Alternative therapies in health and medicine最新文献

Objective: This study aimed to evaluate the diagnostic value of combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing in ovarian tumors.

Methods: Sixty-four patients suspected of having ovarian tumors, admitted to our hospital from July 2021 to July 2023, were selected for the study. All patients underwent ultrasound-guided percutaneous biopsy and serum tumor markers CA125 and CEA level testing. Surgical pathology results were used as the gold standard for comparison. The diagnostic performance of ultrasound-guided percutaneous biopsy alone, serum CA125, serum CEA, and their combination were evaluated. Receiver operating characteristic (ROC) curve analysis was performed, and the sensitivity, specificity, and accuracy were calculated. The differences in diagnostic performance were compared using the chi-square test, with a P < .05 considered statistically significant.

Results: The results of this study demonstrate that combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing significantly improved the diagnostic accuracy for ovarian tumors compared to individual testing modalities. Surgical pathology, the gold standard, confirmed 52 malignant and 12 benign tumors among the 64 patients examined. When evaluated individually, the concordance rate between ultrasound-guided biopsy and surgical pathology was 90.63%, while serum CA125 and CEA had diagnostic accuracies of 73.44% and 64.06%, respectively. However, when the two serum markers were used in combination, the diagnostic accuracy increased to 81.25%. Notably, the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing produced the highest diagnostic accuracy at 95.31%. Statistical analysis confirmed this combined approach had significantly better accuracy, sensitivity, and specificity compared to individual tests (P < .05). ROC curve analysis further substantiated the superior diagnostic value of this integrated testing strategy.

Conclusion: The findings of this study demonstrate that the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing markedly enhances diagnostic accuracy for ovarian tumors, with a combined accuracy exceeding 95%. This integrated diagnostic protocol represents a robust and clinically valuable approach that should be more widely adopted to improve early detection and optimize the management of ovarian neoplasms. The implementation of this combined testing strategy has the potential to significantly impact clinical decision-making and patient outcomes in the diagnosis and treatment of ovarian tumors.

Objective: To investigate the efficacy of piperacillin-tazobactam (PIP/TAZ) versus PIP/TAZ plus erythromycin in the treatment of children with bronchopneumonia, and to evaluate the influence of these treatments on inflammatory factors and intestinal flora. Assessing the impact on these parameters is crucial to provide a comprehensive understanding of the treatment effects.

Methods: A total of 120 children with bronchial pneumonia who were treated in Yichang Central People's Hospital from April 2018 to April 2020 were randomized (1:1) either into the control group or the observation group. The control group was given PIP/TAZ treatment. The observation group was additionally treated with erythromycin on the basis of the control group. The clinical efficacy, disappearance time of main symptoms and signs, inflammatory factors, and intestinal flora before and after treatment were compared between the two groups.

Results: The treatment with PIP/TAZ plus erythromycin led to a significantly higher total clinical effective rate versus PIP/TAZ alone (P < .05). PIP/TAZ plus erythromycin resulted in a shorter time taken for the disappearance of fever, cough, and pulmonary rales versus PIP/TAZ alone (P < .05). These findings suggest that the combination regimen was more effective at resolving the key clinical symptoms of bronchopneumonia in children, which is important for improving patient outcomes and reducing the duration of illness. Patients given PIP/TAZ plus erythromycin experienced lower serum levels of the inflammatory markers CRP, TNF-α, and IL-8 as compared with patients given PIP/TAZ alone (P < .05). The reduction in these inflammatory factors indicates that the addition of erythromycin may have provided greater anti-inflammatory benefits beyond the antimicrobial effects of PIP/TAZ alone. Modulating the inflammatory response is clinically significant, as excessive inflammation can contribute to lung damage and disease severity in pneumonia. Conversely, the observation group showed a higher incidence of gastrointestinal disturbances, including increased stool frequency, watery stools, and elevated stool white blood cell counts after treatment (P < .05), suggesting that the erythromycin component may have disrupted the balance of intestinal flora. Maintaining a healthy gut microbiome is important for overall health, immunity, and preventing further complications. The clinical significance of this finding is that the addition of erythromycin to the treatment regimen may have unintended adverse effects on the gut that should be carefully monitored.

Conclusion: PIP/TAZ plus erythromycin might be a promising candidate in the treatment of children with bronchopneumonia by significantly improving clinical outcomes, shortening the duration of key symptoms, and regulating the level of inflammatory factors. These findings suggest the combination regimen could provide grea

Background: Medial unicompartmental knee arthroplasty (UKA) is a surgical procedure that replaces only the damaged medial compartment of the knee joint, preserving the healthy lateral compartment. Previous studies have investigated the impact of body mass index (BMI) on the efficacy of UKA for knee osteoarthritis, but the effect of the ratio of waist circumference to thigh circumference in obese patients has not been reported. This study aimed to explore the impact of the waist-to-thigh ratio on the efficacy of medial UKA in obese patients with knee osteoarthritis.

Methods: A retrospective analysis was conducted on the clinical data of 99 patients with knee osteoarthritis who underwent medial UKA at our hospital from February 2021 to March 2023. Patients were grouped based on their waist-to-thigh ratio, with a ratio ≤1.7 classified as the normal group and >1.7 as the obese group. Continuous variables such as age, height, weight, surgical indicators, and pain scores were compared between the two groups using the independent samples t test or Mann-Whitney U test, depending on the normality of data distribution. Categorical variables like gender, comorbidities, and patient satisfaction were analyzed using the chi-square test or Fisher's exact test. Repeated measures ANOVA was used to compare changes in outcome measures over time between the two groups. P < .05 was considered statistically significant. Surgical indicators, hematological indicators, pain status, postoperative recovery, daily living abilities, risk of pressure ulcers and falls, nutritional status, and patient satisfaction were compared between the two groups using the appropriate statistical tests.

Results: This study included 51 patients in the normal group and 48 in the obese group, with no significant differences in baseline characteristics except for gender, BMI, thigh circumference, waist circumference, and waist-to-thigh ratio. The normal group had significantly shorter hospitalization time (5.2 ± 1.3 vs 7.1 ± 2.1 days, P < .001) and surgical time (65.3 ± 11.4 vs 78.6 ± 14.2 minutes, P < .001) compared to the obese group. There were no differences in intraoperative blood loss or time to achieve 90° flexion-extension. Postoperatively, the normal group had lower Visual Analog Scale (VAS) pain scores at all timepoints up to 2 months (P < .05). They also ambulated sooner (2.1 ± 0.6 vs 3.5 ± 1.1 days, P < .001) and discontinued crutches earlier (22.4 ± 4.2 vs 29.1 ± 5.3 days, P < .001) compared to the obese group. Within 1 year, a higher proportion of normal group patients could squat (84.3% vs 62.5%, P = .012). The normal group also had a lower incidence of patellofemoral pain (5.9% vs 18.8%, P = .045).

Conclusion: Patients with a high waist-to-thigh ratio (>1.7) experienced poorer outcomes after medial UKA, including higher postoperative pain, slower recovery, and greater incidence of patellofem

Objective: To explore the risk factors contributing to the development of premature coronary artery disease (PCAD) in patients with ankylosing spondylitis (AS) and assess the clinical implications of this association.

Methods: The study used a retrospective analysis design to investigate the risk factors and clinical significance of ankylosing spondylitis (AS) combined with early-onset coronary heart disease (AS-PCAD). A total of 80 patients diagnosed with AS and coronary heart disease who were admitted to the hospital between February 2019 and February 2022 were included in the analysis. The patients were divided into two groups based on the age of onset of coronary heart disease - the PCAD group (n=42, mean age 41.48±2.69 years) and the non-early-onset coronary heart disease (NPCAD) group (n=38, mean age 69.13±4.50 years). Relevant clinical data, including demographics, medical history, laboratory results, and imaging findings, were extracted from electronic health records. Binary logistic regression analysis was employed to identify risk factors influencing the incidence of AS-PCAD. The study aimed to uncover the distinctive clinical features and risk factors associated with AS patients who experience early-onset coronary heart disease, in order to guide diagnosis and treatment strategies for this patient population.

Results: The results of the study revealed several notable findings. Significant differences were observed between the PCAD and NPCAD groups in terms of age and age at AS onset (P < .05). Specifically, patients in the PCAD group had a younger mean age at AS onset compared to the NPCAD group (41.48±2.69 years vs 69.13±4.50 years, respectively). Additionally, the two groups exhibited statistically significant differences in several laboratory parameters. Levels of C-reactive protein (CRP) were found to be markedly higher in the PCAD group compared to the NPCAD group (P < .05). Hemoglobin levels and the prevalence of anemia also showed significant variations between the two cohorts (both P < .05). Importantly, the binary logistic regression analysis identified two key risk factors that independently influenced the incidence of PCAD in AS patients: younger age at AS onset and elevated levels of C-reactive protein.

Conclusions: The key findings of this study underscore the heightened risk of premature coronary artery disease in patients with ankylosing spondylitis, particularly those with a younger age of AS onset and elevated levels of systemic inflammation as marked by C-reactive protein. These results have important clinical implications. Identifying AS patients at increased risk for PCAD, based on factors such as younger disease onset and higher inflammatory burden, enables targeted screening and early intervention strategies. Comprehensive cardiovascular risk assessment and management should be an integral part of the care approach for this pa

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Background: Lung adenocarcinoma (LUAD) is a major pathological subtype of non-small cell lung cancer and occurs more commonly in females than other lung cancer subtypes. Studying female-specific oncogenes in LUAD may provide personalized medicine approaches for females with LUAD.

Objective: We aimed to identify the possible female-specific oncogenes of LUAD and understand their potential impact on treatment strategies for specific cancer subgroups.

Methods: The gene expression profiles of LUAD were downloaded from The Cancer Genome Atlas (TCGA) database and the GSE72094 dataset. TCGA database is currently the largest database of cancer genetic information. Female-specific differentially expressed genes (DEGs) were identified by R programming software. Functional annotation of DEGs was conducted based on KEGG pathway enrichment analysis. Univariate and multivariate Cox proportion analyses were applied to construct a prognostic risk score model with the DEGs. Kaplan‒Meier and ROC curves were plotted to validate the predictive effect of the prognostic DEGs signature. Gene set enrichment analysis (GSEA) was applied to identify the potential pathways in the high-risk groups in female LUAD. Finally, the immunohistochemical staining (IHC) was conducted to verify the expression of CABLES1 in human LUAD samples.

Results: We constructed a prognostic signature that includes 12 female-specific DEGs (P < .05). Among them, ABHD6, CABLES1, CXCL5, DNAJB4, EFNB2, HLX, MEOX2, MTMR10, PPFIBP1, and RERG were down-regulated in LUAD, while MFSD6L and SOX9 were up-regulated in LUAD (P < .0001). The Kaplan-Meier, and receiver operator characteristic (ROC) curves revealed efficient and stable prediction of the prognostic signature in the female LUAD patients. It was showed the risk score model has a good predictive effect on the prognosis of female LUAD patients but is not effective for male patients (P < .0001). The ROC curve showed that the areas under the curve (AUC) of first-, third- and fifth-year survival were 0.70, 0.69, and 0.79, respectively, which indicated good sensitivity and specificity of the 12-gene risk score algorithm in predicting the prognosis of female LUAD. GSEA revealed that the high-risk group was significantly enriched in the EMT, E2F targets, Myc targets, G2/M checkpoint, glycolysis, hypoxia, and mTORC1 signaling pathways (P < .05). Immunohistochemical staining showed lower CABLES1 expression was associated with higher pTNM stage in female LUAD but not in male LUAD (P < .05).

Conclusion: Our study constructed and verified a prognostic signature based on 12 female-specific DEGs of LUAD, which could improve the understanding of sex-related risk factors involved in LUAD carcinogenesis and progression, and may provide personalized treatment strategies for female LUAD patients.

Objective: To investigate the current state of nurses' intentions to report harmful incidents in the hematology department, and the influencing factors, to provide a relevant basis for ensuring healthcare quality and patient safety.

Methods: By using a stratified sampling technique, 80 nurses from the hematology department of our hospital between June 2020 and June 2022 were randomly chosen as the research objects. The Chinese version of intention to report adverse event questionnaire (15 items with a scale of 0 to 1), adverse event report cognitive questionnaire (8 items with a scale of 0 to 1), and adverse event reporting attitude questionnaire (25 projects with a scale of 0 to 4) were used to collect data. Multiple linear regression model was used to explore the influencing variables based on the single-factor indicators with statistical significance.

Results: When adverse events caused serious casualties or even death, the majority cases (96.25%) were reported to the superior supervisor; when the adverse events did not cause relevant injury, and was in potential vulnerability, the proportion of discussing with colleagues was the most (90.00% and 88.75%, respectively). For cognition on adverse events, "whether they understand the medical safety event reporting system" accounted for the most proportion (98.75%). The nurses had the highest scores for reporting standard [(25.58 ± 6.19) points] and lowest score for reporting purpose [(8.62 ± 1.51) points]. Age, educational background, years of employment, and professional titles were influencing factors of nurses' inclination to report unfavorable events (P < .05).

Conclusion: The cognition and reporting attitude of nurses in the hematology department on adverse events need further improvement. The intention of the nurses to report adverse events is influenced by age, educational background, years of experience, and professional titles. Patient safety education especially with simulation-based training should be implemented, to decrease frequency of adverse incidents.

Objective: To investigate the therapeutic effect of Cf-252 neutron intracavitary brachytherapy (ICBT) in the treatment of primary vaginal carcinoma of stage I-III, along with advanced complications.

Methods: Between August 2009 and August 2013, 41 patients with intact primary vaginal carcinoma based on the histological diagnosis at the Second Cancer Hospital of Heilongjiang Province (Beidahuang Group General Hospital) and the Daping Hospital of the Third Military Medical University were included in this study. Among them, 32 patients were squamous cell carcinoma, and 9 adenocarcinomas. Stage I patients were treated with ICBT alone. Patients at stages II and III were treated using ICBT combined with external beam radiotherapy (EBRT).

Results: The mean age, the rate of the 5-year local control, the rate of the 5-year overall survival was increased. The rate of the 5-year tumor-free survival was 56.1%, and the incidence of advanced serious complications (grade II and above radiation cystitis, proctitis, etc.) was 29.3%. Compared to later stages, early-stage patients are in better physical shape, so they are better able to withstand the toxic side effects of treatment. The local control (LC), overall survival (OS), or disease-free survival (DFS) rate in stage III patients was significantly lower than those in stage I and stage II. The rate of OS in stage I patients was 90.9% (10/11), which was significantly higher than that in all patients (56.1%; 23/41). Moreover, the mean survival time was significantly different between stage III and stage I. In addition, the survival status of squamous cell carcinoma and adenocarcinoma was also very different.

Conclusion: In summary, the use of Cf-252 ICBT radiotherapy resulted in a higher rate of local control of vaginal cancer and a lower rate of recurrence, better-shrinking effect, and efficacy for advanced tumors, and has clinical prospects.

Objective: The objective of this study was to analyze the application of health management and medication self-management education in the control of chronic diseases in the elderly, specifically focusing on patients with diabetes, hypertension, cardiovascular diseases, and chronic obstructive pulmonary disease (COPD). The study aimed to assess the impact of these interventions on patients› self-management abilities, quality of life, medication adherence, intervention satisfaction, and the occurrence of adverse events. The findings aimed to provide a scientific basis for improving elderly chronic disease management and enhancing patients› health and quality of life.

Methods: A total of 106 elderly chronic disease patients admitted to our hospital from July 2021 to April 2023 were selected as the research subjects. All patients met the complete inclusion criteria. They were divided into two groups based on the type of health management intervention received. The control group (n=53) received conventional health management intervention. In contrast, the observation group (n=53) received health management from the medical examination center based on the PDCA model and medication self-management education intervention. The self-management ability, quality of life, medication adherence, occurrence of adverse events, and intervention satisfaction of the two groups of patients were compared. The PDCA (Plan-Do-Check-Act) model was chosen as the framework for this study due to its systematic approach to management and its potential to address the specific needs and complexities associated with chronic diseases in the elderly. The PDCA model emphasizes a continuous cycle of improvement, involving planning, implementation, evaluation, and adjustment of interventions.

Results: Before the intervention, there was no significant difference in self-concept, self-management responsibility, self-management knowledge, and self-management skills between the two groups (P > .05). After the intervention, the observation group's self-concept, self-management responsibility, self-management knowledge, and self-management skills were significantly higher than those of the control group (P < .05). Before the intervention, there was no significant difference in SF-36 scores between the two groups (P > .05). After the intervention, the SF-36 scores of the observation group were significantly higher than those of the control group (P < .05). The medication adherence score in the control group was (5.73±0.92), and the incidence of adverse events was 32.08%. In the observation group, the medication adherence score was (7.42±0.81), and the incidence of adverse events was 11.32%. The medication adherence score in the observation group was significantly higher than that in the control group, and the incidence of adverse events was significantly lower than that in the control group (P < .05). The intervention satisf

To explore the effect of continuity of nursing (CON) service platform application under "smart elderly care (SEC)" on family nursing of elderly patients with chronic diseases (CDs) after discharge. 200 elderly patients with CDs treated in Medical Care Ward, Zhejiang Hospital were included and grouped into the control group (CG) and experimental group (EG) in line with the sequential order of admission (100 cases per group). After discharge, routine nursing and smart CON services were given, respectively. 36-Item Short Form Questionnaire (SF-36) score of quality of life (QOL), Barthel index (BI) score of activity of daily living (ADL), Self-rating Depression Scale (SDS) score of depression, Self-rating Anxiety Scale (SAS) score of anxiety, compliance, and nursing satisfaction were compared. Compared to CG, SF-36 score and BI score were highly increased in EG 0 months (mo) and 3 mo after discharge, while SDS and SAS scores were greatly decreased (all P < .001). The compliance rate was 70% in CG and 93% in EG during the follow-up period. The nursing satisfaction rate of CG reached 92%, while that of EG was 97%. Compared with CG, the compliance and nursing satisfaction rates of EG were notably higher (P < .001). It was illustrated that the smart CON service model could enhance the effect of discharged family nursing for elderly patients with CDs, improve patients' mental status and QOL, and raise nursing compliance. Therefore, it was conducive to the rehabilitation of patients. The findings of this study highlight the transformative potential of smart CON service models in enhancing the effectiveness of family nursing for elderly patients with CDs post-discharge. Embracing these innovative approaches has the potential to not only improve individual patient outcomes but also contribute to the advancement of patient-centered care practices and healthcare delivery systems on a broader scale.