Alternative therapies in health and medicine最新文献

Objective: To explore the effect of a teamwork model applied to the optimization of coronary CT angiography (CCTA) examination.

Methods: A total of 118 patients who underwent CCTA examination in our hospital from June 2020 to June 2021 were selected as study objects. They were randomly divided into two groups (observation and control), with 59 patients in each group. Examination measures based on a routine model were performed on patients in the control group, while examination measures based on a teamwork model were performed on patients in the observation group. The examination-related indicators, heart rate, imaging quality, and negative emotions were compared between the two groups.

Results: The readiness rate and first-attempt success rate of the observation group were higher than those of the control group; the waiting time and examination time of the observation group were shorter than those of the control group, and the radiation dose of the observation group was lower than that of the control group (P < .05). During the examination, the heart rate of the observation group was lower than that of the control group; the imaging quality of the observation group was better than that of the control group; and, after the intervention, the SAS and SDS scores of the observation group were lower than those of the control group (P < .05).

Conclusion: Interventions based on the teamwork model applied to CCTA can relieve the negative emotions of patients, promote the readiness rate and first-attempt one-time success rate, shorten the waiting time and inspection time, and improve the heart rate and imaging quality.

Objective: To investigate the association of serum MMP-2, Siglec-1, and Th1/Th2 cell ratio with disease activity in rheumatoid arthritis (RA).

Methods: Between August and November 2020, Peking University People's Hospital recruited 40 patients with RA and 40 healthy individuals. Various methods such as ELISA, flow cytometry, and RT-PCR were used to assess the levels of sCR1, MMP-2, MMP-9, and Siglec-1 in the participants. Correlation analysis was conducted between Siglec-1 expression and DAS28 and hs-CRP. T lymphocyte subsets; cytokines IFN-γ and IL-4, were assessed using flow cytometry and ELISA in both patient groups.

Results: Rheumatoid arthritis was linked to lower levels of serum sCR1 and higher levels of MMP-2 and MMP-9 compared to healthy individuals (P < .05). The percentage of Siglec-1-positive cells in PBMCs was significantly higher in patients with RA than in the healthy group (P < .05), with monocytes being the predominant cells expressing Siglec-1. Patients with RA exhibited a significantly higher expression of Siglec-1 mRNA compared to those in a healthy condition (P < .05), and the expression of Siglec-1 in these patients was positively correlated with DAS28 and hs-CRP (P < .05). Study patients demonstrated a notably lower level of peripheral blood CD8+ cells and a higher CD4+/CD8+ ratio when compared to healthy individuals (P < .05). There was no statistically significant difference in CD3+CD4+ levels between the 2 groups (P > .05). Rheumatoid arthritis was associated with a higher level of peripheral blood IFN-γ and a lower IL-4 level than healthy individuals (P < .05).

Conclusion: There was a strong link between sCRl, MMP-2, and MMP-9 and the progression of rheumatoid arthritis. These markers can effectively monitor disease activity in patients with rheumatoid arthritis. Siglec-1 is highly expressed in peripheral blood and can be used to track disease activity and inflammation in these patients. Regulating Th1/Th2-mediated homeostasis may help alleviate symptoms in individuals with rheumatoid arthritis.

Objective: This study aimed to compare the effects of ketamine and fentanyl combined with dexmedetomidine in lumbar anesthesia for proximal femur fractures among elderly patients.

Design: This study employed a prospective, randomized controlled trial (RCT) design.

Settings: The study was conducted at Beijing Jishuitan Hospital.

Participants: A total of 100 elderly patients with proximal femur fractures who underwent lumbar anesthesia between January 2022 and January 2023.

Intervention: Participants were divided into two groups: the ketamine group (n=49) and the fentanyl group (n=51). The ketamine group received ketamine combined with dexmedetomidine, while the fentanyl group received fentanyl combined with dexmedetomidine.

Outcome measures: The following outcome measures were assessed and compared between the two groups: (1) hemodynamic indexes; (2) visual analogue scale (VAS) scores; (3) stress reaction indexes; (4) Incidence of adverse effects. These comparisons were made using the random number table method.

Results: No significant differences were observed in systolic blood pressure (SBP), transcutaneous oxygen saturation (SPO2), and heart rate (HR) between the two groups at each time point (P > .05). SBP and HR of both groups were lower than baseline (T0) from T1 onwards. Throughout the surgery, SBP and HR exhibited a decreasing trend with operation time, followed by an increase post-operation. SPO2 showed minimal fluctuations during surgery in both groups. Preoperatively, VAS scores were comparable between groups (P > .05). However, at 12h, 24h, and 48h post-surgery, VAS scores were significantly lower in the ketamine group (P < .05). Stress indicator levels were similar preoperatively (P > .05), but postoperatively, serum cortisol (Cor), epinephrine (E), and norepinephrine (NE) levels were lower in the ketamine group (P < .05).

Conclusion: Dexmedetomidine combined with ketamine demonstrates safety and efficacy in the elderly. It significantly reduces postoperative pain and stress reactions while decreasing the incidence of adverse reactions.

Objective: This study aimed to explore the risk factors and dietary status of middle-aged and elderly people at high risk of stroke in urban and rural areas of Xiangtan City, with a view to providing a basis for formulating stroke prevention and control strategies in urban and rural areas of Xiangtan City.

Methods: Using the cluster sampling method, a total of 8,453 permanent residents aged ≥40 years old were selected from Yuetang Street, Yuetang District, and Jiangshe Town, Yuhu District, Xiangtan City in 2020 and 2021 for face-to-face questionnaire surveys to collect their demographic information, daily life Method, family history, height, weight, waist circumference, blood pressure, blood sugar, blood lipids, glycosylated hemoglobin, homocysteine and other indicators, and analyze them.

Results: A total of 8453 permanent residents were screened in this study, and a total of 1804 stroke high-risk patients (including stroke and TIA, 21.34%) were screened out, including 973 urban residents (23.53%), and 831 rural residents (19.25%), and the distinction had statistical significance (P < .05); 263 stroke sufferers were screened out, and the prevalence ratio was 3.11%. The exposure rates of risk factors for high-risk groups in urban and rural areas of Xiangtan City from high to low are hypertension, dyslipidemia, smoking, family history of stroke, diabetes, obesity, lack of exercise and atrial fibrillation or heart valve disease. The high-risk groups for urban strokes The proportions of lack of exercise (23.54%) and obesity (38.44%) were significantly higher than the proportions of lack of exercise (17.09%) and obesity (22.64%) in rural areas. The high-risk groups in rural areas had hypertension (87.73%) and a history of TIA (2.89%). The proportion of patients with hypertension (82.43%) and TIA history (1.34%) was significantly higher than those in urban areas, and the differences were statistically significant (P < .05). The proportion of rural residents who eat a salty diet (17.93%) and eat fruits ≤2 days/week (93.98%) is significantly higher than that of urban residents who eat a salty diet (14.49%) and eat fruits ≤2 days/week (59.61%). There are differences. Statistically significant (P < .05), the proportion of urban residents who consume vegetables ≤2 days/week (11.91%) is significantly lower than the proportion of urban residents who consume vegetables ≤2 days/week (28.98%) (P < .01).

Conclusion: The high-risk factors for stroke in Xiangtan City are mainly hypertension, dyslipidemia, smoking history, family history of stroke, and diabetes. Tailored public health measures should be taken by residents to address the different risk status and dietary habits of urban and rural populations. Especially dietary intervention for rural residents.

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Context: Man-made disasters and natural disasters bring huge losses to human life and property. High-quality nursing teams play an important role in reducing casualty and disability rates in disaster areas, reducing the prognosis of the injured, accelerating community recovery and even promoting social rehabilitation. This work aimed to analyze the current situation and influencing factors of disaster emergency rescue (DER) of nurses in Hunan Province by surveying their knowledge, attitude, and practice of DER in Grade A hospitals.

Methods: 1260 nurses working in 13 Grade A hospitals in Hunan Province from March to October 2022 were selected as subjects by a random sampling method and conducted by a questionnaire survey. The general data of the subjects were collected by "behaviors", forming the "nurses' knowledge, attitude, and practice questionnaire, and their DER knowledge, attitude and behavior were evaluated.

Results: 1260 questionnaires were distributed, and 1,256 were effectively received, with a recovery rate of 99.68%. The total score of DER-related knowledge of 1.256 investigators was 136.82 ± 9.73 points. Among them, the highest and lowest scores were observed in the Triage (26.79 ± 2.09 points) and the sanitary and anti-epidemic (17.97 ± 1.28 points). The scores of DER attitude of 1256 respondents were close, which were arranged as about 3.87 ± 0.39 (with a range of 4.34 ~ 4.20). 1,256 investigators expressed the highest score in participating in the DER-related courses (4.93 ± 0.34 points) and the lowest score in participating in the on-site DER (2.01 ± 0.13 points). The results showed that they were correlated with gender, educational background, working years, department, and out-of-hospital emergency rescue experience (P ≤ .05), but not with age. The scores of DER-related knowledge and behaviors of hospital nurses were higher in men than in women. The higher the education, the higher the score, and the more the working years. Emergency and ICU nurses scored higher than those in other general departments. In addition, nurses with out-of-hospital emergency rescue experience scored higher than those without.

Conclusion: The overall DER-related knowledge, attitude, and practice of hospital nurses is not high. Nursing managers should incorporate disaster nursing into emergency rescue nurses' training, strengthen clinical nurses' training and exercise in DER-related knowledge, pay special attention to DER drills and practices, and provide reasonable and correct DER guidance. Furthermore, it should cultivate the noble social citizenship qualities of clinical nursing nurses, such as the sense of mission to save the dying and heal the injured, the sense of satisfaction in realizing self-worth, and the sense of social responsibility. In addition, it is suggested that a reasonable incentive and reward system be established to encourage hospital nurses to

Objective: Our aim was to study the clinical effect of a foot correction exerciser used for postoperative rehabilitation in external fixation in high-energy Pilon fracture.

Methods: From March 2017 to November 2019, 43 patients with AO/OTA type C closed Pilon fractures treated with external fixation were retrospectively analyzed. A total of 23 patients were rehabilitated by foot correction exerciser (1 patient fell off the study), and 20 patients were treated by conventional rehabilitation (2 patients fell off the study). During postoperative hospitalization and regular follow-up after discharge, various indicators were recorded for statistical comparison and evaluation through angle measurement, imaging and questionnaire surveys.

Results: There was no significant difference in postoperative complications in the 2 groups (P > .05). The fracture healing time and stent wearing time in the study group were shorter than in the control group, and the comfort score and functional exercise compliance were higher in the study group than in the control group. The ankle joint mobility was higher in the study group than in the control group at all time points in the first 6 months, and the excellent and good rate of ankle joint function was higher than in the control group, with statistical significance (P < .05).

Conclusion: Use of the orthopedic exerciser in the high-energy Pilon fracture external fixation postoperative rehabilitation process and the early introduction of resistance training can reduce pain and soft tissue edema and improve the degree of patient comfort and exercise compliance, accurately measure the force load of the limbs, contribute to the dataization and standardization of rehabilitation exercise programs, accelerate the recovery of joint mobility and improve long-term limb function.

Background: Non-small cell lung cancer (NSCLC) represents a significant portion of lung cancer cases, with a poor prognosis and limited treatment options for advanced stages. Enhancing the effectiveness of chemotherapy through adjunctive therapies is a critical area of research.

Objective: To evaluate the effect of Shenmai injection combined with chemotherapy on T-cell subsets and cytokine expression in patients with advanced NSCLC.

Methods: A comparative prospective study was conducted, and a total of 96 patients with advanced NSCLC were selected. Patients were divided into two groups based on different chemotherapy regimens: an observation group (48 patients) receiving Shenmai injection combined with chemotherapy and a control group (48 patients) receiving chemotherapy alone. The study measures and compares the levels of T-cell subsets (CD3+, CD4+, CD4+/CD8+) and cytokines (IL-2, IL-4, IL-5, IL-6, TNF-α, IFN-γ, VEGF, bFGF, CA125, and CEA) before and after treatment in both groups. Statistical analysis was performed on the collected data.

Results: Significant changes were observed in the levels of T-cell subsets and cytokines before and after chemotherapy in both groups (P < .05). Compared with the control group, the observation group exhibited significant improvement in T-cell subsets CD3+, CD4+, and CD4+/CD8+ (P < .05). Furthermore, the levels of cytokines IL-2, IL-4, IL-5, IL-6, TNF-α, IFN-γ, VEGF, bFGF, CA125, and CEA were significantly lower in the observation group compared to the control group (all P < .05).

Conclusions: Shenmai injection combined with chemotherapy enhances the cellular immune function in patients with advanced NSCLC. This combination therapy not only reverses tumor progression but also improves the overall therapeutic effect, suggesting a promising adjunctive treatment strategy for advanced NSCLC.

Objective: This study aims to compare the clinical efficacy and longevity of facial rejuvenation treatments using PPDO thread lifts alone versus in combination with facial hyaluronic acid fillers in middle-aged and elderly patients.

Methods: A retrospective analysis of case data was conducted on 92 middle-aged and elderly patients treated in our hospital with suboptimal facial contours or signs of aging from January 2016 to January 2017. Patients who exhibited facial aging issues and desired rejuvenation, had complete case data for analysis, received treatments at our hospital, and agreed to 5-year post-treatment follow-up were included. Based on the different treatment interventions received by the patients, they were divided into the control group (n=43) and the observation group (n=49). Patients in the control group received standalone PPDO thread lift intervention, while patients in the observation group received a combination of facial hyaluronic acid filler in addition to the treatment received by the control group. Clinical treatment effects, complication rates, facial improvement maintenance duration, and facial contour scores were compared between the two groups at different time points (preoperative, T0; postoperative 1 month, T1; postoperative 3 months, T2; postoperative 6 months, T3; and postoperative 12 months, T4).

Results: The observation group, receiving both PPDO thread lifts and hyaluronic acid fillers, demonstrated a significantly higher total effective treatment rate of 89.80% compared to 72.09% in the control group treated solely with PPDO thread lifts. Within the initial month post-surgery, the observation group experienced rates of facial pain, swelling, bruising, concavity, and thread extrusion at 61.22%, 53.06%, 30.61%, 20.41%, and 0.00%, respectively, while the control group experienced rates at 55.81%, 48.84%, 39.53%, 20.93%, and 2.33%, respectively. No significant difference in complication rates was observed between the two groups (P > .05). The combined treatment method resulted in a significantly prolonged facial improvement maintenance duration, averaging 4.67 years, compared to 4.13 years in the control group. At T0, facial contour scores showed no significant difference between the groups (P > .05); however, at T1, T2, T3, and T4, the observation group exhibited significantly higher scores compared to the control group (P < .05). Although there were variations in the types of complications, the overall rates of complications did not show a significant difference between the two groups, thus affirming the safety of the combined treatment.

Conclusion: The study concludes that combining facial hyaluronic acid fillers with PPDO thread lifts offers superior facial rejuvenation outcomes and longer-lasting effects without increasing complication risks, proving to be a highly safe and effective strategy for middle-aged and elderly pa

Objective: To compare the effectiveness of abdominal ultrasound and magnetic resonance imaging (MRI) in diagnosing congenital choledochal cysts (CCC) in children.

Methods: This retrospective analysis included 186 pediatric cases diagnosed with CCC through abdominal ultrasound and MRI examinations at our hospital between July 15, 2015, and November 29, 2023. Inclusion and exclusion criteria were applied to ensure the study's objectivity. Chi-square and t-tests were used to compare the diagnostic performance of ultrasound and MRI.

Results: MRI demonstrated a superior detection rate of bile duct dilation compared to ultrasound (P < .001). Compared to ultrasound, a lesser number of nonspecific cysts was reported by MRI, indicating its higher specificity (P = .008). Although the rate of misdiagnosis was slightly higher in ultrasound, the difference was not statistically significant (P = .123). Regarding consistency with postoperative pathological diagnosis results, MRI exhibited higher accuracy, with sensitivity and specificity both exceeding 75%.

Conclusion: MRI exhibits higher sensitivity, specificity, and accuracy in diagnosing pediatric CCC. Despite the strong correlation in diagnostic consistency between MRI and ultrasound, MRI remains the superior diagnostic tool and should be prioritized for diagnosis and preoperative planning.