1.Summary of the best evidence for non-pharmacological management of cancer pain patients
Chunyuan BO ; Liming LYU ; Miao GUO ; Qi WANG ; Yanxia YANG
Chinese Journal of Modern Nursing 2025;31(4):478-484
Objective:To retrieve, summarize and evaluate the best evidence for the non-pharmacological management of patients with cancer pain, so as to provide an evidence-based basis for the scientific management of cancer pain by healthcare professionals.Methods:A systematic search of the national and international literature on the non-pharmacological management of cancer pain was conducted, with a timeframe of January 2017 to January 2024. The quality of the included literature was evaluated, and evidence was extracted and summarized for those that met the quality criteria.Results:A total of 18 papers were included, including one clinical decision, seven guidelines, three expert consensus, and seven systematic reviews. Twenty-eight pieces of evidence were summarized around six themes of pain assessment, cognitive-behavioral interventions, physical therapy, interventional therapy and surgery, and self-management education and follow-up.Conclusions:Healthcare professionals should develop a patient-centered, appropriate and feasible non-pharmacological management plan for cancer pain with multiple agreements with patients and families, taking into account the clinical context and individual differences of patients in China, in order to improve the quality of life.
2.Research progress on the interactive effects of cardiovascular disease and cognitive frailty in the elderly
Qiqi JIANG ; Yanxia LIN ; Shijie ZHAO ; Nannan LI ; Huanrui ZHANG ; Liye SHI ; Wen TIAN ; Guoxian QI ; Jinyang LI ; Ling CHEN
Chinese Journal of Geriatrics 2025;44(8):1056-1061
The escalating phenomenon of global population aging is posing multi-dimensional challenges to society, the economy and medical healthcare system.Among the significant health threats to the elderly population are cardiovascular diseases(CVD)and cognitive frailty(CF), both of which profoundly affect the quality of life and increase the risks of adverse health outcomes, including disability, hospitalization, and death.The concurrent presence of CVD and CF in elderly patients is prevalent, as these conditions share many common risk factors and underlying pathophysiological mechanisms, such as atherosclerosis, microcirculation dysfunction, and inflammation, which interact to perpetuate a vicious cycle.Notably, CF exhibits a certain degree of reversibility; thus, the implementation of a diagnosis and treatment paradigm that incorporates "comprehensive geriatric assessment and geriatric interdisciplinary teams" should be established as a conventional management strategy for elderly patients affected by both CVD and CF.Cognitive digital therapeutics, along with personalized exercise prescriptions based on cardiopulmonary exercise tests, may represent more appropriate precision interventions for these patients.Consequently, there is a necessity for further in-depth research in this area moving forward.
3.Analysis of acupoint selection rules for acupuncture treatment of functional constipation based on data mining
Yitong LIU ; Qi QIN ; Dong CHEN ; Yanxia GENG ; Yanyun MU
Journal of Clinical Medicine in Practice 2025;29(2):75-79
Objective To analyze the characteristics of acupoint selection in treatment for func-tional constipation.Methods Clinical literature on acupuncture and electroacupuncture therapy for functional constipation from January 1,2013,to December 31,2023,was retrieved from CNKI.The acupuncture prescriptions were collected and organized,and data mining techniques were employed to analyze the patterns of acupoint selection.Results A total of 182 articles were included,yielding 123 acupuncture prescriptions involving 92 acupoints with usage frequency of 967 times.The top 10 acu-points in frequency were Tianshu(158 times),Shangjuxu(138 times),Dachangshu(61 times),Zu-sanli(60 times),Zhigou(57 times),Fujie(57 times),Guanyuan(35 times),Zhongwan(34 times),Qihai(34 times),and Quchi(28 times).The meridians of the selected acupoints for acu-puncture treatment of functional constipation were mainly involved in stomach,bladder,Ren,and spleen meridians.Association rule analysis revealed that the combination of Tianshu-Shangjuxu had the highest occurrence probability(75.82%),followed by Tianshu-Dachangshu(33.52%)and Tianshu-Zusanli(32.97%).Cluster analysis of acupoints showed that the main acupoints selected for acu-puncture treatment of functional constipation could be divided into 10 clusters,including primary acu-points,acupoints for various syndrome types,acupoints for regulating spirit,and acupoints for regula-ting sympathetic nerves.Conclusion Acupuncture treatment for functional constipation should follow the principles of holistic treatment and syndrome differentiation,combined with the methods of selecting acupoints based on their upper-lower,proximal-distal,and anterior-posterior relationships.The acu-point selection patterns identified in this study can provide important references for clinical treatment of functional constipation,offer guidance for practitioners in acupoint selection,facilitate precise treatment,and promote early patient recovery.
4.Summary of the best evidence for non-pharmacological management of cancer pain patients
Chunyuan BO ; Liming LYU ; Miao GUO ; Qi WANG ; Yanxia YANG
Chinese Journal of Modern Nursing 2025;31(4):478-484
Objective:To retrieve, summarize and evaluate the best evidence for the non-pharmacological management of patients with cancer pain, so as to provide an evidence-based basis for the scientific management of cancer pain by healthcare professionals.Methods:A systematic search of the national and international literature on the non-pharmacological management of cancer pain was conducted, with a timeframe of January 2017 to January 2024. The quality of the included literature was evaluated, and evidence was extracted and summarized for those that met the quality criteria.Results:A total of 18 papers were included, including one clinical decision, seven guidelines, three expert consensus, and seven systematic reviews. Twenty-eight pieces of evidence were summarized around six themes of pain assessment, cognitive-behavioral interventions, physical therapy, interventional therapy and surgery, and self-management education and follow-up.Conclusions:Healthcare professionals should develop a patient-centered, appropriate and feasible non-pharmacological management plan for cancer pain with multiple agreements with patients and families, taking into account the clinical context and individual differences of patients in China, in order to improve the quality of life.
5.Research progress on the interactive effects of cardiovascular disease and cognitive frailty in the elderly
Qiqi JIANG ; Yanxia LIN ; Shijie ZHAO ; Nannan LI ; Huanrui ZHANG ; Liye SHI ; Wen TIAN ; Guoxian QI ; Jinyang LI ; Ling CHEN
Chinese Journal of Geriatrics 2025;44(8):1056-1061
The escalating phenomenon of global population aging is posing multi-dimensional challenges to society, the economy and medical healthcare system.Among the significant health threats to the elderly population are cardiovascular diseases(CVD)and cognitive frailty(CF), both of which profoundly affect the quality of life and increase the risks of adverse health outcomes, including disability, hospitalization, and death.The concurrent presence of CVD and CF in elderly patients is prevalent, as these conditions share many common risk factors and underlying pathophysiological mechanisms, such as atherosclerosis, microcirculation dysfunction, and inflammation, which interact to perpetuate a vicious cycle.Notably, CF exhibits a certain degree of reversibility; thus, the implementation of a diagnosis and treatment paradigm that incorporates "comprehensive geriatric assessment and geriatric interdisciplinary teams" should be established as a conventional management strategy for elderly patients affected by both CVD and CF.Cognitive digital therapeutics, along with personalized exercise prescriptions based on cardiopulmonary exercise tests, may represent more appropriate precision interventions for these patients.Consequently, there is a necessity for further in-depth research in this area moving forward.
6.Regulation of methamphetamine-induced activation and polarization of microglia by Nrf2
Genmeng YANG ; Yanxia PENG ; Xinjie ZHANG ; Yuhan HOU ; Jing XU ; Lihua LI ; Qi DU ; Shijun HONG
Chinese Journal of Comparative Medicine 2024;34(12):1-7
Objective To investigate the regulatory role of nuclear factor erythroid 2-related factor 2(Nrf2)in the activation and polarization of microglia induced by methamphetamine(METH).Methods BV2 and HMC3 cells were studied in vitro and wild-type mice and Nrf2-knockout mice were studied in vivo.In vivo and in vitro toxicity models induced by METH were established,respectively.The activation and polarization of microglia in each group were examined using immunofluorescence and Western blot,respectively.Results METH treatment significantly increased the fluorescence level of inducible nitric oxide synthase(iNOS)in BV2 and HMC3 cells(P<0.001),and significantly decreased the fluorescence level of Arginase1(Arg1)(P<0.05,P<0.01).METH exposure activated microglia in the cortex,increased expression levels of ionized calcium binding adaptor molecule-1(IBA1)and iNOS(P<0.001,P<0.05),and decreased the expression of Arg1(P<0.01).The number of activated microglia was significantly increased after Nrf2 gene knockout(P<0.01),compared with the WT METH group,while the expression levels of IBA1 and iNOS were also increased(P<0.001,P<0.01)and the expression level of Argl was decreased(P<0.01).Conclusions Nrf2 plays an important role in regulating the activation and polarization of microglia induced by METH.Nrf2 may thus be a potential target for the treatment of neuroinflammation induced by METH.
7.Association of interpregnancy interval and risk of adverse pregnancy outcomes in woman by different previous gestational ages
Peiran CHEN ; Yi MU ; Zheng LIU ; Yanping WANG ; Xiaohong LI ; Li DAI ; Qi LI ; Mingrong LI ; Yanxia XIE ; Juan LIANG ; Jun ZHU
Chinese Medical Journal 2024;137(1):87-96
Background::With an increasing proportion of multiparas, proper interpregnancy intervals (IPIs) are urgently needed. However, the association between IPIs and adverse perinatal outcomes has always been debated. This study aimed to explore the association between IPIs and adverse outcomes in different fertility policy periods and for different previous gestational ages.Methods::We used individual data from China’s National Maternal Near Miss Surveillance System between 2014 and 2019. Multivariable Poisson models with restricted cubic splines were used. Each adverse outcome was analyzed separately in the overall model and stratified models. The stratified models included different categories of fertility policy periods (2014–2015, 2016–2017, and 2018–2019) and infant gestational age in previous pregnancy (<28 weeks, 28–36 weeks, and ≥37 weeks).Results::There were 781,731 pregnancies enrolled in this study. A short IPI (≤6 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.63 [1.55, 1.71] for vaginal delivery [VD] and 1.10 [1.03, 1.19] for cesarean section [CS]), low Apgar scores and small for gestational age (SGA), and a decreased risk of diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. A long IPI (≥60 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.18 [1.11, 1.26] for VD and 1.39 [1.32, 1.47] for CS), placenta previa, postpartum hemorrhage, diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. Fertility policy changes had little effect on the association of IPIs and adverse maternal and neonatal outcomes. The estimated risk of preterm birth, low Apgar scores, SGA, diabetes mellitus in pregnancy, and gestational hypertension was more profound among women with previous term births than among those with preterm births or pregnancy loss.Conclusion::For pregnant women with shorter or longer IPIs, more targeted health care measures during pregnancy should be formulated according to infant gestational age in previous pregnancy.
8.Psychological experience of cancer bereaved: a Meta-synthesis of qualitative research
Miao GUO ; Liming LYU ; Qi WANG ; Chunyuan BO ; Yanxia YANG
Chinese Journal of Modern Nursing 2024;30(20):2695-2700
Objective:To systematically evaluate the psychological experience of cancer bereaved, so as to provide basis for bereavement care and intervention.Methods:Qualitative studies on the emotional experiences of cancer bereaved were searched in PubMed, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Database. The search period was from database establishment to July 2023. The quality evaluation was conducted using the 2020 version of the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center, and the results were integrated using the Meta-synthesis.Results:A total of 11 studies were included, 44 research results were extracted, and 8 new categories and 3 integrated results were summarized, namely the differences in grief emotions after bereavement, grief coping, and support needs after bereavement.Conclusions:The psychological experience of bereaved is relatively complex, and their grief emotions vary. Medical and nursing staff should pay attention to the grief response of the bereaved, guide them to self-adjustment, attach importance to the needs of the bereaved, and provide social support to assist them in returning to society as soon as possible.
9.Regulation of methamphetamine-induced activation and polarization of microglia by Nrf2
Genmeng YANG ; Yanxia PENG ; Xinjie ZHANG ; Yuhan HOU ; Jing XU ; Lihua LI ; Qi DU ; Shijun HONG
Chinese Journal of Comparative Medicine 2024;34(12):1-7
Objective To investigate the regulatory role of nuclear factor erythroid 2-related factor 2(Nrf2)in the activation and polarization of microglia induced by methamphetamine(METH).Methods BV2 and HMC3 cells were studied in vitro and wild-type mice and Nrf2-knockout mice were studied in vivo.In vivo and in vitro toxicity models induced by METH were established,respectively.The activation and polarization of microglia in each group were examined using immunofluorescence and Western blot,respectively.Results METH treatment significantly increased the fluorescence level of inducible nitric oxide synthase(iNOS)in BV2 and HMC3 cells(P<0.001),and significantly decreased the fluorescence level of Arginase1(Arg1)(P<0.05,P<0.01).METH exposure activated microglia in the cortex,increased expression levels of ionized calcium binding adaptor molecule-1(IBA1)and iNOS(P<0.001,P<0.05),and decreased the expression of Arg1(P<0.01).The number of activated microglia was significantly increased after Nrf2 gene knockout(P<0.01),compared with the WT METH group,while the expression levels of IBA1 and iNOS were also increased(P<0.001,P<0.01)and the expression level of Argl was decreased(P<0.01).Conclusions Nrf2 plays an important role in regulating the activation and polarization of microglia induced by METH.Nrf2 may thus be a potential target for the treatment of neuroinflammation induced by METH.
10.Influencing factors and prognosis of emphysematous urinary tract infection
Qi WANG ; Zhaoli GAO ; Hailin LYU ; Xiaotian MA ; Peng LU ; Yanxia GAO ; Zhao HU ; Qiang WANG
Chinese Journal of Nephrology 2022;38(5):413-419
Objective:To explore the influencing and prognosis factors of emphysematous urinary tract infection (EUTI).Methods:The baseline clinical data of the patients admitted to Shandong University Qilu Hospital (Qingdao) from December 2013 to June 2020 and diagnosed with EUTI were analyzed retrospectively. The patients with non-EUTI (NEUTI) during the same period were selected as the control group. The baseline characteristics between the two groups were compared. Logistic regression analysis method was used to analyze the influencing factors of EUTI.Results:(1) 24 EUTI patients and 53 NEUTI patients were included in the present study. Compared with the NEUTI group, the hemoglobin level was lower ( t=-5.245, P<0.001) and the levels of blood urine nitrogen ( Z=-4.361, P<0.001), serum creatinine (Scr, Z=-4.543, P<0.001), blood glucose ( Z=-2.608, P=0.009), and triacylglycerol ( Z=-2.408, P=0.016) were higher in the EUTI group. The proportions of diabetes mellitus ( χ2=13.453, P<0.001) and chronic kidney disease ( χ2=17.936, P<0.001) in the EUTI group were higher than those in the NEUTI group. Increasing Scr was the risk factor of EUTI in patients with urinary tract infection ( OR=1.011, 95% CI 1.001-1.020, P=0.025). (2) Escherichia coli ( E.coli, 14 cases, 58.3%) was the most common causative organism. The other causative organisms included Klebsiella pneumoniae (2 cases, 8.3%), Enterococcus faecium (1 case, 4.2%), Pantoea (1 case, 4.2%), and mixed bacteria of E.coli and Enterococcus faecium (1 case, 4.2%). Ten cases of E.coli were extended-spectrum β-lactamases (ESBL)-positive. (3) Of the 24 patients with EUTI, 4 patients had adverse outcomes. The length of stay ( Z=-2.457, P=0.014), blood urea nitrogen ( t=2.432, P=0.024), shock ( P=0.002), autoimmune disease ( P=0.022), and white blood cell count ( Z=-2.091, P=0.036) were statistically different between good prognosis group ( n=20) and poor prognosis group ( n=4). However, logistic regression analysis results showed that neither was the influencing factor of poor prognosis of EUTI. Conclusions:The elevated Scr level is the independent influencing factor of EUTI among urinary infection patients. E.coli is the most common pathogenic bacteria, and ESBL-positive bacteria are common.

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