively collected.

RESULTSTwenty-two patients of 28 LT recipients had 47 episodes of pneumonia throughout the study period. Thirtyeight episodes of pneumonia in 19 recipients occurred post-LT with a median follow-up of 257.5 days (1-2104 days), the incidence of pneumonia was 192.4 episodes per 100 LT/year and its median time of onset was 100.5 days (0-946 days) post-transplantation. Bacteria, virus and fungi accounted for 62%, 16% and 15% of the microbial pathogens, respectively. The most frequent were Pseudomonas aeruginosa (20%), cytomegalovirus (CMV) (15%), and Aspergillus fumigatus (10%). A total of 29% (11/38) of pneumonias occurred in the first month post-LT, and then the incidence decreased gradually. The incidence of CMV pneumonia was 25% (7/28) with a median time of 97 days (10-971 days). More than one bacterial infection and CMV infection were independent risk factors for aspergillus infection. The incidence of pulmonary tuberculosis (TB) was 18% (5/28), and the history of TB was a risk factor for TB relapse. There were 58% (7/12) of recipients who died of infection, and 71% (5/7) of these died in the first year after LT.

CONCLUSIONSPneumonia is still a major cause of morbidity and mortality in LT recipients. The most frequent microorganisms were Pseudomonas aeruginosa, CMV, and Aspergillus fumigates. The incidence of CMV pneumonia decreases with a delayed median time of onset. More than one incidence of bacterial infection and CMV infection are independent risk factors for aspergillus infection. LT recipients are at high risk for TB, and the history of TB is a risk factor for TB relapse.

Aspergillus fumigatus ; pathogenicity ; Cytomegalovirus ; pathogenicity ; Humans ; Lung Transplantation ; adverse effects ; Pneumonia ; etiology ; microbiology ; virology ; Prospective Studies ; Pseudomonas aeruginosa ; pathogenicity

Immunotherapy has emerged as one of the major modalities for clinical cancer therapy, along with surgery, chemotherapy, radiotherapy and targeted therapy. However, tumor-targeted delivery of immune therapeutics is challenged by a series of barriers including non-specific release, poor tumor penetration capacity, and insufficient cellular uptake of the therapeutic regimens, which seriously restricted the efficiency and efficacy of immunotherapy. To address above challenges, nanosized drug delivery systems (NDDS) have been extensively exploited to achieve tumor-targeted delivery of immunotherapy drugs. It has been well investigated that solid tumors are of unique characteristics including acidic, hypoxic and enzymatic extracellular microenvironment. Meanwhile, the tumor cells are of acidic, reductant and reactive oxygen species intracellular microenvironment. In recent years, a large variety of tumor microenvironment-activatable NDDS have been exploited to respond specifically to the stimulus of extracellular or intracellular tumor microenvironment for enhancing the accumulation, retention and penetration in the tumor tissue. These NDDS were also employed to promote intracellular uptake and tunable drug release inside the tumor cells. In this review article, we summarized the recent progress of our laboratory using the tumor microenvironment-activatable NDDS for immune efficient therapeutics delivery, and improved cancer immunotherapy. We also briefly discussed the challenges and provided perspective of NDDS-based cancer immunotherapy.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and &ge;the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of &ge;grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The &ge; grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective: To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women. Methods: The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January, 2017 to October, 2020 were retrospectively analyzed. The 29 transgender women ranged in age from 19-47 (27.0±6.3) years old. Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female (TVQ^MtF). Objective parameters included fundamental frequency (F₀), highest pitch, lowest pitch, habitual volume, Jitter, Shimmer, maximal phonation time (MPT), noise to harmonic ratio (NHR) and formants frequencies(F1, F2, F3, F4). SPSS 25.0 software was used for statistically analysis. Results: Three months after surgery, the score of TVQ^MtF was significantly decreased [(89.9±14.7) vs. (50.4±13.6), t=11.49, P<0.001]. The F₀ was significantly elevated [(152.7±23.3) Hz vs. (207.7±45.9) Hz, t=-6.03, P<0.001]. Frequencies of F1, F2 and F3 were significantly elevated. No statistical difference was observed in the frequencies of F4. The highest pitch was not significantly altered while the lowest pitch was significantly elevated [(96.8±17.7) Hz vs. (120.0±28.9) Hz, t=-3.71, P=0.001]. Habitual speech volume was significantly increased [(60.0±5.2) dB vs. (63.6±9.6) dB, t=-2.12, P=0.043]. Jitter, Shimmer, NHR and MPT were not obviously altered (P>0.05). Conclusions: Wendler Glottoplasty could notably elevate the vocal pitch, formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality. It can be an effective treatment modality for voice feminization.
Humans ; Male ; Female ; Young Adult ; Adult ; Middle Aged ; Transgender Persons ; Retrospective Studies ; Speech Acoustics ; Voice Quality ; Phonation