Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To develop a Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation and conduct psychometric testing for its reliability and validity.Methods:Based on the common-sense model of self-regulation, the scale was developed through a literature review and semi-structured interviews to construct an item pool. The scale draft was formed through expert consultation and a pre-survey. Using convenience sampling, 361 patients with atrial fibrillation who had undergone catheter ablation and were either hospitalized or attending outpatient follow-up at the Department of Cardiology, Affiliated Hospital of Qingdao University, between January and March 2024, were selected for questionnaire survey. Item analysis and reliability and validity tests were performed on the scale.Results:Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 74.375%. Confirmatory factor analysis showed good model fit. The final scale included five dimensions and 24 items: trigger factors, recurrence risk perception, disease uncertainty, psychological burden, and coping strategies. The content validity index at the scale level was 0.864, and the item-level content validity index ranged from 0.684 to 0.947. The Cronbach's α coefficient of the scale was 0.919, the split-half reliability coefficient was 0.834, and the test-retest reliability coefficient was 0.872.Conclusions:The development of the Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation is scientific and standardized, and the scale has good reliability and validity. It can effectively assess the level of recurrence fear in these patients.

Objective:To develop a Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation and conduct psychometric testing for its reliability and validity.Methods:Based on the common-sense model of self-regulation, the scale was developed through a literature review and semi-structured interviews to construct an item pool. The scale draft was formed through expert consultation and a pre-survey. Using convenience sampling, 361 patients with atrial fibrillation who had undergone catheter ablation and were either hospitalized or attending outpatient follow-up at the Department of Cardiology, Affiliated Hospital of Qingdao University, between January and March 2024, were selected for questionnaire survey. Item analysis and reliability and validity tests were performed on the scale.Results:Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 74.375%. Confirmatory factor analysis showed good model fit. The final scale included five dimensions and 24 items: trigger factors, recurrence risk perception, disease uncertainty, psychological burden, and coping strategies. The content validity index at the scale level was 0.864, and the item-level content validity index ranged from 0.684 to 0.947. The Cronbach's α coefficient of the scale was 0.919, the split-half reliability coefficient was 0.834, and the test-retest reliability coefficient was 0.872.Conclusions:The development of the Recurrence Fear Scale for Patients with Atrial Fibrillation after Catheter Ablation is scientific and standardized, and the scale has good reliability and validity. It can effectively assess the level of recurrence fear in these patients.

Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To gain a deeper understanding of the fear of recurrence in patients with atrial fibrillation during the "blanking period" after catheter ablation.Methods:The interview outline was developed based on common-sense model of self-regulated. From July to September 2023, purposive sampling was used to select 15 patients with atrial fibrillation in the "blanking period" after catheter ablation at the Cardiovascular Outpatient of the Affiliated Hospital of Qingdao University as research subjects, and semi-structured interviews were conducted. The targeted content analysis method was used to analyze data.Results:Four themes were extracted, namely triggering factors of fear of recurrence, perception of atrial fibrillation recurrence, negative emotional distress, and insufficient ability to cope with atrial fibrillation recurrence.Conclusions:For patients with atrial fibrillation during the "blanking period" after catheter ablation, medical and nursing staff should closely monitor the patient's cognitive level and psychological state, and carry out targeted health education to meet the patient's needs for postoperative disease management, life adaptation, and other aspects, so as to reduce the fear of recurrence in atrial fibrillation patients during the "blanking period" after surgery.

Background: Job performance is known as an essential reflection of nursing quality. Colleague solidarity, positive emotion, and turnover intention play effective roles in a clinical working environment, but their impacts on job performance are unclear. Investigating the association between nurses’ colleague solidarity and job performance may be valuable, both directly and through the mediating roles of positive emotion and turnover intention. Methods: In this cross-sectional study, a total of 324 Chinese nurses were recruited by convenience sampling method from July 2016 to January 2017. Descriptive analysis, Spearman’s correlation analysis, and the structural equation model were applied for analysis by SPSS 26.0 and AMOS 24.0. Results: A total of 49.69% of participants were under 30 years old, and 90.12% of participants were female. Colleague solidarity and positive emotion were positively connected with job performance. The results indicated the mediating effects of positive emotion and turnover intention in this relationship, respectively, as well as the chain mediating effect of positive emotion and turnover intention. Conclusions In conclusion, dynamic and multiple supportive strategies are needed for nurse managers to ameliorate nursing job performance by improving colleague solidarity and positive emotion and decreasing turnover intention based on the job demand-resource model.

OBJECTIVE: To investigate the safety of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients and the related risk factors admitted to the intensive care unit (ICU) after LPD. METHODS: The perioperative data of patients who underwent LPD in Tianjin Medical University General Hospital from February 2017 to June 2023 were retrospectively collected, including basic data, preoperative laboratory indicators, intraoperative and postoperative indicators, pathological results (tumor size, lymph node dissection and pathological type), postoperative complications, ICU postoperative management and prognosis. The patients were divided into the elderly group (≥ 65 years) and the non-elderly group (< 65 years) according to age. Perioperative data between two groups were compared. Kaplan-Meier survival curve was drawn to analyze the survival rate of the elderly group and the non-elderly group, and the pancreatic head carcinoma group and other type of tumors group after LPD. Logistic regression was used to analyze the risk factors of ICU stay (length of ICU stay > 1 day) after LPD in elderly patients. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of this risk factor for ICU stay after LPD in elderly patients. RESULTS: A total of 160 patients were enrolled, including 57 cases in the elderly group (17 cases of vascular reconstruction) and 103 cases in the non-elderly group (40 cases of vascular reconstruction). All patients underwent R0 resection and were transferred to the comprehensive ICU for treatment. The follow-up time of patients with malignant tumors was 43 (6, 72) months. The elderly group had significantly longer surgery time, postoperative hospital stay and oral feeding time than the non-elderly group, and the incidence of delayed gastric emptying (DGE) was significantly higher than that in the non-elderly group. There were no significant differences in intraoperative blood transfusion rate, intraoperative blood loss, pathological results, short-term and severe postoperative complications, reoperation rate and 90-day mortality between the two groups. In patients with vascular resection reconstruction, the intraoperative blood loss in the elderly group was significantly higher than that in the non-elderly group, and the operation time and postoperative hospital stay were significantly longer. During ICU, the acute physiology and chronic health evaluation II [APACHE II: 12 (9, 14) vs. 8 (7, 10)], sequential organ failure assessment [SOFA: 6 (4, 8) vs. 3 (2, 5)] within 24 hours after admission to ICU were significantly increased in the elderly group (both P < 0.05), the time of mechanical ventilation [hours: 12 (10, 15) vs. 9 (5, 13)] and the length of ICU stay [days: 2 (1, 2) vs. 1 (1, 1)] were significantly increased in the elderly group (both P < 0.05), and the proportion of multi-disciplinary team (MDT) was also significantly increased in the elderly group (33.3% vs. 17.4%, P < 0.05), there were no significant differences in the levels of hemoglobin (Hb), albumin, and blood lactic acid between the two groups. Logistic regression analysis showed that the APACHE II score was an independent risk factor for ICU stay after LPD in elderly patients (β = 1.737, P = 0.028). ROC curve showed that the prediction performance was the best when the APACHE II score was 13, with the sensitivity of 72.41% and the specificity of 96.43%, and the area under the ROC curve (AUC) of 0.884. The Kaplan-Meier survival curve showed that there were no significant difference in median survival time (months: 24.1 vs. 24.7) and 5-year survival rate (19.01% vs. 19.02%) between the elderly group (52 cases) and the non-elderly group (92 cases) among the 144 patients with malignant tumors (both P > 0.05). The median survival time in the pancreatic head carcinoma group was significantly shorter than that in the other tumors group (63 cases; months: 20.2 vs. 40.1, P < 0.05), 5-year survival rate was significantly lower than that in the other tumors group (21.98% vs. 30.91%, P < 0.05). CONCLUSIONS LPD is a safe and feasible treatment for elderly patients. APACHE II score has a certain predictive value for ICU stay after LPD in elderly patients.
Humans ; Aged ; Middle Aged ; Sepsis/therapy* ; ROC Curve ; Pancreaticoduodenectomy/adverse effects* ; Retrospective Studies ; Blood Loss, Surgical ; Prognosis ; Pancreatic Neoplasms/surgery* ; Postoperative Complications ; Intensive Care Units

Patients with cardiovascular diseases have poor medication adherence, which seriously affects the prognosis of their diseases. This article reviewed the prediction model of medication compliance for patients with cardiovascular diseases, analyzed its predictive factors, model efficacy and application, and put forward opinions on the construction of relevant prediction models, which could provide reference for the clinical development of targeted intervention programs.

To investigate the degradation of polycyclic aromatic hydrocarbons (PAHs) and the changes of rhizosphere microorganisms in the rhizosphere soil of Leymus chinensis during the remediation of PAHs contaminated soil by Comamonas testosteroni (C.t)-assisted Leymus chinensis, we evaluated the removal of PAHs in the rhizosphere of Leymus chinensis using gas chromatography-mass spectrometry (GC-MS), analyzed the bacterial community and the diversity in Leymus chinensis rhizosphere soil by high-throughput sequencing technology, characterized the correlation among PAHs degradation and bacterial community components performing redundancy analysis (RDA) and network analysis, and predicted PAHs degradation potential via PICRUSt software in this paper. The degradation of PAHs in the rhizosphere of Leymus chinensis was promoted, the abundance and diversity of bacteria and the correlation among bacteria and PAHs were changed, and the degradation potential of PAHs in Leymus chinensis rhizosphere soil was enhanced in the later stage of phytoremediation (60-120 d) due to the incorporation of C.t. The accelerated degradation of three PAHs (Nap, Phe, BaP) was accompanied by the differ abundance and correlation of Proteobacteria (Sphingomonas, MND1, Nordella), Actinomycetes (Rubrobacter, Gaiella), Acidobacteria (RB41) and Bacteroides (Flavobacterium) affected by C.t. The results provide new insight into the microorganism choices for microbial assisted plant remediation of soil PAHs and the mechanisms of enhanced PAHs degradation via the combination of Comamonas testosteroni engineering bacteria and plants.
Biodegradation, Environmental ; Comamonas testosteroni/genetics* ; Polycyclic Aromatic Hydrocarbons/analysis* ; Rhizosphere ; Soil ; Soil Microbiology ; Soil Pollutants

Objective:To compare and analyze the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic assisted surgery (LAS) in the treatment of advanced gastric cancer.Methods:Articles of the efficacy comparison of HALS and LAS in D2 radical gastrectomy for gastric cancer from 2000 to 2019 published in PubMed, Cochrane library, EM-BASE, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese full-text database of Chinese Sci-Tech journals, Chinese biomedical literature database were retrieved, and the literatures were screened according to the pre-established inclusion and exclusion criteria. The quality of the two groups was evaluated, and the short-term indexes and complications for meta-analysis of the two groups were analyzed by using Revman 5.3 software.Results:A total of 1277 patients were included in 10 articles, including 629 in the HALS group and 648 in the LAS group. The results of the meta-analysis showed that compared with the LAS group, the operation time was shorter in the HALS group (WMD=24.02, 95% CI: -40.41--7.62, P=0.004), but the auxiliary incision was slightly longer (WMD=0.27, 95% CI: 0.06-0.47, P=0.01), and there were no statistically significant difference in the remaining number of lymph node dissections (WMD=0.58, 95% CI: -1.22-2.39, P=0.53), intraoperative blood loss (WMD=-7.94, 95% CI: -16.21-0.33, P=0.06), gastrointestinal tract recovery time (WMD=0.00, 95% CI: -0.03- 0.04, P=0.85), total length of hospital stay (WMD=-0.14, 95% CI0: -0.36-0.09, P=0.23) and postoperative complications ( OR=0.89, 95% CI: 0.58-1.37, P=0.61). Conclusions:Compared with the LAS for D2 radical surgery of advanced gastric cancer, HALS has significantly shorter operation time and is easier to perform than LAS, but the incision length is slightly increased. Physicians can choose the appropriate operation method according to the specific conditions of the operation and themselves.