Objective To investigate and analyze the employment status and related influencing factors of maintenance hemodialysis (MHD) patients. Methods MHD patients from four hemodialysis centers in Beijing between January 2020 and January 2021 were selected. The baseline data and clinical data of patients with long dialysis interval were collected. An anxiety and depression survey was conducted on the patient. Results A total of 108 MHD patients were included. Among them, 41 patients were working and 67 patients were not working. Among the 41 patients at work, there were 3 workers, 1 farmer, 14 company employees, 6 public institution employees, 11 self-employed, 5 freelancer and 1 other. Among the 67 patients who did not work, 8 patients had the ability to work but did not work. Body mass index was an independent influencing factor for employment in MHD patients [odds ratio=1.135, 95% confidence interval (1.017, 1.266), P=0.024]. Conclusion The nutritional status of MHD patients should be taken seriously to improve their employment rate.
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
To investigate the effect of propofol intra-aortic and intravenous infusion on the concentration of propofol for an ischemia-reperfusion spinal cord injury in rabbits. Methods Forty-six healthy adult New Zealand white rabbits were randomly divided into 3 groups: sal ine infusion group (group N, n=10), propofol intra-aortic infusion group (group A, n=16) and propofol intravenous infusion group (group V, n=16). The infrarenal abdominal aorta was occluded for 30 min during which propofol 50 mg/kg was infused continuously intra-aortic or intravenous with a pump in group A and V. In group N, the same volume of normal sal ine was infused in the same way and at the same rate as in group A. Upon reperfusion, propofol concentration of the spinal segments of L4-6 and T6-8 was examined in group A and V. At 48 hoursafter reperfusion, the neurological outcomes were recorded in each group. Results Mean blood pressure in group V from the time of 5 minutes after occlusion decreased more than in group N (P lt; 0.05) and than in group A from the time of 10 minutes after occlusion(P lt; 0.05). The mean blood pressure in group N increased more than in group A from 15 minutes after occlusion (P lt; 0.05). The heart rate increased more in group V from 10 minutes after occlusion than in group N and A (P lt; 0.05) in which no difference was observed. The propofol concentration in L4-6 of group A (26 950.5 ± 30 242.3) ng/g was higher than that in T6-8 of group A (3 587.4 ± 2 479.3) ng/g and both L4-6 (3 045.9 ± 2 252.9) ng/g and T6-8 (3 181.1 ± 1 720.9) ng/g of group V(P lt; 0.05). The paraplegia incidence was lower (30%) and the median of normal neurons was higher (8.4) in group A than in group N (80%, 2.2) and group V(100%, 1.9), (P lt; 0.05). There was no significant difference in group N and V in paraplegia incidenceand the median of normal neurons (P gt; 0.05). Conclusion Intra-aortic infusion shows a better neurological outcome than intravenous infusion and could contribute to higher concentration of propofol in the ischemia spinal cord.
Objective To assess the effectiveness and safety of biphasic insulin aspart 30 given three times a day in the management of type 2 diabetes. Methods Such databases as CENTRAL, MEDLINE, PubMed and CNKI were searched on computer; additionally, the relevant conference proceedings from associations like American Diabetes Association, and the references of all selected literatures were also hand-searched. The randomized controlled trials (RCTs) on biphasic insulin aspart 30 given three times a day in treating type 2 diabetes were screened according to inclusive and exclusive criteria, without concerning the limitation of languages and blind methods. After data extraction and quality evaluation, Meta-analysis was performed by using RevMan 4.2 software. Results Ten trials involving 1 415 patients were included. The sub-group analysis showed that compared with the group of given biphasic insulin aspart 30 twice a day (the bid group), the group of given biphasic insulin aspart 30 three times a day (the tid group) was superior in decreasing HbAlc (Plt;0.000 01). Compared with the group of thrice preprandial injection of Novolin R plus one injection of Novolin N at bedtime (the qid group), Meta-analysis showed that, a) As to the average fasting glucose levels: the tid group was not superior to the qid group (P=0.65); b) As to the average 2-hour postprandial glucose levels: the tid group was superior to the qid group (P=0.0003); c) As to the therapeutic time: the tid group was not superior to the qid group (P=0.38); d) As to the insulin doses: the tid group was superior to the qid group (P=0.000 1); e) As to the insulin costs: the tid group was inferior to the qid group (P=0.02); and e) As to the incidence of hypoglycaemia: the tid group was superior to the qid group (P=0.000 2). Compared with the oral antidiabetic drugs, the results of Meta-analyses showed: the tid group was superior in decreasing HbAlc (P=0.001). Conclusion The limited current evidence shows that biphasic insulin aspart 30 given three times a day, as a simple insulin intensified scheme, is safe and effective for type 2 diabetes, and is worth recommending in clinic. However, all these findings should be further confirmed with more large sample and well-designed RCTs.
Objective To compare the analgesic efficiency and safety of subacromial bursa continued ropivacaine analgesia with patient-controlled intravenous analgesia for arthroscopic rotator cuff repair. Methods A total of 64 patients undergoing rotator cuff repair surgery between October 2013 and February 2015 were randomly divided into the subacromial bursa group (JFX group, 32 cases) and the patient-controlled intravenous analgesia group (JM group, 32 cases). At the end of surgery, a catheter was inserted into the subacromial bursa of the patients in JFX group under arthroscopic visualisation and fixed properly, and analgesia pump was connected after surgery; in JM group, analgesia pump was connected to the vein channel after surgery. The pain Visual Analogue Scale (VAS) (motion and rest) scores 1 hour and 12, 24, 48, 72 hours after surgery, adverse reactions, use of analgesic pump, number of additional analgesia and patients satisfaction were recorded. Results There were no differences between the two groups in the number of additional analgesia, patients satisfaction, additional use of antiemetic drugs, motion and rest VAS scores 1 hour and 12, 72 hours after surgery, and the incidence of moderate-severe pain (VAS≥4) at each time point (P>0.05). The motion and rest VAS scores 24, 48 hours after surgery in JFX group were lower than those in JM group, the analgesia times and the incidence of nausea and vomiting in JFX group were lower than those in JM group, and the differences were statistically significant (P<0.05). Conclusion Efficiency of subacromial bursa infiltration of ropivacaine sustained analgesic is slightly better than that of patient-controlled intravenous analgesia, with lower incidence of adverse reactions.
Cardiac rehabilitation can safely and effectively improve the quality of patient's life and reduce readmission rate and mortality after cardiac surgery. Early cardiac rehabilitation after cardiac surgery is an indispensable part of cardiac rehabilitation. It can speed up the recovery of patient's exercise endurance, prevention of postoperative complications, shorten the time of returning to the family, increase the confidence of sustained rehabilitation, and lay foundation and set rehabilitation targets for the later stage of cardiac rehabilitation. This paper reviews the development history of early cardiac rehabilitation after cardiac surgery, and summarizes the current status, problems and outlook of rehabilitation management in China.
Objective To investigate the expression of miR-92a in breast cancer tissues and whether it can influence the migration and invasion ability of breast cancer cells through kruppel-like factor 4 (KLF4). Methods ① The expressions of miR-92a and KLF4 mRNA in cancer tissues and adjacent tissues were detected by qRT-PCR in 122 breast cancer patients who were operated in our hospital from May 2017 to October 2019. ② The expression of miR-92a in MCF-7 breast cancer cells was up-regulated or knocked out. Cell survival rate was detected by MTT assay, cell migration ability was detected by scratch assay, cell invasion ability was detected by Transwell assay, and the relative expression levels of KLF4, E-cadherin (E-cad), and N-cadherin (N-cad) proteins were detected by Western blotting. ③ The targeting relationship between miR-92a and KLF4 was detected by dual luciferase reporter gene assay. Results ① The relative expression levels of miR-92a and KLF4 mRNA in cancer tissues were higher than those in adjacent tissues (P<0.05). ② The up-regulation of miR-92a expression had no effect on the survival rate of MCF-7 breast cancer cells, but the migration and invasion ability of cells were enhanced (P<0.05). The knockdown of miR-92a expression decreased the survival rate of MCF-7 breast cancer cells and the ability of cell migration and invasion (P<0.05). ③ The miR-92a and KLF4 had a direct targeting relationship, up-regulation of miR-92a expression increased the relative expression levels of KLF4 and N-cad proteins, while decreased the relative expression level of E-cad protein (P<0.05). After knockout of miR-92a expression, the relative expression levels of KLF4 and N-cad proteins were decreased, while the relative expression level of E-cad protein was increased (P<0.05). Conclusion The miR-92a is highly expressed in breast cancer cells, and knockout of miR-92a expression can inhibit KLF4 signaling pathway and reduce the migration and invasion ability of breast cancer cells.