1.Effects of home hospice care team service model on fall risk in patients with end-stage malignant tumors and main caregivers
Fangping ZHOU ; Yuzhen HE ; Mingcai HU ; Lixia ZOU ; Rixia XIAO ; Xuejun HUANG ; Jun ZHOU
Chinese Journal of Practical Nursing 2024;40(28):2165-2172
Objective:To explore the effects of home hospice care team service model in patients with end-stage malignant tumors and main caregivers, so as to provide intervention programs for improving the quality of life of patients with end-stage malignant tumors.Methods:In the prospective and controlled study, 106 patients with malignant tumors who received end-stage hospice care in Yuebei People′s Hospital and main caregivers from May 2021 to July 2021 were selected by convenience sampling method, and divided into trial group (53 pairs) and control group (53 pairs) according to the random number table method. The control group was treated with routine nursing intervention, and the trial group was given home hospice care team service model intervention based on the control group. The occurrence of falls and negative emotions and quality of life of patients, psychological stress of primary caregivers before and after intervention were observed by using Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Relative Stress Scale (RSS) and European Organization for Research and Treatment of Cancer Quality of Life Scale (EORTC QLQ-C30).Results:Finally, 103 patients and main caregivers completed the study, with 52 pairs in the control group and 51 pairs in the trial group. In the control group, the patients were 29 males and 23 females, aged (54.33 ± 12.24) years old,and the main caregivers were 22 males and 30 females, aged (41.67 ± 8.14) years old. In the trial group,the patients were 27 males and 24 females,aged (55.17 ± 10.56) years old,and the main caregivers were 24 males and 27 females, aged (43.62 ± 7.39) years old. After intervention, the total incidence of falls and the total incidence of fall complications in the trial group were 7.84% (4/51) and 1.96% (1/51), respectively, which were lower than 25.00% (13/52) and 11.54% (7/52) in the control group, the differences were statistically significant ( χ2=5.50, 4.75, both P<0.05). There was no significant difference in the score of SAS, SDS, RSS, EORTC QLQ-C30 before intervention between the two groups (all P>0.05). After intervention, the scores of SAS and SDS in trial group were (32.66 ± 3.18), (31.19 ± 4.50) points,which lower than those in control group (34.54 ± 3.91), (34.31 ± 4.03) points, the differences were statistically significant ( t=2.67, 2.51, both P<0.05). After intervention, the RSS scores of psychological distress, life disruption, negative emotion and total score of the main caregivers in trial group were (3.52 ± 0.48), (3.66 ±0.56), (3.47 ± 0.82), (10.65 ± 0.67) points, which were lower than those in the control group (4.74 ± 2.75), (4.67 ± 2.64), (4.12 ± 2.13), (13.53 ± 2.26) points, the differences were statistically significant ( t values were 2.04-8.73, all P<0.05). After intervention, the EORTC QLQ-C30 score in the trial group was (74.14 ± 5.64) points, which was lower than that in the control group (70.54 ± 7.07) points, the difference was statistically significant ( t=2.85, P<0.05). Conclusions:The application of home hospice care team service model can effectively reduce the risk of falls in patients with malignant tumor chemotherapy, improve the negative emotions of patients and the psychological stress state of their main caregivers, and improve the quality of life of patients.
2.Correlation between posterior longitudinal ligament injury and vertebral body injury parameters in thoracolumbar burst fractures
Qiang HE ; Xuejun YANG ; Feng LI ; Baolong YU ; Shengxiang LIU ; Xu GAO ; Zhi HUANG ; Wenkai ZHENG ; Yifeng DA ; Zhi WANG ; Wenhua XING
Chinese Journal of Orthopaedics 2024;44(22):1474-1481
Objective:To evaluate the correlation between the degree of posterior longitudinal ligament (PLL) injury and various parameters of vertebral body injury in patients with thoracolumbar burst fractures.Methods:A total of 48 patients with thoracolumbar burst fractures were admitted to the Spine Surgery Center of the Second Affiliated Hospital of Inner Mongolia Medical University between December 2022 and January 2024. The cohort consisted of 31 males and 17 females, with a mean age of 44.1±11.8 years (range, 18-65 years). Based on the PLL injury grading method proposed by Sun Zhaoyun, patients were classified into three groups: mild, moderate, and severe. However, due to an insufficient number of patients in the severe group ( n=3), the moderate and severe groups were combined for statistical analysis, resulting in two groups: mild, and moderate-to-severe. Patient demographic and clinical data were collected. Local kyphosis (LK), inversion angle (IA), horizontal rotation angle (HRA), increased interspinous distance (IISD), anterior vertebral body compression ratio (AVBCR), posterior vertebral body compression ratio (PVBCR), middle vertebral body compression ratio (MVBCR), the ratio of height of bone fragment (RHBF), the ratio of width of bone fragment (RWBF), and mid-sagittal canal diameter compression ratio (MSDCR) were measured. Statistical analyses were performed using SPSS 25.0. Categorical variables were expressed as frequency (percentage) and analyzed using chi-square and Fisher exact tests. Continuous variables were tested for normality, with non-normally distributed data analyzed using the rank-sum test and expressed as median (interquartile range). Multivariate logistic regression analysis was performed to identify independent risk factors, and receiver operating characteristic (ROC) curves were plotted to calculate the area under the curve (AUC) to evaluate predictive performance. Results:Among the 48 patients, only 3 were found to have severe PLL injury, necessitating the combination of the moderate and severe groups for statistical purposes. Patients in the moderate-to-severe group demonstrated significantly higher AVBCR, PVBCR, RHBF, MVBCR, MSDCR, and IA compared to the mild group ( P<0.05). Multivariate logistic regression identified AVBCR, PVBCR, MSDCR, and IA as independent risk factors for moderate-to-severe PLL injury ( OR>1, P<0.05). ROC curve analysis revealed that AVBCR, PVBCR, MSDCR, IA, and their combined index could effectively predict moderate-to-severe PLL injury ( P<0.05). Notably, the combined index showed superior predictive performance (AUC=0.970) compared to individual parameters. Threshold values were determined as follows: AVBCR>45.30%, PVBCR>12.17%, MSDCR>27.13%, IA>5.90°, and the combined index >0.61, indicating PLL damage. Conclusion:AVBCR, PVBCR, MSDCR, IA, and their combined index are significantly associated with moderate-to-severe PLL injury in thoracolumbar burst fractures. The combined index demonstrates superior predictive ability compared to single parameters, providing a reliable tool for assessing PLL integrity.
3.Clinical characteristics of psoriasis and current status of medical care for patients in county areas of China
Min LI ; Bo ZHANG ; Wenjun WANG ; Yixuan ZHANG ; He HUANG ; Yihe WANG ; Hao JIANG ; Daihua TAN ; Lina CHEN ; Yuxiu JIANG ; Yingyou ZHAO ; Qunli ZHAO ; Xianyong YIN ; Liangdan SUN ; Furen ZHANG ; Xinghua GAO ; Yong CUI ; Xuejun ZHANG
Chinese Journal of General Practitioners 2024;23(11):1155-1161
Objective:To investigate the clinical characteristics of psoriasis and status quo of medical care for patients in county areas of China.Methods:This study was a cross-sectional investigation. Based on the “Qianxian Wuyin” Project (a national project for upgrating ability for psoriasis care at county level), an online questionnaire survey was conducted in the dermatology departments of 459 county hospitals in 404 pilot administrative counties across China from February to June 2023. The questionnaire included demographic information of patients (gender, ethnicity, age, place of residence, education, marital status), and clinical characteristics of psoriasis (disease course, type, comorbidities, body surface area (BSA) and previous treatment. The Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were applied for assessing the quality of life and disease severity, and completed by patients or guardian and doctors, respectively.Results:A total of 16 935 patients completed the questionnaire. The age of patients was 1-102(44.17±11.58)years, and 71.0% (12 036/16 935) were 30-59 years old. The ratio of male to female was 2.21∶1; 24.3%(4 117/16 935) of patients had high school education; there were 9 940 patients(58.7%) with previous or current smoking and/or alcohol use; 42.8%(7 218/16 855) of patients had a disease course of 1-5 years. There were 15 630 patients(92.3%) with DLQI≥10, 8 346 patients(49.7%) with PASI≥10, 15 017 patients(89.2%) with BSA≥10%. The plaque type was the most common disease type ( n=14 965, 88.7%), and spotting type ranked the second ( n=1 141, 6.8%). The most common initial site was the trunk ( n=12 309, 72.9%). Among the comorbidities, hypertension was the most common one ( n=1 681, 10.0%). There were 7 650 reports of treatment response to conventional topical drug therapy and 3 112 reports of treatment response to systemic drug therapy, with 6 269 (81.9%) and 2 493 (80.1%) reporting poor or no response, respectively. Conclusions:The survey shows that in the county areas of China, the majority of psoriasis patients are severe patients with short course of disease, plaque type is the most common type, and hypertension is the most common comorbidity; and the conventional treatment is less effective for most patients.
4.Research progress in limb salvage surgery for diabetes
Journal of Chinese Physician 2024;26(4):627-632
Diabetes foot is a serious complication of diabetes. It is a complex disease with difficult treatment, poor prognosis, high cost, long cycle and easy repetition, which not only seriously affects the quality of life of patients, but also increases the economic burden, leading to an increased amputation rate. In recent years, the ways of treating diabetes foot at home and abroad have become more and more abundant and diverse. From traditional Chinese medicine to western medicine, from internal medicine to surgery, the research results are fruitful. However, limb salvage treatment for patients with diabetes foot is still a key and difficult point at present. It needs multidisciplinary team to jointly diagnose and treat, and explore more limb salvage schemes that can be applied to clinical practice. This article reviews the related research on diabetes foot salvage surgery, introduces the latest research progress of diabetes foot salvage surgery, and provides a reference for clinicians to select appropriate limb salvage surgery for diabetes foot patients.
5.Meta analysis of the correlation between chronic periodontitis and postmenopausal osteoporosis
Xuehui HU ; Hao YIN ; Zhiguo LUO ; Guoliang TANG ; Xuejun HE
Journal of Chinese Physician 2024;26(7):1010-1016
Objective:To systematically evaluate the correlation between chronic periodontitis and postmenopausal osteoporosis (PMOP).Methods:Electronic searches were conducted on Cochrane Library, Pubmed, Embase, Ovid, CNKI, CBM, VIP, and WF databases to collect research literature on the correlation between chronic periodontitis and PMOP. The Newcastle Ottawa Scale (NOS) criteria were used to evaluate the quality of the included literature, and RevMan 5.3 software was used for meta-analysis. The outcome measures were clinical attachment loss (CAL), probing depth (PD), plaque index (PI), calculus index (CI), bleeding on probing (BOP), and simplified oral hygiene index (OHI-S).Results:A total of 16 articles were included, with a total of 1587 patients. Compared with the postmenopausal non osteoporosis group, the osteoporosis group showed significant abnormalities in CAL [standardized mean difference (SMD)=1.09, 95% CI: 0.62-1.57, P<0.001], PD(SMD=0.71, 95% CI: 0.28-1.14, P<0.001), PI(SMD=0.43, 95% CI: 0.29-0.56, P<0.001), and OHI-S(SMD=0.28, 95% CI: 0.22-0.35, P<0.001) indicators, as well as in BOP(SMD=0.01, 95% CI: -0.48-0.49, P=0.97) and GI(SMD=0.01, 95% CI: -0.48-0.49, P=0.97). At the level of 0.24 and 95% CI: -0.34 to 0.81, P=0.42, there was no statistically significant difference. Conclusions:Women with PMOP exhibit more significant changes in indicators such as CAL, PD, PI, and OHI-S, suggesting that postmenopausal women with osteoporosis are more likely to suffer from periodontitis.
6.Progress of Chinese and Western Medicine in Treating Diabetic Retinopathy db/db Mice
Runxi HE ; Xiaodong LI ; Mei ZHANG ; Xuejun XIE
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(6):2097-2104
Diabetic retinopathy(DR)is a neurovascular unit lesion caused by diabetes mellitus,the incidence of which has increased significantly with the increase of the diabetic population.Therefore,it is important to use a reasonable animal model to explore the pathogenesis and therapeutic targets of DR.The db/db mouse is a relatively mature animal model of spontaneous type 2 diabetes and is therefore widely used in early prevention and treatment studies of type 2 DR.This paper describes the progress of db/db mouse model in exploring the pathogenesis of DR and the pharmacological research of Chinese and Western medicine,in order to provide a certain reference for the research of DR and drug development.
7.Research progress of probiotics intervening osteoporosis through intestinal tract
Journal of Chinese Physician 2023;25(3):468-472
Osteoporosis (OP) is a systemic bone disease characterized by decreased bone density and damage to bone microstructure, leading to brittle fractures. It is a multifactorial disease that is more common in postmenopausal women, and its high incidence and serious complications are receiving increasing attention. Currently, clinical anti-osteoporosis drugs are mainly divided into two categories: inhibiting bone resorption and promoting bone formation, including bisphosphonates, calcitonin and estrogen, etc. But the side effects and high economic cost of drugs limit the scope of their use to some extent. In recent years, the effect of intestinal flora on bone health, especially on osteoporosis, has become a potential new target for regulating bone density. Probiotics belong to intestinal flora and are defined as living microorganisms. They have initially shown good efficacy in the treatment of some bone metabolic diseases, suggesting that intestinal flora can be used as a potential target for the prevention and treatment of osteoporosis and the application of probiotics as a new therapeutic method for osteoporosis. This paper mainly reviews the relevant studies on probiotics and osteoporosis, shows the latest research progress of probiotics intervention in OP, clarifies the relevant action mechanism of probiotics intervention in OP through intestinal tract, and analyzes the research status and prospect of probiotics treatment in OP.
8.Risk factors and prognosis of acute stroke within 1 year after hip fracture surgery in elderly patients
Xiaobin CHEN ; Daojing QIU ; Yuanming HE ; Meng LU ; Ben XIAO ; Xuejun LI
Chinese Journal of Geriatrics 2023;42(6):711-714
Objective:To study the risk factors of acute stroke within 1 year after hip fracture in the elderly and its effect on prognosis.Methods:From January 2018 to December 2020, 278 elderly hip fracture patients undergoing surgery were retrospectively analyzed, including 101 males and 177 females, aged from 60 to 99 years with an average of(78.9±8.7)years.According to whether acute stroke occurred within 1 year after operation, the patients were divided into stroke group and non-stroke group.A multivariate Logistic regression was used to evaluate the risk factors for acute stroke within 1 year after hip fracture, and the prognosis was analyzed.Results:Acute stroke occurred in 28 patients(10.1%)within 1 year after operation, and the peak of stroke onset occurred in the third months after operation.Patients in the stroke group were older, and had a higher proportion of hypertension, arrhythmia, previous stroke history, and use of anticoagulant or antiplatelet drugs before fracture( P<0.05 for all). Multivariate Logistic regression analysis showed that advanced age( OR=1.078, 95% CI=1.007-1.153, P=0.030), male( OR=2.643, 95% CI=1.060-6.742, P=0.037)and previous stroke history( OR=12.202, 95% CI=4.662-31.940, P<0.001)were independent risk factors for stroke in elderly patients with hip fracture within 1 year after operation.The 1-year mortality, complication rate and readmission rate in the stroke group were significantly higher than those in the non-stroke group( P<0.05 for all). Conclusions:The incidence of stroke is high in elderly patients with hip fracture within 1 year after operation.Older age, male, and previous stroke history were independent risk factors for acute stroke.The prognosis of stroke was poor in elderly patients with hip fracture, and the 1-year mortality, complication and readmission rates were high.
9.Application of the interleukin-23 inhibitor guselkumab in the treatment of psoriasis
Chinese Journal of Dermatology 2023;56(2):181-184
Guselkumab is the first monoclonal antibody that selectively targets interleukin (IL) -23. Several randomized controlled clinical trials have demonstrated that it is highly effective and safe in the treatment of moderate to severe plaque psoriasis, and can significantly improve the quality of life of patients. This review summarizes the action mechanisms of IL-23 and guselkumab, as well as the application of guselkumab in the treatment of psoriasis.
10.Application of magnetic compression anastomosis to colorectal anastomosis and reconstruction
Jing LI ; Guifang LU ; Miaomiao ZHANG ; Shiqi LIU ; Xiaopeng YAN ; Feng MA ; Xiaoyang REN ; Xuejun SUN ; Yi LYU ; Shuixiang HE ; Mudan REN
Chinese Journal of Digestive Endoscopy 2023;40(5):397-400
Clinical cases treated by magnetic compression anastomosis (MCA) for different causes and types of intestinal stenosis/ atresia to successfully achieve intestinal recanalization were reviewed, so as to explore the clinical application of MCA. From May 2019 to August 2022, 4 patients underwent colorectal MCA for intestinal recanalization in the First Affiliated Hospital of Xi'an Jiaotong University and Northwest Women and Children's Hospital. All operations went well, and the intestinal anastomosis was recanalized. The magnetic ring was discharged in 7-15 days, and the postoperative colonoscopy or radiography showed that the anastomosis was intact. MCA can be used to treat different types of colorectal stenosis and atresia due to different reasons, and can also be used to assist intestinal anastomosis in colorectal surgery.

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