Objective:To explore the psychological vulnerability characteristics of patients after percutaneous coronary intervention (PCI) based on symptom network analysis, and to provide evidence for maintining their psychological health.Methods:Using a cross-sectional survey method, from October 2023 to March 2024, a convenience sampling approach was employed to conduct a questionnaire survey among patients who underwent percutaneous coronary intervention (PCI) in the general ward of the Cardiology Department at Peking University Third Hospital. The survey involved a general information questionnaire and Mental Vulnerability Questionnaire. The R language was used to construct a symptom network to describe the relationship between each symptom of patients′psychological vulnerability, and its centrality index was calculated.Results:A total of 260 post-PCI patients were enrolled, including191 males and 69 females, with a mean age of (62.38 ± 12.91) years and a total psychological vulnerability score of (47.25 ± 13.18). Multiple linear regression analysis showed that the level of mental vulnerability was higher in patients with female gender ( β = 0.207, P = 0.001) and higher number of comorbidities/past history ( β = 0.126, P = 0.039). In the symptom network analysis, the symptoms with the highest node strength, tight centrality, and mediator centrality were "You often feeling unwell" ( rs = 1.25, rc = 0.003 45, rb = 2.61), "You always in a bad mood" ( rs = 1.15) and "You often have anxiety attacks" ( rs = 1.13) were second only to "You often feeling unwell" in the center of intensity. Conclusions:The core symptom of psychological vulnerability in post-PCI patients is "You often feeling unwell", and mental symptoms are in a more central position. Nursing staff should take mental symptoms as the target of intervention, and strengthen the holistic care for patients′physical-psychological-mental symptoms, so as to effectively reduce the level of psychological vulnerability of the patients, and to maintain their psychological health.

Objective:To analyze the relationship between blood urea nitrogen (BUN)/albumin (ALB) ratio (B/A) and prognosis of patients undergoing percutaneous coronary intervention (PCI) guided by ultrasound before operation.Methods:A total of 116 patients who underwent PCI under the guidance of intra-coronary ultrasound in Xianyang Central Hospital from February 2020 to December 2022 were retrospectively selected as the observation group, and 120 healthy people in the same period were selected as the control group. All patients were followed up for 1 year after surgery, and 116 patients were divided into poor prognosis group ( n=33) and good prognosis group ( n=83), taking major adverse cardiovascular events (MACE) as the end point during follow-up. The levels of BUN and ALB in peripheral blood of all subjects were detected after admission, and B/A was calculated. The basic data, biochemical indexes and B/A of each group were analyzed and compared. The predictive value of preoperative BUN, ALB and B/A on postoperative MACE in patients with PCI guided by intra-coronary ultrasound was analyzed by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was used to evaluate the related influencing factors of postoperative MACE in patients with PCI guided by intra-coronary ultrasound. Results:The left ventricular end-diastolic inner diameter (LVEDD), N-terminal B-type natriuretic peptide (NT-proBNP), creatine kinase isoenzyme (CK-MB), BUN and B/A in the observation group were higher than those in the control group, and left ventricular ejection fraction (LVEF) and ALB were lower than those in the control group (all P<0.05). NT-proBNP, CK-MB, BUN and B/A in the poor prognosis group were higher than those in the good prognosis group, and LVEF and ALB were lower than those in the good prognosis group (all P<0.05). ROC curve results showed that the AUC of peripheral blood BUN, ALB and B/A predicting postoperative MACE in patients with PCI guided by intra-coronary ultrasound were 0.833(95% CI: 0.783-0.883), 0.859(95% CI: 0.809-0.909) and 0.922(95% CI: 0.872-0.972). Multivariate logistic regression analysis showed that LVEF [ OR(95% CI)=1.952(1.317-2.895)], NT-proBNP [ OR(95% CI)=2.625(1.643-4.193)], BUN [ OR(95% CI)=3.353(1.922-5.851)], ALB [ OR(95% CI)=3.792(2.049-7.018)] and B/A [ OR(95% CI)=3.277(2.000-5.370)] were all the influencing factors of postoperative MACE in patients undergoing PCI guided by intra-coronary ultrasound ( P<0.05). Conclusions:The level of B/A in patients with PCI guided by intra-coronary ultrasound increased before surgery, and the high level of B/A is a risk factor for postoperative MACE, which can be used as a biological index to evaluate the postoperative MACE in patients with PCI guided by intra-coronary ultrasound.

Objective:To analyze the relationship between blood urea nitrogen (BUN)/albumin (ALB) ratio (B/A) and prognosis of patients undergoing percutaneous coronary intervention (PCI) guided by ultrasound before operation.Methods:A total of 116 patients who underwent PCI under the guidance of intra-coronary ultrasound in Xianyang Central Hospital from February 2020 to December 2022 were retrospectively selected as the observation group, and 120 healthy people in the same period were selected as the control group. All patients were followed up for 1 year after surgery, and 116 patients were divided into poor prognosis group ( n=33) and good prognosis group ( n=83), taking major adverse cardiovascular events (MACE) as the end point during follow-up. The levels of BUN and ALB in peripheral blood of all subjects were detected after admission, and B/A was calculated. The basic data, biochemical indexes and B/A of each group were analyzed and compared. The predictive value of preoperative BUN, ALB and B/A on postoperative MACE in patients with PCI guided by intra-coronary ultrasound was analyzed by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was used to evaluate the related influencing factors of postoperative MACE in patients with PCI guided by intra-coronary ultrasound. Results:The left ventricular end-diastolic inner diameter (LVEDD), N-terminal B-type natriuretic peptide (NT-proBNP), creatine kinase isoenzyme (CK-MB), BUN and B/A in the observation group were higher than those in the control group, and left ventricular ejection fraction (LVEF) and ALB were lower than those in the control group (all P<0.05). NT-proBNP, CK-MB, BUN and B/A in the poor prognosis group were higher than those in the good prognosis group, and LVEF and ALB were lower than those in the good prognosis group (all P<0.05). ROC curve results showed that the AUC of peripheral blood BUN, ALB and B/A predicting postoperative MACE in patients with PCI guided by intra-coronary ultrasound were 0.833(95% CI: 0.783-0.883), 0.859(95% CI: 0.809-0.909) and 0.922(95% CI: 0.872-0.972). Multivariate logistic regression analysis showed that LVEF [ OR(95% CI)=1.952(1.317-2.895)], NT-proBNP [ OR(95% CI)=2.625(1.643-4.193)], BUN [ OR(95% CI)=3.353(1.922-5.851)], ALB [ OR(95% CI)=3.792(2.049-7.018)] and B/A [ OR(95% CI)=3.277(2.000-5.370)] were all the influencing factors of postoperative MACE in patients undergoing PCI guided by intra-coronary ultrasound ( P<0.05). Conclusions:The level of B/A in patients with PCI guided by intra-coronary ultrasound increased before surgery, and the high level of B/A is a risk factor for postoperative MACE, which can be used as a biological index to evaluate the postoperative MACE in patients with PCI guided by intra-coronary ultrasound.

Objective:To explore the psychological vulnerability characteristics of patients after percutaneous coronary intervention (PCI) based on symptom network analysis, and to provide evidence for maintining their psychological health.Methods:Using a cross-sectional survey method, from October 2023 to March 2024, a convenience sampling approach was employed to conduct a questionnaire survey among patients who underwent percutaneous coronary intervention (PCI) in the general ward of the Cardiology Department at Peking University Third Hospital. The survey involved a general information questionnaire and Mental Vulnerability Questionnaire. The R language was used to construct a symptom network to describe the relationship between each symptom of patients′psychological vulnerability, and its centrality index was calculated.Results:A total of 260 post-PCI patients were enrolled, including191 males and 69 females, with a mean age of (62.38 ± 12.91) years and a total psychological vulnerability score of (47.25 ± 13.18). Multiple linear regression analysis showed that the level of mental vulnerability was higher in patients with female gender ( β = 0.207, P = 0.001) and higher number of comorbidities/past history ( β = 0.126, P = 0.039). In the symptom network analysis, the symptoms with the highest node strength, tight centrality, and mediator centrality were "You often feeling unwell" ( rs = 1.25, rc = 0.003 45, rb = 2.61), "You always in a bad mood" ( rs = 1.15) and "You often have anxiety attacks" ( rs = 1.13) were second only to "You often feeling unwell" in the center of intensity. Conclusions:The core symptom of psychological vulnerability in post-PCI patients is "You often feeling unwell", and mental symptoms are in a more central position. Nursing staff should take mental symptoms as the target of intervention, and strengthen the holistic care for patients′physical-psychological-mental symptoms, so as to effectively reduce the level of psychological vulnerability of the patients, and to maintain their psychological health.

Objective:To evaluate and summary the relevant evidence of emergency target blood pressure management in acute aortic dissection, so as to provide guidance for the evidence-based practice of emergency target blood pressure management.Methods:According to the "6S" evidence pyramid model, the evidence about emergency target blood pressure management of acute aortic dissection in various databases and professional association websites at home and abroad was retrieved, including clinical decision, guidelines, expert consensus, systematic evaluation, randomized controlled trial, cohort study, case series, etc. Two researchers used corresponding literature quality evaluation tools to evaluate the quality of the included literature, extracted and summarized the evidence of the literature above grade B.Results:A total of 22 articles were included in this study, including 6 clinical decisions, 5 guidelines, 7 expert consensus, 1 systematic evaluation, 1 randomized controlled trial, 1 cohort study and 1 case series, forming 37 best evidences, including 9 topics such as target value setting, management strategies, disease observation, medical history collection, monitoring methods, vasoactive drugs, non vasoactive drugs, auxiliary examination, health education.Conclusions:The summarized best evidence provides a reference for emergency medical staff to manage the emergency target blood pressure of acute aortic dissection. It is recommended that emergency medical staff follow the summarized best evidence to formulate an individualized target blood pressure management scheme for patients.

Objective To explore the safety of salbutamol and doxofylline treatments with different orders.Methods The subjects were inpatients who need to be treated with salbutamol and doxofylline in Department of Respiratory and Critical Care Medicine Ward,Beijing Hospital during September 2012 to December 2014.Firstly,the nurses were divided into A,B,and C groups and the admitted patients in accordance with inclusion criteria were entered into the on-duty nurses' group.The patients in the group A received intravenous injection of doxofylline after salbutamol inhalation,the patients in the group B received salbutamol inhalation and intravenous injection of doxofylline at the same time,and the patients in the group C received salbutamol inhalation after intravenous injection of doxofylline (a total of 1 to 2 treatment cycles,the treatment was stopped if adverse reactions occurred).The adverse reactions in the 3 groups were observed.Results Each group comprised 100 patients.There were 63 males in the group A and average age was (71 ±13) years;58 males in the group B and average age was (71 ± 12) years;64 males in the group C and average age was (73 ± 12) years.The diseases in patients in the 3 groups included chronic obstructive pulmonary disease,pneumonia,lung cancer,lung infection,bronchiectasis,and bronchial asthma,etc.The differences of age,gender distribution,and percentages of different diseases among the three groups were not statistically significant (all P ＞ 0.05).Totally 24 cases of adverse reactions appeared in 16 patients in the 3 groups,including 12 cases of palpitations,10 cases of shortness of breath,and 1 case of finger tremor.The incidence of adverse reactions in the 3 groups were 2％ (2/100),10％ (10/100),and 5％ (5/100),respectively.The difference between the group A and the group B was statistically significant (P =0.045).Conclusions Salbutamol inhalation and intravenous injection of doxofylline with different order had an marked impact on medication safety.The incidence of adverse reactions was the lowest when the patients were given intravenous injection of doxofylline after salbutamol inhalation.

Objective To explore the safety of salbutamol and doxofylline treatments with different orders.Methods The subjects were inpatients who need to be treated with salbutamol and doxofylline in Department of Respiratory and Critical Care Medicine Ward,Beijing Hospital during September 2012 to December 2014.Firstly,the nurses were divided into A,B,and C groups and the admitted patients in accordance with inclusion criteria were entered into the on-duty nurses' group.The patients in the group A received intravenous injection of doxofylline after salbutamol inhalation,the patients in the group B received salbutamol inhalation and intravenous injection of doxofylline at the same time,and the patients in the group C received salbutamol inhalation after intravenous injection of doxofylline (a total of 1 to 2 treatment cycles,the treatment was stopped if adverse reactions occurred).The adverse reactions in the 3 groups were observed.Results Each group comprised 100 patients.There were 63 males in the group A and average age was (71 ±13) years;58 males in the group B and average age was (71 ± 12) years;64 males in the group C and average age was (73 ± 12) years.The diseases in patients in the 3 groups included chronic obstructive pulmonary disease,pneumonia,lung cancer,lung infection,bronchiectasis,and bronchial asthma,etc.The differences of age,gender distribution,and percentages of different diseases among the three groups were not statistically significant (all P ＞ 0.05).Totally 24 cases of adverse reactions appeared in 16 patients in the 3 groups,including 12 cases of palpitations,10 cases of shortness of breath,and 1 case of finger tremor.The incidence of adverse reactions in the 3 groups were 2％ (2/100),10％ (10/100),and 5％ (5/100),respectively.The difference between the group A and the group B was statistically significant (P =0.045).Conclusions Salbutamol inhalation and intravenous injection of doxofylline with different order had an marked impact on medication safety.The incidence of adverse reactions was the lowest when the patients were given intravenous injection of doxofylline after salbutamol inhalation.

The human Gadd45 protein family plays critical roles in DNA repair, negative growth control, genomic stability, cell cycle checkpoints and apoptosis. Here we report the crystal structure of human Gadd45γ [corrected], revealing a unique dimer formed via a bundle of four parallel helices, involving the most conserved residues among the Gadd45 isoforms. Mutational analysis of human Gadd45γ [corrected] identified a conserved, highly acidic patch in the central region of the dimer for interaction with the proliferating cell nuclear antigen (PCNA), p21 and cdc2, suggesting that the parallel dimer is the active form for the interaction. Cellular assays indicate that: (1) dimerization of Gadd45γ [corrected] is necessary for apoptosis as well as growth inhibition, and that cell growth inhibition is caused by both cell cycle arrest and apoptosis; (2) a conserved and highly acidic patch on the dimer surface, including the important residues Glu87 and Asp89, is a putative interface for binding proteins related to the cell cycle, DNA repair and apoptosis. These results reveal the mechanism of self-association by Gadd45 proteins and the importance of this self-association for their biological function.
Amino Acid Motifs ; Animals ; Apoptosis ; radiation effects ; CDC2 Protein Kinase ; Cell Cycle ; Cell Survival ; Crystallography, X-Ray ; Cyclin B ; metabolism ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Cyclin-Dependent Kinases ; HeLa Cells ; Humans ; Intracellular Signaling Peptides and Proteins ; chemistry ; genetics ; metabolism ; Mice ; Mutagenesis, Site-Directed ; Mutation, Missense ; Proliferating Cell Nuclear Antigen ; metabolism ; Protein Binding ; Protein Interaction Domains and Motifs ; Protein Multimerization ; Protein Structure, Quaternary ; Ultraviolet Rays

Objective To know the influence of preoperative respiratory function exercise on the postoperative pulmonary function among patients with lung cancer. Methods Divided 80 patients with lung cancer into the observation group and the control group, there were 40 cases in the each group. Routine perioperative nursing cares was used in the control group, while a two weeks respiratory function exercise was used in the observation group. Compared the incidence rate of complications be-tween the two groups after the intervention, some indexes which can indicate the respiratory function were compared before and after the exercise in the observation group. Results The indexes such as PaO_2, SpO_2, MVV, TCL and FEV in the observation group after the respiratory function exercise were better than before significantly. The incidence rate of complications in the control group was more than in the observa-tion group. Conclusions Strengthen respiratory function exercise can effective improve the respiratory func-tion for patients with lung cancer when cured by thoractomy, which can promote patients' compliance, and then avoid certain postoperative complications.