OBJECTIVES: With the accelerating aging of the population and the rising prevalence of chronic diseases, the number of patients with pressure injuries (PIs) has increased markedly, prolonging the period of disease-related care. Informal caregivers play a critical role in the daily care of patients with pressure injuries, and their care burden has become increasingly prominent. This study aims to investigate the current status and influencing factors of care burden among informal caregivers of patients with PIs, providing evidence for targeted intervention strategies. METHODS: A total of 170 informal caregivers of patients with PIs were selected by convenience sampling from the Third Xiangya Hospital of Central South University. General demographic and clinical data of both patients and caregivers were collected. The Zarit Caregiver Burden Inventory (ZBI), Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, General Self-Efficacy Scale (GSES), and Family Caregiver Task Inventory (FCTI) were used to assess caregiving burden, knowledge-attitude-practice level, self-efficacy, and caregiving ability, respectively. Pearson correlation analysis was conducted to evaluate relationships among ZBI, Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, GSES, and FCTI scores. Stepwise multiple linear regression analysis was used to identify factors influencing caregiving. RESULTS: Among the 170 patients with pressure injuries, the age was (65.52±15.88) years; 118 (69.41%) were male and 52 (30.59%) were female. The duration of PIs was less than 1 month in 108 (63.53%) cases and 1 to 6 months in 40 cases (23.53%). Stage II injuries were predominant (135 cases, 79.41%). A total of 193 pressure injury sites were recorded, most commonly located at the sacrococcygeal region (127 sites, 65.80%), followed by the head (3 sites, 1.55%), shoulder and back (9 sites, 4.66%), feet (24 sites, 12.44%), and other regions (30 sites, 15.55%). Informal caregivers were 48.82% aged 46 to 59 years, 54.71% female, 41.77% primarily spouses and 47.06% children of the patients, and 77.06% lived with the patients. Caregivers who received assistance from others or had higher family per-capita monthly income reported significantly lower caregiver burden scores than those without assistance or with lower income (all P<0.001). The total ZBI score was 50.89±14.95, indicating a moderate burden. The total scores of the Knowledge-Attitude-Practice Scale for Informal Caregivers, GSES, and FCTI were 50.61±7.22, 26.03±7.11, and 14.76±8.70, respectively. Pearson correlation analysis revealed that ZBI scores were correlated with scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs (r=-0.543, P<0.001), GSES scores (r=-0.545, P<0.001), and FCTI scores (r=0.800, P<0.001). The scores on Knowledge-Attitude-Practice Scale for Informal Caregivers of patients with PIs were correlated with GSES scores (r=0.500, P<0.001) and FCTI scores (r=-0.461, P<0.001); GSES scores was negatively correlated with FCTI scores (r=-0.415, P<0.001). Stepwise multiple linear regression analysis showed that assistance availability, family per-capita monthly income, total scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, total GSES score, and total FCTI score were the main influencing factors of caregiver burden, jointly explaining 79.38% of its variance. CONCLUSIONS The main factors influencing the caregiving burden of informal caregivers of patients with PIs include the availability of assistance, family per-capita monthly income, total score on the Knowledge-Attitude-Practice Scale for Informal Caregivers of PI patients, total score on the GSES, and total score on the FCTI. Developing targeted intervention strategies addressing these factors may help alleviate the caregiving burden among informal caregivers of patients with PIs.
Humans ; Caregivers/psychology* ; Pressure Ulcer/nursing* ; Female ; Male ; Middle Aged ; Cost of Illness ; Adult ; Aged ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice ; Self Efficacy ; Caregiver Burden ; China

Objective:To analyze the effects of different psychological interventions on cancer patients' fear of cancer recurrence(FCR).Methods:Randomized controlled trials examining the effects of various psychological interventions on FCR among cancer patients were searched for in both Chinese and English literature databases.A network meta-analysis was conducted to explore the intervention effects,utilizing standardized mean difference(SMD),95％confidence interval(CI),and surface under the cumulative ranking(SUCRA)of FCR as the effect indicators.Results:A total of 34 studies involving 3 772 participants were included,of which five types of psycho-logical interventions were evaluated,namely acceptance and commitment therapy(ACT),gratitude-expansion thera-py(GET),cognitive behavioral therapy(CBT),mindfulness therapy(MT),and multi-component psychological in-tervention(Mul).According to the time of effect evaluation,three effect evaluation timing were confirmed,with immediate post-intervention group,1-2 months post-intervention group,and 3-6 months post-intervention group identified.Compared with conventional care,in the immediate post-intervention group,ACT(SMD=-1.80,95％CI:-2.47--1.13),GET(SMD=-1.33,95％CI:-2.07--0.59),MT(SMD=-0.59,95％CI:-1.03--0.14)and CBT(SMD=-0.54,95％CI:-0.93--0.15)could effectively reduce FCR,and the SUCRA val-ue of ACT was upmost to 0.96.In the 1-2 months post-intervention group,GET(SMD=-2.32,95％CI:-2.99--1.65)and ACT(SMD=-1.46,95％CI:-2.23--0.70)could effectively reduce FCR,and the SUCRA value of GET was upmost to 0.99.In the 3-6 months post-intervention group,Mul(SMD=-1.82,95％CI:-3.03--0.61)and MT(SMD=-1.43,95％CI:-2.33--0.54)could effectively reduce FCR,and the SU-CRA value of Mul was upmost to 0.90.Conclusion:Different psychological interventions vary in their effectiveness on FCR across effect evaluation time points,highlighting the need for tailored approaches on mitigating FCR in clin-ical practice.

Objective To compare the effects of Tripterygium wilfordii polyglycosides,cyclophosphamide,and cisplatin on the establishment of a mouse model of diminished ovarian reserve(DOR).Methods Mice were randomly divided into the following treatment groups:control(Ctrl),Tripterygium wilfordii polyglycosides(TWP),cyclophosphamide(CTX),and cisplatin(DDP).Mice in the TWP group received a 50 mg/kg suspension of Tripterygium wilfordii polyglycosides by gavage for 14 days,mice in the CTX group received a 20 mg/kg cyclophosphamide suspension by intraperitoneal injection for 14 days,and mice in the DDP group received a 1.5 mg/kg cisplatin solution by intraperitoneal injection for 14 days.The body weight,uterine index,and ovarian index were recorded,the estrous cycle was monitored using the vaginal smear method,and the levels of anti-Mullerian hormone(AMH),estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH)were detected using ELISA.Hematoxylin and eosin staining was used to detect ovarian follicle development.The rates of oocyte maturation and fertility were analyzed.Results The three treatment groups of mice all showed the following:significantly decreased body weight and ovarian index(P＜0.05);apparent disorder of the estrous cycle;significantly decreased levels of AMH and E2(P＜0.05);decreased and increased rates of developing follicles and atretic follicles,respectively(P＜0.05);and significantly decreased rates of oocyte maturation,pregnancy,and live birth(P＜0.05).Conclusions DOR mouse models were successfully constructed using Tripterygium wilfordii polyglycosides,cyclophosphamide,or cisplatin,as evidenced by decreased body weight and ovarian index,disordered estrous cycle and hormones,and DOR function,resulting in reduced rates of oocyte maturation,pregnancy,and total number of live births.These DOR effects were most appropriate in the cyclophosphamide group.

Objective:To analyze the effects of different psychological interventions on cancer patients' fear of cancer recurrence(FCR).Methods:Randomized controlled trials examining the effects of various psychological interventions on FCR among cancer patients were searched for in both Chinese and English literature databases.A network meta-analysis was conducted to explore the intervention effects,utilizing standardized mean difference(SMD),95％confidence interval(CI),and surface under the cumulative ranking(SUCRA)of FCR as the effect indicators.Results:A total of 34 studies involving 3 772 participants were included,of which five types of psycho-logical interventions were evaluated,namely acceptance and commitment therapy(ACT),gratitude-expansion thera-py(GET),cognitive behavioral therapy(CBT),mindfulness therapy(MT),and multi-component psychological in-tervention(Mul).According to the time of effect evaluation,three effect evaluation timing were confirmed,with immediate post-intervention group,1-2 months post-intervention group,and 3-6 months post-intervention group identified.Compared with conventional care,in the immediate post-intervention group,ACT(SMD=-1.80,95％CI:-2.47--1.13),GET(SMD=-1.33,95％CI:-2.07--0.59),MT(SMD=-0.59,95％CI:-1.03--0.14)and CBT(SMD=-0.54,95％CI:-0.93--0.15)could effectively reduce FCR,and the SUCRA val-ue of ACT was upmost to 0.96.In the 1-2 months post-intervention group,GET(SMD=-2.32,95％CI:-2.99--1.65)and ACT(SMD=-1.46,95％CI:-2.23--0.70)could effectively reduce FCR,and the SUCRA value of GET was upmost to 0.99.In the 3-6 months post-intervention group,Mul(SMD=-1.82,95％CI:-3.03--0.61)and MT(SMD=-1.43,95％CI:-2.33--0.54)could effectively reduce FCR,and the SU-CRA value of Mul was upmost to 0.90.Conclusion:Different psychological interventions vary in their effectiveness on FCR across effect evaluation time points,highlighting the need for tailored approaches on mitigating FCR in clin-ical practice.

Objective To compare the effects of Tripterygium wilfordii polyglycosides,cyclophosphamide,and cisplatin on the establishment of a mouse model of diminished ovarian reserve(DOR).Methods Mice were randomly divided into the following treatment groups:control(Ctrl),Tripterygium wilfordii polyglycosides(TWP),cyclophosphamide(CTX),and cisplatin(DDP).Mice in the TWP group received a 50 mg/kg suspension of Tripterygium wilfordii polyglycosides by gavage for 14 days,mice in the CTX group received a 20 mg/kg cyclophosphamide suspension by intraperitoneal injection for 14 days,and mice in the DDP group received a 1.5 mg/kg cisplatin solution by intraperitoneal injection for 14 days.The body weight,uterine index,and ovarian index were recorded,the estrous cycle was monitored using the vaginal smear method,and the levels of anti-Mullerian hormone(AMH),estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH)were detected using ELISA.Hematoxylin and eosin staining was used to detect ovarian follicle development.The rates of oocyte maturation and fertility were analyzed.Results The three treatment groups of mice all showed the following:significantly decreased body weight and ovarian index(P＜0.05);apparent disorder of the estrous cycle;significantly decreased levels of AMH and E2(P＜0.05);decreased and increased rates of developing follicles and atretic follicles,respectively(P＜0.05);and significantly decreased rates of oocyte maturation,pregnancy,and live birth(P＜0.05).Conclusions DOR mouse models were successfully constructed using Tripterygium wilfordii polyglycosides,cyclophosphamide,or cisplatin,as evidenced by decreased body weight and ovarian index,disordered estrous cycle and hormones,and DOR function,resulting in reduced rates of oocyte maturation,pregnancy,and total number of live births.These DOR effects were most appropriate in the cyclophosphamide group.

Objective:To analyse the clinical features of encephalitis patients with antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR).Methods:Three anti-AMPAR encephalitis patients diagnosed in Tangdu Hospital, the Air Force Military Medical University between January 2020 and May 2021 were retrospectively reviewed. The clinical symptoms, supplementary examination, treatment options and outcomes with knowledge from literature were summarized in this study.Results:Three patients aging from 12 to 70 years presented with symptoms ranging from cognitive impairment, personality change to headache and paralysis. The lung occupying lesion was pathologically proved to be small cell lung cancer in case 1. Antibody to AMPAR (AMPAR-ab) was positive in both blood and cerebrospinal fluid of case 1, with coexisting antibodies against sex-determining region of Y chromosome-related high mobility group box 1 in blood, and the symptoms persisted but did not recur following therapy with corticosteroids. AMPAR-ab was detected only in serum in case 2, with the lesion located in both frontal and temporal lobes, centrum semiovale and lateral ventricle, combined with classic imaging features of intracranial hypotension, and the syndrome was partially improved following treatment with corticosteroids. The lesions were located in the pons and middle cerebellar peduncle, accompanied by cerebellar atrophy in case 3. Spinal cord magnetic resonance imaging showed long hyperintense lesions involving the cervical and thoracic cord, extending from C 2 to Th 10 level on T 2-weighted images. AMPAR-ab was positive in both serum and cerebrospinal fluid. And the symptoms improved significantly following treatment with corticosteroids and intravenous immunoglobulin. Conclusions:The clinical manifestations of anti-AMPAR encephalitis are highly heterogeneous, and brainstem and spinal cord can also be involved in addition to the limbic system, accompanied by brain atrophy. Combining with concurrent antibodies, especially the intracellular antibodies, malignancy needs to be closely monitored; the immunotherapy is effective and the presence of tumor superimposed with multiple antibodies may be associated with poor prognosis.

Objective:To evaluate the incidence of pretransplant sarcopenia and its effect on prognosis in patients receiving hematopoietic stem cell transplantation (HSCT).Methods:Several electronic databases (PubMed, Embase, Web of Science, Cochrane Library, EBSCO, CINAHL, CBM, CNKI, VIP, WanFang data) were searched from inception to March 2022. Cohort and case-control studies on the outcomes of HSCT patients with pre-transplant sarcopenia were collected, and the quality of the studies was evaluated using the Newcastle-Ottawa Scale. After literature screening, data extraction and quality evaluation, meta-analysis was performed using RevMan 5.3.Results:9 cohort studies were included, of which 6 were of high quality and 3 were of medium quality. The total sample size was 2,255 cases, including 862 cases in the sarcopenia group. The incidence of pretransplant sarcopenia in HSCT patients was 40% (95% CI: 0.35 to 0.46). Pretransplant sarcopenia was associated with decreased overall survival rate ( HR = 1.73, 95% CI: 1.38 to 2.04, P = 0.04) and increased non-relapse mortality after transplantation ( HR = 1.84,95% CI: 1.47 to 2.32, P < 0.01). There was no significant correlation between pretransplant sarcopenia and the incidence of acute graft-versus-host disease ( OR = 1.08, 95% CI: 0.84 to 1.39, P = 0.55). Sarcopenia before transplantation had no significant effect on the duration of hospital stay ( MD = 3.57, 95% CI: -0.13 to 7.26, P = 0.06). Conclusions:Pretransplant sarcopenia was associated with reduced overall survival and increased non-relapse mortality after transplantation. More attention to pretransplant sarcopenia is needed domestically and large-scale, multi-center, prospective studies assessing early screening for sarcopenia are necessary to provide guidance about prevention and treatment strategies.