【Abstract】Objective To investigate the effects of tension-free herniorrhaphy on endocrine functions of patients with inguinal hernia. MethodsOne hundred and twenty-seven patients were randomly divided into tension-free group(n=65) and conventional group (n=62). The mean ages of tension-free group and conventional group were(51.8±14) year and(48.4±12) year respectively. There were 52 indirect hernias and 13 direct hernias in tension-free group. There were 51 indirect hernias and 11 direct hernias in conventional group. Bassini repair was used in conventional group. Peripheral blood samples were obtained preoperatively and 3 h, 24 h after operation for measuring the levels of cortisol, T3, TSH, insuline, Cpeptide and and glucose. The data were analysed through t test. ResultsThe levels of cortisol, C-peptide and glucose in conventional group were remarkably higher (P6”0.05) while the levels of T3,TSH were notably lower (P＜0.05) than those in tension-free group at 3 h, 24 h postoperatively, the level of insulin in conventional group was significantly higher than that in tension-free group at 24 h postoperatively. ConclusionThe results of this study indicate that tension-free repair imposes less influence on the endocrine functions of patients with inguinal hernia postoperatively than conventional repair does. This might explain pathophysiologically the quick recovery of the patients receiving tension-free herniorrhaphy.
ObjectiveTo investigate the current situation of stress load and professional benefit of hemodialysis nurses during the outbreak period and the remission period of coronavirus disease 2019 (COVID-19) epidemic, and discuss the differences in stress load and professional benefit of hemodialysis nurses between the two periods.MethodsIn February 2020, 119 hemodialysis nurses from three hemodialysis centers in Sichuan Province were selected as the respondents. Using the Stress Overload Scale and the Questionnaire of Nurses’ Perceived Professional Benefits, questionnaire survey was conducted in February 2020 and April 2020, respectively. Paired-sample t test was used for analysis.ResultsA total of 109 valid questionnaires were collected. The scores of stress load of hemodialysis nurses in outbreak period and remission stage were 3.00±1.26 and 2.17±1.16, respectively, of which the scores of event load dimension were 3.49±1.15 and 2.31±1.27, respectively, and the scores of individual vulnerability dimension were 2.59±1.19 and 2.05±1.06, respectively; the professional benefit scores of hemodialysis nurses in outbreak and remission were 4.19±0.83 and 4.21±0.78, respectively. The difference in stress load of the same group of hemodialysis nurses between different time periods was statistically significant (P<0.05), while there was no significant difference in professional benefit (P>0.05).ConclusionsDuring the outbreak of COVID-19 epidemic, the stress load of hemodialysis nurses was ata medium level, and that in the remission stage of COVID-19 epidemic was at a low level; the professional benefit of nurses in the outbreak and remission period was at a high level. The stress load status of hemodialysis nurses was different between different periods of the epidemic. We should take incentive mechanism or targeted psychological intervention measures to improve the professional benefit level of nurses.
【Abstract】ObjectiveTo review the research advance of intestinal barrier changes and its pathogenesis in stress conditions.MethodsThe literatures in recent years on the changes of the intestinal barrier,and its pathogenesis in stress conditions were reviewed.Results In some severe stress conditions, such as trauma, severe inflammation and acute severe pancreatitis, etc, a series of pathophysiologic disorders of intestinal barrier， even systemic inflammatory response syndrome and multiple organ dysfunction syndrome or multiple organ failure were induced. The pathogenesis was a result of a series of neurologic, immunologic and endocrine factors making one another. ConclusionRecognizing the changes and pathogenesis have an important clinical significance for treating and preventing the intestinal barrier dysfunction induced by stress.
Objective To evaluate the effectiveness and safety of tension-free vaginal tapes (TVT) compared with Burch colposuspension for female stress urinary incontinence (SUI). Methods We searched MEDLINE (1966 to October 2007), EMBASE (1988 to October 2007), Cochrane Central Register of Controlled Trials (1993 to October 2007), CMCC (1979 to October 2007) and CNKI (January 1979 to October 2007). We collected randomized controlled trials (RCTs) comparing TVT with Burch colposuspension in the treatment of SUI. Data were extracted and evaluated by two reviewers independently. The Cochrane Collaboration’s RevMan 4.2 was used for data analyses. Results Ten RCTs reporting data on effectiveness and safety of TVE versus Burch colposuspension were included. Meta-analyses showed that TVT was superior to Burch colposuspension as measured by the overall cure rate (OR 1.73; 95%CI 1.26 to 2.38; P=0.0007), negative stress test (OR 2.54; 95%CI 1.71 to 3.78; Plt;0.00001) and negative pad test (OR 1.67; 95%CI 1.16 to 2.41; P=0.006). The total complication rate was higher after TVT (OR 1.39; 95% CI 1.08 to 1.80; P=0.01), while the re-operation rate was significantly higher after Burch colposuspension (OR 0.29; 95%CI 0.10 to 0.80; P=0.02). The incidences of haematoma (OR 1.06; 95% CI 0.39 to 2.84; P=0.91), urinary tract infection (OR 1.27; 95% CI 0.64 to 2.52; P=0.50) and lower urinary tract symptoms (OR 1.20; 95% CI 0.89 to 1.62; P=0.23) were similar after TVT and Burch colposuspension. Conclusion The evidence for short-term superiority of TVT is currently limited. Although the re-operation rate is lower, the risk of bladder or vaginal injury is higher with TVT. Methodologically sound and adequately powered RCTs with long-term follow-up are needed.
Female pelvic floor dysfunction (PFD) is a common disease affecting women's quality of life, especially in older women. The establishment and application of multimodal evaluation system is the key to the accurate diagnosis and effective treatment of PFD. The purpose of this expert consensus is to provide a comprehensive, multi-layered assessment framework that includes clinical examinations, imaging examinations, biomechanical tests, and questionnaires to comprehensively assess pelvic floor function in women. By integrating different assessment methods, we aim to improve the early identification and diagnostic accuracy of PFD, so that personalized treatment can be developed to improve patient outcomes. The consensus also discusses the advantages and disadvantages of various assessment techniques and suggests directions for future research and clinical applications.
ObjectiveTo explore the effect of spiritual care on improving the psychological stress levels of relatives of patients with terminal cancer.
MethodsDuring January 2013 and January 2014, 220 relatives of patients with terminal cancer were selected. Convenience sampling method was adopted to select 100 relatives out of 190 who were agreed to be participated in the investigation, who were divided into the trial group and the control group with 50 in each according to the random alphabet method. The control group was given routine care and psychological counseling, and the trial group was given spiritual care intervention additionally. Before intervention, all of the individuals in both of the two groups should conduct the questionnaire of general demographic data, caregiver stress scale, fatigue rating scale, quality of life scale (QLS), social support scale (SSS), and relatives stress scale (RSS).
ResultsAfter one month's intervention, caregiver stress scale score (52.14±4.75), fatigue rating score (76.75±8.69), RSS score (15.71±3.97), SSS score (22.59±2.22), the QLS score (66.9±7.5) in the trial group were significant better than those in the control group (P < 0.05). After intervention, all the scores in the trial group were significant better than whose before the intervention (P < 0.05).
ConclusionFor the relatives of the patients with terminal cancer, spiritual care can reduce the occurrence rate of stress and fatigue, relieve the psychological stress level, and improve the social support and quality of life.
【Abstract】ObjectiveTo explore the mechanisms of anabolism intensified by recombination human growth hormone (GH) on the basis of total parenteral nutrition (TPN) during postoperative in gastrointestinal carcinoma patients. MethodsNinety-four gastrointestinal carcinoma patients undergone operation were randomly divided into TPN group and TPN+GH group. The levels of TNF-α, IL-1, IL-6 and CRP were detected in the first, third, seventh postoperative day. ResultsThe levels of TNF-α, IL-1, IL-6 and CRP were significantly lower in TPN+GH group than those in the TPN group at the first, third, seventh postoperative day （P＜0.01）. The levels of TNF-α, IL-1, IL-6 and CRP were significantly higher at the indicated time of postoperative days than the pre-operative days in the two groups (P＜0.01）. ConclusionBy inhibiting TNF-α, IL-1, IL-6 and CRP production in gastrointestinal carcinoma patients undergone operation and blocking high catabolism induced by inflammatory cytokines, GH promotes the synthesis of anabolism.
Objectives The Faculty of Medicine of National Yang-Ming University is committed to helping students enhance intellectual, personal, and professional development while fully supporting students during this time of intense training and personal growth. The student portfolio system has sprung from the Faculty’s devotion to innovative medical education initiatives and is one attempt to fulfill our obligations to our past and future, to our society and to the rest of the world. The basic approach toward helping students enhance their cognitive, personal and professional development while coping with internal or external environmental stressors would be to identify and provide supportive elements within medical education. In order to achieve the goal, we explore possible factors, both micro and macro elements of the students’ environment, which may contribute to their stress, mental disturbances and status attainment. Methods We established a multi-dimensional and multi-functional “student portfolio” framework that integrated dynamic, timely, and continuous exploration as well as modification of students’ learning processes, mental status and environmental impact. The first step in this project was to locate and validate students’ “red flag”: factors that contributed to their stress, mental disturbances and status attainment. Self reports by the students were used for the “risk factor” analyses. Results Status achievement by students was associated with their parents’ educational attainment, in particularly the educational attainment of their mothers. This was associated with the student’s stress, mental disturbance, attitude toward life and status achievement. The educational attainment of the parents of our students increased yearly, suggesting that the social economic status and marital matching situation of individuals were associated with social environment and time. Conclusions The associations of cognitive processes, family condition, societal values, mental status and learning behaviors are intertwined dynamically with time and environment. However, longitudinal and multi-dimensional research in this area is very limited. It is important for contemporary medical education to develop a framework for the theory and practice of the development of medical students that leads to their attainment of professional, sociological, and psychological competencies. This study suggests that particular social economic status factors may increase the risk that medical students will experience stress, mental disturbances, and status attainment.
Previous studies have shown that growth arrest, dedifferentiation, and loss of original function occur in cells after multiple generations of culture, which are attributed to the lack of stress stimulation. To investigate the effects of multi-modal biomimetic stress (MMBS) on the biological function of human bladder smooth muscle cells (HBSMCs), a MMBS culture system was established to simulate the stress environment suffered by the bladder, and HBSMCs were loaded with different biomimetic stress for 24 h. Then, cell growth, proliferation and functional differentiation were detected. The results showed that MMBS promoted the growth and proliferation of HBSMCs, and 80 cm H2O pressure with 4% stretch stress were the most effective in promoting the growth and proliferation of HBSMCs and the expression level of α-smooth muscle actin and smooth muscle protein 22-α. These results suggest that the MMBS culture system will be beneficial in regulating the growth and functional differentiation of HBSMCs in the construction of tissue engineered bladder.
Objective To investigate the effects and possible mechanism of the local content changes of nitrogen monoxidum on bile reflux in rats’ pylori stress ulcer. Methods Fifty adult SD rats were restrained in planes and then were soaked in cold water to make stress ulcer. They were divided into three groups randomly: the stress group (30 cases), the L-NAME group (10 cases), whose pylori were injected with L-NAME solution and the normal saline group (10 cases), whose pylori were treated with saline solution. Besides, there were another 10 rats taken as the control group. The gastric ulcer index, pH value and bile acid concentration of gastric juice in each group were measured before and after stress. The local concentrations of nitrogen monoxidum in rats’ pylori were also measured by nitrogen monoxidum Biochemical Detection Kit. Results The local content of nitrogen monoxidum in rats’ pylori increased to maximum at 1 h after stress （P＜0.01）, while the bile acid and pH value of gastric juice went up to the maximum at 2 h after stress （P＜0.01）. The ulcer index reached the peak value at 4 h after stress （P＜0.01）. The bile acid concentration and ulcer index of the group injected with L-NAME solution in rats’ pylori decreased significantly compared with those of the group treated with normal saline solution (P＜0.01). The local concentration of nitrogen monoxidum also decreased significantly in the L-NAME group (P＜0.05）. However, there was no difference on pH values of gastric juice between those two groups (Pgt;0.05). Conclusion There is a positive correlation between the local concentration of nitrogen monoxidum in pylori and bile acid in the stomach in rats with stress ulcer. Injection of L-NAME solution in rats’ pylori may reduce the local content of nitrogen monoxidum so that the pyloric sphincter become less tense, which may lead to the significant decreases of ulcer index and bile acid in the stomach. Thus, L-NAME may protect gastric mucus effectively.
