Treatment of retroperitoneal echinococcosis: the experience of a single center

Retroperitoneal echinococcosis (RE) is a rare condition that is associated with a high mortality and disability rate. It is associated with a high rate of misdiagnosis, a high risk of surgery, and is extremely difficult to manage. There is no uniform standard for determining the exact form of surgical method and the timing of surgery.This was a retrospective analysis of the characteristics and surgical management of patients diagnosed with RE in our hospital between 2012 and 2019.Between 2012 and 2019, 1257 cases of echinococcosis and 121 cases of RE were diagnosed in our hospital. Of these, 68 cases involved surgical treatment, 53 involved non-surgical treatment, and 12 cases were lost to follow-up (4 cases in the surgical group and 8 cases in the non-surgical group). Thus, 109 cases were followed-up. RE cases were divided according to different treatment methods into a radical resection group (Group A, 31 cases), a non-radical resection group (Group B, 37 cases), and a non-surgical group (Group C, 53 cases). We carried out a detailed analysis of the 109 cases experiencing surgical intervention with effective follow-up.Our analysis found that radical resection is the first line of treatment of RE, although non-radical surgery can benefit most patients. It is important to emphasize the importance of the first round of surgery, particularly in cases involving hepatic echinococcosis. If the lesion can be removed radically during the first round of surgery, then radical surgery should be performed.     

Risk factors of mental illness among adult survivors after the Wenchuan earthquake

Purpose

This study was to analyze the mental health status of the adults from the areas struck by the Wenchuan earthquake, to understand the factors that may have impact on their mental health after they were exposed to the earthquake, to obtain information specifically relevant to further research and future preventive measures.

Methods

We used multistage stratified random sampling methods in three areas that were severely damaged in the Wenchuan earthquake, Sichuan Province, China. For this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 were screened with the 12-item General Health Questionnaire (GHQ-12), and 3,692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by 180 investigators.

Results

The risk factors for post-traumatic stress disorder included old age, female gender, low school education and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for anxiety disorder included old age, female gender, low school education, living alone and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for depression included old age, female gender, low school education and living alone (P < 0.05, 95 % CI).

Conclusions

Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after the earthquake.     

Development and validation of an instrument for measuring junior nurses’ recognition and response abilities to clinical deterioration (RRCD)

BackgroundNurses of all levels are expected to be competent in managing clinical deterioration. Given their limited experience and basic-level knowledge, there is a concern about junior nurses' clinical and patient management skills. However, junior nurses’ abilities to recognise and respond to clinical deterioration have not been adequately explored because of the absence of a comprehensive tool.ObjectivesThe aim of this study was to develop a new self-assessment scale to assess the junior nurses’ recognition and response abilities to clinical deterioration and to examine its reliability and validity.MethodsScale items were based on literature reviews and interviews. The preliminary scale was generated through two rounds of expert review. A panel of five experts evaluated content validity. After a pilot study, the questionnaire was distributed to 168 junior nurses via convenience sampling. Subsequent statistical analysis of results included construct validity, internal consistency, and test–retest reliability.ResultsSix factors were included, and 69.310% of the total variance was explained by the 25 items comprising the scale. The Cronbach's alpha coefficient was 0.905 (95% confidence interval [CI]: 0.812–0.979) for the overall scale and 0.655–0.838 for its subscales. The Guttman split-half reliability was 0.856 (95% CI: 0.806–0.894). The test–retest reliability of the scale was 0.878 (95% CI: 0.836–0.911).ConclusionWe developed a scale for measuring the abilities of junior nurses to recognise and respond to clinical deterioration and confirmed its reliability and validity. More experimental studies are needed to further evaluate this instrument.     

LncRNA OGFRP1 promotes angiogenesis and epithelial-mesenchymal transition in colorectal cancer cells through miR-423-5p/CTCF axis

ObjectiveTo investigate the mechanism of lncRNA OGFRP1 affecting angiogenesis and epithelial-mesenchymal transition (EMT) in colorectal cancer (CRC) and provide a new target for the treatment of CRC.MethodsThe expressions of OGFRP1, miR-423-5p, and CTCF were measured in CRC cell lines (HT29, LoVo, HCT116, SW620, and SW480) and normal colonic epithelial cells NCM460. Gain and loss of function experiments were performed on HCT116 and SW620 cells, after which the proliferation, apoptosis, EMT, invasion, and migration of the cells were measured using CCK-8 and colony formation assays, flow cytometry, Western blotting, Transwell, and scratch assay. The transfected cells were incubated with human umbilical vein endothelial cells (HUVECs) to assess angiogenesis using tube formation assay. ELISA was performed to detect VEGF in the conditioned medium of HCT116 and SW620 cells. The interactions among OGFRP1, CTCF and miR-423-5p were validated by dual-luciferase reporter assay.ResultsCRC cell lines had increased expression levels of OGFRP1 and CTCF and a suppressed expression level of miR-423-5p when compared with NCM460 cells. Suppression on OGFRP1 or CTCF and overexpression of miR-423-5p led to inhibited proliferation, EMT, invasion and migration and increased apoptosis of HCT116 and SW620 cells. HUVECs incubated with cells transfected with si-OGFRP1, si-CTCF or miR-423-5p mimic had suppressed angiogenesis ability. The effect of OGFRP1 suppression in CRC cells could be counteracted by miR-423-5p inhibition. Both CTCF and OGFRP1 could bind to miR-423-5p.ConclusionOGFRP1 promotes proliferation, EMT, and angiogenesis in CRC through miR-423-5p/CTCF axis.     

雅安市社区在管严重精神障碍患者现状研究

目的了解雅安市社区在管严重精神障碍患者的现况,为改进雅安市严重精神障碍管理治疗工作提出可行性建议。方法采用分层随机抽样的方法,抽取雅安市纳入社区管理的严重精神障碍患者1 002例,采用重性精神疾病管理随访表调查患者规范管理情况、服药情况、居家稳定情况以及肇事肇祸情况。结果完成有效问卷803份,雅安市社区在管严重精神障碍患者规范管理率为93. 03%(95%CI:91. 30%~94. 80%),服药率为65. 13%(95%CI:61. 80%~68. 40%),规律服药率为50. 44%(95%CI:47. 00%~53. 90%),居家稳定率为90. 78%(95%CI:88. 80%~92. 80%)。肇事肇祸发生率为4. 61%(95%CI:3. 20%~6. 10%)。结论雅安市严重精神障碍患者规范管理率、规律服药率达到国家标准,服药率尚未达到国家标准,居家稳定率较高,肇事肇祸率较低。     

Activin A level is associated with physical function in critically ill patients

BackgroundActivin A is a potent negative regulator of muscle mass elevated in critical illness. It is unclear whether muscle strength and physical function in critically ill humans are associated with elevated activin A levels.ObjectivesThe objective of this study was to investigate the relationship between serum activin A levels, muscle strength, and physical function at discharge from the intensive care unit (ICU) and hospital.MethodsThirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia. Participants were included if they were mechanically ventilated for >48 h and expected to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute Walk Test distance at hospital discharge. Secondary outcome measures included handgrip strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total serum activin A levels were measured daily in the ICU.ResultsHigh peak activin A was associated with worse Six-Minute Walk Test distance at hospital discharge (linear regression coefficient, 95% confidence interval, p-value: −91.3, −154.2 to −28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the secondary outcome measures.ConclusionsHigher peak activin A may be associated with the functional decline of critically ill patients. Further research is indicated to examine its potential as a therapeutic target and a prospective predictor for muscle wasting in critical illness.Study registrationACTRN12615000047594.