Objective:To explore the impact of the fear of disease progression on the return-to-work readiness of patients after percutaneous coronary intervention (PCI) , and the chain mediating effect of psychological consistency and disease acceptance between the two factors.Methods:A convenience sampling method was used to select 198 PCI patients at the Affiliated Hospital of Jining Medical University from February 2023 to May 2024. The General Information Survey, Return-To-Work Readiness Scale, Fear of Progression Questionnaire-Short Form, Acceptance Illness Scale, and Sense of Coherence-13 were used to investigate the patients.Results:A total of 198 questionnaires were distributed, with 178 valid questionnaires returned, yielding an effective response rate of 89.90%. Among the patients' return-to-work readiness, 42 patients were in the pre-intention stage, 60 patients in the intention stage, 36 patients in the action preparation-self-assessment stage, and 40 patients in the action preparation-behavior stage. The fear of disease progression significantly influenced the patients' return-to-work readiness. Psychological consistency and disease acceptance played significant chain mediation roles between the fear of disease progression and return-to-work readiness, with a total mediation effect value of -0.072, accounting for 41.38% of the total effect.Conclusions:Return-to-work readiness in PCI patients needs improvement. Psychological consistency and disease acceptance play a chain mediation role between the fear of disease progression and return-to-work readiness. Healthcare providers should develop personalized care strategies based on patients' specific conditions, improve their psychological state, and enhance their readiness to return to work.

Objective:To explore the impact of the fear of disease progression on the return-to-work readiness of patients after percutaneous coronary intervention (PCI) , and the chain mediating effect of psychological consistency and disease acceptance between the two factors.Methods:A convenience sampling method was used to select 198 PCI patients at the Affiliated Hospital of Jining Medical University from February 2023 to May 2024. The General Information Survey, Return-To-Work Readiness Scale, Fear of Progression Questionnaire-Short Form, Acceptance Illness Scale, and Sense of Coherence-13 were used to investigate the patients.Results:A total of 198 questionnaires were distributed, with 178 valid questionnaires returned, yielding an effective response rate of 89.90%. Among the patients' return-to-work readiness, 42 patients were in the pre-intention stage, 60 patients in the intention stage, 36 patients in the action preparation-self-assessment stage, and 40 patients in the action preparation-behavior stage. The fear of disease progression significantly influenced the patients' return-to-work readiness. Psychological consistency and disease acceptance played significant chain mediation roles between the fear of disease progression and return-to-work readiness, with a total mediation effect value of -0.072, accounting for 41.38% of the total effect.Conclusions:Return-to-work readiness in PCI patients needs improvement. Psychological consistency and disease acceptance play a chain mediation role between the fear of disease progression and return-to-work readiness. Healthcare providers should develop personalized care strategies based on patients' specific conditions, improve their psychological state, and enhance their readiness to return to work.

Objective:To investigate the value of diffusion kurtosis imaging (DKI) combined with quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting axillary lymph node metastasis in breast cancer.Methods:A total of 150 cases of breast cancer confirmed by pathology in the Affiliated Hospital of Jining Medical University were retrospectively analyzed. 68 cases had axillary lymph node (ALN) metastasis and 82 cases had no ALN metastasis. All breast lesions were examined by DKI and DCE-MRI before operation. We analyzed clinical case data, routine MRI features, DKI, and DCE-MRI parameters between two groups, including diffusion kurtosis (MK), mean diffusion rate (MD), volume transfer constant (K trans), extravascular volume fraction (Ve), and rate constant (Kep); The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of quantitative parameters for ALN metastasis of breast cancer. Results:The proportion of lesions with blurred edges in the metastatic group was higher than that in the non ALN metastatic group ( P=0.032); The proportion of uneven and circular enhancement within the ALN metastasis group was relatively high ( P=0.018). The MD value of the ALN transfer group was lower than that of the group without ALN transfer ( P=0.021); The MK value, K trans value, and Kep value were higher than those in the group without ALN metastasis (all P<0.01). The K trans value of DCE-MRI model was the most effective in diagnosing ALN metastasis of breast cancer, and the area under the ROC curve (AUC) was 0.831; The AUC of DCE-MRI model was 0.833, which was higher than that of DKI model (AUC=0.733), and the difference was statistically significant ( Z=2.208; P=0.027). The AUC of DCE-MRI and DKI models were higher than that of conventional MRI models ( Z=3.184, P=0.002; Z=1.917, P=0.046). The sensitivity and accuracy of combined DKI and DCE-MRI models in the diagnosis of ALN metastasis in breast cancer were higher than those of single model. Conclusions:DKI and DCE-MRI models can be used to predict axillary lymph node metastasis in breast cancer. Among them, the K trans value of DCE-MRI model is the most effective in diagnosing axillary lymph node metastasis in breast cancer.

BACKGROUND/OBJECTIVES: The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers. SUBJECTS/METHODS: This cross-sectional study included 1,255 eligible participants in the ‘H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project’ among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus. RESULTS: The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01–1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22–6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04–3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables. CONCLUSION In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.

Objective:To examine the effect of surgical treatment in children with pulmonary artery sling and the surgical treatment strategy.Methods:Relevant data of 110 children with pulmonary artery sling admitted to the Department of Cardiac Surgery, Children′s Hospital Affiliated to Shandong University from February 2017 to July 2022 were retrospectively analyzed. There were 55 males and 55 females, aging ( M(IQR)) 9.0 (10.6) months (range: 1 to 96 months). The weight was 7.8 (3.5) kg (range: 2.5 to 25.0 kg). Of the 110 patients, 108 had different degrees of tracheal stenosis and 2 had normal trachea. Left pulmonary artery transplantation and tracheoplasty were performed in 78 patients. Left pulmonary artery transplantation was performed in 30 patients (11 in our hospital and 19 in other hospitals) due to the lack of an early tracheoplasty technique, in which 24 patients needed stage Ⅱ tracheoplasty due to obvious respiratory symptoms and limited activity endurance, and 6 cases did not intervene. Two children with normal trachea only underwent left pulmonary artery transplantation. Results:Among the 78 children who underwent surgery in the same period, 70 cases recovered smoothly after surgery, of whom respiratory symptoms were significantly reduced or disappeared during the 1 to 65 months follow-up, with similar activity endurance to normal children of the same age. Eight cases died, including 4 cases of postoperative multi-drug resistant bacteria infection, died from tracheal anastomotic opening or septic shock, 1 cases with severe congenital heart disease died from postoperative low cardiac output syndrome difficult to correct, 1 case died from blood pressure could not be maintained due to the compressed left pulmonary artery after transplantation, 2 cases of postoperative digestive system diseases (adhesive intestinal obstruction, gastrointestinal bleeding, etc.). The 24 patients in the staging group were followed for 1 to 84 months. All patients needed stage Ⅱ tracheoplasty due to respiratory symptoms and decreased endurance to activity. Eight cases of the non-intervention tracheal group were successfully separated from the ventilator, cured and discharged in a short period of time.Conclusions:Most children with pulmonary artery sling have tracheal stenosis. Children with low degree of tracheal stenosis and inconspicuous respiratory symptoms can only undergo left pulmonary artery transplantation by lateral thoracotomy. For patients combined with severe tracheal stenosis or obvious respiratory symptoms, a simultaneous left pulmonary artery transplantat and tracheoplasty is recommended.

Objective:To examine the effect of surgical treatment in children with pulmonary artery sling and the surgical treatment strategy.Methods:Relevant data of 110 children with pulmonary artery sling admitted to the Department of Cardiac Surgery, Children′s Hospital Affiliated to Shandong University from February 2017 to July 2022 were retrospectively analyzed. There were 55 males and 55 females, aging ( M(IQR)) 9.0 (10.6) months (range: 1 to 96 months). The weight was 7.8 (3.5) kg (range: 2.5 to 25.0 kg). Of the 110 patients, 108 had different degrees of tracheal stenosis and 2 had normal trachea. Left pulmonary artery transplantation and tracheoplasty were performed in 78 patients. Left pulmonary artery transplantation was performed in 30 patients (11 in our hospital and 19 in other hospitals) due to the lack of an early tracheoplasty technique, in which 24 patients needed stage Ⅱ tracheoplasty due to obvious respiratory symptoms and limited activity endurance, and 6 cases did not intervene. Two children with normal trachea only underwent left pulmonary artery transplantation. Results:Among the 78 children who underwent surgery in the same period, 70 cases recovered smoothly after surgery, of whom respiratory symptoms were significantly reduced or disappeared during the 1 to 65 months follow-up, with similar activity endurance to normal children of the same age. Eight cases died, including 4 cases of postoperative multi-drug resistant bacteria infection, died from tracheal anastomotic opening or septic shock, 1 cases with severe congenital heart disease died from postoperative low cardiac output syndrome difficult to correct, 1 case died from blood pressure could not be maintained due to the compressed left pulmonary artery after transplantation, 2 cases of postoperative digestive system diseases (adhesive intestinal obstruction, gastrointestinal bleeding, etc.). The 24 patients in the staging group were followed for 1 to 84 months. All patients needed stage Ⅱ tracheoplasty due to respiratory symptoms and decreased endurance to activity. Eight cases of the non-intervention tracheal group were successfully separated from the ventilator, cured and discharged in a short period of time.Conclusions:Most children with pulmonary artery sling have tracheal stenosis. Children with low degree of tracheal stenosis and inconspicuous respiratory symptoms can only undergo left pulmonary artery transplantation by lateral thoracotomy. For patients combined with severe tracheal stenosis or obvious respiratory symptoms, a simultaneous left pulmonary artery transplantat and tracheoplasty is recommended.

BACKGROUND AND OBJECTIVEIt has been proven that telomerase activation correlates with the carcinogenesis, aggressiveness and turnover of lung cancer. Telomerase is one of the improtant molecular biomarkers for diagnosis and targeting therapy in lung cancer. The aim of this study is to investigate the diagnostic value of the combined determination of telomerase activity in induced sputum, pleural effusion and fiberobronchoscopic biopsy in lung cancer patients.

METHODSThe technique of TRAP (telomeric repeat amplification protocal)-PCR-ELISA was employed to detect telomease levels of induced sputum, pleural effusion and fiberobronchoscopic biopsy in 80 lung cancer patients with pleural effusion and 50 benign pulmonary disease patients with pleural effusion.

RESULTSTelomemse levels of induced sputum, pleural effusion and fiberobronchoscopic biopsy were all significantly higher in patients with lung cancer than those with benign pulmonary disease (P < 0.001). There was no significant difference in the level of telomerase activity between different pathologic types (P > 0.05). The sensitivity of induced sputum, pleural effusion and fiberobronchoscopic biopsy were 62.5% (50/80), 46.3% (37/80) and 60.0% (48/80), respectively. The specificity were 72.0% (36/50), 66.0% (33/50) and 70.0% (35/50), respectively. The overall accuracy were 66.2% (86/130), 53.8% (70/130) and 63.8% (83/130), respectively. The sensitivity, specificity and overall accuracy of combined induced sputum, pleural effusion and fiberobronchoscopic biopsy were 85.0% (68/80), 78.0% (39/50) and 82.3% (107/130), respectively. The sensitivity of telomease level in combined detection for diagnosis of lung cancer was much higher than that in single sample detection (P < 0.01).

CONCLUSIONThe sensitivity of telomease activity in combined three samples was the highest. It can further improve the accuracy for the diagnosis of lung cancer with pleural effusion.

Aged ; Biopsy ; Bronchoscopy ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lung Neoplasms ; diagnosis ; enzymology ; Male ; Middle Aged ; Pleural Effusion ; enzymology ; Polymerase Chain Reaction ; Sputum ; enzymology ; Telomerase ; metabolism

Objective To study collagen changes in dermis of hairless mice that were exposed to ultraviolet. Methods The hairless mice was irradiated under UVA, UVB and the combination of the two for 20 weeks, total dose of UVA was 222J/cm~2, and that of UVB was 5.9J/cm~2. After irradiation, the dorsal skin's collagens of animals were analysed by computer imaging analysis system, histopathologic examination, specific stains and electorn microscopy. Results The hairless mice exposed to ultraviolet A were unchanged in dermis collagen. The hairless mice was irradiated under UVB and the both UVA and UVB, and the content of collagen was decreased with less affinity for collagen staining. These findings were supported by electron microscopy, which showed fraying, thickened, and proliferating collagen, coalesced into extensive denaturalization. The ratio of types Ⅲ/Ⅰ+Ⅲ collagen was significantly increased. Conclusion The qualitative and quantitative changes of the collagen in the ultraviolet irradiated skin of hairless mice are related to ultraviolet B but not to UVA. UVB is a key factor of skin collagen damage in UV-irradiation.

Objective To study the changes of skin wrinkles in hairless mice while exposed to ultraviolet. Methods The hairless mice were irradiated under long-wave ultraviolet ray (UVA), medium-frequency wave ultraviolet ray (UVB) and the combination of the two for 20 weeks. Total dose of UVA was 222J/cm~2, and that of UVB was 5.9J/ cm~2. After irradiation, the skin wrinkling of animals were analysed by the naked eye, dermatoglyphics enlarges and applied color skin system of pathologic portrait quantitative analysis. Results Control group: The hairless mice skin were fine and delicate, the ditch and ridge of skin distributed even, and had no the obvious cornification. Long wave ultraviolet ray (UVA) set: The skin was slightly rough, skin ditch and ridge distributed still even, and had no obvious cornification; quantitative analysis had no the obvious difference from that of control group. Medium-frequency wave ultraviolet ray (UVB) set: The dermatoglyphics were disorderly, and the skin ditch deepened, widened, and the skin ridge increased the breadth and obvious cornification, and quantitative analysis had obvious difference from that of control group. Long wave and medium-frequency wave ultraviolet ray (UVA+ UVB) set: The dermatoglyphics was disorderly, and the skin ditch deepened, widened, the skin ridge increased the breadth, skin cornification was more obvious, quantitative analysis had obvious difference from that of control group. Conclusions The qualitative and quantitative changes of the wrinkles in the ultraviolet irradiated skin of hairless mice are related to ultraviolet B but not to UVA. UVB is a key factor of skin wrinkling in UV-irradiation.

Objective To promote the use of chemical peeling in facial rejuvenation with the phenol and croton oil peeling agents to the UVA/B-irradiated skin of hairless mice, and to provide the experimental evidence for the clinical application of the treatment of irradiated skin.Methods Sixty BALB/C hairless mice were photo-aged by use of chronic ultraviolet A and ultraviolet B irradiation for 20 weeks. After irradiation the animals were randomly divided into two groups:untreated (10 mice) and treated (50 mice). The phenol and croton oil chemical peeling agents were applied to the dorsal skin of treated animal group while it was full anesthetized. Punch biopsies were taken at 7, 14, 30, 60, and 90 days after peel for histological analysis. At 60 days after irradiation, the skin wrinkling of animals were analyzed by macroscopy, cleavage line amplification, and computer imaging analysis system. Results The treated areas of irradiated skin recovered rejuvenation and exhibited a unique connective tissue layer composed of fine collagen fibers beneath the epidermis. Conclusion The mixture of phenol-croton oil may reverses the visible stigmata of photoaging skin. Our results will be of great help to promote the use of chemical peeling in facial rejuvenation.