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OBJECTIVE: To investigate the status quo of postoperative mindfulness level in patients with oral and maxillofacial malignant tumors, to analyze its influencing factors, and to provide targeted support for the patients, in order to provide evidence for clinical support. METHODS: A total of 452 patients with oral and maxillofacial malignant tumor who were admitted to the Peking University School of Stomatology from January 2021 to June 2021 were followed up by convenience sampling method, the general information questionnaire, the Five Facet Mindfulness Questionnaire, the 10-item perceived stress scale, and the self-esteem scale were used. The t test and analysis of variance were used to compare the scores of mindfulness of the patients with different demographic characteristics after oral and maxillofacial malignant tumors, and the differences of mindfulness levels between the patients with oral and maxillofacial malignant tumors and the normal population were compared by the Z test, Spearman correlation analysis was used to analyze the correlation between the scores of mindfulness and perceived stress and self-esteem. Multiple linear regression was used to analyze the influencing factors of mindfulness levels. RESULTS: A total of 439 valid questionnaires were collected. The average score of postoperative mindfulness of the patients with oral and maxillofacial malignant tumor was 120.28±13.86. The scores of each dimension from high to low were as follows: act with awareness, non-judging, describing, observing, and non-reacting. Compared with the normal population, the patients with oral and maxillofacial malignant tumor showed significant differences in the total scores and scores of various dimensions after surgery. The t test and ANOVA showed that different duration of disease, age, residence, education, marital status, per capita monthly income, occupation, and medical payment methods had influences on postoperative mindfulness level of the patients with oral and maxillofacial malignant tumor (P < 0.10). Spearman correlation analysis showed that the level of mindfulness was negatively correlated with the level of perceived stress, and positively correlated with the level of self-esteem. The duration of illness, marital status, stress perception and self-esteem were included in the regression equation, suggesting that postoperative mindfulness levels of the patients with oral and maxillofacial malignant tumor had an important effect. CONCLUSION: Patients with oral and maxillofacial malignant tumors have low postoperative mindfulness, which is related to duration of disease, marital status, and the level of perceived stress. Medical staff should identify this group as soon as possible, provide effective psychological intervention, help to improve the level of mindfulness, and strive to improve the patients'mental health.
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Atención Plena , Neoplasias , Humanos , Modelos Lineales , Atención Plena/métodos , Encuestas y Cuestionarios , UniversidadesRESUMEN
OBJECTIVE: To preliminarily investigate the role of long non-coding RNA (lncRNA) MIR4697 host gene (MIR4697HG) in regulating the adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). METHODS: For adipogenic differentiation, BMSCs were induced in adipogenic media for 10 days. The mRNA expression levels of lncRNA MIR4697HG and adipogenic marker genes including peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhanced binding protein α (CEBP/α) and adiponectin (ADIPQ) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) at different time points (0, 1, 2, 3, 5, 7, 10 days). The MIR4697HG stable knockdown-BMSC cell line was generated by infection of MIR4697HG shRNA-containing lentiviruses. To avoid off-target effect, two target sequences (shMIR4697HG-1, shMIR4697HG-2) were designed. And then cells were induced to differentiate in adipogenic medium. Oil red O staining, Western blot and qRT-PCR were used to detect the effect of MIR4697HG knockdown on adipogenic differentiation of BMSCs. RESULTS: The mRNA expression level of MIR4697HG was significantly increased during adipogenic differentiation (P < 0.01), and adipogenic differentiation of BMSCs was evidenced by upregulated mRNA levels of specific adipogenesis-related genes including PPARγ, CEBP/α and ADIPQ. Observed by fluorescence microscopy, more than 90% transfected target cells expressed green fluorescent protein successfully after shMIR4697HG-1 group, shMIR4697HG-2 group and shNC group transfection for 72 h. And the transfection efficiency of MIR4697HG examined by qRT-PCR was above 60%. Then the BMSCs were treated with adipogenic media for 7 days and showed that the mRNA expression levels of adipogenesis-related genes including PPARγ, CEBP/α and ADIPQ were significantly decreased in the MIR4697HG knockdown group (P < 0.01), while the expression levels of PPARγ and CEBP/α proteins were decreased remarkably as well (P < 0.01). Consistently, MIR4697HG knockdown BMSCs formed less lipid droplets compared with the control BMSCs, which further demonstrated that MIR4697HG knockdown inhibited adipogenic differentiation of BMSCs. CONCLUSION: lncRNA MIR4697HG played a crucial role in regulating the adipogenic differentiation of BMSCs, and MIR4697HG knockdown significantly inhibited the adipogenic differentiation of BMSCs. These data may suggest that lncRNA MIR4697HG could serve as a therapeutic potential target for the aberrant adipogenic differentiation-associated disorders including osteoporosis.
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Células Madre Mesenquimatosas , ARN Largo no Codificante , Adipogénesis/genética , Células de la Médula Ósea/metabolismo , Diferenciación Celular , Células Cultivadas , Osteogénesis , PPAR gamma/genética , PPAR gamma/metabolismo , PPAR gamma/farmacología , ARN Largo no Codificante/genética , ARN Mensajero/metabolismoRESUMEN
AIM: To determine the characteristics of coronary artery atherosclerotic plaques in chronic kidney disease (CKD) with coronary computed tomography angiography (CTA). MATERIALS AND METHODS: Sixty-six patients with CKD who underwent coronary CTA were analysed retrospectively. The extent, distribution, and types of plaques and stenosis severity were evaluated. The imaging features were compared between dialysis and non-dialysis groups. In the dialysis group, the imaging features were compared between diabetes and non-diabetes patients. RESULTS: In total, 152 coronary vessels (2.3±1.3 per patient) and 306 segments (4.6±3.5 per patient) were found to have plaques. The most common diseased coronary vessel was the left anterior descending (LAD) artery (53 vessels, 34.9%) followed by the left circumflex (LCX) artery (39 vessels, 25.7%), and right coronary artery (RCA; 37 vessels, 24.3%) in sequence. The most commonly involved coronary artery segment was the middle segment of LAD artery (14.1%). Calcified plaques (65.9%) were detected more frequently than mixed (25.6%) or non-calcified (8.5%) plaques (p<0.001). Among the degrees of coronary stenosis, minimal stenosis (55.8%) was the most common (p<0.001). The majority of calcified plaques were non-obstructive plaques (n=134, 78.2%), while about half of non-calcified (n=14, 63.6%) and mixed plaques (n=30, 45.5%) were obstructive plaques (p<0.001). CONCLUSION: A heavy plaque burden was detected in CKD patients at coronary CTA. Non-obstructive calcified plaque was the most common imaging feature. CKD patients with type 2 diabetes mellitus had more obstructive mixed plaques.
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Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/etiología , Placa Aterosclerótica/diagnóstico por imagen , Placa Aterosclerótica/etiología , Insuficiencia Renal Crónica/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Medios de Contraste , Femenino , Humanos , Yopamidol , Masculino , Persona de Mediana Edad , Interpretación de Imagen Radiográfica Asistida por Computador , Diálisis Renal , Insuficiencia Renal Crónica/terapia , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Free flap transplantation has become a mainstay for the restoration of oral and maxillofacial defects. However, the complexity of the surgical procedure and long hospitalization time result in high hospitalization costs. This study was performed to retrospectively analyse the composition of hospitalization expenses and factors influencing this for 507 patients who underwent oral and maxillofacial free flap transplantation at a representative medical institution in China. The aim was to provide evidence for the reasonable control of expenditure and effective utilization of medical resources, and to gain an indirect reflection of the healthcare model characteristics of public hospitals in China. The average hospitalization cost was found to be US$ 9265±2284. Factors affecting hospitalization expenses were the type of free flap, tracheotomy, postoperative complications, and length of stay. The largest proportion of hospitalization expenses was the cost of materials (44.94%). Although the total hospitalization cost was lower than that in Western countries, the medical burden of patients was higher, and the corresponding medical charges do not fully reflect the value of medical services. We recommend reducing hospitalization expenses and the medical burden by shortening the hospital stay, selecting reasonably priced medical materials, strengthening airway management of patients undergoing tracheotomy, and enhancing the control and treatment of comorbidities in order to reduce the incidence of postoperative complications.
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Colgajos Tisulares Libres , Procedimientos de Cirugía Plástica , China , Humanos , Tiempo de Internación , Estudios RetrospectivosRESUMEN
AIM: To investigate the superiority of free-breathing coronary computed tomography angiography (CCTA) with 16-cm wide-detector CT for challenging patients who cannot hold their breath. MATEIALS AND METHODS: A total of 76 patients (62% with either heart rate >75 beats/min or arrhythmia) who were unable to breath-hold underwent both free-breathing CCTA and invasive coronary angiography (ICA) were included. Two reviewers evaluated coronary arteries on a per-segment, per-vessel, and per-patient basis for image quality using a four-point scale and stenosis degree. CCTA results were compared with ICA to calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: Out of 1,368 segments, 228 (16.7%) were <1.5 mm in diameter and were excluded. Thirty-two (2.3%) with calcification and 26 (1.9%) with motion artefacts were considered positive at CT. One thousand and eighty-two segments (79.1%) were evaluated both on CCTA and ICA, and 128 (11.8%) segments had ≥50% stenosis on ICA. The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of CCTA were 90.8%, 88.3%, 91.1%, 57.1%, and 98.3% on a per-segment basis; 93.4%, 90.6%, 94.2%, 80.5% and 97.4% on a per-vessel basis; and 92.1%, 100%, 85%, 85.7% and 100% on a per-patient basis. For patients with high heart rates or arrhythmia, 81% (versus 79.1%) segments were evaluable, and the accuracy, sensitivity, specificity, PPV, and NPV were statistically the same as the entire study population. CONCLUSION: Free-breathing CCTA using 16-cm wide-detector CT has high accuracy compared to ICA for detecting coronary artery stenosis for challenging patients.
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Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Anciano , Anciano de 80 o más Años , Angiografía por Tomografía Computarizada/instrumentación , Angiografía Coronaria/instrumentación , Estenosis Coronaria/diagnóstico , Humanos , Persona de Mediana Edad , Respiración , Sensibilidad y EspecificidadRESUMEN
AIM: To assess the severity of pure aortic regurgitation by measuring regurgitation volumes (RV) and fractions (RF) with dual-source computed tomography (DSCT) as compared to magnetic resonance imaging (MRI) and echocardiography. MATERIALS AND METHODS: Thirty-eight patients (15 men, 23 women; mean age 46±11 years) with isolated aortic valve regurgitation underwent retrospectively electrocardiogram (ECG)-gated DSCT, echocardiography, and MRI. Stroke volumes of the left and right ventricles were measured at DSCT and MRI. Thus, RVs and RFs were calculated and compared. The agreement between DSCT and MRI was tested by intraclass correlation coefficient and Bland-Altman analyses. Spearman's rank order correlation and weighted κ tests were used for testing correlations of AR severity between DSCT results and corresponding echocardiographic grades. RESULTS: The RV and RF measured by DSCT were not significantly different from those measured using MRI (p=0.71 and 0.79). DSCT correlated well with MRI for the measurement of RV (r(I)=0.86, p<0.001) and calculation of the RF (r(I) =0.90, p<0.001). Good agreement between the techniques was obtained by using Bland-Altman analyses. The severity of regurgitation estimated by echocardiography correlated well with DSCT (r(s)=0.95, p<0.001) and MRI (r(s)=0.95, p<0.001). Inter-technique agreement between DSCT and two-dimensional transthoracic echocardiography (2DTTE) regarding the grading of the severity of AR was excellent (κ=0.90), and good agreement was also obtained between MRI and 2DTTE assessments of the severity of AR (κ=0.87). CONCLUSION: DSCT using a volume approach can be used to quantitatively determine the severity of pure aortic regurgitation when compared with MRI and echocardiography.