Background:The incidence of gastric polyps in adolescents has been increasing every year in recent years. Endoscopic mucosal resection (EMR) is one of the most common treatments for adults, but there are few reports on the association between EMR of gastric polyps and the occurrence of bleeding and recurrence after the procedure in adolescents. This study sought to analyze the independent risk factors for postoperative bleeding and polyp recurrence after EMR to provide a reference for reducing the occurrence of postoperative complications.Methods:We retrospectively analyzed the data of 579 adolescent patients who developed gastric polyps from June 2016 to June 2021. Postoperative follow-up was conducted for 1 year by telephone, e-mail, and outpatient review. The general characteristics of the study population were compiled using a general information questionnaire designed by the investigators. The relationship between the patients' clinical characteristics and postoperative bleeding or recurrence was analyzed using the chi-square test. A binary logistic regression analysis was conducted to analyze the independent risk factors for the occurrence of postoperative bleeding and polyp recurrence in patients.Results:The results of the binary logistic regression analysis showed that being female [odds ratio (OR) =0.306, P=0.009], polyps >1 cm in diameter (OR =2.557, P=0.029), polyps in gastric sinus (OR =3.889, P=0.032), sessile lesions (OR =0.398, P=0.036), the need for additional intraoperative sedation (OR =3.469, P=0.005), concurrent diverticulum (OR =3.570, P=0.004), and intraoperative bleeding (OR =4.855, P=0.001) were independent risk factors for postoperative bleeding. We also found that polyps >1 cm in diameter (OR =2.134, P=0.003), multiple polyps (OR =2.117, P=0.005), adenomatous polyps (OR =2.684, P=0.041), combined Helicobacter pylori infection (OR =2.036, P=0.009), the occurrence of postoperative gastrointestinal reflux (OR =1.998, P=0.015), and an operative time ≥40 min (OR =2.021, P=0.010) were independent risk factors for the recurrence of polyps.Conclusions:There is still a high probability of postoperative bleeding and polyp recurrence after EMR in adolescents with gastric polyps. Clinicians should pay close attention to the clinical features of polyps, such as polyp size, number, morphology, and pathological type, to identify the related risk factors as early as possible and reduce the probability of postoperative bleeding and polyp recurrence in patients.
特发性血小板减少症的发病机制主要是由于体液免疫功能出现障碍而造成的,主要临床特点是骨髓巨核细胞数量增多或成熟障碍、血小板数量减少、内脏出血等.通过对免疫系统异常、淋巴细胞凋亡的作用、抗原特发性T淋巴细胞的免疫作用、Th17 细胞的CD4+T细胞分化方法、巨核细胞的异常等特发性血小板减少症的发病机制研究进展进行综述,为特发性血小板减少症的防治提供参考依据.
Objective Key targets of resveratrol(RSV)in the treatment of Alzheimer's disease(AD)are predicted by network pharmacology.Methods The traditional Chinese medicines which contain RSV were searched by the TCMSP database,and their property and flavor,meridian distribution and phamacologic action were summarized and analyzed.The targets of RSV were predicted by SwissTargetPrediction,SEA and HERB databases.The targets of AD were retrieved using GeneCards,OMIM,TTD and DisGeNRT databases.The intersection targets of RSV and AD were taken as the potential therapeutic targets.Analysis gene ontology(GO)annotations of potential therapeutic targets by biological information annotation database(DAVID).Did KEGG cluster analysis and protein interactions(PPIs)of potential therapeutic targets in STRING database,and mapped PPI networks in Cytoscape.Verified changes of AD key targets in AlzData database.Docking RSV and key proteins in SwissDock website.Results The most Tropism of taste of the traditional Chinese medicines that contain RSV:bitter,cold,in the liver.And the main phamacologic action is clearing away heat and toxic materials.There are 388 predicted targets of RSV,1624 targets of AD,119 intersection targets.Alzheimer's pathway in KEGG enriched pathway was enriched to 27 proteins.The proteins which expression changed of AD patients was analysised in AlzData database.The results of molecular docking showed that RSV had good binding ability with AKT1,IL-6,CTNNB1 and TNF.Conclusion The results of network pharmacological analysis show that the treatment of AD by RSV is multi-target and multi-pathway,which can provide reference for subsequent research directions.
Objective To explore the impact of personalized educational interventions on knowledge,attitudes,and self-management abilities of patients with atrial fibrillation.Methods Totally 70 elderly patients with atrial fibrillation admitted to the hospital from May 2022 to May 2023 were selected as the research subjects.They were divided into an observation group and a control group based on the principle of balanced and comparable baseline data such as gender and age between the groups,with 35 cases in each group.The observation group received 50 minutes of personalized self-management education,while the control group received routine care.Compare the knowledge,attitudes,and self-management behaviors towards atrial fibrillation and stroke prevention between two groups of patients.Results Before personalized education intervention,there was no statistically significant difference(P>0.05)in the scores of knowledge level,stroke risk factors,stroke symptoms,NOAC treatment,and symptom monitoring between the two groups of patients.After personalized education intervention,the scores of atrial fibrillation and stroke prevention knowledge in both groups of patients increased,and the observation group was higher than the control group,with a statistically significant difference(P<0.05).Before personalized education intervention,there was no statistically significant difference(P>0.05)in the scores of perceived severity,perceived susceptibility,perceived benefits,and perceived setbacks between the two groups of patients.After personalized education intervention,the above scores of both groups of patients increased,and the observation group was higher than the control group,with a statistically significant difference(P<0.05).Before personalized education intervention,there was no statistically significant difference(P>0.05)in self-management scores and total scores of medication,lifestyle,physical activity,and symptom monitoring between the two groups of patients.After personalized education intervention,the above scores of both groups of patients increased,and the observation group was higher than the control group,with a statistically significant difference(P<0.05).Conclusion Individualized and personalized educational interventions should be implemented for elderly patients with atrial fibrillation,which can improve their knowledge and attitudes towards atrial fibrillation and stroke prevention,and enhance their self-management level in daily life.
目的 探究针对性护理对阿替普酶早期溶栓治疗急性脑梗死患者康复效果的影响.方法 选取2021年6月-2023年6月医院就诊的124例接受阿替普酶早期溶栓治疗急性脑梗死的患者为研究对象,按照组间性别、年龄、发病至入院时间、体质指数(BMI)均衡匹配的原则分为对照组和观察组,各62例.对照组实施常规护理,观察组实施针对性护理.比较两组患者的运动功能、生活能力、神经功能恢复情况、凝血指标及并发症总发生率.结果 护理干预前,两组患者上下肢运动功能得分、日常生活活动能力量表(ADL)、神经功能缺损评分量表(NIHSS)评分比较,差异无统计学意义(P>0.05);护理干预后,两组患者上下肢运动功能得分、ADL评分均升高,两组患者NIHSS评分均降低,但观察组患者上、下肢运动功能得分、ADL、NIHSS评分均优于对照组,差异有统计学意义(P<0.05).针对性护理干预后,观察组患者部分活化凝血酶原时间(APTT)、血浆凝血酶原时间(PT)、D-二聚体(D-D)水平优于对照组,差异有统计学意义(P<0.05);观察组患者并发症总发生率低于对照组,差异有统计学意义(P<0.05).结论 将针对性护理方案应用于溶栓后的急性脑梗死患者中,可以促使患者运动功能、生活能力、神经功能的恢复,改善凝血指标,降低并发症的发生.
