Publications by authors named "Jingfang Hong"

28 Publications

  • Page 1 of 1

Circ-HACE1 Aggravates Cigarette Smoke Extract-Induced Injury in Human Bronchial Epithelial Cells via Regulating Toll-Like Receptor 4 by Sponging miR-485-3p.

Int J Chron Obstruct Pulmon Dis 2021 1;16:1535-1547. Epub 2021 Jun 1.

Department of Health and Nursing, Anhui Vocational College of City Management, Hefei City, Anhui Province, People's Republic of China.

Background: Smoking is the most common cause of chronic obstructive pulmonary disease (COPD), and the early diagnosis for COPD remains poor. Exploring the molecular mechanism and finding feasible biomarkers will be beneficial for clinical management of COPD. Circular RNAs (circRNAs) are noncoding RNAs that act as miRNA sponges to regulate the expression levels of genes, leading to the changes of cellular phenotypes and disease progression. CircRNA HECT domain and ankyrin repeat containing E3 ubiquitin protein ligase 1 (circ-HACE1) was abnormally expressed after the induction of cigarette smoke extract (CSE) in cell model. This study was performed to explore its function and mechanism in COPD.

Methods: Circ-HACE1, microRNA-485-3p (miR-485-3p) and toll-like receptor 4 (TLR4) detection was performed by quantitative real-time polymerase chain reaction (qRT-PCR). Cell viability and apoptosis/cell cycle were respectively examined using cell counting kit-8 (CCK-8) and flow cytometry. Inflammatory cytokines were determined by enzyme-linked immunosorbent assay (ELISA). Oxidative stress was evaluated through the measurement of malondialdehyde (MDA) and superoxide dismutase (SOD). The target binding analysis was conducted via dual-luciferase reporter assay. Western blot was employed for protein expression detection of TLR4.

Results: Circ-HACE1 was overexpressed in smokers or smokers with COPD and CSE upregulated circ-HACE1 expression in 16HBE cells. Knockdown of circ-HACE1 attenuated CSE-stimulated cell viability and cell cycle repression, as well as the enhancement of cell apoptosis, inflammatory response and oxidative stress. MiR-485-3p was a target of circ-HACE1. Circ-HACE1 regulated CSE-induced cell injury via targeting miR-485-3p. TLR4 was a downstream target of miR-485-3p, and miR-485-3p inhibited the CSE-induced cell damages by directly downregulating the level of TLR4. Circ-HACE1/miR-485-3p regulated TLR4 expression in CSE-treated 16HBE cells, and TLR4 overexpression also reversed all effects of si-circ-HACE1 on CSE-treated 16HBE cells.

Conclusion: These findings elucidated that circ-HACE1 contributed to the CSE-induced cell damages in COPD cell models via regulating TLR4 by acting as the sponge of miR-485-3p.
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http://dx.doi.org/10.2147/COPD.S304859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179752PMC
June 2021

Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students.

Nurse Educ Pract 2021 May 16;53:103055. Epub 2021 Apr 16.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Evaluation and cultivation of clinical competence in undergraduate nursing students are essential in nursing education. Self-efficacy and good clinical learning environments are expected to have a positive influence on the clinical competence of undergraduate nursing students, but few studies have focused on the relationships among clinical competence, self-efficacy, and clinical learning environments. This study aimed to examine clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. A cross-sectional questionnaire survey was conducted with 1518 undergraduate nursing students being recruited from five medical colleges in China. The nursing students' clinical competence, self-efficacy, and clinical learning environments were assessed using a set of self-reported questionnaires, including Chinese versions of the Holistic Clinical Assessment Tool; General Self-Efficacy Scale; and Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale. Factors significantly associated with the clinical competence of undergraduate nursing students were professional interest, self-efficacy, and clinical learning environments, accounting for 36.1% of the total variance. Self-efficacy played a mediating role between clinical learning environments and clinical competence. The results of this study can be applied as reference for the enhancement of a nursing education program to improve the clinical competence of Chinese undergraduate nursing students.
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http://dx.doi.org/10.1016/j.nepr.2021.103055DOI Listing
May 2021

Effectiveness of lay-led, group-based self-management interventions to improve glycated hemoglobin (HbA1c), self-efficacy, and emergency visit rates among adults with type 2 diabetes: A systematic review and meta-analysis.

Int J Nurs Stud 2021 Jan 24;113:103779. Epub 2020 Sep 24.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address:

Background: Diabetes is a debilitating health condition that is rapidly increasing in prevalence globally. Diabetes self-management is known as an important aspect of diabetes care, and group-based self-management interventions led by lay leaders have been explored previously. However, the effects of such an interventional approach to improve glycated hemoglobin (HbA1c) levels, self-efficacy, and emergency visit rates among adults with type 2 diabetes remains inconclusive.

Objectives: To review and perform a meta-analysis systematically of the effectiveness of lay-led, group-based self-management interventions to improve HbA1c levels, self-efficacy, and frequency of emergency visit rates in adults with type 2 diabetes.

Methods: A systematic literature search was conducted through the following seven databases: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, SCOPUS, and Web of Science. Screening and assessment for risk of bias were conducted by two independent reviewers. Meta-analyses were performed for HbA1c levels, self-efficacy, and frequency of emergency visits, using RevMan 5.3 software.

Results: Sixteen randomized controlled trials were included in this review. Meta-analyses results indicated significant effects on HbA1c (pooled MD = 0.23, 95% CI [-0.41, -0.05], p = 0.01) self-efficacy (d = 0.27; 95% CI [0.19, 0.36]; p <0.00001), and frequency of emergency visits (pooled MD = 0.15; 95% CI [-0.26, -0.05]; p = 0.004], favoring the intervention groups. However, possible publication bias was detected. Significant heterogeneity was observed for HbA1c but not for self-efficacy or frequency of emergency visits.

Conclusions: Possible effects of lay-led, group-based self-management interventions on improving HbA1c, self-efficacy, and frequency of emergency visits among adults with type 2 diabetes were demonstrated in this review. Although possible publication bias and heterogeneity were detected for HbA1c, the results point toward a potentially feasible and effective treatment for adults with type 2 diabetes, allowing them to manage and sustain self-care behaviors.
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http://dx.doi.org/10.1016/j.ijnurstu.2020.103779DOI Listing
January 2021

The multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with heart failure.

Heart Lung 2020 Nov - Dec;49(6):842-847. Epub 2020 Oct 1.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Background: Previous researchers have found that depression can influence self-care behaviors of patients with heart failure (HF). However, the specific path of depression on self-care behaviors remains unclear.

Objectives: To determine the multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with HF.

Methods: A cross sectional study on HF patients (n = 310) was conducted at a tertiary hospital in China. The Chinese versions of the Hospital Anxiety and Depression Scale (HADS-D), Health Literacy Scale for Patients with Chronic Disease and Self-care of Heart Failure Index (C-SCHFI) were used to assess depression, health literacy, self-care confidence and self-care behaviors of the HF patients respectively.

Results: Depression had significant negative correlations with health literacy (r = -0.40, P < 0.01), self-care confidence (r = -0.41, P < 0.01), self-care maintenance (r = -0.18, P < 0.01) and management (r = -0.19, P < 0.01). After controlling for covariates, mediation modeling analysis showed that health literacy and self-care confidence were mediating variables between depression and self-care management and all the three paths were significant. A higher level of depression debilitated health literacy (β = -0.23, P < 0.001), and a higher degree of health literacy was associated with better self-care confidence (β = 0.31, P < 0.001) which contributed to better self-care management (β = 0.43, P < 0.001). Total mediation effect was -0.1940 with 95% CI from -0.2702 to -0.1266. However, self-care confidence did not mediate between depression and self-care maintenance.

Conclusion: Health literacy and self-care confidence exert a multiple mediating effect on the relationship between depression and self-care management. The relationship between variables should be considered when developing the tailored interventions for patients with HF to enhance their self-care behaviors.
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http://dx.doi.org/10.1016/j.hrtlng.2020.09.011DOI Listing
March 2021

The caring experience and supportive care needs of male partners for women with gynaecologic cancer: A qualitative literature review.

J Clin Nurs 2020 Dec 19;29(23-24):4469-4481. Epub 2020 Oct 19.

Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Objective: To systematically review male partners' caring experience and supportive care needs when caring for women with gynaecologic cancer.

Methods: The PRISMA guidelines were used to conduct this systematic review. We performed a comprehensive literature search in nine databases and qualitative studies published in English or Chinese from inception to January 2020. The included papers were appraised, using the Critical Appraisal Skills Program tool for qualitative research. An inductive thematic analysis method was adopted to synthesise major findings to construct core concepts and themes.

Results: Eight studies were included in this review, and four overarching themes emerged the following: the negative experience of disease, the need for supportive care to cope, adapting to a new life and post-traumatic growth.

Conclusions: This study shows that male partners had both negative and positive experiences in the caring process, and they could adjust themselves to some extent. Their perceived supportive care needs were often neglected.

Relevance To Clinical Practice: Male partners of women with gynaecologic cancer are an under-recognised group. The couple-oriented or family-oriented supportive care programmes should be implemented to meet the supportive care needs of male partners to enhance their health and well-being.
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http://dx.doi.org/10.1111/jocn.15501DOI Listing
December 2020

Effectiveness of Tai Chi on quality of life, depressive symptoms and physical function among community-dwelling older adults with chronic disease: A systematic review and meta-analysis.

Int J Nurs Stud 2020 Nov 1;111:103737. Epub 2020 Aug 1.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address:

Background: With a rapid increase in aging population and prevalence of chronic diseases worldwide, older adults are seen facing more physical and psychological burdens, affecting their quality of life (QoL). Tai Chi, a traditional Chinese mind-body physical activity, appeals to many older adults and has been extensively studied. However, the effectiveness of Tai Chi on QoL, depressive symptoms and physical function on community-dwelling older adults remains vague.

Objectives: To synthesise and evaluate effectiveness of Tai Chi on QoL, depressive symptoms and physical function among community-dwelling older adults with chronic disease.

Methods: Searches were performed across seven databases systematically (PubMed, Embase, Cochrane, CINAHL, Scopus, ProQuest, CNKI). Only randomised controlled trials (RCTs), written in English or Chinese were included. All eligible studies were screened with risk of bias examined by two independent reviewers. Meta-analyses were conducted using RevMan 5.3 software while narrative syntheses were performed where meta-analysis was inappropriate and heterogeneity was present.

Results: A total of 3416 records were generated and 13 RCTs were eligible for inclusion. Meta-analysis reported statistically significant small effect size favouring Tai Chi on QoL and depressive symptoms. No statistically significant differences were seen for mobility and endurance of physical function. Majority had high heterogeneity hence findings should be interpreted carefully.

Conclusion: Tai Chi was found to have favourable effects on QoL and depressive symptoms of older adults with chronic disease which can act as a complement to disease management. However, future research can be improved to explore theoretical framework and include high-quality studies with larger sample sizes.
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http://dx.doi.org/10.1016/j.ijnurstu.2020.103737DOI Listing
November 2020

Computational analysis and verification of molecular genetic targets for glioblastoma.

Biosci Rep 2020 06;40(6)

Department of Neurosurgery, 900 Hospital of the Joint Logistics Team, Fuzhou, Fujian 350025, P.R. China.

Background: Glioblastoma (GBM) is the most common malignant brain tumor with a poor prognosis. The initial treatment for high-grade gliomas is surgical excision. However, even with concomitant use of radiation or chemotherapy, patients are still prone to recurrence. The specific pathogenesis of GBM is still controversial.

Methods: Differentially expressed genes (DEGs) and differentially expressed miRNAs (DEMs) between GBM and normal brain tissues were screened. P-value was obtained by Bayes test based on the limma package. Statistical significance was set as P-value <0.05 and |Fold change (FC)| > 0.2 (GSE90886); P-value <0.05 and |FC| > 1 (GSE116520, GSE103228). Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), protein-protein interaction (PPI) network were performed. Hub genes were selected from miRNA target genes and DEGs. GBM and normal brain tissues were extracted to verify the expression.

Results: A total of 100 DEGs were overlapped in both datasets. Analysis of pathways and process enrichment tests indicated that ion transport, positive regulation of macromolecule metabolic process, cell cycle, axon guidance were enriched in the GBM. Sixteen hub genes were identified. Hub genes ADARB1 and neuropilin 1 (NRP1) were significantly associated with overall survival (OS) and disease-free survival (DFS) (P<0.05). Eukaryotic translation termination factor 1 (ETF1) was associated with DFS (P<0.05).

Conclusions: DEGs and DEMs were found between GBM tumor tissues and normal brain tissues. These biomarkers may be used as targets for early diagnosis and specific treatment.
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http://dx.doi.org/10.1042/BSR20201401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298167PMC
June 2020

Anterior communicating artery complex fenestration combined with tandem aneurysm: a case report and literature review.

Medicine (Baltimore) 2020 May;99(19):e20013

Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, 900th Hospital.

Introduction: Clinically, anterior communicating artery complex fenestration combined with fenestration-related aneurysms is rare, and combination of this condition with tandem aneurysms is even rarer.

Patient Concerns: A case of a 43-year-old man with spontaneous subarachnoid hemorrhage.

Diagnosis: A computed tomography angiography examination revealed a fenestrated anterior communicating artery complex combined with 2 aneurysms. Then, a digital subtraction angiography examination was performed to further determine the diagnosis, which showed a complex anatomical structure of the local tissue. After the aneurysms ruptured, they were partially wrapped by a hematoma and compressed, which increased the difficulty of surgery.

Interventions: An endovascular interventional therapy method was chosen, and a simple coil was successfully inserted through the blood vessel into the tandem aneurysms to maintain the integrity of the anatomical structure.

Outcomes: The patient recovered well postoperatively. An imaging review after the operation did not show the aneurysms, and the upper and lower branches were patent.

Conclusion: Therefore, endovascular treatment is an appropriate choice for arterial fenestration combined with tandem aneurysms, once the aneurysms have ruptured.
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http://dx.doi.org/10.1097/MD.0000000000020013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220171PMC
May 2020

Effectiveness of internal Qigong on quality of life, depressive symptoms and self-efficacy among community-dwelling older adults with chronic disease: A systematic review and meta-analysis.

Int J Nurs Stud 2019 Nov 28;99:103378. Epub 2019 Jun 28.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Background: With increasingly aged populations worldwide, the quality of life and psychosocial wellbeing of older adults, especially those with chronic disease, become of increasing importance. There are multiple studies on the use of internal Qigong, a popular mind-body exercise commonly practiced by older adults. However, the effectiveness of internal Qigong on quality of life, depressive symptoms, and self-efficacy on older adults remains unclear.

Objectives: To review updated evidence to determine the effectiveness of internal Qigong interventions on quality of life, depressive symptoms, and self-efficacy among community-dwelling older adults with chronic disease.

Method: Six databases (PubMed, CENTRAL, CINAHL, Embase, Scopus, CNKI) were systematically searched for studies from January 2008 to December 2018 in English and Chinese. Relevant randomised controlled trials (RCTs) were screened and assessed for risk of bias by two independent reviewers. A meta-analysis on study outcomes of quality of life, depressive symptoms and self-efficacy using the RevMan 5.3 software was performed.

Results: The search retrieved 3439 records. After screening, a total of 13 RCTs with 1340 participants were included in this review. Meta-analysis revealed a significant effect favouring internal Qigong on the quality of life (combined MD = 3.72; 95% CI: 2.27-5.18; p = 0.0001) compared to controls. No significant effects were found for depressive symptoms and self-efficacy. Low heterogeneity among the studies was found for quality of life, whereas high heterogeneity was shown for depressive symptoms and self-efficacy.

Conclusion: Internal Qigong appears to have potential benefits on overall quality of life among community-dwelling older adults with chronic disease. The findings of this study suggest potential use of internal Qigong as an adjunct activity for chronic disease management. Future research may enhance the rigour of trials and explore theoretical underpinnings behind Qigong.
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http://dx.doi.org/10.1016/j.ijnurstu.2019.06.009DOI Listing
November 2019

Supportive Care Needs of Patients With Lung Cancer in Mainland China: A Cross-Sectional Study.

J Nurs Res 2019 Dec;27(6):e52

MSN, RN, Teaching Assistant, School of Nursing, Anhui Medical University, Hefei, China.

Background: The diagnosis and treatment of lung cancer necessitate a variety of supportive care needs. To our knowledge, no studies have been conducted that target specifically the supportive care needs of patients with lung cancer in Mainland China. Cross-cultural studies indicate that supportive care needs vary by cultural background. Thus, it is necessary to investigate the supportive care needs of patients with lung cancer in the cultural context of China.

Purpose: This study aimed to describe the level of supportive care required by patients with lung cancer in China and to examine the relationships between supportive care needs and demographic factors and between supportive care needs and treatment variables.

Methods: A cross-sectional descriptive study design was adopted. Five hundred fifty-four patients with lung cancer were recruited using a convenience sampling method from inpatient departments in four tertiary teaching hospitals that are affiliated with a medical university in Anhui Province, China. The Nursing Professional Social Support Needs Scale and background information list were used as the data collection instruments. A Wilcoxon rank sum test and a Kruskal-Wallis rank sum test were conducted to examine the differences among the professional supportive care needs of patients of different demographic characteristics and under different treatment conditions.

Results: Participants self-reported the highest scores in the domain of informational needs (M = 3.67, interquartile range = 1.25). The most common supportive care need was "to be cared for by nurses with skilled venipuncture techniques." There were significant differences in needs across different genders, age groups, educational levels, and income levels (p < .05). Patients with metastasis and other illnesses had greater supportive care needs in terms of total and subscale scores in Stages III and IV (p < .05).

Conclusions: Patients with serious diseases and heavy socioeconomic burdens have greater supportive care needs. Therefore, healthcare providers should improve their awareness and expertise to identify the needs of their patients and to provide supportive care to patients with lung cancer. In addition, patients with high supportive care needs should be identified.
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http://dx.doi.org/10.1097/jnr.0000000000000338DOI Listing
December 2019

Enhanced effect of catalpol on specific immune therapy in treatment of asthmatic mice.

Am J Transl Res 2019 15;11(4):2463-2469. Epub 2019 Apr 15.

Department of Pulmonary and Critical Care Medicine, 900 Hospital of The Joint Logistics Team (Fuzhou General Hospital of Nanjing Military Area Command), Dongfang Hospital, Xiamen University, Fuzong Clinical College of Fujian Medical University Fuzhou 350025, Fujian Province, P. R. China.

The effects and enhancement of catalpol (CP) on specific immune therapy (SIT) were investigated with an established animal model associated with bronchial asthma. A total of 50 adults BALB/c mice were randomly divided into five groups with 10 mice in each group. These groups are control group, model group, CP group, SIT group and CP/SIT joint group. The mice were sensitized and challenged with OVA and Bronchoalveolar lavage fluid (BALF) and peripheral blood were obtained, the cell counts and the levels of cytokines (IL-1, IL-4, IFN-γ) in BALF were detected using ELISA methods. The total number of cells in BALF of the group treated with CP/SIT joint group was significantly lower than the other experimental groups. Furthermore the eosinophils of the mice were dramatically reduced comparing the other experimental groups, the cytokines IL-1 and IL-4 display the similar tendency, but the IFN-γ concentration for the experimental groups was higher than the model group. After the therapy using CP, SIT and a combination of CP and SIT, asthma-associated inflammation was inhibited, IL-4 level was decreased and IFN-γ level was increased. In addition, the expression of TLR-4 protein in peripheral blood was detected by Western Blot method. In summary, CP can enhance the treating effect of SIT and the joint treatment by CP/SIT might be a potential method for clinical treatment of asthma, the mechanism is related to the inhibition of TLR-4 signaling pathway.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511798PMC
April 2019

Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with type 2 diabetes: A systematic review and meta-analysis.

Int J Nurs Stud 2021 Apr 8;116:103286. Epub 2019 Feb 8.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Objectives: To review the evidence and determine the effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life, glycated hemoglobin, body mass index (BMI), and blood pressure (BP) levels of adults with type 2 diabetes mellitus .

Methods: A systematic search of five databases (PubMed, Embase, Cochrane, CINAHL and Scopus) was conducted. Studies published in English from January 2007 to January 2018 were considered. Only randomized controlled trials (RCTs) of smartphone-based self-management interventions for patients with type 2 diabetes mellitus that reported any of the study outcomes were included. Two reviewers independently screened the studies, extracted data and assessed the quality of the studies. Meta-analyses were conducted for the different study outcomes.

Results: A total of 26 articles, consisting of 22 studies with 2645 participants, were included in the review. The results from meta-analysis on the studies revealed that as compared to control group, participants received smartphone-based self-management intervention had better self-efficacy with large effect size of 0.98 (P <  0.001), self-care activities with effect size of 0.90 (P <  0.001), health related quality of life with effect size of 0.26 (p=0.01), and lower glycated hemoglobin (pooled MD=-0.55; p<0.001). Subgroup analyses were also conducted for self-efficacy as significant heterogeneity was present among the studies. The effects on BMI and BP were not statistically significant.

Conclusions: Smartphone-based self-management interventions appear to have beneficial effects on self-efficacy, self-care activities and health-relevant outcomes for patients with type 2 diabetes mellitus. However, more research with good study design is needed to evaluate the effectiveness of smartphone-based self-care interventions for T2DM.
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http://dx.doi.org/10.1016/j.ijnurstu.2019.02.003DOI Listing
April 2021

Effects of Increased Intracranial Pressure Gradient on Cerebral Venous Infarction in Rabbits.

World Neurosurg 2018 Dec 7;120:e161-e168. Epub 2018 Aug 7.

Department of Neuro-interventional Radiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China. Electronic address:

Background: Cerebral venous infarction (CVI) is a rare vascular disease most commonly caused by cerebral venous thrombosis that leads to hemorrhage or infarct formation. A rabbit model of CVI was established by placing a recoverable epidural sacculus to research effects of increased pressure on CVI.

Methods: Rabbits were randomly divided into the following groups: A, CVI; B, 0.2-mL epidural sacculus placed on the basis of CVI; C, 0.4-mL epidural sacculus; D, 0.6-mL epidural sacculus; E, sham operation. Two sacculus-release groups were then added, 8 hours (group F) and 24 hours (group G), on the basis of group D. Brain water content, extent of cerebral infarction, hemorheology indexes, D dimer, and fibrinogen were observed at 8, 24, and 48 hours after surgery.

Results: Brain water content was higher in groups A-D compared with group E with the exception of the 24-hour A group. Brain water content was significantly lower in sacculus-release groups compared with the 48-hour D group. Extent of cerebral infarction in group D was significantly higher at 24 and 48 hours compared with groups A and E. Extent of cerebral infarction in sacculus-release groups was significantly lower compared with group D at 48 hours. Hemorheology indexes and fibrinogen were significantly higher in group D compared with groups A and E at corresponding time points and increased with increasing intracranial pressure.

Conclusions: In the rabbit model of CVI, degree of brain edema, extent of cerebral infarction, hemorheology indexes, and fibrinogen increased as intracranial pressure gradient increased, which may promote formation of a hypercoagulable state. Early removal of intracranial hypertension reduced degree of edema and extent of cerebral infarction in rabbits.
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http://dx.doi.org/10.1016/j.wneu.2018.07.264DOI Listing
December 2018

A Cognitive-Behavioral Intervention for the Symptom Clusters of Chinese Patients With Gastrointestinal Tract Cancer Undergoing Chemotherapy: A Pilot Study.

Cancer Nurs 2019 Nov/Dec;42(6):E24-E31

Author Affiliations: School of Nursing, Anhui Medical University, Hefei, Anhui, China.

Background: Patients with gastrointestinal tract (GIT) cancer undergoing chemotherapy often experience several symptoms that constitute symptom clusters and can cause patients to suffer. Effective interventions are lacking for this kind of patients.

Objective: The aims of this study were to test the feasibility and acceptability of a cognitive-behavioral (CB) intervention developed for Chinese patients with GIT cancer undergoing chemotherapy and to estimate the efficacy of the intervention for symptom clusters.

Methods: In this pilot, quasi-randomized controlled trial, 40 patients were assigned to the CB intervention or control group. The CB intervention, considering characteristics of patients and Chinese culture, contained 4 sections including cognitive reframing, cancer-diet education, relaxation, and exercise techniques. Symptom clusters, illness perception, anxiety, and depression were measured.

Results: Thirty-nine patients (97.5%) completed the study program and expressed willingness to follow the intervention. Compared with the control group, all outcomes were improved (all P < .05) in the CB group after the intervention, except for the gastrointestinal symptom cluster (t = 0.25, P = .802). In the CB group, the scores of all outcomes (all P < .05) decreased except for depression (t = 1.76, P = .095).

Conclusion: The CB intervention is partially feasible and acceptable. It may also help to improve part of the symptom clusters of Chinese patients with GIT cancer undergoing chemotherapy. However, some modifications are needed in future studies to better test effectiveness.

Implications For Practice: Symptom management remains a major problem in clinical nursing. Such a CB intervention can be beneficial to the clinical management of symptom clusters.
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http://dx.doi.org/10.1097/NCC.0000000000000625DOI Listing
May 2020

Radiation of Bactrocera dorsalis (Diptera: Tephritidae) Eggs to Improve the Mass Rearing of Diachasmimorpha longicaudata (Hymenoptera: Braconidae).

J Econ Entomol 2018 05;111(3):1157-1164

Institute of Beneficial Insects, Plant Protection College, Fujian Agriculture and Forestry University, Fuzhou, China.

This study explored the potential for Bactrocera dorsalis (Hendel) (Diptera: Tephritidae) larvae hatched from irradiated eggs as hosts for Diachasmimorpha longicaudata (Ashmead) (Hymenoptera: Braconidae). B. dorsalis eggs of three different ages (12-, 24-, and 36-h old) were analyzed for hatchability, pupation rate, pupal weight, emergence rate, and sex ratio after exposure to different doses of radiation (5 and 10 Gy) at different dose rates (1 and 6 Gy/min). For the eggs of different ages exposed to radiation, only the hatchability and pupal weight of 36-h-old eggs exposed to the dose rate of 1 Gy/min were not affected; therefore, 6 Gy/min was not suitable for irradiating eggs. The viability of the parents and progenies of D. longicaudata when the parents were reared from 36-h-old eggs irradiated at nine different doses (0, 5, 10, 15, 20, 25, 30, 35, and 40 Gy) under laboratory conditions were investigated. The emergence percentage, sex ratio, and longevity of parasitoids developed from irradiated eggs were similar to those reared from nonirradiated hosts. A significant increase in larva mortality was observed for the eggs irradiated at doses above 25 Gy, and no redundant adult flies emerged at doses above 15 Gy. Hence, for B. dorsalis eggs to be applied in the mass rearing of D. longicaudata, the age of 36 h and a dose of 20-25 Gy are the optimal parameters. The results reveal that hosts and parasitoids need not be separated, enabling a reduction in cost, labor, and time and resulting in an improved mass rearing procedure for D. longicaudata.
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http://dx.doi.org/10.1093/jee/toy032DOI Listing
May 2018

Experience of nursing support from the perspective of patients with cancer in mainland China.

Nurs Health Sci 2016 Dec 11;18(4):510-518. Epub 2016 Aug 11.

Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

This study was conducted to understand patients' experiences of nursing support, to identify gaps between patients' expected needs and the nursing support they received, and to explore reasons for such disparity. A qualitative study with a phenomenological approach was used. A purposive sample of 22 patients with different types of cancer was recruited and interviewed using semistructured guidelines. The data were analyzed using phenomenological analytic methods. Several needs regarding nursing support were expressed, including informational, psychological, clinical, care coordination and communication needs, and there were some unmet or partially-met needs. Reasons for the disparities covered both patient- and nurse-related factors, including patients' lack of awareness regarding how to acquire professional assistance and reluctance to express their needs, and nurses' lack of active communication with patients, inability to provide specific support, and limited resources for coordination. The expectations of nursing support did not always correspond with the actual delivery of nursing care. A tailored intervention is warranted to meet patients' expectations, which might contribute to quality-of-care improvements.
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http://dx.doi.org/10.1111/nhs.12303DOI Listing
December 2016

Poor Prognostic Outcome in Cerebral Venous Sinus Thrombosis Associated with Dyskinesia and Elevated Platelet Volume.

Curr Neurovasc Res 2016 ;13(1):50-7

Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, No.156 Xihuanbei Road, Fuzhou 350025, P. R. China.

Although about 80% of patients with cerebral venous sinus thrombosis have a good prognosis, some patients develop severe complications and a small proportion do not survive. The study included patients who had been diagnosed with cerebral venous sinus thrombosis in our hospital from May 2008 to February 2014. Based on the modified Rankin Scale (mRS) scores at 3 months for outcome, the patients were divided into two groups: good prognosis (mRS score ≤ 2) and poor prognosis (mRS score > 2). Univariate and multivariate regression analysis were performed to identify significant prognostic factors for poor outcome. A total of 86 patients with cerebral venous sinus thrombosis, 54 males and 32 females, average age 41.3 years (range, 3-83 years), were enrolled. Of these 86 patients, 64 (74.4%) had a good prognosis and 22 (25.6%) a poor prognosis. Univariate analysis revealed that dyskinesia was a significant risk factor (factor with odds ratio >1) for poor prognosis. In multivariate analysis, the risk of poor prognosis in patients with dyskinesia was 23 times higher than for those without dyskinesia (p < 0.001). Thrombosis of the sinus transervus was found to reduce the risk of poor prognosis in both univariate and multivariate analysis. Most patients with cerebral venous sinus thrombosis have a good prognosis but patients with dyskinesia have a poorer prognosis.
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http://dx.doi.org/10.2174/1567202613666151116143530DOI Listing
October 2016

Relationship between pituitary adenoma texture and collagen content revealed by comparative study of MRI and pathology analysis.

Int J Clin Exp Med 2015 15;8(8):12898-905. Epub 2015 Aug 15.

Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University Fuzhou 350025, P. R. China.

This study is to reveal the relationship between pituitary adenomas and tumor texture by comparing MRI and pathologic results. Preoperative imaging data of 38 cases of pituitary adenoma patients and collagen content of tumor specimens measured by histopathological were analyzed and compared. T2WI and diffusion coefficient assessment were used to reveal the relationship between tumor texture and collagen content. There were 13 cases of soft texture, 17 cases of medium texture and 8 cases of tough texture tumors. Signal intensity of different texture Pituitary adenomas had significant difference on T2WI and ADC map (P < 0.05). The signal intensity ratio of tumor and pons on T2WI had high consistency with tumor texture. Mean collagen contents of soft, medium and tough texture group were 1.51% ± 0.91%, 7.35% ± 2.99% and 18.10% ± 8.24%, respectively. There were significant differences in collagen content of different texture tumors (P < 0.01). The signal intensity of T2WI and ADC images have prediction value for pituitary adenomas texture and T2WI is more reliable.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4612891PMC
November 2015

Evaluation of a web-based educational programme on changes in frequency of nurses' interventions to help smokers quit and reduce second-hand smoke exposure in China.

J Adv Nurs 2016 Jan 1;72(1):118-26. Epub 2015 Oct 1.

David Geffen School of Medicine, University of California, Los Angeles, California, USA.

Aims: To evaluate a web-based educational smoking cessation programme on changes in the frequency of hospital-based nurses' self-reported interventions to help smokers quit using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), to reduce exposure to second-hand smoke and to change attitudes about nurses' involvement in tobacco control.

Background: Few nurses in China support smokers' quit attempts using evidence-based smoking cessation interventions based on the 5 As. Limited knowledge is a barrier to intervention. Web-based tobacco cessation programs have the potential to reach a large population of nurses.

Design: A prospective single-group design with pre-, 3- and 6-month follow-up after the educational programme evaluated the feasibility of conducting web-based educational programs in two cities in China in 2012-2013.

Methods: Frequency of interventions was assessed using a valid and reliable web-based survey with a convenience sample of nurses from eight hospitals in Beijing and Hefei, China. Generalized linear models, adjusting for age, clinical setting, education and site were used to determine changes in the consistent (usually/always) use of the 5 As from baseline to 3 and to 6 months.

Results: Nurses (N = 1386) had baseline and/or 3- and 6-month data. At 6 months, nurses were significantly more likely to Assess, Assist and Arrange for smoking cessation and recommend smoke-free home environments. There was significant improvement in attitudes about tobacco control.

Conclusions: Nurses receiving web-based smoking cessation education significantly increased self-reports of frequency of providing interventions to patients who smoke, including recommending smoke-free home environments to support quit attempts.
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http://dx.doi.org/10.1111/jan.12816DOI Listing
January 2016

Helping smokers quit: behaviours and attitudes of Chinese Registered Nurses.

J Adv Nurs 2016 Jan 28;72(1):107-17. Epub 2015 Sep 28.

David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Aims: To describe the self-reported frequency of Chinese nurses' interventions to help smokers quit, using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), attitudes towards tobacco control and differences in consistency interventions by demographic and professional characteristics prior to an educational intervention to increase nurses' support for quit efforts.

Background: Tobacco use is the leading cause of preventable death in China; quitting smoking reduces health risks and premature death. The China Tobacco Cessation Treatment Guideline supports the 5 As model for intervention, but nurses' frequency of delivering smoking cessation interventions is unknown.

Design: Descriptive survey using a convenience sample.

Methods: Nurses from eight hospitals in Beijing and Hefei, China completed a web-based survey in 2012. Differences in consistency of the 5 As by nurse characteristics were determined using multivariate logistic regression. Overall importance of nurses in tobacco control was evaluated on a 1-5 scale (5 = most important).

Results: Nurses (N = 2440; 1404 Beijing, 1036 Hefei) participated. 64% consistently asked about smoking status, 85% advised patients to quit, 52% assessed readiness to quit and assisted with smoking cessation and 17% arranged for follow-up. Interventions varied by nurses' education and clinical setting. Nurses positively viewed involvement in tobacco control (4·3/5) and thought nurses should be smoke-free role models (4·8/5·0).

Conclusions: This study demonstrates that the majority of nurses asked about smoking status, but few assisted patients with quitting. Further efforts are needed to help nurses actively promote smoking cessation interventions.
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http://dx.doi.org/10.1111/jan.12811DOI Listing
January 2016

Guidance value of MRI for transsphenoidal surgery of pituitary adenomas with cystic degeneration.

Int J Clin Exp Med 2015 15;8(4):5370-8. Epub 2015 Apr 15.

Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University Fuzhou 350025, P. R. China.

Objective: This study is to evaluate the surgical outcomes of transsphenoidal surgery in pituitary adenoma (PA) patients with cystic degeneration by using MRI.

Methods: Eighty-three patients with surgically and pathologically confirmed PA were enrolled. They were divided into three groups according to preoperative MR images: substantive adenoma group (n = 40), cystic degeneration without fluid-fluid level group (n = 19), cystic degeneration with fluid-fluid level group (n = 24). The PA was removed by transsphenoidal surgery and the surgical outcomes were retrospectively compared.

Results: The number of cases with abundant blood supply was 17 cases (42.5%) in substantive adenoma group, 13 cases (68.4%) in cystic degeneration without fluid-fluid level group and 16 cases (66.7%) in cystic degeneration with fluid-fluid level group. Blood supply in cystic degeneration with fluid-fluid level group was significantly richer than that in substantive adenoma group (P < 0.05). Peritumoral adhesion was significantly greater in cystic degeneration with fluid-fluid level group than in substantive adenoma group. And, PA with fluid-fluid level has significantly lower tumor total resection rate and MVD as well as higher recurrence rate (P < 0.05). Differences in cerebrospinal fluid leakage and postoperative diabetes insipidus were both not significant among the three groups (P > 0.05).

Conclusions: Compared with other types of PA, cystic degeneration with fluid-fluid level were often richer in blood supply, greater in adhesion with peritumoral structures and easier to be found with tumor residual. Thus, more patience should be needed during the surgeries and more dynamic reviews are required postoperatively.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483807PMC
July 2015

Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

J Clin Nurs 2015 Sep 29;24(17-18):2439-47. Epub 2015 Apr 29.

School of Nursing, Anhui Medical University, Hefei, Anhui, China.

Aims And Objectives: The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer.

Background: Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions.

Design: This is a descriptive correlational survey study.

Methods: The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire.

Results: The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses.

Conclusion: These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles.

Relevance To Clinical Practice: Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life.
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http://dx.doi.org/10.1111/jocn.12816DOI Listing
September 2015

Repeated transsphenoidal surgery for resection of pituitary adenoma.

J Craniofac Surg 2015 Mar;26(2):452-5

From the Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, People's Republic of China.

To investigate the surgical strategy of repeated microscopic transsphenoidal surgery (TSS) for treatment of pituitary adenoma, surgical techniques and treatment outcomes for 29 patients with pituitary adenoma were reviewed and analyzed. There were 17 patients who underwent TSS 18 times and 12 patients who underwent TSS 13 times. The interval between each TSS ranged from 3 months to 18 years, with a median time of 4 years. The tumor height was 15 to 45 mm on the last surgery. Among the 29 patients, 16 patients underwent total tumor resection, 11 patients underwent subtotal resection, and 2 patients underwent partial resection. Cerebrospinal fluid leak occurred in 10 patients. Among 24 patients who were followed up effectively, 1 patient developed abducens paralysis after surgery, 1 patient had chronic diabetes insipidus, and 1 patient received steroid-dependent alternative treatment. The repeated TSS may present satisfied outcomes in experienced hands. The upper edge of the posterior choanae should be identified to ensure the right orientation. The openings of the anterior wall of the sphenoid sinus and the sellar floor should be appropriately expanded to improve tumor exposure. The artificial materials should be identified and removed carefully. Intraoperative cerebrospinal fluid leakage should be managed well.
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http://dx.doi.org/10.1097/SCS.0000000000001226DOI Listing
March 2015

Perception and fulfillment of cancer patients' nursing professional social support needs: from the health care personnel point of view.

Support Care Cancer 2014 Apr 28;22(4):1049-58. Epub 2013 Nov 28.

School of Nursing, Anhui Medical University, No.69 Mei Shan Road, Shu Shan District, Hefei, Anhui Province, People's Republic of China,

Purpose: This study aimed to (1) explore the needs of cancer patients regarding common nursing professional social support from the perspective of physicians and nurses, (2) identify what type of needs clinical nurses actually fulfill and what remains to be improved, and (3) analyze the potential reasons for the gap between the identified needs and those that are fulfilled.

Methods: A qualitative approach using focus group interviews was adopted to explore the perception and provision of cancer patients' needs regarding nursing professional social support. A purposive sample of 32 health care professionals was recruited from two teaching hospitals in Anhui province, China. Five focus group interviews were conducted and all interviews were tape-recorded and transcribed verbatim. A content analysis was performed with the data.

Results: The healthcare professionals perceived various nursing professional support needs of cancer patients; these include informational, emotional/psychological, and technical support needs; the mobilization of social resources; and palliative care during certain stages. The findings also indicated that there are still many unmet needs, especially needs related to the mobilization of social resources and palliative care. The reasons for the deficiencies in the fulfillment of these needs varied and included both subjective and objective aspects, such as the patients' lack of awareness of how to search for professional support, a shortage of professional staff, and the lack of a culturally appropriate assessment tool.

Conclusions: Cancer patients' supportive care needs were not always fully provided by nurses, even when these needs were identified by healthcare professionals. Nursing professional social support needs should be assessed quickly and effectively so that the appropriate interventions can be offered to cancer patients.
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http://dx.doi.org/10.1007/s00520-013-2062-6DOI Listing
April 2014

Magnetic resonance imaging appearance of the medial wall of the cavernous sinus for the assessment of cavernous sinus invasion by pituitary adenomas.

J Neuroradiol 2013 Oct 22;40(4):245-51. Epub 2013 Jul 22.

Department of Neurosurgery, Fuzhou General Hospital, 156, Xihuanbei Road, Fuzhou Fujian 350025, China; Capital Medical University, Beijing Neurosurgical Institute, 6, Tiantanxili, Beijing 100050, China.

Purpose: The diagnostic criteria for cavernous sinus invasion (CSI) by pituitary adenomas are still unsatisfactory and controversial. For this reason, the study examined the appearance of the medial wall of the cavernous sinus (MWCS) on proton-density-weighted (PDW) magnetic resonance imaging (MRI) to determine its value for preoperative assessment of CSI.

Methods: A 3.0-Tesla MRI scanner was used to obtain preoperative PDW images and conventional MRI sequences of 48 consecutive pituitary adenomas, and the MWCS was examined in PDW images to determine the presence of CSI in comparison to surgical findings and three traditional MRI criteria: Knosp grading system (KGS); percentage of encasement of the internal carotid artery (PEICA); and replacement of cavernous sinus compartments (RCSC) by tumors. The value of the MWCS as seen on MRI was compared with that of the Ki-67 labelling index (Ki-67 LI).

Results: CSI images showed that continuity of the MWCS was interrupted and that tumor tissue had infiltrated the cavernous sinus (CS) compartments through the defects. In 96 CSs from 48 patients, the sensitivity of MRI visualization of the MWCS for detection of CSI was 93.3% with a specificity of 93.8%, which was significantly higher than with KGS, PEICA and RCSC (P=0.007, P=0.008 and P=0.056, respectively). Histopathological results showed no significant differences between MRI visualization of the MWCS and the Ki-67 LI.

Conclusion: PDW imaging permits adequate visualization of the MWCS and is superior to traditional diagnostic criteria for the detection of CSI, providing accurate preoperative images for intraoperative navigation.
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http://dx.doi.org/10.1016/j.neurad.2013.06.003DOI Listing
October 2013

1,25-Dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) attenuates airway remodeling in a murine model of chronic asthma.

J Asthma 2013 Mar 16;50(2):133-40. Epub 2012 Nov 16.

Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.

Objectives: 1,25-Dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) has immune- and inflammation-modulating properties in asthma, but its possible effects on asthmatic airway remodeling remain uncertain. In this study, we investigated the effects of 1,25-(OH)(2)D(3) on airway remodeling in a murine model of chronic asthma and investigated its role in regulating nuclear factor-κB (NF-κB) activation.

Methods: BALB/c mice were sensitized to ovalbumin (OVA) and subsequently exposed to intranasal OVA challenges for 9 weeks. Some mice also received an intraperitoneal injection of 1,25-(OH)(2)D(3) at the time of challenge. At the end of the challenge period, mice were evaluated for chronic airway inflammation and airway remodeling. Nuclear translocation of NF-κB p65 in lung tissue was examined by Western blot. Inhibitor of NF-κB alpha (IκBα) expression was determined by real-time quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Western blot. Phosphorylated IκBα protein expression was also determined by Western blot.

Results: 1,25-(OH)(2)D(3) treatment reduced OVA-induced chronic inflammation in lung tissue and attenuated established structural changes of the airways, including subepithelial collagen deposition, goblet cell hyperplasia, and increased airway smooth muscle mass. 1,25-(OH)(2)D(3) also inhibited the nuclear translocation of NF-κB p65 in lung tissue. Concurrently, 1,25-(OH)(2)D(3) induced increased IκBα protein levels via inducing increased IκBα mRNA levels and decreased IκBα phosphorylation.

Conclusion: 1,25-(OH)(2)D(3) could attenuate asthmatic airway remodeling and its inhibition of NF-κB activation may underlie this protective effect.
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http://dx.doi.org/10.3109/02770903.2012.738269DOI Listing
March 2013

Development of a theory-based sexual and reproductive health promotion and HIV prevention program for Chinese early adolescents.

Nurs Health Sci 2010 Sep;12(3):360-8

School of Nursing, Anhui Medical University, No.15 Fei Cui Road, Economic Development Zone, He Fei City 230601, Anhui Province, China.

The purpose of this study was to develop a theory-based program for Chinese early adolescents in order to promote their sexual and reproductive health and to prevent HIV infection. The program was designed based on the Information-Motivation-Behavioral skills model and a needs assessment among the stakeholders. A technical collaborative action research approach was applied. The study's participants were 102 early adolescents in a public middle school in mainland China, with the involvement of other key stakeholders, including 15 teachers and 12 parents. The results revealed a statistically significant improvement in the scores of sexual and reproductive health promotion and HIV prevention information, motivation, and behavioral skills after the program's implementation. Meanwhile, qualitative data from the early adolescents' reflection indicated that the content was useful and comprehensive, the trainers were friendly and knowledgeable, and participatory learning with an "edutainment" style was especially impressive. Additionally, the early adolescents expressed that they could apply the knowledge and skills in their daily life, which would benefit themselves and their family and peers. The Information-Motivation-Behavioral skills model could be explored in a non-Western context and the program was shown to be acceptable for use in a Chinese middle school setting.
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http://dx.doi.org/10.1111/j.1442-2018.2010.00538.xDOI Listing
September 2010

Clinical analysis of 103 elderly patients with pituitary adenomas: transsphenoidal surgery and follow-up.

J Clin Neurosci 2008 Oct 6;15(10):1091-5. Epub 2008 Aug 6.

Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China.

Our objective was to study the single-center clinical diagnosis and surgical treatment of pituitary adenomas in elderly patients. A retrospective single-center study was performed on 103 patients aged 65 years and over with a diagnosis of pituitary adenoma and with a mean follow-up duration of 6.1+/-1.3 years. All cases were macroadenomas. The clinical course was dominated by visual disturbance and headache, and hypopituitarism was also not uncommon. Despite the majority of patients (81.6%) having coexisting medical conditions, transsphenoidal surgery (TSS) was performed and well tolerated in all patients. Before 2000, conventional post operative radiotherapy was performed in 32 patients with radiological evidence of tumor remnants. Long-term follow-up revealed no tumor regrowth. However, progressive hypopituitarism was found in a number of patients. After 2000, gamma knife surgery was used for selected cases with documented tumor regrowth. All the remnant tumors treated using this approach appeared to either stabilize or regress without side-effects during the study period. The findings of this analysis support the use of TSS as a feasible treatment for pituitary adenomas in elderly patients. Age alone is no longer considered a contra-indication for treatment with TSS. With appropriate perioperative management, the technique is associated with minimal morbidity and is tolerated well by patients regardless of age. Additional follow-up, especially neuroradiological follow-up is needed to monitor tumor recurrence. However, the indications for post operative radiotherapy should be better defined.
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http://dx.doi.org/10.1016/j.jocn.2007.11.003DOI Listing
October 2008