1.Application of the integrated medical and industrial training model in the training of oncology talents from the perspective of new medical sciences
Guogui SUN ; Yanlei GE ; Huaiyong NIE ; Yaning ZHAO ; Haimei BO ; Fengmei XING ; Yating ZHAO ; Hongcan YAN
Clinical Medicine of China 2024;40(1):77-80
The medical-industrial fusion training model combines the knowledge and technology of medical and engineering disciplines in the training of oncology graduate students, which can help accurate diagnosis and treatment of tumors, promote cooperation and innovation in oncology research, as well as promote the cultivation and exchanges of composite and innovative medical talents in oncology, promote the innovation and development of oncology diagnostic and treatment technology, and improve the survival rate and quality of life of oncology patients. This paper discusses the application of medical-industrial fusion training model in the training of o ncology professionals, and explores the new teaching mode of medical-industrial fusion thinking in the cultivation of complex and innovative medical talents in oncology under the background of "new medical science".
2.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine: Perimenopausal Syndrome
Shiwan HU ; Haiyan LIANG ; Kun MA ; Xiaona MA ; Zihan FANG ; Wenpei BAI ; Xinmin LIU ; Hongtian LI ; Fengmei LIAN ; Wei ZHANG ; Lihua QIN ; Min SHANG ; Ailuan LAI ; Xiuxiang TENG ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(21):234-242
Perimenopausal syndrome (MPS), a common endocrine system disease, is one of the diseases responding specifically to traditional Chinese medicine (TCM). The China Association of Chinese Medicine organized experts in endocrinology, gynecology, and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine, TCM, and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency, with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause, whereas such a therapy has certain risks, necessitating close monitoring of adverse reactions. Moreover, the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes, sweating, sleep disorders, and emotional abnormalities of MPS without causing obvious adverse reactions. However, its efficacy is slower than the hormone replacement therapy, and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First, an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second, high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third, efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.
3.Effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia
Ya'nan YANG ; Liping MU ; Fengmei XING ; Xinhong XUE ; Xiaoguang WANG ; Yangyu TAO ; Zhumei SUN ; Xiaoli ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2023;29(8):869-874
ObjectiveTo explore the effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia. MethodsFrom September, 2022 to February, 2023, 124 elderly people with sarcopenia were conveniently sampled from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City, Hebei Province. According to the coin toss, 62 elderly people from Shuxiangyuan Community were designated as control group, and 62 elderly people from Lishuiwan Community were as intervention group. The intervention group implemented the intervention based on the theory of planned behavior, including behavior attitude, behavior, subjective norms, perceived behavior control and behavior awareness; the control group maintained their original lifestyle, for twelve weeks. Before and after intervention, the grip strength, time of Five-Times-Sit-to-Stand Test, relative appendicular skeletal muscle index (RASM), 6-minute walking speed and the score of Berg Balance Scale (BBS) were compared. ResultsAfter intervention, the grip strength, RASM, 6-minute walking speed, and the score of BBS significantly increased, and the time of Five-Times-Sit-to-Stand Test shortened in the intervention group (|Z| > 6.257, |t| > 28.643, P < 0.001), and they were better in the intervention group than in the control group (|Z| > 2.288, |t| > 3.177, P < 0.05). ConclusionThe intervention based on theory of planned behavior can effectively relieve the muscle attenuation of the elderly with sarcopenia, and improve their balance ability.
4.Effect of nutrition combined with exercise on stroke patients with sarcopenia
Xinhong XUE ; Xiaoguang WANG ; Yangyu TAO ; Na LI ; Jing DONG ; Zijiao XUE ; Fengyu CAI ; Fengmei XING
Chinese Journal of Rehabilitation Theory and Practice 2023;29(5):595-600
ObjectiveTo explore the effect of nutrition combined with exercise intervention on stroke patients with sarcopenia. MethodsFrom January to June, 2022, 60 stroke patients with sarcopenia were randomly divided into control group (n = 15), nutrition group (n = 15), exercise group (n = 15) and combined group (n = 15). All the groups received routine rehabilitation training, while the nutrition group received nutrition intervention, the exercise group received exercise intervention, and the combined group received both the nutrition and exercise intervention, for four weeks. Before and after intervention, the muscle index was measured with bioelectrical impedance analysis, gripping strength of the healthy and the affected side was measured with gripping strength meter, and the patients were assessed with modified Barthel Index (MBI) and Berg Balance Scale (BBS). ResultsFour cases in the control group, two in the nutrition group, one in the exercise group, and three in the combined group dropped down. The muscle index, gripping strength, and the scores of MBI and BBS improved in all the groups after intervention (|t| > 3.004, P < 0.05), while all improved more in the combined group than in the other three groups (P < 0.05), and the grip strength of the healthy side was more in the exercise group than in the nutrition group (P < 0.05). ConclusionNutrition or exercise intervention alone can improve the muscle quality, grip strength, activities of daily living and balance of stroke patients with sarcopenia, while the combination is more effective.
5.Polypharmacy burden and the associated factors among inpatients with elderly comorbidity
Zhiyu WANG ; Xianyu LU ; Fengmei XING
Chinese Journal of Practical Nursing 2022;38(12):906-910
Objective:To explore the current status and influencing factors of polypharmacy burden in inpatient with elderly comorbidity.Methods:Convenience sampling method was used to select 393 in patients with elderly comorbidity of multiple medications who were hospitalized in North China University of Science and Technology Affiliated Hospital from September 2020 to January 2021 as the research object, using the general situation questionnaire, the Living with Medicines Questionnaire (LMQ), the Perceived Social Support Scale (PSSS), the Medication Compliance Scale (Morisky Scale) to investigate. Descriptive analysis of general data characteristics and polypharmacy burden scores were performed, and t-test, variance analysis, and multiple linear stepwise regression analysis were used to analyze influencing factors. Results:The polypharmacy burden for inpatient with elderly comorbidity was (136.95 ± 22.34) points, and the score rate was 70.23%, which was at a moderately high level. Multi-factor analysis showed that age, education level, personal monthly income, the number of illnesses, the number of medications, the duration of medication, social support, and medication compliance were independent factors influencing polypharmacy burden in inpatient with elderly comorbidity ( R 2=0.821, adjusted R 2=0.818, F=220.65, P<0.001). Conclusions:The polypharmacy burden in inpatient with elderly comorbidity is at a moderately high level. It is recommended that medical staff should develop individualized nursing interventions to reduce the polypharmacy burden for the factors that affect the burden of multiple medications for this population.
6.Dynamic measurement of volume of atelectasis area in the evaluation of the prognosis of patients with moderate-to-severe acute respiratory distress syndrome
Xing LU ; Yuxin HAN ; Xinjing GAO ; Fengmei WANG ; Lei XU
Chinese Critical Care Medicine 2020;32(9):1056-1060
Objective:To assess the impact of not inflated lung tissue (NILT) volume on the prognosis of patients with moderate-to-severe acute respiratory distress syndrome (ARDS).Methods:The clinical data of 131 patients with moderate-to-severe ARDS admitted to the intensive care unit (ICU) of Tianjin Third Central Hospital from March 2016 to June 2019 were collected. The basic data of patients, including gender, age, body mass index (BMI), causes of ARDS, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score and oxygenation index (PaO 2/FiO 2), were collected. The CT imaging data of patients on the 1st and 7th day in the ICU were collected. According to the CT value, they were divided into hyperventilated areas (-1 000 to -900 HU), normal ventilation areas (-899 to -500 HU), poorly ventilated areas (-499 to -100 HU), and atelectasis area (-99 to 100 HU). The total lung volume and the percentage of NILT to the total lung volume (NILT%) were calculate. At the same time, duration of mechanical ventilation, length of ICU stay, total length of hospital stay were collected. According to the 28-day follow-up, they were divided into survival group and death group. Multivariate Logistic regression analysis was used to determine the risk factors for 28-day death in ARDS patients. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and 95% confidence interval (95% CI) were calculated to determine the accuracy of NILT% in predicting the 28-day prognosis of ARDS patients, and the NILT% threshold was used for subgroup analysis of patients. Results:Among the 131 patients with moderate-to-severe ARDS, patients were excluded for more than 48 hours after ARDS diagnosis, repeated admission to ICU due to ARDS, the ICU duration less than 7 days, death within 72 hours of admission, chronic interstitial lung disease or congestive heart failure, no chest CT examination within 7 days of admission to ICU, and no specimen collection within 2 hours of admission to ICU. Finally, a total of 53 patients were enrolled in the analysis. Of the 53 patients, 31 patients survived and 22 patients died. The 28-day mortality was 41.5%. Compared with the survival group, patients in the death group were older (years old: 65.32±11.29 vs. 55.77±14.23), and had a higher SOFA score (11.68±3.82 vs. 8.39±2.23) with significant differences (both P < 0.05), while there were no significant differences in gender, BMI, ARDS cause, APACHE Ⅱ score and PaO 2/FiO 2 between the two groups. There was no significant difference in CT value, total lung volume and NILT% between the two groups at 1st day after admission to ICU; NILT% on day 7 after admission to ICU in the death group was significantly higher than that in the survival group [(28.95±8.40)% vs. (20.35±5.91)%, P < 0.01], but there was no significant difference in CT value and total lung volume between the two groups. Multivariate Logistic regression analysis showed that the 28-day prognosis of ARDS was related to age, SOFA score and NILT% independently [age: odds ratio ( OR) = 0.892, 95% CI was 0.808-0.984, P = 0.023; SOFA score: OR = 0.574, 95% CI was 0.387-0.852, P = 0.006; NILT%: OR = 0.841, 95% CI was 0.730-0.968, P = 0.016]. ROC curve analysis showed that 7-day NILT% could predict the 28-day prognosis of patients with moderate-to-severe ARDS, and AUC was 0.810 (95% CI was 0.678-0.952, P < 0.01). The NILT% threshold was 15.50%, sensitivity was 95.5%, specificity was 80.6%, positive predictive value was 85.7%, and negative predictive value was 74.6%. According to the 7-day NILT% threshold, a subgroup analysis of patients was performed, and 7-day NILT% > 15.50% was defined as a high-risk clinical prognosis, and ≤ 15.50% was a low-risk. Compared with low-risk patients ( n = 7), the duration of mechanical ventilation, the length of ICU stay and total length of hospital stay in high-risk patients ( n = 46) were significantly prolonged [duration of mechanical ventilation (days): 9.37±6.14 vs. 4.43±1.72, length of ICU stay (days): 12.11±5.85 vs. 7.57±1.13, total length of hospital stay (days): 18.39±5.87 vs. 11.29±2.22, all P < 0.05]. Conclusion:The 7-day NILT% > 15.50% of patients with moderate-to-severe ARDS after ICU admission is related to poor prognosis.
7.Impact of nursing intervention based on stress system on posttraumatic growth and social support in patients with stroke
Jie ZHANG ; Fengmei XING ; Jie LYU ; Xiujuan ZHANG ; Guihong LIU ; Baomin WANG
Chinese Journal of Modern Nursing 2020;26(5):652-656
Objective:To investigate the effect of nursing intervention based on stress system theory on posttraumatic growth (PTG) and social support in patients with stroke.Methods:120 stroke patients who were hospitalized in Department of Neurology, Tangshan People's Hospital from January to August 2018 were selected as the research subjects by convenient sampling. A total of 120 stroke patients were divided into intervention group and control group according to the random number table method with 60 patients in each group. The control group was given routine care, and the intervention group was given stress system intervention on this basis. The Post-traumatic Growth Assessment Inventory (PTGI) and the Perceived Social Support Scale (PSSS) were used to compare the PTG and social support levels of the two groups.Results:After 2 months of intervention, the total score of PTGI in the intervention group was (69.67±9.10) , and that in the control group was (48.62±7.94) , the difference between the two groups was statistically significant ( P<0.05) . After the intervention, the PSSS score of the intervention group was (59.15±13.47) , which was higher than that in the control group (50.87±20.09) , the difference between the two groups was statistically significant ( P<0.05) . Conclusions:Stress system intervention can improve PTG and social support in patients with stroke.
8.Effects of different local intervention temperatures on endoplasmic reticulum stress and cell apoptosis in pressure ulcer of rats
Qing WANG ; Xiaofei DU ; Fengmei XING ; Fenglan WANG ; Xiaoli ZHANG
Chinese Journal of Comparative Medicine 2018;28(1):56-63
Objective To compare the effects of different local intervention temperatures of pressure ulcer on endoplasmic reticulum stress (ERS) and apoptosis in rats, and to provide an experimental evidence for clinical prevention and treatment of pressure ulcer. Methods The rat model of pressure ulcer was established by ischemia reperfusion, and a total of 40 SPF adult, male SD rats were divided into 4 groups: the sham group (anesthesia only, without other treatment), model group (ischemia at 22℃ for 1 h and reperfusion at 22℃ as one cycle, repeated for 5 cycles), high-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 32℃ as one cycle, repeated for 5 cycles) and low-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 12℃ as one cycle, repeated for 5 cycles). At the end of the experiment, muscle tissues at the sites under pressure of the rats were taken on ice. The pathological changes of skeletal muscle tissues were observed by HE staining. The expression levels of ERS-related proteins GRP78, caspase-12 and CHOP were detected by Western blot, and the expression of caspase-12 and CHOP was also observed by immunofluorescence. Moreover, apoptosis in the skeletal muscle cells was examined by TUNEL staining. Results Compared with the model group, skeletal muscle cell damages became more severe and apoptotic cells were increased in the high-temperature intervention group. Besides, the results of the immunofluorescence assay showed an increased positive expression of caspase-12 and CHOP, and the results of Western blot showed that the expression levels of GRP78, caspase-12 and CHOP were all higher than those of the model group (P< 0. 05). In contrast, skeletal muscle cell damages were alliviated and apoptotic cells were reduced in the low-temperature intervention group. Meanwhile, the positive expression of caspase-12 and CHOP was decreased, as shown by immunofluorescence, and all the expression levels of GRP78, caspase-12 and CHOP detected by Western blot were lower than the control group (P < 0. 05). Conclusions Local low-temperature intervention can alleviate the pressure ulcer damages in rats through inhibition of the ERS-mediated apoptotic pathway. Local high-temperature intervention may exacerbate the pressure ulcer damages in rats by activating the ERS-mediated apoptotic pathway and promoting cell apoptosis. Local low-temperature intervention may be promising in clinical prevention and treatment of pressure ulcer.
9.Effects of self efficacy and coronary heart disease knowledge on health literacy of young and middle-aged patients with coronary heart disease
Qian ZHANG ; Liang ZHU ; Liwei JING ; Fenglan WANG ; Xiaoli ZHANG ; Fengmei XING
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(3):252-255
Objective To investigate the effect of self efficacy and coronary heart disease knowledge on health literacy of young and middle-aged patients with coronary heart disease.Methods Investigation was conducted among 500 patients using general questionnaire,chronic health literacy scale,self-efficacy scale and coronary heart disease knowledge questionnaire.Results The score of health literacy for young and middle-aged patients was (97.76± 15.45),and 57% of the patients had good health literacy.Self-efficacy and coronary heart disease knowledge were positively correlated with health literacy (r=0.301,r=0.309;P< 0.05).Multiple regression analysis showed that self-efficacy (β=0.210),coronary heart disease knowledge (β=0.226) were significant factors of health literacy(both P<0.01).Conclusion The self-efficacy and coronary heart disease knowledge have impact on the health literacy.The more self-efficacy and coronary heart disease knowledge,the higher health literacy.
10.Intervention effects of mindfulness-based stress reduction on housebound elders with depression
Meng DENG ; Fengmei XING ; Yuding HU ; Kun YANG ; Xiaoli ZHANG ; Fenglan WANG
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(11):1031-1034
Objective To explore the effect of mindfulness decompression therapy on the house-bound elders with depression. Methods By the stratified random sampling method,screening 1 371 more than 60 year old people in the community,86 cases housebound elders with depression were randomly divided into intervention group and control group. Intervention group received mindfulness decompression therapy in-tervention,and control group with blank control. The housebound state assessment scale and the Geriatric Depression Scale (GDS) were evaluated before intervention,4 weeks after intervention and 8 weeks after in-tervention. Results During the intervention period,3 cases were dropped out,83 cases were all included (41 cases in the intervention group and 42 cases in the control group). There was no significant difference between the two groups in the general situation before the intervention (P>0. 05),and the balance between the two groups was comparable. After intervention,the total score of housebound (8. 4±2. 0) and the total score of depression (12. 2±4. 3) in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0. 05). Conclusion Mindfulness-based stress reduction can ef-fectively improve the depression and housebound condition of the elderly.

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