Objective To explore the current status and its influencing factors of electronic health literacy of caregivers of total laryngectomy patients and its influencing factors.Methods A total of 145 caregivers of total laryngectomy patients who were admitted to The First Affiliated Hospital of Naval Medical University from August 2018 to August 2023 were selected by convenience sampling.A questionnaire survey was conducted on these caregivers by demographic data questionnaire,electronic health literacy scale(e-HLS),and general self-efficacy scale.Results The average total score of electronic health literacy among the caregivers was 25.09±5.31.One-way analysis of variance showed that there were significant differences in the scores of e-HLS among caregivers with different age,education level,self-efficacy,frequency of online health information search,and disease course(P<0.05).Multivariate logistic regression analysis showed that age,education level,self-efficacy,frequency of online health information search,and disease course were the main factors affecting the electronic health literacy of caregivers of total laryngectomy patients.Conclusion Electronic literacy of caregivers of total laryngectomy patients is at a low level,and it was affected by many factors.Appropriate guidance can be provided to caregivers with low electronic health literacy,so as to improve the electronic health literacy of caregivers and the quality of care for total laryngectomy patients.

Objective To explore and analyze adverse drug events(ADE)signals of azithromycin,identify common adverse events and suspected adverse reactions that occur easily in the real clinical application of azithromycin.Methods The adverse drug event reports related to azithromycin recorded in the US FDA Adverse Event Reporting System database from October 1,2003,to October 1,2023,were mined using the OpenVigil 2.1 drug surveillance platform.Signal detection and analysis were carried out using the reporting odds ratio(ROR)and Bayesian confidence propagation neural network method(BCPNN).Results A total of 5498 ADE signals were identified,with a total of 112485 reports.Eventually,31,041 azithromycin-associated adverse event reports were extracted,involving 898 positive signals,27 system organ classes,mainly concentrated in respiratory system diseases,infections,gastrointestinal system diseases,and others.Additionally,some adverse reactions possibly caused by azithromycin were discovered,such as asthma,wheezing,and potential reactions like incomplete abortion.Conclusion When using azithromycin,besides paying attention to the adverse reactions listed in the drug instructions,we should also pay attention to some adverse reactions that have not been timely recorded or updated,in order to prevent the medication safety risks caused by outdated instructions,provide reasonable medication advice,and ensure the medication safety of patients.

Objective·To evaluate the relationship between body mass index(BMI)and chronic metabolic diseases.Methods·The elderly(≥60 years old)who were underwent physical examination in the Physical Examination Center of Renji Hospital,Shanghai Jiao Tong University School of Medicine from 2014 to 2021 were studied.Their results of biochemical indicators were collected.Their height,body weight,and blood pressure were measured by trained nurses.The history of chronic metabolic diseases was collected by self-reported questionnaire.Systolic blood pressure≥140 mmHg(1 mmHg=0.133 kPa),diastolic blood pressure≥90 mmHg,or self-reported hypertension history was defined as hypertension.Fasting blood glucose≥7.0 mmol/L or self-reported history of diabetes was defined as diabetes.Total cholesterol≥6.2 mmol/L,triglyceride≥2.3 mmol/L,or self-reported history of dyslipidemia was defined as dyslipidemia.The relationship between BMI and hypertension,diabetes,and dyslipidemia was evaluated by using receiver operator characteristic(ROC)curve analysis and binary logistic regression.Results·Data of 59 083 subjects were collected[30 807 men and 28 276 women,average age:(67.9±6.3)years old].The prevalence of hypertension,diabetes and dyslipidemia was 76.5%(45 219/59 083),24.1%(14 225/59 083)and 50.0%(29 544/59 083),respectively.Compared to the elderly people aged 60?74 years,those aged 75 years and above had a higher proportion of hypertension and diabetes,and a lower proportion of dyslipidemia and no metabolic abnormalities.With ROC analysis,the BMI cut-off values for hypertension,diabetes,and dyslipidemia were 24.3,23.9,and 23.9 kg/m2.The BMI cut-off values for hypertension and diabetes in elderly men were similar to those in elderly women(for hypertension:24.3 kg/m2 in elderly men vs 24.2 kg/m2 in elderly women;for diabetes:24.0 kg/m2 in elderly men vs 23.7 kg/m2 in elderly women);however,BMI cut-off value for dyslipidemia was obviously higher in elderly men than that in elderly women(24.0 kg/m2 in elderly men vs 22.5 kg/m2 in elderly women).The BMI cut-off value for chronic metabolic diseases was higher in the elderly people aged 60?74 years than that in the elderly people aged 75 years and above(24.2?24.7 kg/m2 vs 22.9?23.8 kg/m2).Conclusion·Elderly people aged 60?74 years should maintain the BMI below 24.0 kg/m2,while those aged 75 years and above should aim for the BMI below 23.0 kg/m2,so as to reduce the risk of chronic metabolic diseases.

Objective:To explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder (ADHD).Methods:A case-control study was used, from May 2021 to August 2023, patients diagnosed with attention deficit hyperactivity disorder (ADHD) were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), and the development levels of total language, receptive, expressive, semantics and syntax of the two groups were compared by independent sample t-test. The influential factors of language lag in children with ADHD were analyzed by univariate χ2 analysis and multiple logistic regression. Results:There were 272 children with ADHD, including 206 males and 66 females, with an age range of 6-8 (7.29±1.17) years. While in the control group, there were 117 healthy children, including 91 males and 26 females, with an age range of 6-8 (7.02±0.82) years. The average scores of total language, expressive and syntax of ADHD children were lower than those of healthy children [(92.73±12.47/96.36±11.04), t=-2.857, P<0.05; (84.49±13.24/87.78±15.25), t=-2.029, P<0.05; (87.93±10.26/90.27±11.05), t=2.022, P<0.05]. Univariate χ2 analysis showed that disharmonious family relationship ( χ2=4.183, P<0.05), the main caregivers were non-parents ( χ2=9.121, P<0.05), early screen exposure ( χ2=3.889, P<0.05), ADHD family history ( χ2=5.423, P<0.05) were influential factors of language development lag in ADHD children. The results of multivariate logistic regression model analysis showed that cesarean section ( OR=2.137, 95% CI: 1.078-4.379, P=0.030), disharmonious family relationship ( OR=2.659, 95% CI: 1.178-5.999, P=0.019), early screen exposure ( OR=3.556, 95% CI: 1.127-11.213, P=0.030), ADHD family history ( OR=1.959, 95% CI: 1.058-3.630, P=0.033) were risk factors for comorbidities of language development in children with ADHD. Conclusion:The total language ability, expressive and syntax scores of ADHD children lag behind those of healthy children. The delayed language development of ADHD children is related to delivery mode, family relationship, the main caregivers, early screen exposure, family history of ADHD.

Objective:To explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder (ADHD).Methods:A case-control study was used, from May 2021 to August 2023, patients diagnosed with attention deficit hyperactivity disorder (ADHD) were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), and the development levels of total language, receptive, expressive, semantics and syntax of the two groups were compared by independent sample t-test. The influential factors of language lag in children with ADHD were analyzed by univariate χ2 analysis and multiple logistic regression. Results:There were 272 children with ADHD, including 206 males and 66 females, with an age range of 6-8 (7.29±1.17) years. While in the control group, there were 117 healthy children, including 91 males and 26 females, with an age range of 6-8 (7.02±0.82) years. The average scores of total language, expressive and syntax of ADHD children were lower than those of healthy children [(92.73±12.47/96.36±11.04), t=-2.857, P<0.05; (84.49±13.24/87.78±15.25), t=-2.029, P<0.05; (87.93±10.26/90.27±11.05), t=2.022, P<0.05]. Univariate χ2 analysis showed that disharmonious family relationship ( χ2=4.183, P<0.05), the main caregivers were non-parents ( χ2=9.121, P<0.05), early screen exposure ( χ2=3.889, P<0.05), ADHD family history ( χ2=5.423, P<0.05) were influential factors of language development lag in ADHD children. The results of multivariate logistic regression model analysis showed that cesarean section ( OR=2.137, 95% CI: 1.078-4.379, P=0.030), disharmonious family relationship ( OR=2.659, 95% CI: 1.178-5.999, P=0.019), early screen exposure ( OR=3.556, 95% CI: 1.127-11.213, P=0.030), ADHD family history ( OR=1.959, 95% CI: 1.058-3.630, P=0.033) were risk factors for comorbidities of language development in children with ADHD. Conclusion:The total language ability, expressive and syntax scores of ADHD children lag behind those of healthy children. The delayed language development of ADHD children is related to delivery mode, family relationship, the main caregivers, early screen exposure, family history of ADHD.

Objective·To explore the effect of online courses combined with the teach-back method among patients with laryngectomy and their family caregivers.Methods·Convenience sampling was used to select patients with laryngectomy treated in the Department of Otolaryngology,Shanghai Changhai Hospital from July 2022 to June 2023 and their family caregivers.The participants were divided into a control group and an observation group using the random number table method.The intervention was conducted in two different wards.General information of the two groups of patients and caregivers was collected.After admission,the control group watched offline videos recorded by the department.The videos introduced laryngocarcinoma-related knowledge and standard procedures of airway stoma care,suctioning,nasal feeding,etc.,which were divided into 4 sessions with 30 min each.The patients watched one session per week.The observation group watched the same videos(8 lessons)online on their own after admission,while the nursing staff used the teach-back method for health education,consolidating 2 lessons once a week,45 min/session for 4 weeks.The effectiveness of the intervention was evaluated by using Caregiver Preparedness Scale(CPS),Family Caregiver Task Inventory(FCTI),and Chinese Quality of Life Instruments for Cancer Patients-Head and Neck Cancer(QLICP-HN)at baseline(1st week),before discharge(4th week),and one month after discharge(8th week),as well as the incidence of adverse events during home care.Results·The study included a total of 120 pairs of patients and caregivers,with 60 pairs in each group.Five pairs in each group were excluded due to various reasons,leaving a total of 55 pairs in each group.There were no statistically significant differences between the two groups in terms of general information of the patients and the caregivers,QLICP-HN scores of the patients,and CPS and FCTI scores of the caregivers at baseline(P＞0.05).Before discharge and 1 month after discharge,the CPS scores of the caregivers and the QLICP-HN scores of the patients in the observation group were significantly higher than those in the control group,and the FCTI scores were significantly lower(lower scores indicating better nursing care),with statistically significant differences(P＜0.05).Within 1 month after discharge,the incidence of adverse home care events in the observation group was lower than that in the control group(5.5%vs 29.1%),and the difference was statistically significant(P＜0.05).Conclusion·The online courses combined with the teach-back method help improve the readiness to care and caregiving competence of family caregivers of post-laryngectomy patients,improve patients'quality of life,and reduce the incidence of adverse events during home care.

Objective To explore the effect of 5A nursing model combined with empowerment health education in the perioperative period of laryngeal cancer.Methods Eighty patients with laryngeal cancer admitted to Department of Otolaryngology of The First Affiliated Hospital of Naval Medical University from January 2021 to December 2022 were selected as study subjects.Forty patients admitted between January and December 2021 were assigned to control group,and 40 patients admitted between January and December 2022 were divided into observation group.The patients of both groups received unified surgical treatment.During perioperative period,the control group received routine nursing intervention,and the observation group was given 5A nursing model combined with empowerment health education on the basis of routine nursing.Self-care ability,psychological resilience,compliance rate,complication rate,and quality of life scores were compared between the two groups.The patients of both groups were intervened until 3 months after surgery.Results After 3-month intervention,the exercise of self-care agency(ESCA)scores of the observation group in the terms of self-care skills,self-responsibility,self-concept,and health knowledge were higher than those of the control group(P＜0.05).After intervention,the scores of the Connor-Davidson Resilience Scale(CD-RISC)of the observation group in the terms of resilience,self-reliance,and optimism,were higher than those in the control group(P＜0.05).After intervention,the rates of compliance behaviors in the observation group,including taking medication on time,taking regular rest,quitting smoking and alcohol,eating reasonably,exercising moderately,and taking regular reexaminations,were higher than those in the control group(P＜0.05).After intervention,the incidence of complications in the observation group was 7.50%(3/40),which was significantly lower than that in the control group(25.00%[10/40],P＜0.05).After intervention,the scores of the generic quality of life inventory-74(GQOL-74)of the observation group in the terms of physical function,psychological function,social function,and material life status were higher than those in the control group(P＜0.05).Conclusion 5A nursing model combined with empowerment health education used in the perioperative period has a good effect in patients with laryngeal cancer,which can enhance patient's self-care ability,improve psychological resilience and compliance behaviors,reduce the postoperative complications,and improve quality of life.

Objective:To observe the efficacy and safety of ultra photon intense pulsed light combined with hydroquinone cream for the treatment of chloasma.Methods:From January 2020 to October 2022, a total of 30 patients with chloasma treated in the Department of Dermatology, Huazhong University of Science and Technology Union Shenzhen Hospital, ranged from 28 to 54 years old with an average age of 39 years, were randomly divided into three groups with 10 patients in each group: combined treatment group was treated with ultra photon intense pulsed light combined with hydroquinone cream; ultra photon intense pulsed light group was treated with ultra photon intense pulsed light alone; hydroquinone group was treated with hydroquinone cream alone. The efficacy and safety of the three groups were compared after four months of treatment.Results:After the treatment, 10 cases were effective in the combined treatment group, 5 cases were effective in the ultra photon intense pulsed light group and 2 cases were effective in the hydroquinone group. The total effective rate of the combined treatment group was significantly better than that of the ultra photon intense pulsed light group and the hydroquinone group, with statistical significance ( P<0.05). The average melasma area severity index score of the three groups after treatment was significantly decreased compared with that before treatment respectively ( P<0.05), and the average melasma area severity index score of the combined treatment group after treatment was significantly lower than that of hydroquinone group, with statistical significance ( P<0.05). No serious adverse reactions were observed in all the patients. Conclusions:Ultra photon intense pulsed light and hydroquinone cream can improve chloasma alone, but ultra photon intense pulsed light combined with hydroquinone cream has better therapeutic effect.

ObjectiveTo explore the relationship between the intestinal flora and the impairment of liver and kidney in HIV-infected men who have heterosexual sex with healthy women. MethodsFecal samples from 41 HIV-infected heterosexual men who have sex with women （PMSW） and 43 age- and BMI-matched healthy heterosexual men who have sex with women （NMSW） were collected and subjected to 16S rDNA sequencing. The blood levels of AST， ALT， TBIL， UREA， Cr， UA， β2-MG and other liver and kidney function indicators were measured. Bioinformatics methods were used to analyze the characteristics of the intestinal flora of the patients in these two groups， to compare the differential bacteria strains， and to analyze their correlation with liver and kidney function indicators. ResultsIn comparison with NMSW， the alpha diversity of intestinal flora was decreased in PMSW， and the beta diversity analysis showed significant differences in flora characteristics between the two groups （P<0.05）. The abundance of Clostridium， Phylum thick-walled， Trichosporon， and Clostridium tumefaciens decreased but Fusobacteriota increased （LDA score >4）. The comparison of liver and kidney function indexes revealed that AST， β2-MG levels were higher in PMSW than in NMSW， while TBIL was lower in PMSW than in NMSW. The number of patients with abnormal β2-MG was much higher in PMSW than in NMSW， and the difference was statistically significant （P<0.001）. It was also found that AST was negatively correlated with Clostridium （P<0.05）； TBIL was negatively correlated with Clostridium and positively correlated with Phylum thick-walled and Trichosporon （P<0.05）. β2-MG was negatively correlated with Phylum thick-walled， Clostridium， Trichosporon and Rumenococcus （P<0.05） and positively correlated with Clostridium （P<0.05）. ConclusionIn PMSW group， the alpha diversity of the flora is decreased. AST and β2-MG levels are increased， and TBIL level is decreased. These changes were significantly correlated with different strains of bacteria in the intestinal flora.

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids