中南大学学报(医学版)最新文献

Objectives: Existing research shows that psychotherapists may experience secondary trauma and burnout, often neglecting self-care. This study aims to examine the effectiveness of self-care education in enhancing self-care efficacy among psychotherapists and explore factors affecting improvements in their self-care abilities.

Methods: A self-care workshop was conducted for 159 psychotherapists from various fields. Participants' demographic information and self-care ability data were collected. The Exercise of Self-Care Agency Scale (ESCA) was used to assess the participant's self-care levels before and after the workshop.

Results: Post-workshop, ESCA total scores and subscale scores of participants showed significant increases (all P<0.001). Notably, score improvement levels differed by gender and years of practice, with female therapists showing greater improvement than male therapists (t=2.069, P=0.040) and those with longer work experience showing greater improvement than those with shorter experience (F=2.537, P=0.042).

Conclusions: Providing self-care education for psychotherapists is essential. Future self-care education programs or interventions for psychotherapists should consider gender and work experience factors to better support their self-care enhancement.

Objectives: Albumin-globulin ratio (AGR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) have been validated as prognostic factors for gastric cancer (GC). However, significant gender differences exist in albumin levels and inflammatory cell counts, and further research is required to understand how these differences influence GC prognosis. This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery, as well as the influence of gender on these indicators' prognostic value.

Methods: The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery, General Surgery, Xiangya Hospital of Central South University from January 2012 to December 2016. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for nutritional and inflammatory factors. Univariate analysis was used to identify factors significantly affecting survival in GC patients, while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.

Results: Multivariate analysis revealed that postsurgical tumor node metastasis (pTNM) stage [stage II: hazard ratio (HR)=3.284, P=0.012; stage III: HR: 8.062, P<0.001], low preoperative AGR (HR=1.499, P=0.012), and postoperative PNI (HR=1.503, P=0.008) were risk factors for overall survival in male patients after radical GC surgery. For female patients, pN2-3 (HR=3.185, P<0.001), total gastrectomy (HR=2.286, P=0.004), low preoperative PLR (HR=1.702, P=0.027), and postoperative PNI (HR=1.943, P=0.011) were identified as risk factors for overall survival.

Conclusions: Postoperative PNI is an independent risk factor for all advanced GC patients. Preoperative PLR is an independent prognostic factor only for female patients, while preoperative AGR is an independent prognostic factor only for male patients. Further research is warranted to investigate the gender-specific differences in GC prognosis.

Critical care medicine focuses on understanding the pathophysiological mechanisms and treatment approaches for life-threatening conditions, including sepsis, severe trauma/burns, hemorrhagic shock, heatstroke, and acute pancreatitis, all of which have high incidence rates. These conditions are primarily characterized by acute multi-organ dysfunction, with sudden onset, severe illness, and high mortality rates. Additionally, critical care treatment demands substantial medical resources, imposing significant economic burdens on patients' families and society. In recent years, critical care medicine has achieved notable progress, especially in multidisciplinary integration with immunology-based fields. Collaboration across disciplines has not only accelerated advancements in critical care but also propelled the rapid development of modern immunology. This paper provides an overview and assessment of the cross-disciplinary fusion between critical care medicine and immunology, exploring how these fields related extensions mutually enhance each other. It further analyzes China's potential to become a global leader in this area within the next 5 to 10 years.

Objectives: Primary frozen shoulder is a shoulder joint disease that severely impacts the quality of life of patients, and intra-articular injection is a common treatment method. This study aims to evaluate and compare the therapeutic effects of sodium hyaluronate (SH), corticosteroids (CS), and autologous platelet-rich plasma (PRP) in the treatment primary frozen shoulder.

Methods: A total of 117 patients diagnosed with primary frozen shoulder and treated with a single injection of SH, CS, or PRP into the glenohumeral joint under ultrasound guidance at the Third Xiangya Hospital of Central South University from January 1, 2020, to December 31, 2022, were included in the study. The patients were divided into a SH group, a CS group, and a PRP group. Clinical data of patients, including Visual Analogue Scale (VAS) pain score, range of motion, Constant score, and Disabilities of Arm, Shoulder, and Hand (DASH) score were collected before treatment and at 1, 3, and 6 months after treatment. The efficacy of these 3 intra-articular injection therapies for primary frozen shoulder was compared.

Results: Compared with the baseline, the SH, CS, and PRP groups all showed significant improvements in shoulder VAS pain scores, range of motion, Constant scores, and DASH scores at 6 months after treatment (all P<0.05). Compared with the SH and PRP groups, the CS group showed better VAS pain score, range of motion, Constant score, and DASH score at 1 month after treatment (all P<0.05). However, the VAS pain score, range of motion, Constant score, and DASH score in the PRP group were better than those in the SH and CS groups at 6 months after treatment (all P<0.05).

Conclusions: A single ultrasound-guided injection of SH, CS, or PRP into the glenohumeral joint can significantly improve pain degree, range of motion, and function in patients with primary frozen shoulder. Among these 3 injection therapies, CS may provide better short-term efficacy, while PRP may offer better long-term outcomes.

Ferroptosis is a unique form of cell death driven by iron-dependent lipid peroxidation, with regulatory mechanisms involving metabolic dysregulation and imbalance in redox systems. Ferroptosis is closely related to various immune cells in the tumor immune microenvironment, including both anti-tumor and pro-tumor immune cells, and it demonstrates significant potential in tumor immunotherapy. A systematic review of the regulatory mechanisms of ferroptosis and its relationship with immune cells can provide deeper insights into its application prospects in tumor immunotherapy.

Renal fibrosis is the common pathological basis for the progressive development of chronic kidney disease (CKD) caused by various etiologies. It is characterized by the persistent deposition of extracellular matrix, leading to renal tissue damage and impaired renal function, and ultimately progressing to kidney failure. Current clinical treatments for CKD mainly focus on managing the primary diseases, with no specific drugs targeting renal fibrosis. The pathogenesis of renal fibrosis is complex, and there are currently no drugs available to reverse it. A comprehensive overview of the pathogenesis of renal fibrosis, alongside a summary of current anti-fibrotic therapies, including some that are already used clinically to slow renal function progression, new drugs in clinical trials, and emerging targeted therapies, could provide new theoretical foundations and perspectives for the treatment of renal fibrosis.

Pyroptosis is a form of programmed cell death triggered by inflammatory caspases, dependent on the gasdermin (GSDM) family proteins forming membrane pores in the plasma membrane, with GSDM proteins serving as the executors of pyroptosis. This process can activate a robust inflammatory response through a cascade effect. Sepsis-associated acute kidney injury (SA-AKI) is a classical inflammatory disease with no specific therapeutic drug available. Studies have highlighted the role of pyroptosis in the onset and progression of SA-AKI, yet the specific renal cell populations affected by pyroptosis and the detailed regulatory mechanisms remain unclear. Pyroptosis may be closely related to SA-AKI, with current strategies for regulating pyroptosis focusing on targeting inflammasomes, key caspase enzymes, GSDM proteins, and downstream inflammatory factors. Although these strategies still present some off-target effects or side effects, they provide a foundation for research into sepsis-targeted therapies and clarify future research directions and the necessity of such studies.