International Journal of General Medicine最新文献

Purpose: The present study assessed the correlation between anxiety and depression in young and middle-aged Chinese patients with coronary artery disease (CAD).

Patients and methods: This study included 313 patients diagnosed with premature CAD at the Department of Cardiology between January and July 2023. The Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) was used as a standardized scale to assess mental health symptoms. A binary logistic regression model (backward) was used to analyze the correlation between anxiety and depression in premature CAD.

Results: Anxiety was observed in 154 persons with a prevalence of 49.20%, with a median SAS score of 53.0 (52.00-54.00). Depression was observed in 91 patients, with a prevalence of 29.07%, with a median SDS score was 55.00 (54.00-57.00). A total of 63 (20.13%) patients had comorbid anxiety and depression. Multivariate logistic regression analysis revealed that anxiety was positively associated with severe coronary artery stenosis, systolic blood pressure (SBP), body mass index, and snoring. However, it is negatively associated with high-income levels. Depression was positively associated with age, severe coronary artery stenosis, and snoring. However, it was negatively associated with SBP. Comorbid anxiety and depression were positively associated with age, severe coronary artery stenosis, and snoring.

Conclusion: For the first time, we investigated the prevalence and correlators of anxiety and depression in premature CAD. Therefore, the correlators of emotional status should be routinely evaluated in both primary and specialized care services.

Objective: To explore the influence of bevacizumab combined with chemoradiotherapy on VEGF, bFGF, and Let-7 in patients with non-small cell lung cancer (NSCLC), and to analyze the factors affecting its efficacy.

Methods: Totally 150 patients with non-small cell lung cancer (NSCLC) treated in our hospital from November 2018 to November 2023 were retrospectively analyzed. The serum levels of VEGF, bFGF, and Let-7 were collected and compared. Patients were divided into good efficacy and poor efficacy groups based on short-term efficacy, and logistic regression analysis was used to analyze the factors affecting efficacy.

Results: Before treatment, there was no significant difference in the levels of VEGF, bFGF, and Let-7 between the two groups (P>0.05). After treatment, the levels of VEGF, bFGF, and Let-7 in both groups improved compared to before treatment, and compared with the control group, the study group had lower levels of VEGF and bFGF, and higher levels of Let-7, with statistically significant differences (all P<0.05). Multifactorial logistic regression analysis revealed that the course of disease, tumor diameter, and treatment regimen were independent factors influencing the therapeutic efficacy of NSCLC (all P<0.05).

Conclusion: For patients with NSCLC, the treatment regimen of bevacizumab combined with chemoradiotherapy can achieve better efficacy, with a higher objective response rate, effectively reduce the level of vascular endothelial growth factor, increase Let-7 level, and ensure safety. In addition, disease course, tumor diameter, and treatment regimen are independent factors affecting the efficacy of NSCLC. Therefore, these factors should be comprehensively considered when formulating treatment plans to ensure the best therapeutic effect.

Objective: To explore the effect of narrative nursing intervention on patients with esophageal, gastric, and intestinal cancers.

Methods: A retrospective analysis was conducted on the clinical data of 103 patients with digestive tract malignant tumors admitted to our hospital from January 2022 to January 2024. According to the nursing intervention received by the patients, they were divided into a control group (n=51) and an observation group (n=52). The control group received routine nursing intervention, while the observation group received narrative nursing intervention in addition to the routine nursing intervention. The compliance behavior, negative emotional status, self-perceived burden, quality of life, and adverse reactions of the two groups were compared.

Results: After intervention, the observation group showed higher scores in medication, exercise, dietary, and emotional regulation adherence than the control group (P<0.05). Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) for negative emotions decreased in both groups, with a greater reduction in the observation group (P<0.05). Economic, physical, and emotional burden levels also decreased more in the observation group (P<0.05). Quality of life scores in physiological, social/family, emotional, and functional conditions improved more in the observation group (P<0.05). Adverse reactions, including nausea, vomiting, fatigue, pain, gastrointestinal reactions, and insomnia, were less frequent in the observation group than in the control group (P<0.05).

Conclusion: Narrative nursing intervention for patients with digestive tract malignant tumors can effectively improve patient compliance behavior, alleviate negative emotions, reduce self-perceived burden, promote the improvement of patient quality of life, and reduce the occurrence of related adverse reactions. However, the study is limited by its small sample size and single-center design, which may affect the generalizability of the findings. Further research with larger and more diverse populations is recommended.

Background: This six-year retrospective study provides an in-depth analysis of the epidemiological and clinical patterns associated with Acinetobacter baumannii (A. baumannii) infections, focusing on age distribution, antibiotic resistance profiles, and specimen types.

Aim: The research examines the incidence and characteristics of both non-Multi-Drug Resistant (non-MDR) and Multi-Drug Resistant (MDR) A. baumannii strains by reviewing patient records from January 2016 to December 2022.

Methods: Through a statistical analysis, the study highlights the incidence rates across diverse age groups and explores the impact of antibiotic treatment regimens on infection outcomes. Additionally, it identifies the primary clinical specimen types for each strain, noting an association between non-MDR A. baumannii and midstream urine samples, while MDR A. baumannii strains were more frequently found in respiratory, wound, peripheral, and central line swaps/specimens.

Results: The results indicate that in 2016, non-MDR A. baumannii infections were notably more frequent compared to MDR A. baumannii cases. However, a significant shift occurred in 2021 and 2022, with a marked decrease in non-MDR A. baumannii cases and an increase in MDR A. baumannii infections. Antibiotic susceptibility testing revealed that non-MDR strains were commonly tested against cefazolin, ceftazidime, ciprofloxacin, gentamicin, nitrofurantoin, oxacillin, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole. In contrast, MDR strains were frequently tested against amikacin, cefepime, colistin, meropenem, imipenem, and tigecycline.

Conclusion: This study enhances the understanding of A. baumannii clinical behaviour and resistance patterns, offering valuable insights to support future research and inform strategies for infectious disease management and control.

Background: Cerebral hernia is a serious complication after thrombectomy in patients with acute ischemic stroke (AIS). This study aims to explore the predictive value of emergency preoperative plasma D-dimer levels in cerebral herniation after successful thrombectomy.

Methods: Between January 2019 and December 2023, patients with AIS who received a successful thrombectomy in our single comprehensive stroke center were retrospectively enrolled. We conducted a statistical analysis on the data using SPSS 26.0. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of D-dimer level for cerebral herniation.

Results: Among 278 enrolled patients, 20 cases (7.19%) experienced cerebral herniation. In patients with cerebral hernia, the score of the National Institutes of Health Stroke Scale was higher (16.5 vs 12.0, P < 0.001), the Alberta Stroke Plan early CT score was lower (6.5 vs 8.0, P < 0.001), the score of collateral circulation was lower (2.0 vs 3.0, P < 0.001), the proportion of eTICI blood flow grading of 3 of the occluded vessel was less (35% vs 75.19%), the proportion of pathogenesis of large atherosclerosis was less (5.00% vs 46.51%, P < 0.001), and the level of plasma D-dimer was higher (2.61 vs 0.82). After adjusting for potential confounders, the level of D-dimer (adjusted OR = 1.131, 95% CI 1.022-1.250, P = 0.017) was significantly correlated with cerebral hernia. Based on the ROC curve, the sensitivity and specificity of D-dimer in predicting cerebral herniation were 75.0% and 73.3%, respectively, and the area under the curve was 0.766.

Conclusion: Although our study had certain limitations, we found that elevated emergency preoperative plasma D-dimer level is an independent predictive factor for the cerebral herniation after successful thrombectomy in patients with AIS, which is of great clinical significance.

Background: Non-smoking women with lung adenocarcinoma(NSWLA) is a significant health problem globally; the carcinogenesis and prognostic signature remain poorly understood. Circular RNAs (circRNAs) are gradually implicated in cancer formation through sponging miRNAs to regulate mRNAs.

Methods: Tumor and paracancerous specimens from non-smoking women after lung adenocarcinoma surgery were collected for high-throughput sequencing of circRNA. miRNA and mRNA datasets were downloaded from TCGA. A circRNA-miRNA-mRNA network was built using differentially expressed circRNAs (DEcircRNAs), miRNAs (DEmiRNAs), and mRNAs (DEmRNAs). Following that, GSEA was applied to analyze the biological function of mRNAs in the ceRNA network. Utilizing the mRNAs associated with prognosis, we created an original prognostic risk score model. The expression of DEmRNA in the ceRNA network was verified by mRNA-seq and scRNA-seq data (GSE131907). The expression of BTBD3 and EIF4EBP2 was then verified by immunohistochemistry.

Results: 16 pairs of adenocarcinoma tissues and their corresponding para-tumor samples were collected from thoracic surgery. We created a circRNA related ceRNA in NSWLA. The hsa_circ_0002346 regulation of the cancer cell proliferation may through the hsa_circ_0002346/miR-96-5p/EIF4EBP2 axis. Hsa_circ_0072309 may affect proliferation of lung adenocarcinoma and activate Nature Killer cells by targeting miR-32-5p to regulate PCMTD1 expression. Based upon mRNA (BTBD3, CFL2, EIF4EBP2, EVI5, PCMTD1, SYDE2) related to overall survival, we also created a predictive signature. According to mRNA-seq, scRNA-seq, and immunohistochemical data, the expression of BTBD3 and EIF4EBP2 was lower in tumor samples than in normal tissues nearby.

Conclusion: The circRNA related mRNAs played an important role in predicting the overall survival of NSWLA. The circRNA in the ceRNA network might unravel the pathogenesis and be potential novel targets for NSWLA.

Purpose: The purpose of this study is to investigate the association between Chinese Visceral Adipose Index(CVAI) and brachial-ankle pulse wave velocity (baPWV) in type 2 diabetes (T2D) patients, in order to provide scientific evidence for the prevention and treatment of macrovascular complications in T2D.

Patients and methods: This research adopts the cross-sectional study design. Anthropometric assessment, baPWV assessment and biochemical assessment were performed in 2906 T2D patients. CVAI was calculated from the combination of triglycerides, age, high-density lipoprotein cholesterol, waist circumference, body mass index. Multivariate regression analysis and generalized additive model were used to analyze the association between bapwv and CVAI. Subgroup analysis and interaction analysis were used to analyze the influencing factors.

Results: After adjustment for covariates, baPWV tended to increase in the quartiles of CVAI. In males, As CVAI increases by a unit, baPWV was increased by 0.28 cm/s (95% CI: -0.05, 0.61 P=0.0934). In females, As CVAI increases by a unit, baPWV was increased by 1.60 cm/s (95% CI: 1.07, 2.14). A non-linear connection in males and a linear connection in females between the CVAI and baPWV was revealed. In males, we found that CVAI interacted with baPWV in different duration of diabetes (P interaction = 0.0052), alcohol consumption status (P interaction = 0.0375). In females, CVAI interacted with baPWV in glycated hemoglobin (P interaction = 0.0003), systolic blood pressure (P interaction = 0.0001), diastolic blood pressure (P interaction<0.0001), duration of diabetes (P interaction = 0.0014), the use or non-use of glucose-lowering drugs (P interaction = 0.0006), the use or non-use antihypertensive drugs (P interaction = 0.0004), females' menopausal status (P interaction = 0.0012).

Conclusion: The relationship between CVAI and baPWV in T2D patients is positively non-linear in males and linear in females. In all subjects, this relationship was influenced by diabetes duration. In males, drinking status affected this relationship, and in females, It is influenced by blood pressure, glycemic control, menopausal status, and the use of glucose-lowering and hypotensive drug, highlighting the complex interplay between visceral fat and arterial stiffness in the T2D population.

Aim: This study aimed to investigate the prevalence and associated factors of hypokalemia in patients with acute ischemic stroke.

Methods: A cohort of 996 patients was assessed using a general data questionnaire, laboratory indicators, the NIH Stroke Scale (NIHSS), the Barthel Index (BI), the Frail scale, Nutritional Risk Screening (NRS-2002), and the Kubota drinking water test.

Results: Among the 996 patients, 205 (20.6%) were found to have hypokalemia. Logistic regression analysis identified several independent predictors of hypokalemia: age (OR 1.020, 95% CI 1.001-1.039, P=0.041), hypertension (OR 2.691, 95% CI 1.190-6.089, P=0.017), Frail score (OR 1.756, 95% CI 1.034-2.981, P=0.037), Kubota drinking water test grade 3 (OR 2.124, 95% CI 1.055-4.276, P=0.035), Kubota drinking water test grade 4 (OR 3.016, 95% CI 1.113-8.174, P=0.037), NIHSS score (OR 1.135, 95% CI 1.018-1.264, P=0.022), platelet count (OR 0.997, 95% CI 0.994-0.999, P=0.021), and urea nitrogen levels (OR 0.833, 95% CI 0.750-0.926, P=0.001).

Conclusion: The prevalence of hypokalemia is high in patients with acute ischemic stroke. Independent risk factors included age, hypertension, frailty, neurological function, swallowing function, platelet count and blood urea level.

Objective: The plant known as Catha edulis, commonly referred to as Khat, holds significant cultural significance within the populations of East Africa and Southwestern Arabia. The objective of this study is to ascertain and assess the association between the act of chewing khat and the incidence of acute stroke.

Materials and methods: The present study was carried out in a prospective observational manner at the Mogadishu-Somalia Turkish Training and Research Hospital. Data were gathered over a period of three years, from January 2021 to December 2023. The study encompassed all stroke patients who presented at the hospital's emergency department who had the habit of khat consumption and did not have previous risk factors of stroke. The study included a sample size of 52 patients.

Results: The study involved 52 male patients who were diagnosed with acute stroke. Among the participants, 75% (n = 39) were aged between 18 and 39 years, while 25% (n = 13) were aged between 40 and 64 years. The findings indicate that hemorrhagic stroke was the prevailing stroke type, accounting for 88.5% (n = 46) of cases, while ischemic stroke accounted for only 11.5% (n = 6). All 52 participants in the study reported using khat. In addition to the act of chewing khat, it was found that 70% (n = 36) of the participants had been using khat for a period exceeding 5 years; none of the participants exhibited any additional risk factors for stroke.

Conclusion: The findings of our study indicate that Catha edulis, commonly known as khat, is a significant risk factor and potential causative agent for stroke. Khat consumption has been identified as a contributing factor to the incidence of cerebrovascular diseases.

Background: This study examined the current state of health-related quality of life among family caregivers of elderly individuals with dementia, analyzing associated influencing factors to provide a foundation for enhancing their health-related quality of life and developing pertinent intervention strategies and measures.

Methods: From September 2023 to February 2024, a convenient sampling method was used to investigate the status quo of Health-Related Quality of Life (HRQOL) among family caregivers for dementia patients, family caregivers for non-dementia patients, and people with no caregiving burdens in Sichuan, Chongqing and Guizhou in southwest China. The risk factors were analyzed by multiple regression.

Results: A total of 678 questionnaires were distributed, and 630 valid questionnaires were obtained, resulting in a response rate of 92.92%. The study found that family caregivers for elderly individuals with dementia exhibited the lowest scores in both physical and mental health, followed by family caregivers for elderly individuals without dementia, while people with no caregiving burdens scored the highest. The multiple linear regression analysis demonstrated that age, chronic disease, the relationship between the family caregiver and the person being cared for were dependent of physiological health scores. While females, caregivers with secondary-education, and caregivers with a chronic disease showed poorer mental health scores.

Conclusion: We need to focus on the role that family caregivers for dementia patients play in the health and quality of life of older people with dementia. Therefore, we should pay more attention to the physical and mental health of family caregivers for dementia patients and ensure that this should be taken into consideration in policy-making, which will contribute to a better quality of life for theses caregivers.