Objective:To analyze the incidence and progression of overactive bladder(OAB)symp-toms following radical prostatectomy for prostate cancer patients and to identify related risk factors.Methods:A retrospective study was conducted on 263 local stage prostate cancer patients who underwent radical prostatectomy at Peking University Third Hospital from January 2013 to May 2017.Clinical base-line information,comprehensive imaging features,perioperative parameters,preoperative urinary control status,pathological diagnosis,and the incidence of OAB within one year postoperatively were collected and analyzed.In the imaging features,two parameters were defined:Bladder wall thickness(BWT)and bladder mucosal smoothness(BMS),which were used to predict the occurrence of OAB.Patients were evaluated based on their clinical baseline characteristics,including age,body mass index(BMI),co-morbidities,and prostate-specific antigen(PSA)levels.The imaging characteristics were assessed using preoperative MRI,focusing on BWT and BMS.Perioperative parameters included operative time,blood loss,and length of hospital stay.The OAB symptoms were assessed using the overactive bladder symptom score(OABSS)and the international prostate symptom score(IPSS).These scores were correlated with the postoperative incidence of OAB.Results:Among the 263 patients who underwent radical prostatecto-my,52(19.8％)exhibited OAB within one year postoperatively.Of the 40 patients with preoperative OAB symptoms,17(42.5％)showed remission postoperatively,while 23(57.5％)had persistent symptoms.Additionally,29 patients developed new-onset OAB,accounting for 55.77％of all postopera-tive OAB cases.Univariate analysis indicated that BWT,BMS,OABSS,and IPSS score were all associ-ated with the occurrence of postoperative OAB.Further multivariate analysis identified BMS as an inde-pendent risk factor for long-term OAB(P＜0.001).Conclusion:Long-term postoperative overactive bladder is a common complication following radical prostatectomy.The findings suggest that preoperative MRI measurements of bladder wall thickness and bladder mucosal smoothness during bladder filling phase can predict the risk of OAB occurrence postoperatively.Identifying these risk factors preoperatively can help in counseling patients about potential complications and in developing strategies to mitigate the risk of developing OAB after surgery.Early detection and management of these parameters might improve the quality of life for patients undergoing radical prostatectomy.

Objective:To analyze the syndrome differentiation medication law of TCM in treating overactive bladder (OAB) based on data mining techniques.Methods:The articles about the treatment of OAB with TCM were collected from China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP database and SinoMed. A prescription database for OAB was established. Methods such as frequency statistics, association rule analysis, clustering analysis, and factor analysis were used to analyze the medication law of the prescriptions.Results:The results showed that a total of 91 prescriptions were included, involving 134 kinds of Chinese materia medica. Five drugs were with a usage frequency of >30%. The top 4 categories with medication frequency were herbs for tonifying deficiency, herbs for inducing diuresis and draining dampness, herbs for relieving exterior syndrome and herbs for regulating qi. The properties of the included herbs were characterized by mild and warm, and the tastes were mainly sweet, pungent and bitter. The majority of meridian tropism was kidney meridian, supplemented by spleen, liver and lung meridians. The association rule analysis showed eight high-relevance medicine pairs, and four new candidate prescriptions were summarized after the clustering analysis, and six common factors were extracted by factor analysis.Conclusions:The location of the lesion of overactive bladder is mainly about the kidney, related to the spleen, liver and lung. And the pathogenesis is based on the kidney deficiency, which also due to the adverse qi transformation in triple energizer. Clinical medication is mainly about the herbs for tonifying deficiency and the herbs for inducing diuresis and draining dampness; at the same time those herbs for regulating qi and relieving exterior syndrome should be paid attention to, which are able to smooth and regulate the qi of the whole body.

Objective:To investigate the predictive value of serum proenkephalin A 119-159 (penKid) on incidence and the 28-day mortality in patients with sepsis-associated acute kidney injury (SA-AKI).Methods:This study was a single center, observational cohort study. Sepsis/septic shock patients admitted to Department of Critical Care Medicine of Taizhou People's Hospital Affiliated to Nanjing Medical University from September 2021 to September 2022 were selected and divided into the SA-AKI group and the non-SA-AKI group according to whether acute kidney injury (AKI) occurred within 28 days. Patients in the SA-AKI group were subdivided into the death group and the survival group according to whether death occurred within 28 days. Baseline data and laboratory indicators such as penKid concentration were compared among different groups. COX regression analysis was used to explore the risk factors of death within 28 days in the SA-AKI patients, And Kaplan-Meier curve was used to analyze patient prognosis.Result:A total of 161 patients were included in this study, of whom 66 (41.0%) developed AKI. The baseline penKid concentration in the SA-AKI group was significantly higher than that in the non-SA-AKI group [(2.99 ± 0.68) μg/L vs. (1.86±0.75) μg/L, P<0.05]. Multivariate COX regression analysis showed that the baseline penKid ( HR=5.608, 95% CI: 3.507-8.967, P<0.001) and lactate (LA) ( HR=1.089, 95% CI: 1.003-1.183, P=0.043) were independent risk factors for AKI in sepsis/septic shock patients. Of the 66 SA-AKI patients, 27 (40.9%) died within 28 days, and the baseline penKid concentration in the death group was significantly higher than that in the survival group [ (3.55 ± 0.54) μg/L vs. (2.60±0.47) μg/L, P<0.05]. COX regression analysis showed that penKid ( HR=5.892, 95% CI: 2.457-14.132, P<0.001) was an independent risk factor for mortality in SA-AKI patients. Kaplan-Meier curve showed that the 28-day mortality of patients with baseline penKid ≥ 3.24 μg/L was significantly higher than that of patients with baseline penKid <3.24 μg/L ( P<0.001). Conclusions:In sepsis/septic shock patients, the penKid concentration measured on the first day in the SA-AKI group is significantly higher than that in the non-SA-AKI group. In SA-AKI patients, the penKid concentration measured in patients who survived within 28 days is significantly lower than that in the death group. PenKid is an independent risk factor for the occurrence and death of SA-AKI.

Objective:To explore the effect of pectin on improving intestinal barrier injury in elderly stroke patients.Methods:A total of 60 elderly stroke patients who received enteral nutrition in Department of Critical Care Medicine of Taizhou People's Hospital from November 2020 to October 2021 were included. The control group included 30 cases, using conventional enteral nutrition solution. The other 30 cases were in the study group, and pectin was added on the basis of routine enteral nutrition solution. The levels of serum diamine oxidase (DAO) and D-lactic acid (D-LA) were measured on the first and 7th days of enteral nutrition to evaluate the intestinal barrier function of elderly stroke patients. The levels of interleukin-6 (IL-6), procalcitonin (PCT) and high-sensitivity C-reactive protein (CRP) were measured to evaluate the inflammatory response level of elderly stroke patients. The clinical prognosis of the two groups was compared.Results:Compared with the control group, the values of DAO [(4.05±1.56)ng/mL] and D-LA [(6.11±2.20) μmol/L] in the study group were significantly lower than those in the control group on the 7th day (all P < 0.05). Also the levels of IL-6 [(15.43±12.53) ng/mL], PCT [(0.82±0.98) ng/mL] and CRP [(6.94±6.60) mg/L] in the study group were lower than those in the control group, and the difference between the two groups was statistically significant (all P < 0.05). Compared with the control group, the length of ICU stay and total length of hospital stay in the study group were shorter than those in the control group ( P<0.05), but there was no significant difference in the incidence of stroke-related pneumonia (16.7% vs. 30.0%) and 30-day mortality (16.7% vs. 20.0%) between the two groups ( P>0.05). Conclusions:The enteral nutrition with pectin supplementation can improve intestinal barrier function and reduce inflammatory response in elderly stroke patients.

Objective:To explore the process of how depressed patients regulate themselves around the cores of mindfulness therapy-cognition, non-judgement and living in the present.Methods:The phenomenology of the qualitative research was adopted. The themes are analyzed, organized and refined through semi-structured in-depth interviews with 23 depressed patients, and using the Cloaizzi 7-step analysis.Results:A total of four themes are analyzed: multiple psychological experiences, mindfulness therapy to change thinking patterns, to promote self-identity, and to form self-coping strategies.Conclusions:Depressed patients are often passive and affected by negative emotions and automatic thoughts when they first participate in mindfulness therapy. Based on patients′ processual experience of participating in mindfulness therapy, health care professionals should focus on the patients′ self-regulation process and develop regulative strategies so as to help patients better understand and adapt to mindfulness therapy, reduce the recurrence of depression, and improve their qualities of life.

Objective:To explore the risk factors of acute kidney injury (AKI) in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation.Methods:A retrospective analysis was conducted. ARDS patients with mechanical ventilation admitted to ICU of Taizhou People's Hospital from January 2019 to December 2019 were enrolled. Patients were divided into the AKI group and non-AKI group according to whether the patients had AKI. Clinical characteristics and laboratory indicators of the two groups were compared. Risk factors of incidence of AKI in ARDS patients were analyzed. The Kaplan-Meier survival curve was drawn to evaluate the survival rates of the two groups.Results:A total of 120 ARDS patients with mechanical ventilation were included, and 57 patients (47.5%) developed AKI. Procalcitonin, increased basal creatinine, decreased pH and impaired consciousness were independent risk factors for AKI in ARDS patients with mechanical ventilation. Fifty-seven of the 120 patients died with a mortality of 38.3%. The Kaplan-Meier survival curve showed that the survival rate of the AKI group was significantly lower than that of the non-AKI group ( P<0.001). Conclusions:The incidence and mortality of AKI is high in ARDS patients with mechanical ventilation. Procalcitonin, increased basal creatinine, decreased pH and impaired consciousness are independent risk factors for AKI in ARDS patients with mechanical ventilation.

Objective To compare the image quality produced by MR high resolution vessel wall imaging (HR?VWI) and ultrasound (US) in evaluating carotid plaque load. Methods This prospective study enrolled 21 patients with carotid plaques undergoing HR?VWI and subsequent 2D US between August 2016 to January 2017 in Hebei General Hospitial. The plaque thickness (PT), lumen area (LA), wall area (WA) and total vessel area (TVA) of the plaques were measured and normalized wall index (NWI) was calculated on both HR?VWI images and US for those plaques with image quality score≥3 and matching between the two methods. The plaque load index was compared by using the independent sample t test or the non?parametric Wilcoxon test, and the correlation between the indexes was based on the Pearson test. Results Forty?five carotid plaques were matched with HR?VWI and US. There was no significant difference in PT, LA, WA, TVA and NWI detected by HR?VWI and ultrasound (P>0.05). The parameters measured by two methods were correlated (r values were 0.83, 0.85, 0.32, 0.83 and 0.59, P<0.05). Conclusion There is a good consistency between HR?VWI and conventional ultrasound in the measurement of carotid plaque load.

Objective: To investigate the effect and mechanism of transforming growth factor β (TGFβ) on the migration ability of hepatic progenitor cells in vitro. Methods: Primary hepatic progenitor cells of male wild-type C57BL/6J mice were isolated by two-step perfusion method and stimulated with different concentrations of TGFβ .The morphological changes were observed under phase -contrast microscopy. The effects of TGFβ on migration ability of hepatic progenitor cells were evaluated by scratch test and transwell method. Expression profiling and signaling phospho antibody array detected the signaling pathways involved in the regulation of TGFβ on hepatic progenitor cells. Protein level of PI3K/AKT/mTOR/p70S6K signaling pathway and the localization of each signaling molecules in hepatic progenitor cells were detected. Data comparison between the two groups was performed by independent sample t-test. One-way ANOVA was used for data comparison between multiple groups. Results: TGFβ made the liver progenitor cells from oval to long spindle type. Scratch test showed that the scratch healing rates of 24 h control group, and 2 ng/ml and 10 ng/ml TGF-beta groups were 36.48% ± 4.37%, 57.35% ± 4.60%, and 73.14% ± 5.02% (F = 65.87, P < 0.01), respectively. Transwell test showed that the number of migrating cells in 24 h control group, 2 ng/ml and 10 ng/ml TGF-beta groups were 127 ± 16, 230 ± 18, and 385 ±36 (F = 94.99, P < 0.01), respectively. The results of expression profiling showed that TGFβ regulates gene expression in hepatic progenitor cells, and differentially expressed genes participate in the PI3K-AKT signaling pathway. Signaling phospho antibody array and western blot showed that TGFβ regulated PI3K/AKT/mTOR/p70S6K signaling pathway in hepatic progenitor cells. Concurrently, immunofluorescence assay showed phosphorylation (p) 70s6k, p AKT1 and PI3K and F-actin co-localizations. Conclusion TGFβ can promote hepatic progenitor cell migration through PI3K/AKT/mTOR/p70S6K pathway, and p70S6K, pAKT1 and PI3K signaling molecules are involved in the regulation of morphology and migration of liver progenitor cells.

Objective To explore the application effect of quality control circle (QCC) activity in improving nursing quality of pain management in ICU.Methods Quality control circle was established,and the theme of QCC and its activity plan were determined.Nursing quality of pain management in ICU was investigated,and corresponding measures was formulated,and relevant indicators before and after implementation was evaluated.Results After QCC activities,pain knowledge score of clinical nurses higher,and correct rate of pain score application as well as reasonable application rate of nurses'pain management standardization process were higher than that activity before [(59.21±10.85) vs.(44.22±10.75);72％,62％ vs.18％,26％,P＜0.01].After implementation of quality control circle,the overall satisfaction of health education and nursing of patients and their families were higher than the activity before (98％,96％ vs.80％,84％,P ＜0.05).Conclusion QCC applied in nursing management of pain in ICU can effectively improve management ability of ICU nurses,enhance work enthusiasm,and improve nursing satisfaction of patients and their families.

Objective To explore the application effect of quality control circle (QCC) activity in improving nursing quality of pain management in ICU.Methods Quality control circle was established,and the theme of QCC and its activity plan were determined.Nursing quality of pain management in ICU was investigated,and corresponding measures was formulated,and relevant indicators before and after implementation was evaluated.Results After QCC activities,pain knowledge score of clinical nurses higher,and correct rate of pain score application as well as reasonable application rate of nurses'pain management standardization process were higher than that activity before [(59.21±10.85) vs.(44.22±10.75);72％,62％ vs.18％,26％,P＜0.01].After implementation of quality control circle,the overall satisfaction of health education and nursing of patients and their families were higher than the activity before (98％,96％ vs.80％,84％,P ＜0.05).Conclusion QCC applied in nursing management of pain in ICU can effectively improve management ability of ICU nurses,enhance work enthusiasm,and improve nursing satisfaction of patients and their families.