1.Reliability and validity of the Chinese version of Propensity to Achieve Healthy Lifestyle Scale
Xiaonan ZHANG ; Qingyun LYU ; Xueying XU ; Yaqi WANG ; Xiaoying ZANG
Chinese Journal of Practical Nursing 2024;40(18):1375-1381
Objective:To translate Propensity to Achieve Healthy Lifestyle Scale (PAHLS) into Chinese and test its reliability and validity in patients with hypertension to provide the reliable assessment tool for medical staff to evaluate the propensity to achieve healthy lifestyle in hypertensive patients.Methods:This was a cross-sectional study. The original scale was translated according to Brislin model. After expert correction, cultural adjustment and pre-investigation, the items for Chinese version of PAHLS were determined. From February to May 2023, 400 patients with hypertension were selected as the participants from Tianjin Hebei District Tiedong Road Street Community Healthcare Center, Tianjin Dongli District Junliang Cheng Hospital by convenience sampling method. Critical ration and correlation analysis were used for item analysis. Content validity, exploratory factor analysis and confirmatory factor analysis were used to evaluate the validity of the Chinese version of PAHLS. Cronbach′s α coefficient and split-half reliability were used to evaluate the reliability of the scale. Results:A total of 400 patients were included in this study ultimately, aged (71.69 ± 7.25) years old, 177 males and 223 females. The Chinese version of the PAHLS included 6 items, and the results of item analysis showed that the content of each item was highly consistent with that of overall scale. The content validity indexes of the Chinese version of PAHLS at both the scale level and item level were 1. Only one factor was extracted based on exploratory factor analysis, with a cumulative variance contribution rate of 72.24%. Confirmatory factor analysis indicated a good fit, with the fitting indexes of χ2/ df=0.53, root mean square error of approximation (RMSEA)<0.01, root of mean square residual (RMR)=0.02, goodness-of-fit index (GFI)=1.00, comparative fit index (CFI)=1.00, normed fit index (NFI)=1.00, adjust goodness-of-fit index (AGFI)=0.98, incremental fit index (IFI)=1.00, Tucker-Lewis index (TLI)=1.01, Convergent validity: composite reliability (CR)=0.86 and average vriance extracted (AVE)=0.53. The overall Cronbach′s α coefficient of the scale was 0.91 and Cronbach′s α coefficients of item level were from 0.87 to 0.91, with split-half reliability value of 0.89. Conclusions:The Chinese version of the PAHLS has good reliability and validity, which can be used by medical staff to evaluate the propensity to achieve healthy lifestyle in hypertensive patients under Chinese cultural background, to increase understanding of decision-making on behavioral change in hypertensive patients and promote medical staff to jointly develop behavioral change plans with hypertensive patients.
2.Clinical analysis of the diagnosis and treatment of hepatic portal venous gas
Qingyun ZHOU ; Xinliang LYU ; Jinde ZHU ; Wei TAN ; Kun ZHANG
International Journal of Surgery 2024;51(10):716-720
Objective:To explore the clinical manifestations, diagnosis and treatment methods, and prognosis of hepatic portal venous gas (HPVG).Methods:Retrospective case analysis was used in the case data of 7 patients with HPVG, who were treated in Lishui Central Hospital from January 2017 to July 2024, including 5 males and 2 females. Age ranged from 46 to 90 years, with an average age of 69 years. Abdominal pain was the first manifestation in 6 cases, and septic shock occurred in 2 cases. The initial symptoms, primary diseases, comorbidities, laboratory results, imaging examinations, treatment plans, and prognosis were analyzed. Prognostic follow-up was conducted by telephone, with the focus on whether the patient had experienced HPVG recurrence and postoperative complications. The deadline for follow-up was July 31, 2024.Results:All patients had elevated white blood cells and C-reactive protein (CRP), and prothrombin time was prolonged in 4 patients. pH and base excess decreased in 4 cases, and lactic acid increased in 5 cases. Alanine aminotransferase increased in 2 cases, and total bilirubin increased in 3 cases. Blood culture was positive in 3 cases. Contrast-enhanced abdominal CT showed clear gas shadows in the portal vein and its branches in all 7 cases, which were confined to the left liver in 4 cases and distributed in both sides of the liver in 3 cases. The primary diseases were intestinal obstruction and necrosis in 4 cases, intestinal perforation and necrosis in 1 case, inflammatory bowel disease in 1 case, and acute pancreatitis in 1 case. Five patients were complicated with hypertension, diabetes and other diseases. Two patients received surgical treatment, and the average time from surgery to diagnosis was 6.8 h. Five cases received conservative treatment, 2 cases were cured and 3 cases died, with an average time from onset to death of 21.2 h.Conclusions:Contrast-enhanced abdominal CT should be the preferred method for the diagnosis of HPVG. The primary disease and its severity should be fully evaluated in the treatment of HPVG. Patients with intestinal necrosis should undergo laparotomy as soon as possible, and enterostomy should be performed during the operation. Clinicians should strengthen the awareness of HPVG in order to improve the prognosis of patients.
3.Analysis of variations in activity concentrations of 7Be, 137Cs and 210Pb in the air in Beijing
Lifan LI ; Xuebo FAN ; Huiping LI ; Qingyun LIU ; Xuya LYU ; Hui LIU
Chinese Journal of Radiological Medicine and Protection 2024;44(8):669-674
Objective:To discusses the variations of 7Be, 137Cs and 210Pb activity concentrations in the air in Beijing from March 16, 2021 to March 31, 2023, and their correlation with temperature, precipitation, relative humidity, barometric pressure, PM10 (only limited to 137Cs) and other meteorological parameters. Methods:A total of 60 aerosol samples were collected using the HRHA01-SFS1000/A ultra-large flowair sampler in the automatic radiation monitoring station. The activity concentrations of 7Be, 137Cs and 210Pb in the aerosol samples were measured by GMX-60 low background anti-Compton high purity germanium gamma spectrometer. Pearson correlation coefficient was used to show the correlation of the relevant parameters. Results:The seasonal mean values of 7Be activity concentration were spring 4.31 mBq/m 3, summer 3.53 mBq/m 3, autumn 3.09 mBq/m 3 and winter 2.45 mBq/m 3, respectively, ranging from 1.17 to 7.79 mBq/m 3, with the overall mean of (3.36±1.33) mBq/m 3. The activity concentration of 137Cs ranged from 0.39 to 8.49 μBq/m 3, with an average of (0.59±1.47) μBq/m 3. The average activity concentrations of 210Pb were spring 0.53 mBq/m 3, summer 0.44 mBq/m 3, autumn 0.72 mBq/m 3 and winter 0.75 mBq/m 3, respectively, ranging from 0.21 to 1.36 mBq/m 3, with an average of (0.56±0.26) mBq/m 3. The activity concentration of 7Be was correlated with temperature and pressure ( r=0.38, -0.40), the activity concentration of 137Cs was correlated with precipitation ( r=-0.41), and the activity concentration of 210Pb was correlated with temperature and pressure ( r=-0.31, 0.37). The variation of 137Cs activity concentration in the air showed an obvious seasonal pattern, and the peak value generally appears in spring of each year (March to May), which was related to the frequent spring dust in Beijing. The activity concentration of 210Pb in the air was affected by coal combustion heating in winter, and has a peak value during November to March. Conclusions:The activity concentrations of 7Be, 137Cs and 210Pb in the air in Beijing are within the normal range, showing a seasonal trend.
4.Efficacy of parathyroid hormone (1-34) and elcatonin in postmenopausal women with osteoporosis:A randomized and controlled trial for 18 months
Xiuzhen ZHANG ; Miao XUAN ; Ying LI ; Hong ZHANG ; Yonglan WANG ; Jun YANG ; Bo WANG ; Xiaohui GUO ; Xiaofeng LYU ; Qingyun XUE ; Gangyi YANG ; Qiuhe JI ; Zhimin LIU ; Chengjiang LI ; Tianfeng WU ; Zhengyan SHENG ; Pengqiu LI ; Jiucui TONG
Chinese Journal of Endocrinology and Metabolism 2015;(2):120-126
Objective Recombinant human parathyroid hormone(1-34) [ rhPTH(1-34)] is the unique anabolic substance acting on the skeleton. The efficacy and safety of long-term administration of rhPTH(1-34) in Chinese postmenopausal women have not been evaluated. This study compared the clinical efficacy and safety of rhPTH(1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods A total of453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH(1-34) 20 μg(200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine ( L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover ( serum bone-specific alkaline phosphatase was measured by radioimmunoassay; C-telopeptide/ creatinine ( CTX/ Cr) measured by quantitative sandwich enzyme-linked immunosorbent assay) at 6, 12, and 18 months. Adverse events were recorded. Results rhPTH(1-34) increased lumbar BMD more significantly than that did by elcatonin at 6 months( M6), 12 months (M12), and 18 months(M18; 4. 3% vs 1. 94% , 6. 8% vs 2. 72% , 9. 51% vs 2. 86% , P<0. 01). There was only a small but significant increase of femoral neck BMD at M18(2. 64% , P<0. 01) in rhPTH(1-34) groups. There were greater increases in bone turnover markers in the rhPTH(1-34) group than in the elcatonin group at M6, M12, and M18[serum bone-specific alkaline phosphatase(BSAP) 93. 67% vs -3. 56% , 117. 78% vs -4. 12% , 49. 24% vs-5. 81% , P<0. 01; urinary CTX/ Cr 250% vs -29. 5% , 330% vs -41. 4% , 273 % vs -10. 6% , P<0. 01]. rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5. 36% (6 / 112) in elcatonin group and 3. 23% ( 11 / 341 ) in rhPTH ( 1-34 ) group ( P = 0. 303 ). Both treatments were well tolerated. Hypercaluria(9. 38% ) and hypercalcemia(7. 04% ) in rhPTH(1-34) group was transient and caused no clinical symptoms. Pruritus(8. 21% vs 2. 68, P=0. 044) and redness of injection site(4. 40% vs 0, P=0. 024) were more frequent in rhPTH(1-34). Nausea / vomiting(16. 07% vs 6. 16% , P = 0. 001) and hot flushes(7. 14% vs 0. 59% , P<0. 001) were more common in elcatonin group. Conclusion rhPTH(1-34) treatment was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months treatment. rhPTH(1-34) could ameliorate back pain effectively. The results of the present study indicate that rhPTH(1-34) is an effective, and safe agent in treating postmenopausal women with osteoporosis.
5.Supplemental parenteral nutrition in enhanced recovery in postoperative liver cancer patients
Kun ZHANG ; Jingde ZHU ; Xinliang LYU ; Chaoyong TU ; Chuan JIANG ; Qiaomei LIN ; Zhuokai LI ; Qingyun ZHOU ; Chuxiao SHAO
Chinese Journal of General Surgery 2019;34(8):693-695
Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P > 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.
6.The mechanism of poly (ADP-ribose) polymerase on the intestinal mucosal barrier injury in rat model with severe acute pancreatitis through NF-κB signaling pathway
Liangyu MI ; Ziqian WU ; Xinting PAN ; Youdong WAN ; Shaoyan LYU ; Qingyun ZHU ; Jingyu SONG ; Yunyun WANG ; Tianjiao LIN
Chinese Journal of Emergency Medicine 2020;29(5):675-681
Objective:To investigate the effects of poly (ADP-ribose) polymerase-1(PARP-1) in intestinal mucosal barrier injury in rat model with severe acute pancreatitis (SAP).Methods:Twenty healthy male Wistar rats were divided into four groups ( n=5 each group) using a random table method: control, SAP, 3-aminobenzamide (3-AB), and 3-AB control groups. The SAP model was induced by intraperitoneal injection of cerulean with lipopolysaccharide. At 30 min, the rats were treated with the PARP-1 inhibitor, 3-AB, or normal saline,separately. After 12 h, all rats were sacrificed to harvest pancreas tissues, intestines tissues, and blood from the hearts for index detection. Serum amylase (AMY) and interleukin (IL)-6 levels were measured using an automatic biochemical instrument and enzyme-linked immunosorbent assay (ELISA), respectively.The protein expression of PARP-1 and nuclear factor (NF-κB) were measured using Western blot and that of occludin was measured using an immunohistochemical test. One-way analysis of variance was used for comparison of multiple groups of variables. Non-parametric tests of rank conversion were used when variances were not uniform. A P <0.05 was considered statistically significant. Results:Compared to the control group, the following indexes in the SAP group were significantly increased: ascites (with serious hemorrhage and necrosis in the pancreas and disordered intestinal villi),serum AMY and IL-6 levels, and the expression of PARP-1 and NF-κB. However, Occludin expression was significantly decreased. There was no significant difference between 3-AB group and 3-AB control group. Compared to the SAP group, the severity of SAP and pancreatitis-associated intestinal injury was significantly attenuated with the administration of 3-AB. Serum AMY and IL-6 levels were significantly decreased (serum AMY: 1 879.25 ± 736.6 U/L vs 5 569.33 ± 1993.48 U/L; IL-6: 77.98 ± 20.65 pg/mL vs 209.14 ± 79.08 pg/mL, both P<0.05), but the expression of PARP-1 and NF-κB were significantly increased (PARP-1: 1.44 ± 0.09 vs 1.49 ± 0.13; NF-κB: 0.63 ± 0.09 vs 0.96±0.08, both P<0.05). Similarly, Occludin expression was significantly decreased (6.7±1.5 vs 3.2±1.1, P<0.05). Conclusions:Inhibition of PARP-1 has protective effects on SAP associated intestinal mucosal barrier damage. The mechanism may be related to the inhibition of NF-κB signaling pathway and increase intestinal mucosal Occludin protein expression.
7.Clinical analysis of the diagnosis and treatment of lymphoepithelioma-like intrahepatic cholangiocarcinoma
Qingyun ZHOU ; Chaoyong TU ; Xinliang LYU ; Min ZHANG ; Wence YANG ; Kun ZHANG
International Journal of Surgery 2024;51(4):260-265
Objective:To explore the diagnosis and treatment of lymphoepithelioma-like intrahepatic cholangiocarcinoma(LEL-ICC).Methods:The retrospective and descriptive study was conducted. The data of 7 patients with pathological diagnosis of LEL-ICC after hepatectomy who were treated in Lishui Central Hospital in Zhejiang Province from December 1, 2009 to January 30, 2024 were collected. There were 2 males and 5 females. The age range was from 40 to 64 years old, with a median age of 52 years old. All 7 patients showed no obvious clinical symptoms.We analysed the imaging manifestations, pathological features, treatmentsand prognoses of patients.Postoperative follow-upswere conducted via telephone, with a focus on whether the patient had relapsed. The deadline was February 20, 2024.Results:Five cases underwent ultrasound examination, of which 4 cases showed hypoechogenicity and 1 case showed hyperechogenicity. 7 cases underwent MRI examination, showing low signal on T1WI, high signal on T2WI, and high signal on diffusion-weighted imaging. 2 cases had type A enhancement, 2 cases had type B enhancement, and 3 cases had type C enhancement. All 7 cases received surgical treatment, 2 cases were received prophylactic transarterial chemoembolization (TACE) after surgery, and 3 cases were received systemic chemotherapy after surgery; All 7 cases underwent postoperative follow-up, with a follow-up time of 1-166 months and a median follow-up time of 56 months. One case developed hilar and retroperitoneal lymph node metastasis after surgery for 6 months, and underwent surgical treatment. After surgery, chemotherapy was performed. 25 months later, right adrenal gland metastasis reappeared, and after combined treatment, the metastatic lesion was reduced and the patient received surgical treatment and chemotherapy, and there is currently no recurrence. The remaining 6 cases showed no recurrence.Conclusions:LEL-ICC lacks specific clinical symptoms and imaging manifestations, diagnosis relies on histopathological and immunohistochemical examinations. Comprehensive treatment with surgical intervention as the main approach can lead to better prognosis for patients.
8.Construction and validation of a risk prediction model for health risk stress perception in patients with systemic lupus erythematosus
Jingmei WU ; Xiaoqing LYU ; Jieyu WANG ; Jingjing LI ; Wangqin TANG ; Xiao XU ; Min HAO ; Qingyun ZHU ; Jingfang HONG
Chinese Journal of Modern Nursing 2022;28(11):1443-1449
Objective:To analyze the risk factors of stress perception in patients with systemic lupus erythematosus (SLE) , and construct and validate a risk prediction model for health risk stress perception in SLE patients.Methods:This study is a cross-sectional study. From October 2020 to March 2021, totals of 310 SLE inpatients and outpatients in the Department of Rheumatology and Immunology from 4 general hospitals in Anhui Province were selected as the modeling object. According to the patients' stress perception score, they were divided into the group with health risk stress ( n=132) and the group without health risk stress ( n=178) . The general data, SLE disease activity, general self-efficacy, emotional intelligence, resilience, sleep disturbance, anxiety, depression were compared between the two groups, and independent risk factors were screened out and Logistic regression was used to construct a risk prediction model. Hosmer-Lemeshow and receiver operator characteristic curve (ROC) area were used to test the fit and prediction effect of the model, respectively, and 206 patients were included for model validation. Results:Binary Logistic regression analysis showed that SLE disease activity, resilience, anxiety, payment type, and family monthly income were the influencing factors of stress perception in SLE patients, and the difference was statistically significant ( P<0.05) . Hosmer-Lemeshow fit test showed χ 2=6.123, P=0.633. Besides, the area under the ROC, maximum Youden index, predictive critical value, sensitivity and specificity were 0.903, 0.660, 0.497, 0.795 and 0.865 respectively. Conclusions:This study is based on five independent risk factors of SLE patients' stress perception, namely SLE disease activity, resilience, anxiety, payment type, and family monthly income. The risk prediction model has good sensitivity and specificity, which can provide a reference for clinical assessment of health risk stress perception in SLE patients.