1.Construction of nutrition management plan for chronic kidney disease patients based on nutritional care procedure and model
Xueqi TIAN ; Zhenxiang LI ; Yan KONG ; Kejing ZONG ; Yanzheng LIU ; Jing ZHANG
Chinese Journal of Modern Nursing 2024;30(15):2008-2014
Objective:To build a systematic and standardized nutrition management plan for patients with chronic kidney disease.Methods:Based on the nutrition care procedure and model, a preliminary draft of a nutrition management plan for chronic kidney disease patients was developed through a literature search, quality evaluation, and group discussions. After two rounds of expert consultation and revision of the preliminary draft of the nutrition management plan, the final plan was formed.Results:A total of 32 experts were invited to complete two rounds of consultation. In two rounds of expert consultation, 32 questionnaires were distributed, and 32 and 31 valid questionnaires were collected, with valid response rates of 100.0% and 96.9%, respectively. The expert authority coefficients were 0.853 and 0.871, respectively. The final nutrition management plan for chronic kidney disease patients included six first-level items of nutrition management personnel: nutrition risk screening, nutrition assessment, nutrition treatment, nutrition monitoring, and nutrition health education, with 23 second-level and 52 third-level items.Conclusions:The constructed nutrition management plan for chronic kidney disease patients is scientific and can provide a reference for nutrition guidance.
2.Latent profile analysis of dyadic mental health literacy among stroke patients and their caregivers
Shirui LI ; Zhenxiang ZHANG ; Wenna WANG ; Yongxia MEI ; Xiaoxuan WANG ; Zhiwei LIU
Chinese Journal of Nursing 2024;59(19):2389-2395
Objective To explore the categories of dyadic mental health literacy among stroke patients and their caregivers,and to analyze the differences in the characteristics of different classes of stroke patients and their caregivers.Methods A convenient sampling method was used to select 287 dyads of stroke patients and their caregivers who were treated at a tertiary general hospital in Henan province from July to October 2020.The general information questionnaire,Multicomponent Mental Health Literacy and Social Support Rating Scale were used for investigation.Latent profile analysis was adopted to explore the categories of dyadic mental health literacy,and multiple logistic regression was used to analyze the influencing factors of each category.Results Stroke patients and their caregivers were divided into 4 categories based on scores of mental health literacy:dyadic low resource group(19.86%),dyadic low literacy group(54.36%),dyadic low belief group(11.15%),dyadic high literacy group(14.63%).The patient's age,average monthly household income,the caregiver's age,the caregiver's Social Support Rating Scale score,the caregiver's educational level,daily care time and total time length of care were the factors influencing the categories of dyadic mental health literacy among stroke patients and their caregivers(P<0.05).Conclusion Stroke patients and their caregivers were divided into 4 categories based on scores of mental health literacy.Medical staff should carry out comprehensive psychological interventions for stroke patients and their caregivers with different dyadic mental health literacy characteristics,so as to improve dyadic mental health literacy.
3.Relationship Between the Peripheral Blood Lymphocytes and the Progress of Amyotrophic Lateral Sclerosis in Central China
Zhenxiang GONG ; Hongyan HOU ; Li BA
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2024;53(1):94-99
Objective To explore the relationship between peripheral blood lymphocytes and disease progression in patients with amyotrophic lateral sclerosis(ALS)in central China.Methods A total of 133 ALS patients diagnosed at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were evaluated for disease progression,and the includ-ed patients were divided into fast progression group and slow progression group.Peripheral blood lymphocyte subsets were de-termined and compared between the two groups.Logistic regression was used to analyze the association between the statistically different lymphocyte subgroups and the rate of disease progression.Results The proportion of CD3+CD19-T lymphocytes in the slow progression group was lower than that of the fast progression group(P<0.05).However,the NK cell count,NK cell proportion,and the proportion of CD28+helper T cells(CD28+Th cells)were higher than those of the fast progression group(all P<0.05).In the logistic regression analysis,an increase in NK cell count(OR=0.992,P<0.05)and an increase in the propor-tion of CD28+Th cells(OR=0.895,P<0.05)were protective factors for the progression of ALS.Conclusion The characteris-tics of peripheral lymphocytes differed between patients with slow and fast progression.Abnormalities in the innate immune sys-tem may be involved in the progression of ALS.
4.Role of HMGB1-TLR4-mediated NF-κB signaling in adenosine pretreatment in protection against cerebral ischemia-reperfusion injury
Zhenxiang ZHANG ; Shouyuan GAO ; Yanwei LI ; He JI ; Jun TAN
Chinese Journal of Immunology 2024;40(3):491-496
Objective:To investigate the role of HMGB1-TLR4-NF-κB signaling pathway in cerebral ischemia-reperfusion in-jury and the effect of adenosine preconditioning on the signaling pathway.Methods:Total 80 adult male Sprague-Dawley rats weighing 220~270 g were selected from the Animal Center of Xinxiang Medical University.The rats were randomly divided into F group(sham operation group),I/R group(ischemia reperfusion group)and AP group(adenosine preconditioning group).The MCAO model of rats was established by wire embolization.Quantitative analysis of neural function in successfully modeled rats using animal behavior scor-ing method,the morphological changes of brain cells were observed by HE staining,TTC staining was used to observe cerebral infarc-tion and cerebral infarction volume was calculated;Immunohistochemical staining was used to detect HMGB1,TLR4 and NF-κB pro-tein expression levels in brain tissues of each group.The data were statistically analyzed by one-way ANOVA in SPSS26.0 software.Results:After ischemia reperfusion,the neurological function of I/R group and AP group showed different degrees of impairment,and the neurological function scores of the two groups were significantly higher than that of F group,the difference was statistically signifi-cant(P<0.05),and the neurological function of the AP group was significantly less than that of I/R group,the difference was also sta-tistically significant(P<0.05).TTC staining showed that AP group,I/R group rat cerebral infarction volume was significantly more than F group[(93.670±4.509)mm3,(123.670±7.234)mm3 vs(0.000±0.000)mm3],and AP group rats infarction volume was signifi-cantly reduced than that in I/R group,the difference had statistical significance(P<0.05).Immunohistochemistry showed that HMGB1,TLR4,NF-κB protein in F group with a small amount of expressions in rats,while significantly expressed in AP group and I/R group relatively,and the AP group of each subgroup rat HMGB1,TLR4,NF-κB protein expressions significantly lower than the amount of I/R group,the difference had statistical significance(P<0.05).Conclusion:Adenosine preconditioning can reduce the expressions of HMGB1,TLR4 and NF-κB protein,and then protect the rats with cerebral ischemia-reperfusion injury.
5.The mediating effect of empathy between nursing students' personality traits and attitude towards death
Shuangrong HAN ; Qiufang LI ; Shali LIAN ; Zhenxiang ZHANG ; Lamei LIU ; Changqing SUN
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(5):442-447
Objective:To explore the mediating effect of empathy between personality traits and death attitude in nursing students.Methods:From April to May 2022, a total of 237 undergraduate nursing students were surveyed by general information questionnaire, big five inventory, Jefferson scale of empathy for nursing students, and death attitude profile-revised. Common method bias test, correlation analysis and descriptive analysis were conducted by SPSS 26.0 software.PROCESS macro program was used to test the mediating effect.Results:Agreeableness(32.78±4.92), empathy(110.03±16.83)were positively correlated with positive death attitude(57.95±12.35)( r=0.274, 0.571, both P<0.01), neuroticism(23.00±4.78)was positively correlated with negative death attitude(31.81±10.04)( r=0.199, P<0.01), empathy was negatively correlated with negative death attitude ( r=-0.226, P<0.01). Empathy partially mediated the relationship between neuroticism and negative death attitude, the mediating effect accounted for 16.08%(0.032/0.199) of the total effect, and empathy played a completely mediating role between the agreeableness and positive death attitude. Conclusion:The death attitude of undergraduate nursing students is mainly natural acceptance. Personality traits can directly affect death attitude and also indirectly affect death attitude through empathy.
6.Meta-integration of qualitative research on exercise promoting and hindering factors in patients with chronic kidney disease
Xueqi TIAN ; Zhenxiang LI ; Yan KONG ; Qi ZHANG ; Yujie LIU ; Jing LI ; Baosheng ZHAO ; Jing ZHANG
Chinese Journal of Practical Nursing 2023;39(33):2627-2634
Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.
7.Effect and mechanism of sodium cantharidate on proliferation,migration and invasion of esophageal cancer EC9706 Cells
Ning GU ; Penghui WANG ; Zhenxiang WANG ; Fengqin CUI ; Zhigang LI
Journal of Xinxiang Medical College 2023;40(12):1114-1120,1125
Objective To investigate the effect and mechanism of sodium cantharidate on the proliferation,migration and invasion of esophageal carcinoma EC9706 cells.Methods Esophageal cancer EC9706 cells were randomly divided into blank control group,low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium canthari-date group and cisplatin group.The EC9706 cells in the low-,medium-and high-dose sodium cantharidate groups were given fi-nal mass concentration of 1.0,2.5 and 5.0 mg·L-1 sodium cantharidate intervention,respectively.The EC9706 cells in the cisplatin group were treated with the final mass concentration of 140 mg·L-1 cisplatin,and the cells in the control group was cultured in Dulbecco's modified Eagle's medium.The cell proliferation rate in each group was detected by cell counting reagent-8 method,the mobility of EC9706 cells in each group was detected by scratch test,the invasion rate of EC9706 cells in each group was detected by Transwell method,and the levels of Wnt3a and β-catenin mRNA in EC9706 cells in each group were detected by real-time quantitative polymerase chain reaction method,and the levels of Wnt3a and β-catenin protein in EC9706 cells in each group were detected by Western blot.Results At 24,48 and 72 h of cultivation,the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium canthari-date group and cisplatin group was significantly lower than that in the blank control group(P<0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group and medium-dose of sodium cantharidate group was significantly higher than that in the high-dose sodium cantharidate group and cisplatin group(P<0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group was significantly higher than that in the medium-dose sodium cantharidate group(P<0.05);there was no significant difference in the proliferation rate of EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P>0.05);the proliferation rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group was significantly decreased with the extension of culture time(P<0.05).The mobility rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group were significantly lower than those in the blank control group(P<0.05);the mobility rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group and medium-dose sodium cantharidate group were significantly higher than those in the high-dose sodium cantharidate group and cisplatin group(P<0.05);the migration rate and invasion rate of EC9706 cells in the low-dose sodium cantharidate group were significantly higher than those in the medium-dose sodium cantharidate group(P<0.05);there was no significant difference in the mobility rate and invasion rate of EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P>0.05).The relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group,medium-dose sodium cantharidate group,high-dose sodium cantharidate group and cisplatin group were significantly lower than those in the blank control group(P<0.05);the relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group and medium-dose sodium cantharidate group were significantly higher than those in the high-dose sodium cantharidate group and cisplatin group(P<0.05);the relative expressions levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells in the low-dose sodium cantharidate group were significantly higher than those in the medium-dose sodium cantharidate group(P<0.05);there was no significant difference in the relative expression levels of Wnt3a and β-catenin mRNA and protein in EC9706 cells between the high-dose sodium cantharidate group and cisplatin group(P>0.05).Conclusion Sodium cantharidate can significantly inhibit the proliferation,migration and invasion of esophageal carcinoma EC9706 cells,and its mechanism may be related to the inhibition of the Wnt3a/β-catenin pathway.
8.Investigation and analysis of radiation doses to CT examinees in 11 medical institutions in Shijiazhuang, China
Peng LI ; Yuanyuan ZHANG ; Yu ZHANG ; Zhiling LIANG ; Qingguo NIU ; Hui XU ; Jing ZHOU ; Zhenxiang SHI ; Yan CHEN
Chinese Journal of Radiological Health 2023;32(3):328-334
Objective To investigate radiation doses to examinees undergoing computed tomography (CT) scanning of different body parts (the head, chest, and abdomen) in medical institutions of Shijiazhuang, China, and to provide a reference for optimizing radiation protection for examinees in medical institutions. Methods March 2021 to March 2022, eleven medical institutions of radiation monitoring in Shijiazhuang were surveyed for the basic information, scanning parameters, and dosimetric data of a total of 930 adults and children who received CT examinations. The dosimetric data of the subjects were analyzed and compared with the domestic and international diagnostic reference levels and the results of other cities in China. Results In the above hospitals, the CTDIvol(P50) of CT subjects in children's group were 17.42-50.45 mGy, 2.13-14.01 mGy and 3.58-28.20 mGy, respectively. DLP(P50) ranges from 228.87 to 966.97 mGy·cm, 33.20 to 296.03 mGy·cm, and 74.90 to 926.53 mGy·cm, respectively. In the adult group, the CTDIvol(P50) in the head, chest and abdomen of CT subjects were 37.28-54.05 mGy, 6.43-14.99 mGy and 8.28-18.75 mGy, respectively. DLP(P50) ranges from 372.81 to 630.56 mGy·cm, from 219.77 to 467.93 mGy·cm, and from 313.86 to 689.87 mGy·cm, respectively. The distribution of radiation doses in different-grade hospitals varied greatly. The abdomen dose of the children's hospital was higher than other hospitals. Especially the primary hospitals were significantly higher than the recommended diagnostic reference level (DRL). Conclusion In some secondary and primary hospitals, the setting of CT scanning parameters was simplified, not specific to the subjects’ age and body types. They should strictly comply with the principal of optimizing radiation protection to strengthen radiation dose optimization and supervision, reducing the radiation dose of examinees in future examinations .
9.Professional Quality of Life of Chinese Nurses and Its Correlation with Benefit Findings
Zhaozhao HUI ; Xin LI ; Hailu ZHU ; Zhenxiang ZHANG ; Fang LIANG ; Niuniu SUN ; Jing LI
Chinese Medical Ethics 2023;36(1):49-56
【Objective:】 To understand the current situation of nurses’ professional quality of life in China and its correlation with benefit findings, so as to provide reference for formulating targeted measures to improve nurses’ professional quality of life in China. 【Methods:】 Questionnaire star was used to conduct a cross-sectional survey of 11 924 registered nurses in China from January 2022 to April 2022 using the General Information Questionnaire, the Professional Quality of Life Scale (ProQOL) and the General Benefit Discovery Scale (GBFS). SPSS 22.0 software was used for data analysis. 【Results:】 The scores of various dimensions of nurses’ ProQOL scale were: compassion satisfaction was (32.71±6.81) points, burnout was (27.38±5.20) points, secondary traumatic stress was (28.44±6.67) points, and the total score of GBFS was (100.90±18.04) points. The results of multiple linear stepwise regression showed that the main influencing factors of compassion satisfaction were marital status, position, work unit level and educational background (P<0.05). The main influencing factors of burnout were position, professional title, work unit level and whether there were children to be taken care of at home (P<0.05). The main influencing factors of secondary traumatic stress were education background, marital status, professional title, whether there was an old person to be taken care of at home, whether to take care of COVID-19 patients, whether to be an epidemic support staff and position (P<0.05). Benefit finding independently predicted the three dimensions of nurses’ professional quality of life (P<0.001). 【Conclusions:】 Chinese nurses’ professional quality of life was at a moderate level and it was significantly affected by benefit finding. Attention should be paid to factors such as marital status, work unit level, position, professional title, education background, whether there was an old person to be taken care of at home, whether to take care of COVID-19 patients, so as to improve the level of nurses’ benefit finding, promote their personal growth, provide good job guarantee, and improve Chinese nurses’ professional quality of life.
10.Relationship of college students’ risk perception of COVID-19 and their anxiety and depression: A moderated mediation model
Yijing HOU ; Yajing LI ; Xun WANG ; Zhaozhao HUI ; Xuan WANG ; Hailu ZHU ; Mei MA ; Zhenxiang ZHANG ; Mingxu WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(2):177-184
【Objective】 To explore the effects of perceived risk of COVID-19 of college students on their anxiety and depression, as well as the roles of attention to negative information and perceived social support, so as to provide theoretical basis for colleges and universities to formulate corresponding intervention measures. 【Methods】 By the convenience sampling method, totally 1 404 college students from Shaanxi and Henan provinces were investigated online by using General Information Questionnaire, Perceived Risk of COVID-19 Pandemic Scale, Attention to Negative Information Scale, Patient Health Questionnaire, Generalized Anxiety Disorder and Perceived Social Support Scale. SPSS 20.0 was used for data analysis, Pearson correlation method was used to explore the correlation between variables. The mediating effect of attention to negative information and the moderating effect of perceived social support were analyzed by PROCESS. 【Results】 The scores of anxiety and depression of the 1 404 college students included in the study were 4.03±4.48 and 6.21±5.41, respectively. The detection rate of anxiety symptom was 29.9%, and that of depression symptom was 44.4%. The risk perception of COVID-19 epidemic of the college students was positively correlated with attention to negative information (r=0.373, P<0.001), anxiety (r=0.227, P<0.001), and depression (r=0.226, P<0.001). Anxiety (r=0.553, P<0.001) and depression (r=0.497, P<0.001) were positively correlated with attention to negative information, while perceived social support was negatively correlated with the risk perception of the COVID-19 (r=-0.154, P<0.001), attention to negative information (r=-0.259, P<0.001), anxiety (r=-0.321, P<0.001) and depression (r=-0.278, P<0.001). The risk perception of COVID-19 affected the anxiety and depression of the students mainly through the mediating effect of attention to negative information. The total effect of risk perception of COVID-19 and anxiety was 0.227, and the mediating effect accounted for 80.18% of the total effect. The total effect of risk perception of COVID-19 and depression was 0.228, and the mediating effect accounted for 90.35% of the total effect. Perceived social support played a moderating role in the last half of this mediating model. 【Conclusion】 Risk perception of COVID-19 indirectly affects the occurrence of anxiety and depression in college students through attention to negative information, and perceived social support plays a moderating role in this mediating model. The findings suggest that when a risk event occurs, colleges and universities should pay attention to guiding students to adjust their attentional bias to external information, and give students enough care and support to improve their mental health.

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