OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing modified radical mastectomy for breast cancer. METHODS: A total of 140 female patients scheduled for unilateral modified radical mastectomy for breast cancer undergoing general anesthesia were randomized into a TEAS group (70 cases) and a sham TEAS group (70 cases, 2 cases dropped out). Patients in both groups received TEAS or sham TEAS at bilateral Neiguan (PC6), Zusanli (ST36), and Danzhong (CV17), respectively, from 30 min before anesthesia induction until the end of surgery, and on 1st, 2nd, and 3rd days after surgery for 30 min a time, once a day. On 1st, 2nd, and 3rd days after surgery, the pain visual analogue scale (VAS) score was observed; on 3, 6, 12 months after surgery, the incidence rate of chronic pain was observed; before surgery, and on 1st, 3rd, and 7th days after surgery, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were detected; the number of analgesia pump press, rescue analgesia, and the occurrence of adverse reaction after surgery were recorded in the two groups. RESULTS: In the TEAS group, the VAS scores on 1st and 2nd days after surgery, and the incidence rates of chronic pain on 3 and 6 months after surgery were lower than those in the sham TEAS group (P<0.05). On 1st, 3rd, and 7th days after surgery, the serum levels of TNF-α, IL-6, and IL-10 were increased compared with those before surgery in both groups (P<0.05, P<0.01); the above indexes in the TEAS group were lower than those in the sham TEAS group (P<0.05). The number of analgesia pump press and the incidence rate of rescue analgesia after surgery in the TEAS group were lower than those in the sham TEAS group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions after surgery between the two groups (P>0.05). CONCLUSION TEAS can effectively improve both the postoperative acute pain and chronic pain in patients undergoing modified radical mastectomy for breast cancer, the mechanism may relate to inhibiting the inflammatory reaction.
Humans ; Female ; Acupuncture Points ; Pain, Postoperative/blood* ; Middle Aged ; Breast Neoplasms/surgery* ; Adult ; Transcutaneous Electric Nerve Stimulation ; Mastectomy, Modified Radical/adverse effects* ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-10/blood* ; Aged

Objective To investigate the school adaptation of non-military cadets,and to propose suggestions for enhancing this adaptability,as well as to explore coping strategies for maladjustment,so as to contribute to the implementation of the"civil-military integration"policy and provide references for the management of non-military cadets and the enhancement of school adaptation.Methods Seventeen non-military cadets from different majors and grades in a military academy were selected as research participants by purposive sampling.Semi-structured interviews were conducted on the participants,and content analysis was applied to analyze the data.Results Non-military cadets enjoyed abundant teaching resources and a safe and orderly campus environment for cultivating good behavioral habits.Multiple departments collaborated closely to establish a robust mental health support system.In the face of challenges,students exhibited diverse coping strategies.Both actively facing difficulties and adjusting negative emotions in a timely manner,effectively enhanced their adaptability.To further enhance the school adaptation of non-military cadets,we proposed the following suggestions:Firstly,innovate the training mode,focusing not only on academic development but also on practical and innovative abilities.Secondly,actively expand employment channels to build broader career development platforms.Simultaneously,it is necessary to clarify the policy differences between military cadets and non-military cadets and tailor exclusive management systems to ensure that each student can thrive in the most suitable environment.Conclusion The school adaptation of the interviewed students is good,and tends to increase with the number of education years.However,there is still room for improvement in the adaptation.The military academy has achieved remarkable results in managing and cultivating non-military cadets,but it is essential to continuously optimize and improve relevant policies and measures to meet the individualized needs of students and promote their comprehensive development.

Objective:To investigate the effects of different surgical approaches on the efficacy and safety of patients with primary central nervous system lymphoma(PCNSL).Methods:The clinical data of 130 PCNSL patients admitted to The First Affiliated Hospital of University of Science and Tecnology of China between July 2012 and May 2023 were retrospectively analyzed.Patients were assigned into resection and biopsy groups according to the surgical approach.The safety and efficacy of the two groups were compared,including the objective re-sponse rate(ORR),overall survival(OS),and progression-free survival(PFS)after chemotherapy.Results:ORR and 2-year OS and PFS rates of the resection group were not significantly different from those of the biopsy group(ORR:63.2%vs.62.8%;2-year OS rate:68.6%vs.73.7%;2-year PFS rate:35.2%vs.40.7%,all P>0.05).The incidence of postoperative complications was significantly higher in the resection group than in the biopsy group(29.3%vs.11.4%,P=0.04).The difference in the length of hospitalization between the two groups was not statistic-ally significant.Treatment of the biopsy group was less expensive(P<0.01).Conclusions:In patients with PCNSL,biopsy and resection had comparable efficacy;however,the safety profile was better,and hospitalization was less costly in biopsy than in resection.

Objective:To improve the clinical ability of interns by establishing the evaluation index system focusing on the training of clinical competence, and to construct the performance incentive mechanism based on the index system.Methods:The subjective evaluation method and expert consultation method were used to construct 5 first-class indexes and 15 second-class indexes. And the indexes and score setting were consulted by experts through questionnaires and in-depth interviews.Results:According to the feedback results of expert consultation, the scores of teaching ward-rounds and small lectures in the index system were need to adjust. At the same time, the minimum graduation standards were set to determine whether to participate in the final examination.Conclusion:The scores of teaching ward-rounds and small lectures have been raised, the scores of case discussion lowered, and the final examination scores are not included in the minimum standards. After the establishment of the initial index system, a series of supporting measures, including two-way selection of tutors, postgraduate reexamination, and other policies, have been carried out for performance incentives. At the same time, new teaching methods, student-oriented teaching activities, and formative evaluation have been adopted to actively improve the clinical competence of interns.

Background: Both type 1 diabetes mellitus (T1DM) and metabolic syndrome (MetS) are associated with an elevated risk of morbidity and mortality yet with increasing heterogeneity. This study primarily aimed to evaluate the prevalence of MetS among adult patients with T1DM in China and investigate its associated risk factors, and relationship with microvascular complications. Methods: We included adult patients who had been enrolled in the Guangdong T1DM Translational Medicine Study conducted from June 2010 to June 2015. MetS was defined according to the updated National Cholesterol Education Program criterion. Logistic regression models were used to estimate the odds ratio (OR) for the association between MetS and the risk of diabetic kidney disease (DKD) and diabetic retinopathy (DR). Results: Among the 569 eligible patients enrolled, the prevalence of MetS was 15.1%. While female gender, longer diabetes duration, higher body mass index, and glycosylated hemoglobin A1c (HbA1c) were risk factors associated with MetS (OR, 2.86, 1.04, 1.14, and 1.23, respectively), received nutrition therapy education was a protective factor (OR, 0.46). After adjustment for gender, age, diabetes duration, HbA1c, socioeconomic and lifestyle variables, MetS status was associated with an increased risk of DKD and DR (OR, 2.14 and 3.72, respectively; both P<0.05). Conclusion Although the prevalence of MetS in adult patients with T1DM in China was relatively low, patients with MetS were more likely to have DKD and DR. A comprehensive management including lifestyle modification might reduce their risk of microvascular complications in adults with T1DM.

Objective:To explore the application of health education based on stage change theory in the follow-up and rehabilitation of patients undergoing heart valve replacement.Methods:Using the convenient sampling method, a total of 200 patients with heart valve replacement who were admitted to Department of Cardiology in Henan Provincial Chest Hospital from January 2017 to January 2018 were selected as the research objects. They were randomly divided into control group and observation group, with 100 cases in each group. The control group was given routine health education, while the observation group was given health education based on stage change theory. The medication compliance, rehabilitation status and the incidence of complications were compared between the two groups after intervention.Results:The score of Morisky Medication Adherence Scale (MMAS) of patients in the observation group at 1 year after operation was higher than that of the control group, left ventricular ejection fraction (LVEF) was higher than that of the control group and the 6-min walking distance was longer than that of the control group, and the differences were all statistically significant ( P<0.05) . The total incidence of complications in the observation group at 3 years after operation was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Health education based on stage change theory is conducive to improving the medication compliance of patients undergoing heart valve replacement, reducing the incidence of postoperative complications, improving postoperative cardiopulmonary function and promoting recovery of patients.

High cholesterol is one of the important factors inducing cardiovascular and cerebrovascular diseases. Drug therapy is the main method for reducing cholesterol, but has the disadvantages such as high cost and side effects. Studies have shown that intestinal bacteria play important roles in cholesterol metabolism. However, there are few reports on the screening and functional evaluation of cholesterol-lowering intestinal bacteria. In this study, 36 bile-tolerant bacteria were screened from healthy people stool through culturomics using bovine bile acid or artificial mixed bile acids as substrates. Taking Lactobacillus rhamnosus GG (LGG) as a positive control, three bile acid concentration groups (0 g/L, 0.3 g/L, 3 g/L) were set up to evaluate the cholesterol-lowering ability of bile-tolerant bacteria in vitro. Ten bacteria (including Proteus mirabilis, Providencia stuartii, Proteus vulgaris et al) were identified as the dominant cholesterol-lowering bacteria. Six of the above bacteria, Proteus mirabilis, Providencia stuartii, Proteus vulgaris, Proteus penneri, Wohlfahrtiimonas chitiniclastica, Providencia rettger, were evaluated for their ability to reduce triglycerides in vitro and tolerance to artificial gastric juice. Comparing with strain LGG, the six bacteria showed better triglyceride-lowering ability in vitro. With the decrease of pH value of artificial gastric juice and the increase of treatment time, the survival rate of six bacteria decreased. The above screening experiments and functional evaluation provide a basis for further development of potential cholesterol-lowering bacterial products.
Animals ; Cattle ; Cholesterol ; Gammaproteobacteria ; Humans ; Proteus mirabilis ; Providencia

Objective:To retrieve the relevant evidence of the application of virtual reality technology in the cognitive rehabilitation of stroke patients and conduct evaluation and summary of the evidence to provide a reference for formulating norms of cognitive rehabilitation of stroke based on virtual reality technology.Methods:Using evidence-based nursing methods, according to the "6S" model system to search guidelines, expert consensus, random controlled trail (RCT) , systematic reviews and other evidence of the use of virtual reality technology in the cognitive rehabilitation training of stroke patients on United States National Guidelines Network, National Institute for Health and Care Excellence, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-Based Health Care Database, PubMed, Web of Science, Springerlink, Science Direct, National Stroke Foundation, China Guidance Network, Medlive, CNKI, Wanfang Database and VIP Database. The retrieval period was from January 2015 to December 2020. Using Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) , Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) and JBI literature quality evaluation tools, two researchers independently evaluated the quality of the literature and the level of evidence.Results:Finally, 17 articles were included, including 6 guidelines, 4 systematic reviews and 7 RCT studies, summarizing 20 evidences of the application of virtual reality technology in cognitive rehabilitation of stroke patients.Conclusions:This research has initially formed a summary and evaluation of the evidence for the application of virtual reality technology in cognitive rehabilitation of stroke patients, in order to provide a reference for the formulation of practical norms of cognitive rehabilitation technology based on virtual reality and improve the effect of cognitive rehabilitation for stroke patients.

Objective To evaluate the efficacy, safety and the prognosis of rituximab combined with CHOP (R-CHOP) or combined with EPOCH (R-EPOCH) regimen in treatment of newly diagnosed myc/bcl-2 double-expression diffuse large B-cell lymphoma (DLBCL). Methods The clinical efficacy, adverse reactions and survival of 16 DLBCL patients who received R-CHOP regimen with double-expression and 15 DLBCL patients who received R-EPOCH regimen with double-expression between August 2014 and December 2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, and all patients with double or triple-hit lymphoma were excluded. Results The ratio of the International Prognostic Index (IPI) score ≥3 in R-EPOCH group was higher than that in R-CHOP group [10 cases vs. 5 cases, χ2＝ 3.888, P＝0.049]. There were no statistical differences in other clinical data of both groups. Complete remission (CR) was achieved in 75% (12/16) of R-CHOP group and 67% (10/15) of R-EPOCH group, and there was no statistical difference between the two groups (χ2＝ 0.013, P＝ 0.908). The incidence of grade 3-4 leukopenia and grade 3-4 thrombocytopenia in R-EPOCH group was higher than that in R-CHOP group, and the difference was statistically significant [93% (14/15) vs. 38% (6/16), χ 2＝ 10.542, P＝ 0.01; 73% (11/15) vs. 6% (1/16), χ 2＝ 14.685, P< 0.01]. The 1-year overall survival (OS) rate and progression-free survival (PFS) rate was 86.5% and 81.3% in R-CHOP group, 76.0% and 51.4% in R-EPOCH group. There was no statistical difference in the 1-year OS rate between the two groups (P＞0.05), and the 1-year PFS rate in R-CHOP group was higher than that in R-EPOCH group (P<0.01). The 1-year OS rate and PFS rate was 100.0% and 93.8% in IPI<3 group, 65.5% and 45.0% in IPI≥3 group. The 1-year OS rate and PFS rate in IPI<3 group were superior to those in IPI≥3 group (all P ＞0.01). The 1-year OS rate and PFS rate of the female group were lower than those of the male group (59.6% vs. 100.0%, 44.2% vs. 86.3%), and there were statistical differences (all P<0.01). Cox regression analysis showed that high IPI score was an independent prognostic factor for all patients ( HR＝6.335, 95% CI 0.740-54.261, P＝0.092). Conclusions R-EPOCH and R-CHOP are the ideal treatment methods for the double-expression lymphoma. Both regimens have similarities in the treatment outcome of myc/bcl-2 double-expression DLBCL. The adverse reactions in R-EPOCH group are severer than those in R-CHOP group.

Objective Toexplorethevalueofmulti-parameterquantitativeanalysisofspectralCTimaging (GSI)indifferentiatingrenal fat-poorangiomyolipoma(fpAML)andchromophobecellrenalcarcinoma(CCRC).Methods 42patientswithrenaltumor,including 25caseswithfpAMLand17caseswithCCRC,wereretrospectivelyanalyzed.Allofthem werescannedinGSImode.Themorphology differencesbetweenthefpAMLgroupandtheCCRCgroupwereanalyzed.GSIViewersoftwarewasusedtocalculatetheiodineconcentration (IC),thenormalizediodineconcentration(NIC),thesloperateofthespectrumenergycurveinthecorticalphase(CP)andmedullaryphase (MP),respectively.Thedifferencesofthoseparameterswerecomparedbetweenthetwogroupsusingthetwo-simplettest.Results Somecharacteristicsigns,suchas"blackspots"sign,cracksignandnecrosishadthevaluefordifferentialdiagnosis.IntheCP,theIC ofthefpAMLandCCRCgroupwere30.20±5.25vs19.97±4.01,theNICswere0.45±0.10vs0.32±0.06,andthesloperatesof spectrumenergycurveswere3.45±1.23vs2.42±0.48,respectively.IntheNP,theICofthefpAMLandCCRCgroupwere27.84± 8.07vs22.94±4.46,theNICswere0.58±0.17vs0.46±0.11,andthesloperatesofthespectrumenergycurveswere3.24±1.25vs 2.69±0.47,respectively.Thereweresignificantdifferencesbetween2groups(P<0.05).TheNICintheCPprovidedhighsensitivity (75%)andspecificity(86%)indifferentiatingfpAMLfrom CCRC,andtheareaundertheROCcurvewas0.886.Conclusion The focalcysticandnecrotic,enhanceduniformityanddegree,"blackspots"sign,cracksignand multi-parametersofGSI,includingIC, NIC,andthesloperateofthespectrumenergycurvecouldplayimportantroleindifferentialdiagnosisbetweenfpAMLandCCRC.