Objective: To evaluate the impact of comprehensive nursing based on the behavioral goal attainment model on the clinical intervention effect among elderly female patients with stress urinary incontinence (SUI), so as to provide a basis for optimizing the nursing strategies for patients with SUI and improving their quality of life. Methods: A total of 190 elderly female patients with SUI who were treated in the Department of Gynecology of the First Hospital of Jilin University from January 2023 to August 2024 were selected and randomly divided into the intervention group and the control group. The control group received routine nursing care, while the intervention group received comprehensive nursing based on the behavioral goal attainment model. The 1-hour pad test was used to assess urinary incontinence symptoms. The bio-electrical stimulation feedback instrument was employed to detect the electromyogram (EMG) values in the pre-resting stage and slow-muscle stage for evaluating pelvic floor function. The bladder function scale was utilized to evaluate bladder function. The Chinese version of urinary incontinence ego-efficacy rating scales and incontinence quality of life assessment scale (IQOL) were used to assess self-efficacy and quality of life. The data on intervention compliance and nursing satisfaction were collected by a questionnaire survey. The differences between the two groups before and after the intervention were compared using the analysis of variance for repeated-measures data to evaluate the intervention effect. Results: There were 95 cases in the control group and 95 cases in the intervention group, with median ages were 64.00 (interquartile range, 23.50) and 64.50 (interquartile range, 19.50) years, respectively. The proportion of patients with cesarean section as the last delivery method was 21.05% in the control group and 12.63% in the intervention group. The proportion of patients with moderate disease severity was 67.36% in the control group and 58.95% in the intervention group. There were no statistically significant differences in age, body mass index, number of pregnancies, number of deliveries, marital status, educational level, mode of last delivery and severity of the disease between the two groups of patients (all P>0.05). The analysis of variance of repeated-measures data showed that there were significant interactions between time and group for the urine leakage volume in the 1-hour pad test, the EMG values in the pre-resting stage, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, and the IQOL scores (all P<0.05). After 12 weeks of intervention, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, the IQOL scores in the intervention group were higher than those in the control group, while the urine leakage volume in the 1-hour pad test and the EMG values in the pre-resting stage in the intervention group were lower than those in the control group (all P<0.05). The good compliance rate of intervention and the satisfaction rate of nursing in the intervention group were higher than those in the control group (83.16% vs. 60.00%, 90.53% vs. 75.79%, both P<0.05). Conclusion Comprehensive nursing based on the behavioral goal attainment model can improve urinary incontinence symptoms, pelvic floor function, bladder function, self-efficacy, quality of life, and intervention compliance of elderly female patients with SUI.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective:To compare the efficacy and safety of Dienogest(DNG)with other drugs in non-surgi-cal pharmacologic treatment and long-term management of drugs after conservative surgery for endometriosis(EMT).Methods:We searched PubMed,Embase,Medline,Google Scholar,Cochrane Library,China National Knowledge Infrastructure,Wanfang,and Weipu databases from the establishment of the database until December 31,2023 for relevant literature on EMT pharmacotherapy.Meta-analysis was performed using Stata 18.0 software to assess the efficacy of DNG,gonadotropin-releasing hormone agonist(GnRH-a),compound short-acting oral contraceptive(COC)and levonorgestrel intrauterine sustained-release system(LNG-IUS)in reducing the diameter of ovarian endometrioma(OMA),relieving pelvic pain and preventing EMT postoperative recurrence in EMT pa-tients after non-surgical drug treatment and conservative surgery,as well as the adverse reactions of drugs.Re-sults:①During non-surgical medication treatment of EMT,there was no statistically significant difference(P＞0.05)between DNG and GnRH-a in reducing OMA diameter and relieving pelvic pain.Compared with COC,DNG was superior to COC in reducing the diameter of OMA(WMD 10.44 mm,P=0.017)and relieving pelvic pain(WMD 12.20 mm,P＜0.001).②During long-term medication management after conservative EMT surger-y:there was no statistically significant difference(P＞0.05)between DNG,GnRH-a,COC and LNG-IUS in re-ducing postoperative recurrence and controlling pelvic pain significant(P＞0.05).③Adverse drug reactions:com-pared with GnRH-a,DNG had a reduced risk of bone loss(bone density WMD2.78 g/cm3,P=0.038),hot fla-shes(OR 0.07,P＜0.001),and an increased risk of irregular vaginal bleeding(OR 19.10,P＜0.001);com-pared with COC,the risk of weight gain,mood abnormalities,and breast tenderness,nausea and vomiting,and sleep disorders in DNG were reduced(OR＜1,P＜0.05);compared with LNG-IUS,the risk of abnormalities of mood in DNG was increased(OR 9.87,P=0.033).Conclusions:DNG treatment is more effective than COC in non-surgical drug therapy for EMT.When supplemental medication was given after conservative EMT surgery,DNG,like other drugs,can effectively prevent postoperative recurrence and control pelvic pain.The safety of DNG is superior to GnRH-a and COC,slightly inferior to LNG-IUS.

Pancreatic cancer induced by mutation KRAS exhibited a higher risk of incidence, recurrence and mortality. C-Myc is downstream of KRAS and can be involved in the regulation of multiple oncogenic pathways and signaling pathways in pancreatic cancer. Over expressing of C-Myc promotes glycolysis and glutamine uptake in pancreatic cancer cells, promotes cell metabolism and proliferation, is an important factor driving the progress and maintenance of pancreatic cancer, and is related to chemotherapy and immunotherapy drug resistance. C-Myc also interacts with cell cyclin-dependent kinase(CDK) and non-coding RNA to regulate the proliferation, development and metastasis of pancreatic cancer. Therefore, targeting C-Myc was regarded as an effective strategy for the treatment of pancreatic cancer. The activation of C-Myc depends on heterodimerization with its partner MAX and thereby paly a role through binding to the canonical E-Box sequence 5’-CACGTG-3’. Researches showed direct targeting of C-Myc can inhibit the growth of pancreatic carcinoma,such as promoting the degradation of C-Myc, inhibiting the binding of C-Myc/MAX and blocking the binding of C-Myc/MAX to E-box. However, direct targeting has been proved challenging because of its special protein structure. Indirect targeting of C-Myc provided a new strategy for the treatment of pancreatic cancer. C-Myc can be indirected targeting through inhibiting transcription and translation of C-Myc, C-Myc-MAX heterodimerization and promote the ubiquitination and degradation of C-Myc, thus affects the occurrence, development and metastasis of pancreatic cancer.

BACKGROUND:The in vitro construction of intestinal smooth muscle layer,as an important component of the intestinal wall,has attracted much attention in the bionic construction of tissue-engineered intestinal canal. OBJECTIVE:To explore the effects of cyclic mechanical stretching on the growth activity of intestinal smooth muscle cells and the expression of functional genes within collagen strips. METHODS:The collagen band culture system of intestinal smooth muscle cells was constructed using a self-designed collagen strip stretching culture device with self-made rat tail collagen as a scaffold and primary rat intestinal smooth muscle cells as seed cells.EthD-1/Calcein-AM cell activity staining,magenta staining,cytoskeleton-Ki67 immunofluorescence staining were used to observe the growth activity and proliferation of the cells,and quantitative RT-PCR was used to detect the expression of desmin,α-sma,and vimentin functional genes. RESULTS AND CONCLUSION:The collagen band culture system of intestinal smooth muscle cells was successfully constructed,and intestinal smooth muscle cells in the band had good cell activity.The number of Ki67 positive cells increased and desmin,α-sma and vimentin were significantly overexpressed under cyclic stretching and dynamic culture conditions(P＜0.001).To conclude,mechanical stimulation is beneficial to maintain the growth phenotype of smooth muscle cells and promote their functional differentiation during three-dimensional culture in vitro.

Objective:To investigate the clinical efficacy and possible mechanism of Sanjie analgesic capsule combined with levonorgestrel intrauterine birth control system in the treatment of adenomyosis with phlegm-stasis interjunction.Methods:Eighty-six cases of adenomyosis with phlegm-stasis interjunction were randomly divided into the observation group (44 cases) and the control group (42 cases). The control group was given levonorgestrel intrauterine birth control system treatment, and the observation group was given Sanjie analgesic capsule combined with levonorgestrel intrauterine birth control system treatment. After 6 months of treatment, the traditional Chinese medicine (TCM) syndrome scores, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2), progesterone (P), vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2), insulin like growth factor (IGF-1), transforming growth factor-β 1(TGF- β 1), clinical efficacy, adverse reactions were compared between the two groups. Results:After treatment, the TCM syndrome scores in the observation group was lower than that in the control group: (7.57 ± 1.23) scores vs. (9.32 ± 1.45) scores, there was statistical difference ( P<0.05). After treatment, the levels of FSH, LH, E 2, P in the observation group were lower than those in the control group: (5.54 ± 1.21) U/L vs. (7.62 ± 1.36) U/L, (4.43 ± 1.05) U/L vs. (6.14 ± 1.15) U/L, (83.54 ± 12.36) μg/L vs. (92.45 ± 11.56) μg/L, (9.64 ± 1.43) pmol/L vs. (11.36 ± 1.52) pmol/L, there were statistical differences ( P<0.05). After treatment, the levels of VEGF, Ang-2, IGF-1, TGF- β 1 in the observation group were lower than those in the control group: (114.32 ± 15.41) ng/L vs. (162.45 ± 16.32) ng/L, (156.14 ± 20.45) ng/L vs. (186.53 ± 22.36) ng/L, (135.21 ± 15.52) ng/L vs. (151.23 ± 16.21) ng/L, (13.43 ± 2.24) ng/L vs. (16.36 ± 2.51) ng/L, there were statistical differences ( P<0.05). After treatment, the clinical efficacy in the observation group was higher than that in the control group and the adverse reactions was lower than that in the control group: 84.09%(37/44) vs. 64.29%(27/42), 13.64%(6/44) vs. 33.33%(14/42), there were statistical differences ( χ2 = 4.73 and 4.67, P<0.05). Conclusions:For adenomyosis with phlegm-stasis interjunction, the combination of Sanjie analgesic capsule and levonorgestrel intrauterine birth control system can improve the clinical symptoms of patients, improve treatment effectiveness, and reduce the occurrence of adverse reactions, which may be related to factors such as inhibiting estrogen, progesterone and vascular associated growth factors.

Objective To compare and analyze the effectiveness of sequential nutritional support and parenteral nutrition support in clinical intervention of pediatric acute pancreatitis.Methods Data of 102 children with acute pancreatitis were retrospectively collected and divided into the parenteral nutrition group(n=51)and the sequential nutrition group(n=51)based on the type of parenteral nutrition support.Changes in nutritional status,immune function indicators and body rehabilitation indicators were compared before and after intervention between two groups.The humoral immune indexes(IgA,IgG and IgM)were detected by immunonephelometry.The body recovery indexes(abdominal distension relief time,oral feeding recovery time,body temperature recovery time,blood and urine amylase recovery time and hospital stay)were compared between the two groups.Results After intervention,levels of serum albumin,total protein and prealbumin were higher in the study group than those in the control group,while levels of blood amylase and urine amylase were lower than those in the control group(P＜0.05).After intervention,the CD3+,CD4+and CD4+/CD8+indicators were higher in the study group than those in the control group(P＜0.05).After intervention,IgA,IgG and IgM indicators were higher in the study group than those in the control group(P＜0.05).The relief time of abdominal distension,recovery time of oral feeding,recovery time of body temperature,recovery time of blood and urine amylase and hospitalization time were all shorter in the study group than those in the control group(P＜0.05).Conclusion Sequential nutritional support can effectively improve the nutritional status of children with acute pancreatitis,enhance immune function and promote physical recovery compared to parenteral nutrition support.

Objective:To compare the efficacy and safety of Dienogest(DNG)with other drugs in non-surgi-cal pharmacologic treatment and long-term management of drugs after conservative surgery for endometriosis(EMT).Methods:We searched PubMed,Embase,Medline,Google Scholar,Cochrane Library,China National Knowledge Infrastructure,Wanfang,and Weipu databases from the establishment of the database until December 31,2023 for relevant literature on EMT pharmacotherapy.Meta-analysis was performed using Stata 18.0 software to assess the efficacy of DNG,gonadotropin-releasing hormone agonist(GnRH-a),compound short-acting oral contraceptive(COC)and levonorgestrel intrauterine sustained-release system(LNG-IUS)in reducing the diameter of ovarian endometrioma(OMA),relieving pelvic pain and preventing EMT postoperative recurrence in EMT pa-tients after non-surgical drug treatment and conservative surgery,as well as the adverse reactions of drugs.Re-sults:①During non-surgical medication treatment of EMT,there was no statistically significant difference(P＞0.05)between DNG and GnRH-a in reducing OMA diameter and relieving pelvic pain.Compared with COC,DNG was superior to COC in reducing the diameter of OMA(WMD 10.44 mm,P=0.017)and relieving pelvic pain(WMD 12.20 mm,P＜0.001).②During long-term medication management after conservative EMT surger-y:there was no statistically significant difference(P＞0.05)between DNG,GnRH-a,COC and LNG-IUS in re-ducing postoperative recurrence and controlling pelvic pain significant(P＞0.05).③Adverse drug reactions:com-pared with GnRH-a,DNG had a reduced risk of bone loss(bone density WMD2.78 g/cm3,P=0.038),hot fla-shes(OR 0.07,P＜0.001),and an increased risk of irregular vaginal bleeding(OR 19.10,P＜0.001);com-pared with COC,the risk of weight gain,mood abnormalities,and breast tenderness,nausea and vomiting,and sleep disorders in DNG were reduced(OR＜1,P＜0.05);compared with LNG-IUS,the risk of abnormalities of mood in DNG was increased(OR 9.87,P=0.033).Conclusions:DNG treatment is more effective than COC in non-surgical drug therapy for EMT.When supplemental medication was given after conservative EMT surgery,DNG,like other drugs,can effectively prevent postoperative recurrence and control pelvic pain.The safety of DNG is superior to GnRH-a and COC,slightly inferior to LNG-IUS.