Evaluation of long-term efficacy,safety, and effect on life quality of pulsed dye laser in rosacea patients

Background: Rosacea is a chronic disease affecting the patients’ life quality negatively. Although various laser systems are used in the rosacea treatment, studies reporting efficacy and long-term continuity of benefit of laser therapies are scarce.

Objectives: We aimed to evaluate the efficacy, safety, continuity of benefit, and effect on life quality of pulsed dye laser (PDL) in the rosacea patients.

Methods: Fourteen rosacea patients treated with PDL were enrolled in the study. The number of treatment sessions were varied from one to four. The efficacy was evaluated by the physicians’ clinical assessment (PCA), patients’ self-assessment (PSA), and erythema and telengiectasia grading scores. Additionally, the patients were asked about the continuity of the benefit and improvement in their life qualities after the treatment.

Results: Both the erythema and telangiectasia scores were significantly improved after the treatment (p < 0.001). According to PCA, nine patients had a clinical improvement of >50%. According to PSA, 11 patients had good/excellent improvement. Moderate/significant benefit of treatment continued in 12 patients at the follow-up period (mean 21.64 ± 14.25 months). The life quality scores were significantly improved. No serious side effects were observed.

Conclusion: PDL has high and long-term efficacy in the treatment of rosacea with a good safety profile.     

左卡尼汀治疗心肌炎的临床效果与安全性观察

目的对心肌炎患者采用左卡尼汀治疗的效果和安全性进行探究。方法研究对象以2018年7月-2019年9月收治的心肌炎患者82例为对象,以随机数字表划分为常规组和研究组,两组患者每组41例。采用常规治疗方式对常规组进行治疗,在此基础上,采用左卡尼汀对研究组进行治疗。在治疗结束后,观察并比较临床疗效和用药过程的安全问题。结果研究组的治疗总有效率为97.6%,但常规组的治疗总有效率只有80.5%,从结果来看研究组的治疗有效率更高,效果更佳突出,组间结果差异对比(P <0.05)。在不良反应方面,研究组的不良反应(4.9%)虽然比常规组(2.4%)更高,然而从统计学结果来看差异无统计学意义(P> 0.05)。结论针对心肌炎患者采用左卡尼汀进行治疗具有很好的效果,而且具有很高的安全性。     

Assessment of the Physical Compatibility of Eravacycline and Common Parenteral Drugs During Simulated Y-site Administration

PurposeEravacycline is a broad-spectrum, intravenous fluorocycline antibiotic approved for the treatment of complicated intra-abdominal infections in adults. A 60-minute infusion is recommended for each infused dose. Compatibility data that may allow convenient Y-site administration of eravacycline with other parenteral medications are unavailable. We aimed to determine the physical compatibility of eravacycline with other intravenous medications by simulated Y-site administration.MethodsEravacycline was reconstituted according to published prescribing information and diluted with 0.9% sodium chloride to a concentration of 0.6 mg/mL. Simulated Y-site administration was performed by mixing 5 mL of eravacycline with an equal volume of 51 other intravenous medications, including crystalloid and carbohydrate hydration fluids and 20 antimicrobials. Secondary medications were assessed at the upper range of concentrations considered standard for intravenous infusion. Mixtures underwent visual inspection and turbidity measurement immediately on mixture and at 3 subsequent time points (30, 60, and 120 minutes after admixture), and pH was measured at 60 minutes for comparison with the baseline value of the secondary medication.FindingsEravacycline was physically compatible with 41 parenteral drugs (80%) by simulated Y-site administration. Incompatibility was observed with albumin, amiodarone hydrochloride, ceftaroline fosamil, colistimethate sodium, furosemide, meropenem, meropenem/vaborbactam, micafungin sodium, propofol, and sodium bicarbonate.ImplicationsEravacycline for injection was physically compatible with most parenteral medications assessed. Pharmacists and nurses should be knowledgeable of the observed incompatibilities with eravacycline to prevent the unintentional mixing of incompatible intravenous medications.     

Impact of Food Intake on Liver Stiffness Determined by 2-D Shear Wave Elastography: Prospective Interventional Study in 100 Healthy Patients

The aim was to evaluate the influence of food intake on liver stiffness measurement (LSM), performed with 2-D shear wave elastography (Logiq E9, GE Medical Systems, Wauwatosa, WI, USA). One hundred healthy volunteers were prospectively enrolled. Mean age was 25.8 (19–55) y, and mean body mass index was 22.43 (17.3–30.8) kg/m². Patients fasted for at least 3 h and subsequently ingested a liquid meal of 800 kcal. Liver stiffness and portal vein velocity were measured before and after food intake. Food intake resulted in significantly higher LSM values compared with baseline LSM (5.74 ± 0.94 kPa vs. 4.80 ± 0.94 kPa, p < 0.001). On multiple linear regression analysis, body mass index was significantly positively correlated with the LSM increase after food intake (p?=?0.01). No correlation between the increase in LSM and the increase in post-prandial portal vein velocity was observed (r?=?0.09). In summary, food intake has a significant influence on LSM. There is an 11% risk of misclassifying non-fasting, healthy patients as having significant fibrosis.     

临床医护人员电离辐射安全和防护知识知晓率调查

目的 了解临床医护人员对电离辐射安全和防护知识的知晓率。方法 采用横断面调查方法，以270例护理人员为调查对象发放自行设计的问卷进行调查。问卷内容包括调查对象社会人口学特征，以及放射物理学和生物学、放射使用原则、辐射防护、电离辐射安全使用指南等三大类放射性知识。采用描述性流行病学方法对问卷调查结果进行分析。结果 共发放调查问卷270份，回收有效问卷252份，有效应答率为93.33%。252例调查对象以女性为主（占99.21%），年龄以25～< 55岁为主（占80.16%），工作年限以≥ 20年为主（占31.35%），受教育程度以本科为主（占66.67%），75.00%曾接受过医学辐射知识培训和教育。调查对象对 “知晓怀孕的放射工作者相关要求”、“在日常工作中尽力普及有关放射性剂量和应用的相关安全知识”、“能意识到在日常工作中做到辐射安全防护”、“知晓辐射安全文化的重要性”、“在辐射控制区工作时能注意到警示标志”、“知晓有关辐射安全警示标志的含义”、“知晓如何报告放射性使用中的异常事件”、“知晓如何合理使用个人辐射防护用品”、“知晓辐射防护的剂量限值原则”、“知晓电离辐射如何产生”、“知晓医用辐射的有害作用是如何产生的”和“知晓记录全部有关辐射应用的必要知识”等问题知晓率均 > 90%，但对“知晓造成成人和青少年患者放射性检查差异的原因”、“知晓辐射防护中平方反比定律的含义”等辐射防护知识知晓率较低。结论 临床医护人员对电离辐射安全和防护知识总体掌握仍较欠缺，需加强电离辐射安全和防护知识培训、提升辐射防护技能。     

Race to Beat the Heat: Climate Change Impacts Physical Activity

Climate change has led to increased frequency, intensity, and duration of extreme heat events with dire consequences for health. These are the deadliest of climate change impacts with preventable mortality from heat-related illnesses and increased threat to safe participation in physical activity and sports. Nurse practitioners can collaborate with community and professional sports health organizations to ensure evidence-based health and safety policies to reduce health-related risks. Adverse consequences on engagement in key health-promoting physical activity and sports may catalyze urgent action to address climate change.     

Factors Associated with Universal Free School Meal Provision Adoption among US Public Schools

BackgroundThe Community Eligibility Provision (CEP) allows high-poverty schools participating in US Department of Agriculture meal programs to offer universal free school meals. Emerging evidence suggests benefits of CEP for student meal participation, behavior, and academic performance. Although CEP became available nationwide in 2014, in school year 2019–2020, one third of eligible schools were not participating.ObjectiveThis study evaluates which school, district, and state factors are associated with CEP participation.DesignCross-sectional study comparing CEP-participating with eligible nonparticipating schools to assess the relationship between CEP participation and school, district, and state factors.ParticipantsUS public schools eligible for CEP in school year 2017–2018 (n = 42,813).Main Outcome MeasuresCEP participation.Statistical Analyses PerformedPenalized regression variable selection methods to determine which factors contribute information to the model. Generalized logistic regression to predict odds of CEP participation unadjusted and adjusted for each factor in the full sample and in stratified analyses by whether a state was part of the CEP phase-in period (early vs late implementing states).ResultsIn the full sample, adjusted odds of CEP participation were greater in states where CEP had been available longer (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34, 1.67). In late implementing states, adjusted odds of CEP participation were higher in schools with more students directly certified for free meals (OR in schools with 80%–89% vs 30%–39% directly certified: 19.32; 95% CI, 12.98, 28.76), Title I schools (OR, 1.85; 95% CI, 1.55, 2.21), and urban schools (OR suburban vs urban, 0.46; 95% CI, 0.36, 0.59). Differences by school level, enrollment, district size, student race/ethnicity, and geographic region also existed.ConclusionsFindings may help advocates, state agencies, and policymakers understand potential barriers to adoption and guide research exploring effective strategies to promote uptake. Future research should use qualitative and longitudinal designs to explore barriers to adoption, including cost and state and local policies.     

电针复合TCI靶控输注在单肺通气食管癌开胸手术麻醉中的应用与安全性＊

目的 探讨电针复合靶控输注（Target Controlled Infusion， TCI）在单肺通气食管癌开胸手术麻醉中的应用价值。方法 选取于我院拟行单肺通气食管癌开胸切除手术患者60例作为研究对象。随机将其分为试验组与对照组，对照组30例采取气管插管全麻及TCI靶控输注维持麻醉深度，试验组30例则在对照组方案基础上辅助电针麻醉，记录两组患者手术麻醉时间、药物用量、苏醒时间、并发症；以及术前（T_Ⅰ）、插管前即刻（T_Ⅱ）、插管后1 min（T_Ⅲ）、切皮即刻（T_Ⅳ）、去骨时（T_Ⅴ）、拔管即刻（T_Ⅵ）时平均动脉压（MAP）、平均心率（HR）、BIS值；术前、术后1天、术后3天简易智能精神状态检查量表（MMSE）；并于麻醉诱导前（T₀）、手术开始2 h（T₁）、术后1天（T₂）、术后3天（T₃）时抽取患者外周静脉血检测IL-1β、IL-6、IL-10、TNF-α浓度。结果 试验组手术用时、麻醉时间略低于对照组，但差异无统计学意义（P>0.05），试验组异丙酚、舒芬太尼用量以及苏醒时间均明显低于对照组（P<0.05）；T_Ⅱ时两组平均动脉压（Mean Arterial Pressure， MAP）、心率（Heartrate， HR）较术前明显降低，且试验组MAP明显低于对照组（P<0.05），但两组T_Ⅱ时HR比较无显著差异（P>0.05）；T_Ⅲ、T_Ⅵ时对照组MAP、HR明显高于T_Ⅰ时，而试验组MAP、HR与T_Ⅰ比较无显著差异（P>0.05）。术后1天、3天试验组简易智能精神状态检查量表（Mini-Mental State Examination， MMSE）评分低于对照组，有显著性差异（P<0.05）。T₁、T₂、T₃时试验组白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子（Tumor Necrosis Factor-α， TNF-α）水平明显低于对照组（P<0.05），白介素-10（IL-10）水平明显高于对照组（P<0.05）。结论 采用电针复合TCI靶控输注麻醉方案可有效提升单肺通气食管癌开胸手术麻醉效果，能够降低患者术后认知功能障碍发生风险。