OBJECTIVE: To analyze the impact of the integrated nursing intervention on the sexual function, mental health and life quality of patients undergoing robot-assisted radical prostatectomy. METHOD: One hundred and twenty-eight patients who underwent robot-assisted radical prostatectomy at Jiangsu Cancer Hospital from May 2023 to May 2024 were included and randomly divided into control group and observation group using the method of random number table, with 64 cases in each group. The patients in control group received routine nursing care. And the integrated nursing was performed in the observation group. Perioperative indicators, scores of pre- and post-nursing sexual function assessment scale(assessed by IIEF-5), mental health scores (assessed by Medical Coping Questionnaire ［MCMQ］ and Hamilton Anxiety Scale ［HAMA］), and quality of life scores ( assessed by Generic Quality of Life Inventory-74 ［GQOLI-74］ for benign prostatic hyperplasia) between two groups of patients were compared. RESULT: The time of operation and length of stay in the observation group were lower than those in the control group (P<0.05). Before the intervention of nursing, there was no statistically significant difference in IIEF-5, MCMQ, HAMA, and GQOLI-74 score between the two groups (P>0.05). After nursing, the IIEF5 score of the observation group was significantly higher than that of the control group. The scores of MCMQ, HAMA, and GQOLI-74 were significantly improved compared to the patients in control group (all P<0.05). CONCLUSION The application of integrated nursing is conducive to sexual function, coping strategies, quality of life and prognosis of the patients received robot-assisted radical prostatectomy.
Aged ; Humans ; Male ; Middle Aged ; Prostatectomy/nursing* ; Prostatic Neoplasms/nursing* ; Quality of Life ; Robotic Surgical Procedures/nursing* ; Surveys and Questionnaires

OBJECTIVE: To assess the cardioprotective effect and impact of Qishen Granules (QSG) on different ischemic areas of the myocardium in heart failure (HF) rats by evaluating its metabolic pattern, substrate utilization, and mechanistic modulation. METHODS: In vivo, echocardiography and histology were used to assess rat cardiac function; positron emission tomography was performed to assess the abundance of glucose metabolism in the ischemic border and remote areas of the heart; fatty acid metabolism and ATP production levels were assessed by hematologic and biochemical analyses. The above experiments evaluated the cardioprotective effect of QSG on left anterior descending ligation-induced HF in rats and the mode of energy metabolism modulation. In vitro, a hypoxia-induced H9C2 model was established, mitochondrial damage was evaluated by flow cytometry, and nuclear translocation of hypoxia-inducible factor-1 α (HIF-1 α) was observed by immunofluorescence to assess the mechanism of energy metabolism regulation by QSG in hypoxic and normoxia conditions. RESULTS: QSG regulated the pattern of glucose and fatty acid metabolism in the border and remote areas of the heart via the HIF-1 α pathway, and improved cardiac function in HF rats. Specifically, QSG promoted HIF-1 α expression and entry into the nucleus at high levels of hypoxia (P<0.05), thereby promoting increased compensatory glucose metabolism; while reducing nuclear accumulation of HIF-1 α at relatively low levels of hypoxia (P<0.05), promoting the increased lipid metabolism. CONCLUSIONS QSG regulates the protein stability of HIF-1 α, thereby coordinating energy supply balance between the ischemic border and remote areas of the myocardium. This alleviates the energy metabolism disorder caused by ischemic injury.
Animals ; Myocardial Infarction/physiopathology* ; Male ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Rats, Sprague-Dawley ; Glucose/metabolism* ; Drugs, Chinese Herbal/therapeutic use* ; Energy Metabolism/drug effects* ; Rats ; Fatty Acids/metabolism* ; Myocardium/pathology*

OBJECTIVE: To explore the efficacy and safety of Juan Bi Pill (JBP) in treatment of active rheumatoid arthritis (RA). METHODS: From February 2017 to May 2018, 115 participants from 4 centers were randomly divided into JBP group (57 cases) and placebo group (58 cases) in a 1:1 ratio using a random number table method. Participants received a dose of JBP (4 g, twice a day, orally) combined with methotrexate (MTX, 10 mg per week) or placebo (4 g, twice a day, orally) combined with MTX for 12 weeks. Participants were required with follow-up visits at 24 and 48 weeks, attending 7 assessment visits. Participants were undergo disease activity assessment 7 times (at baseline and 2, 4, 8, 12, 24, 48 weeks) and safety assessments 6 times (at baseline and 4, 8, 12, 24, 48 weeks). The primary endpoint was 28-joint Disease Activity Score (DAS28-ESR and DAS28-CRP). The secondary endpoints included American College of Rheumatology (ACR) criteria for 20% and 50% improvement (ACR20/50), Health Assessment Questionnaire Disability Index (HAQ-DI), clinical disease activity index (CDAI), visual analog scale (VAS), Short Form-36 (SF-36) score, Medial Outcomes Study (MOS) sleep scale score, serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tender joint count, swollen joint count, and morning stiffness. The adverse reactions were observed during the treatment. RESULTS: After 12 weeks of treatment, DAS28-ESR and DAS28-CRP scores in both groups were lower than before treatment (both P<0.01), while the remission rate of DAS28-ESR and DAS28-CRP and low disease activity of JBP group were higher than those in the placebo group (both P<0.01). JBP demonstrated better efficacy on ACR20 and ACR50 compliance rate at 12 and 48 weeks comparing to placebo (all P<0.05). The CDAI and HAQ-DI score, pain VAS and global VAS change of RA patients and physicians, the serum ESR and CRP levels, and the number of tenderness and swelling joints were lower than before treatment at 4, 8, 12, 24, 48 weeks in both groups (P<0.05 or P<0.01), while the reduction of above indices in the JBP group was more obvious than those in the placebo group at 12 weeks (ESR and CRP, both P<0.05) or at 12 and 48 weeks (all P<0.01). There was no difference in adverse reactions between the 2 groups during treatment (P=0.75). CONCLUSION JBP combined with MTX could effectively reduce disease activity in patients with RA in active stage, reduce the symptoms of arthritis, and improve the quality of life, while ensuring safety, reliability, and fewer adverse effects. (Trial Registration: ClinicalTrials.gov, No. NCT02885597).
Humans ; Arthritis, Rheumatoid/drug therapy* ; Methotrexate/adverse effects* ; Female ; Double-Blind Method ; Male ; Middle Aged ; Treatment Outcome ; Drugs, Chinese Herbal/adverse effects* ; Drug Therapy, Combination ; Adult ; Antirheumatic Agents/adverse effects* ; Aged

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To analyze the effects of lumbar sacral plexus block combined with low-dose ketamine on intraoperative blood pressure fluctuations and heart rate variability in elderly hypertensive hip replacement patients.Methods:88 elderly patients with hypertension who underwent hip replacement in our hospital from December 2022 to June 2024 were collected and divided into two groups using the drawing method:the conventional group(44 cases)and the experimental group(44 cases).The conventional group of patients received lumbar sacral plexus block after entering the room,followed by laryngeal mask anesthesia.The experimental group received intravenous injection of 0.2 mg/kg ketamine before laryngeal mask anesthesia on the basis of the control group.Compare the changes in systolic pressure(SBP)and diastolic pressure(DBP)levels between two groups of patients at the time of entry(T1),immediately after anesthesia(T2),during skin incision(T3),30 minutes after surgery(T4),during incision closure(T5),and immediately after surgery(T6);Standard deviation of R-R interval for all normal sinus beats(SDNN)and mean standard deviation of 5-minute heart beat interval(SDANN)before and 3 days after surgery;Intraoperative dosage of sufentanil,propofol,and usage rate of phenylephrine;And compare the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)before and 3 days after surgery,and finally compare the incidence of adverse reactions between the two groups after surgery.Results:There was a certain degree of fluctuation in SBP and DBP during surgery in both groups of patients,but the fluctuation level in the experimental group was relatively small.There was no significant difference in SBP and DBP levels between the two groups of patients at T1,T2,and T6 times(P＞0.05).The experimental group had lower levels of SBP and DBP at T3,T4,and T5 times compared to the control group(P＜0.05);There was no significant difference in preoperative SDNN and SDANN between the two groups of patients(P＞0.05).After 3 days of surgery,there was no significant change in SDNN and SDANN in the experimental group,while SDNN and SDANN in the conventional group decreased,and the experimental group was higher than the conventional group(P＜0.05);By comparing the dosage of anesthetics,it was found that the experimental group had lower intraoperative doses of sufentanil and propofol compared to the control group,and the usage rate of phenylephrine was lower than that of the control group(P＜0.05);There was no significant difference in preoperative CRP,TNF-α,and IL-6 between the two groups of patients(P＞0.05).On postoperative day 3,CRP,TNF-α,and IL-6 increased in both the experimental group and the control group,with the experimental group being lower than the control group(P＜0.05);There was no significant difference in the incidence of postoperative adverse reactions between the two groups of patients(P＞0.05).Conclusion:Lumbar sacral plexus block combined with low-dose ketamine can stabilize intraoperative blood pressure levels,improve postoperative heart rate variability,reduce the use of anesthetics and vasoactive drugs,alleviate postoperative inflammatory reactions,and have high safety in elderly hypertensive hip replacement patients undergoing anesthesia.

Objective To assess the prognostic value of serum lysine hydroxylase 3(PLOD3)and cytokeratin 19 fragment(CYFRA21-1)in predicting the efficacy of three-dimensional brachytherapy in patients with pulmonary metastases.Methods A total of 102 patients with lung metastases who underwent three-dimensional brachytherapy at our hospital were selected as the lung metastasis group from August 2021 to August 2023.During the same period,a control group consisting of 60 healthy individuals who underwent physical examinations was selected.The lung metastasis group was further divided into an effective group(n=66)and an ineffective group(n=36)based on therapeutic outcomes.Enzyme-linked immunosorbent assay was employed to measure the levels of serum PLOD3 and CYFRA21-1.Multiple logistic regression analysis was conducted to identify factors influencing the efficacy of three-dimensional brachytherapy in the lung metastasis group.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum PLOD3 and CYFRA21-1 for treatment efficacy.Results The levels of serum PLOD3 and CYFRA21-1 in the case group were(34.47±6.17)μg/L,(27.85±5.14)μg/L,respectively,which exhibited significantly higher values compared to those observed in the control group(7.26±2.21)μg/L,(9.31±2.46)μg/L(P<0.05).A positive correlation was found between serum PLOD3 and CYFRA21-1 in the Lung metastasis group(r=0.667,P=0.000).Logistic regression analysis revealed that multiple metastatic lesions along with elevated serum levels of PLOD3 and CYFRA21-1 were identified as risk factors for the efficacy of three-dimensional brachytherapy in patients with lung metastases(P<0.05).Furthermore,when combined with three-dimensional brachytherapy,the area under the curve(AUC)for serum PLOD3 and CYFRA21-1 was calcu-lated as 0.868,demonstrating a superior performance compared to individual measurements of either serum PLOD3 alone(AUC=0.815)or CYFRA21-1 alone(P<0.05).Conclusions The levels of serum PLOD3 and CYFRA21-1 are elevated in patients with lung metastases,exhibiting a significant correlation with the efficacy of three-dimensional brachytherapy.The combined utilization of these two biomarkers demonstrates a robust predictive value for treatment efficacy in patients suffering from lung metastases.

Objective:To compare the differences of three-dimensional computed tomography(3DCT),four-dimensional computed tomography(4DCT),and multi-parametric magnetic resonance(MR)sequences of the radiotherapy for liver cancer in delineation for target area,and analyze which MR sequence was more accurate in assisting CT image to delineate the target area,and design respectively reverse intensity modulated radiotherapy plan,and compare the dosimetric parameters of the target areas of receiving radiotherapy and normal liver tissue.Methods:This retrospective study was conducted to analyze radiotherapy data from case data of 18 patients with hepatocellular carcinoma(HCC)who admitted to the First Affiliated Hospital of Bengbu Medical University between August 2023 and June 2024.These data included 10 respiratory phases in 3DCT and 4DCT,and free-breathing sequence(MR-FB),diaphragm navigation sequence(MR-NAVI),and breath-hold(MR-BH)sequence of multi-parametric MRI,and the gross tumor volumes(GTVs)of them were delineated,which were respectively 5 modal images and liver contours included GTV3D,GTV4D,GTVMR-FB,GTVMR-NAVI,and GTVMR-BH.Pinnacle3 9.8 treatment plan system(TPS)was applied to conduct registration and fusion for image by using mutual information method.The 3DCT(GTV3D)was used as reference image to compare the volume of target area,and the displacement of mass center with other 4 kinds of images.The volume difference(VD),overlap ratio(OR),Dice similarity coefficient(DSC),and Jaccard index(JAC)were used to assess the differences among different target area.The indicators of plan evaluation included conformity index(CI),homogeneity index(HI),GTV doses(D2%,D98%,Dmean),and the exposure dose of normal tissue of liver.Results:In images of five modalities,the GTV median volumes were respectively 28.83,33.10,26.75,25.05,and 22.65 cm3.In images of five modalities,the median volume of liver were respectively 1293.46,1483.09,1213.81,1195.69,and 1141.02 cm3.Compared with other 3 target areas,the displacement of GTVMR-BH was the smallest on head-foot direction,with statistically significant differences among them(Z=-2.305,-2.307,-2.134,P<0.05).The OR,DSC,and JAC values of GTV4D were significantly better than these of GTVMR-FB,GTVMR-NAVI,and GTVMR-BH(ZOR=-2.911,-3.006,-3.195,ZDSC=-2.726,-2.215,-2.556,ZJAC=-2.556,-2.704,-2.953,P<0.05).The VD value of GTVMR-FB was better than that of GTV4D,GTVMR-NAVI,and GTVMR-BH,with statistically significant(Z=-2.675,-2.817,-2.580,P<0.05).Additionally,the OR,DSC,and JAC values of GTVMR-FB and GTVMR-NAVI were better than those of GTVMR-BH,with statistically significant(ZOR=-2.859,-2.817,ZDSC=-2.184,-2.783,ZJAC=-2.385,-2.783,P<0.05).All five plans met clinical dose requirements.Friedman test showed there was no statistically significant differences in dosimetric parameters of target area among different plans(P>0.05).However,compared to the PTV3D plan,the PTVMR-FB,PTVMR-NAVI,and PTVMR-BH plans resulted in lower levels in mean dose(Dmean)of liver and volume parameters(V5,V10,V20,V30)of various doses,with statistically significant differences(Dmean:Z=-2.433,-2.307,-2.807,ZV5=-2.512,-2.433,-2.652,ZV10=-2.433,-2.536,-2.968,ZV20=-2.536,-2.652,-2.807,ZV30=-2.611,-2.652,-2.968,P<0.05).Conclusion:In actually clinical application,MR-NAVI and 4DCT also can be adopted to assist 3DCT to delineate target area besides MR-FB sequence that is conventionally used in MR location,thus can enhance precision of delineation,and optimize radiotherapy plan,and decrease exposure dose of normal liver tissue.

The theory of"eyes as the convergence of various meridians"recorded in the Ling Shu Kouwen chapter is the theoretical basis for acupuncture treatment of eye diseases.This article explained the theoretical connotation of"eyes as the convergence of various meridians"from this perspective:eyes rely on the circulation of the twelve meridians and the nourishment of qi and blood to maintain the divine radiance;the penetrating operation of the twelve meridians enhances the close connection between the eyes,the brain,and various related organs.Based on the above theoretical basis,the basic pathogenesis of amblyopia patients with"lack of dependence on qi and unclear visual perception"was summarized.The treatment principle is"regulating qi and meridians,improving vision",and the application of the regulating qi and improving vision acupoint formula has shown good efficacy.The article also expounded the acupoint selection rules and basis from the perspective of meridian syndrome differentiation,in order to provide reference for the selection and compatibility of acupoints for amblyopia.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.