Routine Laboratory Testing Every 4 Versus Every 6 Weeks for Patients on Maintenance Hemodialysis: A Quality Improvement Project

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Walking speed as a predictor of community mobility and quality of life after stroke

Background: Community mobility (CM) is considered a part of community reintegration that enhances Quality of Life (QoL). Achieving an appropriate gait speed is essential in attaining an independent outdoor ambulation and satisfactory CM.

Objective: The aim of this study was to identify whether gait speed is a predictor of CM and QoL in patients with stroke following a multimodal rehabilitation program (MRP).

Methods: This was a baseline control trial with 6-months follow-up in an outpatient rehabilitation setting at a university hospital. Twenty-six stroke survivors completed the MRP (24 sessions, 2 days/wk, 1 hr/session). The MRP consisted of aerobic exercise, task-oriented exercises, balance exercises and stretching. Participants also performed an ambulation program at home. Outcome variables were: walking speed (10-m walking test) and QoL (physical and psychosocial domains of Euroquol and Sickness Impact Profile).

Results: At the end of the intervention, comfortable and fast walking speed increased by an average of 0.16 (SD 0.21) (*p < .05) and 0.40 (SD 0.51) (**p < .001) m/s, respectively. After the intervention, all participants achieved independent outdoor ambulation with an increase of 34.14 of walking minutes/day in the community and a decrease of sitting time of 95.45 minutes/day. Regarding QoL there were increased mean scores on the physical and psychosocial dimensions of Euroquol and the Sickness Impact Profile, respectively (**p < .001).

Conclusions: The results suggest that improved walking speed after the MRP is associated with CM and higher scores in QoL. These findings support the need to implement rehabilitation programs to promote increased speed.     

Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review

Exercise intolerance is the cardinal symptom of heart failure (HF) and is of crucial relevance, because it is associated with a poor quality of life and increased mortality. While impaired cardiac reserve is considered to be central in HF, reduced exercise and functional capacity are the result of key patient characteristics and multisystem dysfunction, including aging, impaired pulmonary reserve, as well as peripheral and respiratory skeletal muscle dysfunction. We herein review the different modalities to quantify exercise intolerance, the pathophysiology of HF, and comorbid conditions as they lead to reductions in exercise and functional capacity, highlighting the fact that distinct causes may coexist and variably contribute to exercise intolerance in patients with HF.     

基于中药质量标志物和传统用法的中药饮片标准汤剂传承发展研究思路与建议

中药汤剂(也称煎剂)是中医师最常用的中药复方剂型,也是中药历史上应用最久和最广的制剂。药材是饮片的原料,饮片是制备提取物、构成中医处方和中药制剂的原料,更体现了传承发展中药的重要性。基于中药饮片标准汤剂,科学认识汤剂质量,提高药典饮片和中成药质量评价研究理论和方法是科学发展的重要策略。开展以中医药理论为指导、临床应用为基础的中药饮片标准汤剂研究,基于中药质量标志物理论和研究方法探讨饮片和煎煮工艺的影响,形成标准汤剂的质量评价体系,既有利于确保中医处方用药的安全和疗效,也有利于认识标准汤剂在"药材-饮片-中成药"的质量及其标准的差异和价值,提升国家对中药饮片监管水平,保障人民用药安全和有效;还有利于认识标准汤剂在中药饮片生产、中药配方颗粒及经典名方的传承研发中的重要意义。     

Murine models of posterolateral spinal fusion: A systematic review

BackgroundRodent models are commonly used experimentally to assess treatment effectiveness in spinal fusion. Certain factors are associated with better fusion rates. The objectives of the present study were to report the protocols most frequently used, to evaluate factors known to positively influence fusion rate, and to identify new factors.MethodA systematic literature search of PubMed and Web of Science found 139 experimental studies of posterolateral lumbar spinal fusion in rodent models. Data for level and location of fusion, animal strain, sex, weight and age, graft, decortication, fusion assessment and fusion and mortality rates were collected and analyzed.ResultsThe standard murine model for spinal fusion was male Sprague Dawley rats of 295 g weight and 13 weeks’ age, using decortication, with L4-L5 as fusion level. The last two criteria were associated with significantly better fusion rates. On manual palpation, the overall mean fusion rate in rats was 58% and the autograft mean fusion rate was 61%. Most studies evaluated fusion as a binary on manual palpation, and only a few used CT and histology. Average mortality was 3.03% in rats and 1.56% in mice.ConclusionsThese results suggest using a rat model, younger than 10 weeks and weighing more than 300 grams on the day of surgery, to optimize fusion rates, with decortication before grafting and fusing the L4-L5 level.     

恐惧疾病进展在肺癌患者配偶希望水平与生活质量间的中介效应

目的探讨恐惧疾病进展在肺癌患者配偶希望水平与生活质量间的中介作用。方法采取方便抽样法,选取2019年11月—2021年1月新疆某三级甲等肿瘤专科医院165例肺癌患者配偶作为研究对象,采用Herth希望指数量表(Herth Hope Index,HHI)、癌症患者恐惧疾病进展简化量表(Fear ofProgression Questionnaire-Short Form,FoP-Q-SF)、生活质量核心量表(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire,QLQ-C30)进行问卷调查,运用Pearson相关性分析肺癌患者配偶恐惧疾病进展、希望水平、生活质量之间的相关性;采用AMOS23.0软件建立结构方程模型,并用偏差校正的非参数百分位Bootstrap程序对模型进行检验。结果共有162例肺癌患者配偶完成研究,HHI总分为(26.28±2.90)分,FoP-Q-SF总分为(43.74±4.68)分,QLQ-C30总分为(55.29±14.26)分。相关分析显示,肺癌患者配偶生活质量与希望水平呈正相关(r=0.541,P<0.001)与恐惧疾病进展呈负相关(r=-0.469,P<0.001);希望水平与恐惧疾病进展呈负相关(r=-0.574,P<0.001)。希望水平对生活质量有显著正向效应(β=0.428,P<0.001),并通过恐惧疾病进展的部分中介作用间接影响其生活质量,中介效应占总效应的33.12%。结论希望水平对肺癌患者配偶生活质量有直接预测作用,恐惧疾病进展在希望水平与生活质量之间起到部分中介作用。