1.Core competencies of thoracic surgery specialist nurses: a scoping review
Yingjin LI ; Qiuju CHEN ; Di ZHU ; Chaonan YANG ; Yan CHEN
Chinese Journal of Medical Education Research 2024;23(10):1401-1407
Objective:To identify the core competencies of thoracic surgery specialist nurses and provide a reference for training thoracic surgery specialist nurses.Methods:Following the methodological framework for scoping reviews proposed by the Joanna Briggs Institute, 9 databases were searched from inception to February 23, 2024.Results:A total of 17 papers were included, including 11 papers in Chinese and 6 papers in other languages. By analyzing and integrating the included literature, 6 themes, 15 sub-themes, and 59 entries were identified as the core competencies for thoracic surgery specialist nurses. The themes included direct nursing practice competencies, critical thinking competencies, professional development competencies, interpersonal competencies, managerial competencies, and ethical decision-making competencies.Conclusions:This study reviewed the core competencies of thoracic surgery specialist nurses based on publications worldwide. Combined with the national conditions of nursing development in China, we clarified the core competencies of thoracic surgery specialist nurses that align more closely with the clinical nursing practice in thoracic surgery. In the future, we suggest building a standardized training system based on these core competencies, systematically training thoracic surgery specialist nurses, addressing the challenges in developing core competencies of thoracic surgery specialist nurses, and further improving the quality of thoracic surgery nursing in China.
2.Evaluation of the safety of radial artery puncture in neurointerventional surgery in elderly patients aged 75 years and older
Qiuju LI ; Ke PANG ; Hanlin CHEN ; Yue YIN ; Feng GAO ; Xuan SUN ; Ligang SONG ; Ning MA ; Dapeng MO ; Yiming DENG ; Zhongrong MIAO
Chinese Journal of Geriatrics 2024;43(10):1255-1259
Objective:To compare the safety of radial artery puncture in elderly patients aged 75 years and older who are undergoing neurointerventional procedures.Methods:A single-center retrospective study was conducted, involving 350 elderly patients aged 75 years and older who received neurointerventional treatment at Beijing Tiantan Hospital, Capital Medical University, from June to December 2022.The participants were divided into two groups based on the puncture site: femoral artery puncture and radial artery puncture.The safety indicators compared between the two groups included puncture failure, changes in puncture site, general puncture complications(such as subcutaneous bleeding, puncture site hematoma, and vasospasm), severe puncture complications(including distal limb ischemia and pseudoaneurysm), and lower limb venous thrombosis.Multivariate Logistic regression analysis was conducted to evaluate the impact of different puncture methods on the occurrence of complications.Results:Among the 350 patients, 280 underwent femoral artery puncture, while 70 underwent radial artery puncture.There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The proportions of patients using antiplatelet drugs prior to surgery, puncture failure rates, rates of change in puncture sites, and the incidence of severe complications-including distal limb ischemia and pseudoaneurysm-were not significantly different between the two groups( χ2=2.051, 0.075, 0.588, 3.175; P=0.152, 0.784, 0.443, 0.075).In the femoral artery puncture group, 20.4%(57 cases)of patients experienced general puncture complications(including subcutaneous bleeding, puncture site hematoma, and vasospasm), whereas only 8.6%(6 cases)in the radial artery puncture group experienced such complications, revealing a statistically significant difference between the two groups( χ2=5.720, P=0.022).Multivariate Logistic regression analysis indicated that, compared to femoral artery puncture, radial artery puncture was associated with a reduced risk of all complications( OR=0.272, 95% CI: 0.139-0.532, P<0.001), general puncture complications( OR=0.375, 95% CI: 0.153-0.919, P=0.032)and lower limb venous thrombosis( OR=0.219, 95% CI: 0.050-0.954, P=0.043). Conclusions:In elderly patients aged 75 years and older who are undergoing neurointerventional procedures, radial artery puncture is associated with a reduced incidence of general puncture complications and lower limb venous thrombosis when compared to femoral artery puncture, indicating a superior safety profile.
3.HIC Value of Mild Traumatic Rats under Anterior-Posterior and Lateral-Medial Craniocerebral Impact:An Equivalent Study
Guoxiang WANG ; Linna ZHU ; Xun WANG ; Qiuju CHEN ; Tao XIONG ; Qinghang LUO ; Jia YU ; Jingyu XU ; Zhiyong YIN ; Shengxiong LIU
Journal of Medical Biomechanics 2024;39(4):730-735
Objective To investigate the equivalent conversion of head injury criterion(HIC)under anterior-posterior(AP)and lateral-medial(LM)craniocerebral impact for mild craniocerebral injury in rats using motor evoked potential(MEP)and β-amyloid precursor protein(β-APP)immunohistochemistry(IHC).Methods Sixty healthy adult male SD rats were randomly divided into 0 m control group,0.5 m-AP and 0.5 m-LM injury groups,and 1 m-AP and 1 m-LM injury groups(12 rats in each group).The control group did not undergo any impact injury experiment.After the impact injury experiment,the injury and control groups were subjected to excessive anesthesia to produce β-APP immunohistochemical stained slices,and the percentage of positive area and integral optical density(IOD)in the brainstem pyramidal tract area of the slices were determined.The MEP groups were divided in the same manner as the IHC groups and the MEP amplitudes of the MEP and control groups were measured after the impact injury experiment.Results With an increase in the degree of injury,the decrease in MEP amplitude,percentage of positive areas,and IOD in the injury groups significantly increased.When the degree of injury was low,the sensitivity of IHC was higher than that of MEP.When the degree of injury was the same,the HIC in the LM direction was lower than that in the AP direction.When the HIC was the same,the degree of injury in the LM direction was greater than that in the AP direction.Conclusions The joint evaluation of MEP and β-APP can provide experimental references for the study of HIC equivalent conversion in AP-LM craniocerebral impact injury.
4.Exploration of correlation between multiple subjective and objective evaluation indicators in early stage with recovery time in combination of acupuncture and medication for treating facial neuritis
Qiuju SU ; Xueyan WU ; Xun PAN ; Min SU ; Shiqi CHENG ; Zhuwen CHEN
Chongqing Medicine 2024;53(2):246-250,256
Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P<0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P<0.01 or P<0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P>0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.
5.Therapeutic potential of NADH: in neurodegenerative diseases characterizde by mitochondrial dysfunction.
Ziyi CHEN ; Hongyang WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):57-62
Nicotinamide adenine dinucleotide(NADH) in its reduced form of is a key coenzyme in redox reactions, essential for maintaining energy homeostasis.NADH and its oxidized counterpart, NAD+, form a redox couple that regulates various biological processes, including calcium homeostasis, synaptic plasticity, anti-apoptosis, and gene expression. The reduction of NAD+/NADH levels is closely linked to mitochondrial dysfunction, which plays a pivotal role in the cascade of various neurodegenerative disorders, including Parkinson's disease and Alzheimer's disease.Auditory neuropathy(AN) is recognized as a clinical biomarker in neurodegenerative disorders. Furthermore, mitochondrial dysfunction has been identified in patients with mutations in genes like OPA1and AIFM1. However, effective treatments for these conditions are still lacking. Increasing evidence suggests that administratering NAD+ or its precursors endogenously may potentially prevent and slow disease progression by enhancing DNA repair and improving mitochondrial function. Therefore, this review concentrates on the metabolic pathways of NAD+/NADH production and their biological functions, and delves into the therapeutic potential and mechanisms of NADH in treating AN.
Humans
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NAD/metabolism*
;
Neurodegenerative Diseases/metabolism*
;
Mitochondria
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Oxidation-Reduction
;
Mitochondrial Diseases
6.Research progress on hereditary endocrine and metabolic diseases associated with sensorineural hearing loss.
Fang CHEN ; Qinying ZHANG ; Qiujing ZHANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):63-69
Hereditary endocrine and metabolic diseases , caused by genetic factors, exhibit complex and diverse symptoms, including the possibility of concurrent sensorineural deafness. Currently, there is a limited clinical understanding of hereditary endocrine and metabolic diseases that manifest with deafness, the pathogenesis remains unclear,and there is a lack of effective diagnostic and treatment methods. This article summarizes the research progress of hereditary endocrine and metabolic diseases complicated with deafness from the pathogenesis, clinical phenotype, diagnosis and treatment. Understanding the current research progress and integrating genetic analysis into clinical practice are crucial for accurate diagnosis and treatment, evaluating clinical efficacy, and providing effective genetic counseling for these diseases.
Humans
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Deafness/genetics*
;
Hearing Loss, Sensorineural/diagnosis*
;
Phenotype
;
Metabolic Diseases/genetics*
;
Genetic Counseling
7.Clinical features of CAPOS syndrome caused by maternal ATP1A3 gene variation: a case report.
Yun GAO ; Fengjiao LI ; Rong LUO ; Guohui CHEN ; Danyang LI ; Dayong WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):73-76
CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient's mother presented with pes cavus. Genetic testing revealed a c. 2452G>A(Glu818Lys) heterozygous mutation in theATP1A3 gene in the patient . This article aims to enhance clinicians' understanding of CAPOS syndrome, emphasizing the case's clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings.
Humans
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Child
;
Female
;
Cerebellar Ataxia/diagnosis*
;
Talipes Cavus
;
Hearing Loss, Sensorineural/diagnosis*
;
Optic Atrophy/diagnosis*
;
Mutation
;
Phenotype
;
Sodium-Potassium-Exchanging ATPase/genetics*
;
Foot Deformities, Congenital
;
Reflex, Abnormal
8.Mechanism of Shugan Huazheng Prescription Against Liver Fibrosis Based on HIF-1α/VEGF/TGF-β1 Pathway
Anli XING ; Kunpeng ZHAO ; Qiuju ZHANG ; Jiena LI ; Shiyu CHEN ; Jiaqi GUO ; Ming ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):57-65
ObjectiveTo observe the therapeutic effect of Shugan Huazheng prescription on hepatic fibrosis model rats induced by carbon tetrachloride (CCl4) and explore whether it plays its role through hypoxia-induced factor-1α/vascular endothelial growth factor/transforming growth factor-β1 (HIF-1α/VEGF/TGF-β1) pathway. MethodA total of 54 male SPF SD rats were randomly divided into six groups: blank group, model group, colchicine group (0.2 mg·kg-1), and high-, medium-, and low-dose groups (29.52, 14.76, and 7.38 g·kg-1) of Shugan Huazheng prescription, with nine rats in each group. The molding was conducted three times a week for eight weeks. Administration began the day after the first injection, and the drug intervention was once a day for eight weeks. On the day after the last administration, the rats were deprived of food and water, and they were killed the next day, during which the physiological status of each group of rats was dynamically monitored. The pathological changes in the liver were observed by hematoxylin-eosin (HE) staining, and the content of hydroxyproline (HYP) and angiotensin Ⅱ (AngⅡ) in liver tissue were detected by enzyme-related immunosorbent assay (ELISA). Real-time fluorescent quantitative PCR (Real-time PCR) was used to determine the mRNA expression levels of HIF-1α, VEGF, and TGF-β1 in liver tissue, and immunohistochemical method (IHC) and Western blot were used to detect the protein expression levels of HIF-1α, VEGF, and TGF-β1 in liver tissue. ResultCompared with the blank group, the overall condition of rats in the model group decreased significantly. The proliferation of connective tissue and the increase in adipose cells between hepatocytes were obvious. The content of HYP and Ang was increased. The mRNA and protein expressions of HIF-1α, VEGF, and TGF-β1 were increased to varying degrees (P<0.05). Compared with the model group, the proliferation of connective tissue and inflammatory cell infiltration in the liver tissue of colchicine and Shugan Huazheng prescription groups were reduced. The content of HYP and Ang was decreased. The mRNA and protein expression levels of HIF-1α, VEGF, and TGF-β1 were decreased, and the colchicine group and high-dose group of Shugan Huazheng prescription were the most significant (P<0.05). ConclusionShugan Huazheng prescription has an obvious therapeutic effect on CCl4-induced hepatic fibrosis model rats. Its therapeutic mechanism may be related to the regulation of the HIF-1α/VEGF/TGF-β1 signaling pathway and the improvement of hepatic hypoxia, vascular remodeling, and the syndrome of Qi deficiency and blood stasis in hepatic fibrosis.
9.A qualitative study of self-management dilemmas in adults with emerging ankylosing spondylitis
Di ZHU ; Zhiling ZHAO ; Yan CHEN ; Ling YUAN ; Qiuju CHEN ; Renju XU ; Xiaohan NIE
Chinese Journal of Practical Nursing 2024;40(2):117-122
Objective:To explore the experience of self-management dilemma ofadults with emerging ankylosing spondylitis, and to provide reference for the construction of self-management intervention strategies for emerging adults with ankylosing spondylitis.Methods:Descriptive phenomenology was used to conduct in-depth interviews with 14 adults with emerging ankylosing spondylitis in the Rheumatology and Immunology Department of Drum Tower Hospital Affiliated to Medical College of Nanjing University from August 2022 to March 2023. The interview data were analyzed by Colaizzi′s seven-step analysis method.Results:A total of 14 patients completed the interview,10 males, 4 females, aged 21-30 years. In adults with emerging ankylosing spondylitis, there were dilemmas of role maladjustment and disease management disorder, including role maladjustment of disease management and social role maladjustment. Barriers to disease management included weak self-management awareness, insufficient support for self-management information, inadequate self-management skills, and poor compliance with self-management behaviors.Conclusions:The role adaptation and self-management ability of adults with emerging ankylosing spondylitis are seriously inadequate. It is urgent to construct health management strategies for adults with emerging ankylosing spondylitis to help them improve the level of role adaptation and disease management.
10.Construction and validation of a nomogram model to predict abnormal female factors in in vitro fertilization
Chao ZHOU ; Huan LI ; Guangyu YU ; Chunmei YU ; Di CHEN ; Chengmin TANG ; Qiuju MO ; Renli QIN ; Xinmei HUANG
Chinese Journal of Tissue Engineering Research 2024;28(11):1696-1703
BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.

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