1.A study of the current status of female pelvic floor dysfunction patients′ knowledge of minimally invasive laser treatment of the reproductive tract and their intention to make treatment decisions
Shuang-hao ZHANG ; Jie TAO ; Zehua CAI ; Xuerong RAN ; Sisi WEI ; Jinfeng PAN ; Jinguo ZHAI
The Journal of Practical Medicine 2025;41(1):126-133
Objective To investigate the awareness of female patients with pelvic floor dysfunction regarding minimally invasive laser treatment of the reproductive tract and analyze the factors influencing their decision-making intentions,this study aims to provide a foundation for early treatment of pelvic floor dysfunction and further development in reproductive health management.Methods A convenience sampling method was employed to select 164 female patients with pelvic floor dysfunction who sought treatment at the Pelvic Rehabilitation Center of Dongguan Maternal and Child Health Care Hospital between June 2023 and August 2024.The study utilized the Female Sexual Function Index,Incontinence Quality of Life Questionnaire,and Family Support Self-Assessment Scale to conduct a survey.Binary logistic stepwise regression analysis was conducted to investigate the factors influ-encing patients'inclination towards undergoing genital laser minimally invasive treatment.Results Among the 164 female patients,143(87.2%)expressed an intention to receive treatment,with 22.6%demonstrating a rela-tively clear understanding of genital laser minimally invasive treatment.Logistic regression analysis revealed that occupation significantly influenced treatment intention(P<0.05).Compared to healthcare professionals,individuals in the teaching profession(OR=10.81,95%CI:1.04~112.21),self-employed individuals(OR=20.34,95%CI:3.46~119.43),and those in other professions(OR=16.26,95%CI:4.05~65.29)were more inclined to express willingness for undergoing treatment.Furthermore,a lower score on the Incontinence Quality of Life scale was found to positively correlate with treatment intention(OR=0.96,95%CI:0.93~0.99).Conclusion Although patients express a high intention to undergo minimally invasive genital laser treatment,their overall awareness of the procedure remains insufficient.
2.A study of the current status of female pelvic floor dysfunction patients′ knowledge of minimally invasive laser treatment of the reproductive tract and their intention to make treatment decisions
Shuang-hao ZHANG ; Jie TAO ; Zehua CAI ; Xuerong RAN ; Sisi WEI ; Jinfeng PAN ; Jinguo ZHAI
The Journal of Practical Medicine 2025;41(1):126-133
Objective To investigate the awareness of female patients with pelvic floor dysfunction regarding minimally invasive laser treatment of the reproductive tract and analyze the factors influencing their decision-making intentions,this study aims to provide a foundation for early treatment of pelvic floor dysfunction and further development in reproductive health management.Methods A convenience sampling method was employed to select 164 female patients with pelvic floor dysfunction who sought treatment at the Pelvic Rehabilitation Center of Dongguan Maternal and Child Health Care Hospital between June 2023 and August 2024.The study utilized the Female Sexual Function Index,Incontinence Quality of Life Questionnaire,and Family Support Self-Assessment Scale to conduct a survey.Binary logistic stepwise regression analysis was conducted to investigate the factors influ-encing patients'inclination towards undergoing genital laser minimally invasive treatment.Results Among the 164 female patients,143(87.2%)expressed an intention to receive treatment,with 22.6%demonstrating a rela-tively clear understanding of genital laser minimally invasive treatment.Logistic regression analysis revealed that occupation significantly influenced treatment intention(P<0.05).Compared to healthcare professionals,individuals in the teaching profession(OR=10.81,95%CI:1.04~112.21),self-employed individuals(OR=20.34,95%CI:3.46~119.43),and those in other professions(OR=16.26,95%CI:4.05~65.29)were more inclined to express willingness for undergoing treatment.Furthermore,a lower score on the Incontinence Quality of Life scale was found to positively correlate with treatment intention(OR=0.96,95%CI:0.93~0.99).Conclusion Although patients express a high intention to undergo minimally invasive genital laser treatment,their overall awareness of the procedure remains insufficient.
3.Construction of early enteral nutrition standardized bundled nursing plan for critically ill patients
Zhen HAN ; Shihan SHAN ; Chulin CHEN ; Xianghong YE ; Zehua ZHAO ; Jiaqi LI ; Lina CAI ; Hengyu ZHENG
Chinese Journal of Practical Nursing 2024;40(34):2665-2672
Objective:Care bundles for critically ill patients with early enteral nutrition up to goal was constructed. Its purpose was to improve early enteral nutrition, prognosis and provide reference basis for improving the rate of standard of early enteral nutrition in critically ill patients.Methods:By conducting systematic searching of domestic and foreign Chinese and English databases, related guide websites, relevant documents on early enteral nutrition in critically ill patients up to goal, which were obtained, evaluated, extracted, summarized and graded. After discussion by the research group, the first draft was prepared. Delphi method was used to conduct two rounds of expert correspondence, and the final draft of the proposal was established through the reliability analysis of correspondence results.Results:Twenty experts participated finally, and their opinions tended to be consistent after two rounds of expert inquiry. The authority coefficients were 0.92 and 0.91 respectively. The variation coefficients of the importance and operability of the two rounds of correspondence items were 0.05-0.20 and 0.05-0.21, 0.00-0.17 and 0.00-0.20 respectively. The Kendall concordance coefficients for the importance and operability of the two rounds of correspondence items were 0.16 and 0.13, 0.27 and 0.18 respectively. The differences were statistically significant ( χ2 values were 117.01-228.43, all P<0.05). Finally, the final draft of bundle of care for early enteral nutrition up to goal in critically ill patients was established which included three aspects related to evaluation, implementation, and effectiveness monitoring, besides care bundle included 12 intervention perspectives and 29 specific intervention measures. Conclusions:Based on evidence-based and delphi method constructing care bundles for critically ill patients with early enteral nutrition up to goal was scientific, reliable and practical which could provide theoretical and practical guidance for bundled nursing interventions to meet early enteral nutrition standards in critically ill patients.
4.Challenges in screening and early detection of gynecologic malignancies
Journal of Chinese Physician 2023;25(5):641-643
The cancer burden caused by gynecological malignancies poses a serious threat to the health of women in China. Screening and early diagnosis are the key means to reduce the incidence rate and mortality of cancer. This article aims to briefly summarize the current status and challenges of screening and early diagnosis of three common female reproductive tract malignancies (cervical cancer, endometrial cancer, and ovarian cancer), in order to clarify the current stage and future direction of efforts.
5.High-risk human papillomavirus negative cervical lesions in the cervical cancer screening population
Jing ZHAO ; Jing CAI ; Si SUN ; Zaiju HUANG ; Zehua WANG ; Liying WU
Journal of Chinese Physician 2023;25(5):656-660
Objective:To investigate the incidence of high-risk human papillomavirus (hrHPV) negative cervical lesions in the screening population, and based on this, to preliminarily evaluate the potential harm (missed diagnosis) and benefits (reduced colposcopy referral) of HPV primary screening compared to combined screening so as to provide reference for the selection of cervical cancer primary screening methods.Methods:This study was a single center cross-sectional study. Women who underwent joint screening [hrHPV typing test combined with cervical liquid based cytology test (LCT)] at the Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to December 31, 2019 were included in the cervical cancer screening. The proportion of hrHPV negative cytological abnormalities and cervical lesions in the population was analyzed and the theoretical colposcopy referral rate of the combined screening and HPV initial screening protocol was calculated. In the population with cervical pathological results, the number of colposcopy examinations required for the diagnosis of cervical intraepithelial neoplasia grade 2 and above (CIN2+ ) was calculated.Results:A total of 35 321 screened women were included. The overall incidence of hrHPV infection, LCT abnormalities and severe LCT abnormalities in the population was 17.13%(6 051/35 321), 18.07%(6 384/35 321), and 3.97%(1 402/35 321), respectively. The negative rate of hrHPV in women with severe cervical cytology abnormalities was as high as 51.28%(719/1 402), and in CIN2+ lesions diagnosed by cervical biopsy, hrHPV negative accounted for 7.15% (49/685). The theoretical colposcopy referral rates for combined screening and initial HPV screening were 11.28%(3 985/35 321) and 8.33%(2 943/35 321), respectively, with an average diagnosis of CIN2+ requiring 3.51 and 2.81 colposcopy examinations, respectively.Conclusions:In the opportunistic screening population, the proportion of hrHPV negative CIN2+ lesions cannot be ignored, and the HPV initial screening strategy may cause missed diagnosis of these lesions. However, compared to combined screening, HPV initial screening has the potential to improve the efficiency of colposcopy. These results suggest that we should carefully choose the HPV initial screening plan.
6.Analysis on current status and trends of research on standardized nursing terminology in China based on CiteSpace
Zehua CAI ; Gangyi PENG ; Lianhua CHEN ; Huanzhen OU ; Tiantian ZHANG ; Qian ZHANG
Chinese Journal of Modern Nursing 2023;29(2):191-197
Objective:To sort out the current status and development of standardized nursing terminology in China, and reveal research hotspots and trends.Methods:The bibliometric and keyword cluster analysis and burstiness detection were performed using CiteSpace software on periodicals of standardized nursing terminology in China National Knowledge Infrastructure, WanFang Database and VIP Database from their establishment to December 31, 2021.Results:A total of 1 761 articles were included. The development process of standardized nursing terminology includes three stages: sprouting period, stagnant period and rapid growth period. Researches were clinically-oriented. Researches focus on clinical application. The main reference tools of the studies include Omaha system, North America Nursing Diagnosis Association-International (NANDA-I) , Nursing Outcome Classification (NOC) and Nursing Intervention Classification (NIC) . Research settings mostly involve the elderly population and specialties such as stroke, diabetes and chronic obstructive pulmonary disease. Research topics focus on transitional care, case management, home visiting and nursing educationbased on nursing process. The Delphi method is commonly used for quality evaluation.Conclusions:Standardized nursing terminology is paid more attention and the overall trend is positive, but the local construction of nursing terminology needs to be developed. It is suggested that future research aim at actual demand of domestic clinical applications, nursing informatics talents be developed and cultivated, and research consensus be gathered in order to promote the construction of a standardized nursing terminology system with Chinese characteristics.
7.Pathogenesis and Treatment of Diabetic Macroangiopathy Based on Theory of Hidden Pathogen Damaging Collaterals
Qingzhi LIANG ; Yulin LENG ; Zhengtao CHEN ; Mengyuan CAI ; Zehua ZHANG ; Hong GAO ; Hongyan XIE ; Chunguang XIE
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(14):194-199
The basic pathological change of diabetic macroangiopathy is atherosclerosis, and the metabolism legacy effect of hyperglycemia will cause continuous damage to the large vessels. Oxidative stress is a common mechanism for diabetes and its chronic complications and it is also the basis of the metabolism legacy effect which keeps damaging the large vessels. Anti-oxidant therapy can delay the course of diabetic macroangiopathy. According to the theory of traditional Chinese medicine (TCM), the pathogenicity of hidden pathogen is concealing, lingering, and refractory. On the basis of the syndrome and treatment of collateral diseases, vessel-collateral theory, and hidden pathogen theory of TCM, the pathological changes of diabetic macroangiopathy are summarized as pathogen concealment-accumulation of sugar and lipids leading to phlegm and blood stasis-accumulation of toxins-damage to vessels and collaterals-hardening vessels. The core pathogenesis is the hidden pathogen damaging the collaterals, and the basic pathological change is vessel hardening. The toxins of sugar, lipid, phlegm, and stasis are the pathological products and the key to be treated. According to this theory, the medicinal materials with the functions of activating blood to dredging collaterals, resolving phlegm to clearing collaterals, Promoting qi to unblocking collaterals and removing toxins to shunting collaterals can be selected for prescription. These medicinal materials can inhibit the generation of reactive oxygen species, affect the oxidase activity, and enhance the antioxidant capacity, thereby regulating the oxidative stress response, protecting the vascular endothelial function, reducing the damage of the large blood vessels, and slowing down the progression of the disease. Such therapy is of great significance in clinical practice and research, providing a new idea for the prevention and treatment of diabetic macroangiopathy.
8.Thinking about lymphadenectomy for gynecological malignant tumor
Journal of Chinese Physician 2021;23(2):161-166
Lymph node metastasis represents a common way of distant spread of gynecologic malignancies and an independent risk factor of poor prognosis of patients. The pelvic and paraaortic lymphadenectomy is a critical part of the surgical treatment of gynecologic cancer, which potentially improves the survival outcomes of patients through clarifying the node status to guide the subsequent management and/or removal of positive nodes to reduce the tumor burden. However, when we make a decision about lymphadenectomy, we should balance the related survival benefits and morbidities impacting the long-term quality of life. It is noteworthy that the principles of lymph node management are varied between different types and different stages of tumors characterized with different clinical features. Moreover, the sentinel lymph node biopsy, which has been emerging as a promising alternative to traditional systematic lymph node dissection, provides new options while bringing new issues. Here, based on the latest progress in relevant fields, we attempt to figure out the distinct features and unanswered questions in the management of lymph nodes of patients with cervical cancer, endometrial cancer, and ovarian cancer, which may trigger meaningful thoughts regarding related clinical decision.
9.The feasibility and effectiveness of sentinel lymph node detection in ovarian neoplasms: a systematic review
Yujia WANG ; Jing CAI ; Si SUN ; Zehua WANG
Journal of Chinese Physician 2021;23(2):171-177
Objective:To evaluate the feasibility and effectiveness of sentinel lymph node (SLN) detection in the ovarian neoplasms.Methods:A search of the literature describing ovarian SLN was performed using China National Knowledge Infrastructure (CNKI), WANFANG DATA, VIP, PubMed, Embase, web of science, Cochrane library from 2000.01.01 to 2020.07.29. The quality evaluation and data extraction of the included literature were conducted, and the development rate, sensitivity and negative predictive value of SLN were calculated.Results:Eight prospective single-arm studies were included, with heterogeneity I2=57.41%>50%, and the P<0.1. A total of 96 patients with ovarian cancer [Stage International Federation of Gynecology and Obstetrics (FIGO)Ⅰ-Ⅱ] were included, of whom 93 completed systematic pelvic and para-aortic lymphadenectomy after SLN detection. The most common tracers were technetium-99m radioactive colloid ( 99Tc m), blue dye or indocyanine green (ICG), and the most common injection sites were the infundibulopelvic ligaments and the proper ovarian ligaments. The SLN detection rate was 88.5%(85/96) and the average number was 2-3. SLN was found in the ipsilateral or contralateral regions of the tumor, 40.8%(31/76) was found only in the para-aortic, 14.5%(11/76) was found only in the pelvic, and 44.7%(34/76) was found only in the para-aortic and pelvic region. The sensitivity was 90.9%(10/11) and the negative predictive value was 98.8%(82/83) of lymph node metastasis. Conclusions:SLN detection for ovarian neoplasms is feasible, and whether it can effectively predict lymph node status of ovarian cancer still needs large sample, multi-center, prospective clinical studies to further verify.
10.Tie2 Expressing Monocytes/Macrophages in Human Tumors
Chuyi JIANG ; Jing CAI ; Zehua WANG ; Yuanyuan CHEN
Cancer Research on Prevention and Treatment 2021;48(3):314-318
Tie2 expressing monocytes/macrophages (TEMs) are a subtype of monocytes or macrophages which expressing tyrosine kinase receptor Tie2. They can exist in peripheral blood and tissues of both human and mouse. TEMs can participate in the formation of tumor microenvironment by accelerating tumor angiogenesis, lymphangiogenesis and immunosuppression. At present, TEMs have been found to have potential diagnostic and prognostic guiding significance for a variety of tumors, and they are expected to provide new directions and strategies for tumor therapy. This paper reviews the research progress of TEMs in tumor.

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