1.Application of nursing intervention based on leadership life cycle theory in patients with swallowing dysfunction after acoustic neuroma surgery
Guiping YANG ; Yudan GU ; Shu QIN ; Yaya FEI
Chinese Journal of Practical Nursing 2021;37(18):1406-1411
Objective:To explore the effect of nursing intervention based on leadership life cycle theory in patients with swallowing dysfunction after acoustic neuroma surgery.Methods:From February 2017 to March 2020, 100 patients with swallowing dysfunction after acoustic neuroma surgery in our hospital were selected as the research object. According to a random number table, a randomized controlled study was used to divide all patients into an observation group and a control group, 50 cases in each group. Patients in the control group received routine postoperative rehabilitation nursing, and the observation group adopted nursing intervention based on the leadership life cycle theory. After the intervention, the Water swallow test was used to evaluate the recovery of swallowing dysfunction in the two groups. A swallowing dysfunction rehabilitation training compliance questionnaire was used to evaluate rehabilitation compliance. The Swallowing Quality of Life scale (SWAL-QOL) was used to evaluate the quality of life of patients. At the same time the occurrence of aspiration pneumonia was recorded.Results:After the intervention, the result of drinking water test rating was better in the observation group compared the control group, the difference was statistically significant ( Uc=2.053, P <0.05). The participation in compliance, monitoring compliance and learning compliance scores were 16.94±2.46, 6.96±1.24, 5.66±2.11 in the observation group, significantly higher than in the control group (12.36±2.59, 4.80±1.20, 4.48±1.49), the difference was statistically significant ( t value was 9.058, 8.851, 3.236, P <0.05). After a one-month follow-up, the scores of psychological burden, eating time, appetite, swallowing symptom frequency, food choice, language communication, eating fear, mental health, social interaction, fatigue sleep were 8.06±1.39, 7.14±1.76, 10.92±1.79, 58.26±6.41, 6.38±1.81, 7.00±1.07, 15.82±2.41, 21.86±1.81, 16.80±1.81, 18.96±3.24, significantly higher than those of the control gorup (6.76±2.17, 4.80±1.83, 7.84±1.74, 37.30±5.07, 3.72±1.23, 4.98±1.33,12.06±2.97, 16.96±1.67, 11.00±1.76, 1.84±3.05), the differences were statistically significant ( t value was 6.945-18.142, P <0.05). The incidence of aspiration pneumonia in the observation group were 6.00% (3/50), lower than that in the control group 20.00% (10/50), the difference was statistically significant ( χ2 value was 4.332, P<0.05). Conclusions:Nursing intervention based on the leadership life cycle theory is beneficial to promote the recovery of swallowing dysfunction in patients with swallowing dysfunction after acoustic neuroma surgery, improve the compliance of rehabilitation training, improve the quality of life of patients, and reduce the occurrence of aspiration pneumonia.
2.Causality between hypertension and malignant tumors:A Mendelian randomization study
Ruoxin MAO ; Xiya ZHAO ; Yudan CHEN ; Xinyi CHEN ; Xiya YANG ; Jiajing GU ; Wenming HE
China Modern Doctor 2024;62(25):40-46
Objective To assess the causality between 14 malignant tumors and hypertension.Methods Publicly available datasets from genome-wide association study were used,from which independent genetic variants strongly associated with hypertension and 14 malignant tumors were extracted as instrumental variables for bidirectional Mendelian randomization(MR)analysis,including random effect inverse variance weighted(IVW),simple mode,weighted median,weighted mode and MR-Egger to evaluate the causal effect.Sensitivity analysis was used to test the validity and robustness of the analytical results,and multivariate MR method was used to further control for the effects of confounding factors.Results In the MR analysis of malignant melanoma and hypertension,the study included a total of 11 single nucleotide polymorphisms(SNPs)strongly associated with malignant melanoma.After Bonferroni correction,the IVW-based results showed a causal relationship between malignant melanoma and hypertension(OR=1.67,95%CI:1.27-2.21,P<0.001).Cochran's Q test,Mendelian randomization pleiotropy residual sum and outlier test and MR-Egger intercept test showed that there were no outliers and no horizontal pleiotropy among the instrumental variables,and the sensitivity analysis of the leave-one-out method showed that there was no single SNP that had a significant impact on the overall results.In the analysis of hypertension and leukemia,the preliminary analysis results showed that there may be a relationship between the two,but after adjusting for confounders,the effect of hypertension on the risk of leukemia was no longer significant.Conclusion Malignant melanoma may be a risk factor in the development of hypertension.