1.Psychological resilience and its influencing factors of patients with lung cancer
Huan ZHANG ; Ying ZHOU ; Hongmei LI ; Yalan SONG ; Shouzhen CHENG ; Jieya CHEN ; Ying CHEN ; Shaoqing YUAN ; Bikun YANG ; Chun YANG ; Minna ZHANG ; Lian JIANG ; Xiashu YAN
Chinese Journal of Modern Nursing 2015;(30):3640-3645
Objective To investigate the psychological resilience status and its influencing factors of lung cancer patients. Methods A total of 182 patients with lung cancer were selected by convenient sampling method and were investigated the psychological resilience with Chinese Version Connor and Davidson′s resilience scale ( CD-RISC ) , the Chinese version of medical coping modes questionnaire ( MCMQ ) , and the hospital anxiety and depression Scale ( HAD) . Results The total score of resilience in 182 lung cancer patients acquired (65. 2 ± 15. 0). The total score of resilience in 82 preoperative patients was (68. 9 ± 15. 4), postoperative patients (63.5 ±13.6), chemotherapy patients (60.3 ±14.3); resilience status showed down trend (F=5.530,P<0. 05). Different educational background, marriage status, medical insurance type, treatment stage and cancer metastasis had difference of psychological resilience (P<0. 05). The average anxiety score of 182 cancer patients was (5. 72 ± 4. 52) and depression score obtained (4. 74 ± 4. 39). The correlation analysis presented that lung cancer patients′psychological resilience had negative correlation with anxiety, depression and surrender while it had positive correlation with confrontation (P <0. 05), but had no correlation with avoidance (P>0.05). Multiple regression analysis revealed treatment stages, copying strategies and depression were the main influencing factors which all explained 45. 8% of total variation. Conclusions Resilience of patients with lung cancer are at a lower level, which effected by many factors. Nursing staffs should pay attention to patients psychological status, take effective measures to help them to get higher level of psychological resilience, so as to improve quality of life.
2.Analysis of clinical characteristics and risk factors for nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia
Jieya REN ; Meimei YAN ; Xinting LI ; Hui LIU ; Nuer TANG ; Rongjiong ZHENG ; Xiaobo LU
Chinese Journal of Hepatology 2024;32(5):453-460
Objective:To analyze and explore the clinical characteristics and risk factors related to nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia.Methods:252 hospitalized patients with liver cirrhosis combined with atrial arrhythmia from January 2014 to December 2021 were enrolled, and their clinical characteristics were analyzed. The above-mentioned patients were divided into groups according to their nosocomial mortality rate. Among them, 45 nosocomial mortality cases were classified as the mortality group, and 207 survival cases were classified as the survival group. The differences in clinical data and laboratory data between the two groups were compared. The risk factors for nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia were analyzed. The t-test, or rank-sum test, was used to compare measurement data. The chi-square test, or Fisher's exact probability method, was used to compare enumeration data. Multivariate analysis was performed by the logistic regression method.Results:Among the 252 cases, the male-to-female ratio was the same (male/female ratio: 126/126). The age range was 26 to 89 (66.77±10.46) years. Han ethnicity accounted for 79.5%. The main type of atrial arrhythmia was atrial fibrillation ( P ?0.001). The main cause of liver cirrhosis was post-hepatitis B cirrhosis (56.3%). There were 57/72/123 cases of CTP grade A/B/C. The CTP and Model for End-Stage Liver Disease (MELD) scores were 10.30±1.77 and 18.0(11.0, 29.0), respectively. The nosocomial mortality rate was 17.9% (45/252). The overall incidence rate of complications in all patients was 89.28%, with complications occurring in the following order: 71.4% ascites, 71.0% hypersplenism, 64.7% spontaneous peritonitis, 64.3% esophageal gastric varices, 32.5% hepatorenal syndrome, 32.1% hepatic encephalopathy, and 26.2% esophageal gastric variceal bleeding. The incidence rate of new-onset atrial fibrillation in the nosocomial mortality group was 73.3%, which was much higher than the 44.0% rate in the survival group ( P ?0.05). Multivariate logistic regression analysis showed that new-onset atrial fibrillation ( OR=2.707, 95% CI 1.119?~?6.549), esophageal-gastric varices ( OR=3.287, 95% CI 1.189?~?9.085), serum potassium ( OR=3.820, 95% CI 1.532?~?9.526), and MELD score ( OR=1.108, 95% CI 1.061~1.157) were independent risk factors for nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia. Conclusion:Patients with cirrhosis combined with atrial arrhythmias have more severe liver function damage and are more likely to develop complications such as ascites, hypersplenism, and hepatorenal syndrome. New-onset atrial fibrillation, esophageal-gastric varices, hyperkalemia, and a high MELD score are risk factors for nosocomial mortality in patients with liver cirrhosis combined with atrial arrhythmia, so more attention should be paid to corresponding patients for timely symptomatic treatment.
3.Screening and preliminary analysis of differentially expressed miRNAs in gastric cancer cell-derived exosomes induced by Helicobacter pylori
Jieya ZHANG ; Jie DUAN ; Shasha ZENG ; Yao TANG ; Rui LI ; Kaiyun GUO ; Xin TANG ; Lijun HUANG ; Yan ZHANG
Chinese Journal of Microbiology and Immunology 2021;41(8):598-607
Objective:To investigate the differentially expressed microRNAs (miRNAs) in human gastric carcinoma SGC-7901 cell-derived exosomes induced by Helicobacter pylori ( H. pylori), providing new clues for further elucidating the carcinogenic mechanism of H. pylori. Methods:Ultracentrifugation and exosome extraction kit were used to extract the exosomes released by the H. pylori-stimulated and negative control group, and transmission electron microscope(TEM), nanoparticle tracking analysis(NTA) and Western blot experiments were employed to identify exosomes. Then, exosomes were labeled with the fluorescent dye PKH67 and co-cultured with THP-1-derived macrophages. The internalization of exosomes by macrophages was observed by laser confocal fluorescent microscopy. Additionally, miRNA microarray chips were performed to detect the differentially expressed miRNAs of exosomes from the two groups of cells. Real-time fluorescence quantitative PCR (qRT-PCR) was used to verify the expression of four differentially expressed miRNAs. Furthermore, the target genes and their functions as well as the possible signal pathways involved of partial differentially expressed miRNAs were predicted and analyzed by bioinformatics software. Differentially expressed miR-382-5p was labeled by Cy3 to observe whether it could be transferred to macrophages through exosomes. The expression of phenotype molecule CD206 and the cytokines TNF-α, IL-6 and IL-10 in miR-382-5p mimic-transfected macrophages were analyzed by qRT-PCR and ELISA, and the proportion of cells expressing CD206 and HLA-DR was analyzed by flow cytometry. Results:The extracted exosomes were consistent with exosome morphology and highly expressed the surface marker proteins CD9, CD63 and TSG101. After co-culturing with THP-1 derived macrophages for 12 h, the exosomes could be internalized by macrophages. Compared with the control group, there were 130 up-regulated miRNAs and 111 down-regulated miRNAs in the H. pylori-stimulated group. Bioinformatic analysis showed that the potential target genes of partial differentially expressed miRNAs were mainly involved in the regulation of PI3K-AKT, NF-κB, JAK-STAT, stem cell pluripotency and other inflammation and tumor-related pathways. miR-382-5p could be transferred to macrophages through exosomes, and induced the expression of M2-type phenotype molecule CD206 and cytokines IL-10 in macrophages, while inhibited the expression of TNF-α and IL-6 and increased the proportion of CD206 high HLA-DR low cells. Conclusions:H. pylori treatment caused a significant change in the expression level of exosome miRNAs in SGC-7901 cells. Bioinformatics analysis demonstrated that the prospective targets of these differentially expressed miRNAs might play an important role in the regulation of inflammation and tumor-related signaling pathways. miR-382-5p might induce the M2-type polarization of macrophages.
4.Cone-beam CT analysis of the correlation between incisor root resorption rate and tooth movement index in adult patients with fixed orthodontics appliance
Yijun LIN ; Jieya YAN ; Yaxin LI ; An LAO ; Shengxuan LIAO ; Jiaqiang LIU
Chinese Journal of Stomatology 2022;57(7):733-738
Objective:To analyze the correlation between the root resorption rate and tooth movement of the maxillary and mandibular incisors before and after orthodontic treatment in adult patients using cone-beam CT (CBCT), and to explore the related factors that affect the apical root resorption.Methods:In this retrospective study, 23 adult patients with classⅠor class Ⅱ division 1 malocclusion [2 males and 21 females, mean age (23.4±6.3) years, treatment time (2.1±0.7) years] who received orthodontic treatment with fixed appliance in Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People′s Hospital from January 2017 to June 2021 were enrolled. Full-column CBCT examination was performed before and after treatment. A three-dimensional model was established to observe and record the volume of the maxillary and mandibular central and lateral incisors before and after treatment. The change of the incisal edge, the angle of rotation of the incisal edge, and the direction of the long axis of the tooth were also measured. The root resorption in each tooth before and after treatment was compared, and the root resorption rate was calculated. Pearson correlation analysis was performed on the root absorption rate before and after treatment with age, treatment time and tooth movement.Results:After treatment, the tooth volume of the maxillary and mandibular central and lateral incisors decreased significantly ( P<0.01). The root absorption volumes were (20.2±6.0) mm 3 and (11.2±4.7) mm 3 in maxillary central and lateral incisors, and (14.7±4.6) mm 3 and (14.8±5.0) mm 3 in mandibular central and lateral incisors, respectively. The root absorption rates were (9.49±1.75)% and (9.13±3.24)% in maxillary central and lateral incisors, and (8.56±3.43)% and (9.65±2.76)%, in mandibular central and lateral incisors, respectively ( F=0.56, P=0.640). The root resorption rate of maxillary central incisors had a weak positive correlation with the change of sagittal distance of incisal edge ( r=0.36, P=0.015). The root resorption rate of mandibular central incisors had a moderate positive correlation with the vertical movement distance ( r=0.48, P=0.001). The root resorption rate of mandibular lateral incisors was weakly positively correlated with the vertical movement of incisal edge and the treatment time ( r=0.35, P=0.016; r=0.34, P=0.021), and was moderately positively correlated wit the change of sagittal movement of incisal edge ( r=0.44, P=0.002). Conclusions:During orthodontic treatment, both maxillary and mandibular incisors had a certain degree of root resorption, which was related to sagittal and vertical movement of the incisors and the time of orthodontic treatment.