Empowerment in people with Parkinson’s disease: A scoping review and qualitative interview study

ObjectiveTo synthesize empowerment definitions in Parkinson’s disease (PD) literature and understand people with PD’s perspective on empowerment in the context of an existing empowerment conceptual model.MethodsThis mixed-methods study included a scoping review of PD empowerment literature and interviews with adults with PD. Five databases were searched for articles that defined empowerment concepts. We analyzed 1:1 semi-structured interviews on empowerment with people with PD. All data were analyzed using hybrid thematic analysis.ResultsEight of 242 records were included in this review. Empowerment is defined as an intrapersonal (e.g., personal control over oneself or healthcare) or interpersonal construct (e.g., person-centered care). Thirty-seven participants completed the interview. Participants perceived empowerment as a multifaceted concept that interacts with determinants and moderators from different ecological levels.ConclusionEmpowerment is a noteworthy multilevel and relational construct that can interplay with important health-related factors. The developed working conceptual model of empowerment can inform future studies to explore empowerment concepts in more depth and develop PD empowerment-based interventions.Practice implicationsThe empowerment definitions, indicators, determinants, and moderators identified in this study can help researchers, clinicians, and policymakers critically conceptualize empowerment and develop interventions to support people with PD.     

参黄洗液辅助吻合器痔环切手术治疗混合痔效果及其预后不良早期预警

目的:对参黄洗液辅助吻合器痔环切手术(PPH手术)在混合痔治疗中的效果及其预后不良早期预警的价值进行研究,为临床治疗和不良反应的防治提供数据参考。方法:选取2018年5-12月我院手术治疗的混合痔患者120例为研究对象,采用随机数表法分为观察组和对照组,每组60例。观察组采用参黄洗液辅助PPH手术治疗,对照组PPH术后采用高锰酸钾溶液坐浴治疗。术后辅助治疗20d后就疗效、不良反应及随访3个月的远期疗效进行评价和组间比较,并对观察组预后不良病例的早期反应进行分析。结果:观察组总有效率为96.67%(58/60),高于对照组86.67%(52/60)的总有效率(P<0.05);观察组不良反应发生率为21.67%(13/60),低于对照组31.67%(19/60)的不良反应发生率(P<0.05);观察组病例不良预后发生率为25.00%(15/60),低于对照组33.33%(20/60)的不良预后发生率(P<0.05)。结论:参黄洗液辅助PPH手术在混合痔治疗中具有疗效显著、安全性高、预后良好等优势,临床具有推广价值。     

Oncologic outcome of mixed adenoneuroendocrine carcinoma (MANEC): A single center case series

IntroductionMixed adeno-neuroendocrine carcinomas (MANEC) are rare tumors of gastrointestinal tract mostly found in stomach. There are very few case reports and case series with location of colon and rectum. We aimed to report our results in the treatment of colorectal MANEC.MethodsWe performed a prospective analysis of patients with MANEC diagnosis from December 2011 to March 2019 at National Cancer Institute, Lithuania. The demographic information, tumor details, immunohistochemical markers, clinical data, stage, treatment modalities, clinical and oncological outcomes were collected.ResultsNine patients with a diagnosis of MANEC were found in our center. The average age at diagnosis was 64.8 (48–91) years. Seven out of nine (77.8%) patients underwent surgery. Distant metastases were observed in five (55.6%) patients. The adenocarcinoma and neuroendocrine tumor as a dominant component were equal in all cases. The most common tumor localizations were sigmoid colon in three patients (33.3%) and rectum – three patients, following two in an anal canal, and one in the hepatic flexure of colon. The adenocarcinoma component was poorly differentiated (G3) in six patients and moderately differentiated (G2) in three patients. The neuroendocrine component was G3 in seven patients (77.8%), G2 – in two patients (22.2%). Median follow-up was 17 months with a median survival time of 12.5 months.ConclusionMANEC is very rare, aggressive, rapidly spreading, usually with poor prognosis disease.     

Mixed Reality Combined with Three‐Dimensional Printing Technology in Total Hip Arthroplasty: An Updated Review with a Preliminary Case Presentation

Three‐dimensional (3D) printing technology, virtual reality, and augmented reality technology have been used to help surgeons to complete complex total hip arthroplasty, while their respective shortcomings limit their further application. With the development of technology, mixed reality (MR) technology has been applied to improve the success rate of complicated hip arthroplasty because of its unique advantages. We presented a case of a 59‐year‐old man with an intertrochanteric fracture in the left femur, who had received a prior left hip fusion. After admission to our hospital, a left total hip arthroplasty was performed on the patient using a combination of MR technology and 3D printing technology. Before surgery, 3D reconstruction of a certain bony landmark exposed in the surgical area was first performed. Then a veneer part was designed according to the bony landmark and connected to a reference registration landmark outside the body through a connecting rod. After that, the series of parts were made into a holistic reference registration instrument using 3D printing technology, and the patient's data for bone and surrounding tissue, along with digital 3D information of the reference registration instrument, were imported into the head‐mounted display (HMD). During the operation, the disinfected reference registration instrument was installed on the selected bony landmark, and then the automatic real‐time registration was realized by HMD through recognizing the registration landmark on the reference registration instrument, whereby the patient's virtual bone and other anatomical structures were quickly and accurately superimposed on the real body of the patient. To the best of our knowledge, this is the first report to use MR combined with 3D printing technology in total hip arthroplasty.     

适应性回归分析(Ⅲ)——构建具有混合结构的回归模型

本文目的是通过两个实例介绍适应性回归样条算法对具有混杂结构的数据集进行回归建模的实践。当一个数据集包含多个不同的回归模型时,只要给定分类变量的具体取值,SAS中的"ADAPTIVEREG过程"可以比较准确地发掘出其内在规律,并以图形方式呈现模型对资料的拟合效果,还能呈现由"基函数"及其组合所构造出的"回归模型"。图形呈现的结果确实可以给分析者提供一些有价值的"分析线索"或"积极暗示",缩小"探索性研究的空间"。     

中医特色护理技术干预混合痔术后疼痛临床研究

目的:观察在常规术后治疗与护理基础上加用中药熏洗结合针刺、耳穴贴压的综合特色护理技术干预混合痔吻合器痔上黏膜环切术(PPH)术后疼痛的效果。方法:将110例PPH术后患者随机分为对照组和观察组各55例。2组术后患者均行常规补液、抗炎、止血等对症处理,术后第1天起常规每天清洁换药,应用吲哚美辛栓术后纳肛,肛泰软膏适量外涂肛周,口服氨酚双氢可待因片,高锰酸钾坐浴,并予疼痛护理、饮食指导、排便指导等护理措施。观察组加予中药熏洗、针刺、耳穴贴压等中医护理技术。2组疗程均为5天。采用视觉模拟评分法(VAS)分别于术后12 h、1天、2天、3天和5天评价疼痛情况,记录术后5天的氨酚双氢可待因片用量;术后1天、3天、5天评定创面水肿、渗液、便血和尿潴留的症状积分。结果:术后1天、3天、5天,2组VAS评分均较术后12 h下降(P<0.01),观察组术后1天、3天、5天的VAS评分均低于对照组(P<0.01)。术后3天、5天,2组症状积分均较术后1天下降(P<0.01),观察组术后3天、5天的症状积分均低于对照组(P<0.01)。术后5天的氨酚双氢可待因片使用量观察组为(8.62±2.11)片,少于对照组的(12.37±2.53)片(P<0.01)。结论:在常规术后治疗与护理的基础上加用中医综合特色护理技术,能更为有效地减轻混合痔PPH术后疼痛,减少镇痛药物的使用,减少术后其他并发症的发生,从而有利于患者的恢复。