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RSS2024 Vol. 45, No. 10
2024, 45(10): 1-7.
doi: 10.12259/j.issn.2095-610X.S20241001
Abstract:
The growth and disease progression of cartilage are highly complex, influenced by various growth factors, cytokines, and both internal and external environmental factors. This process is regulated by multiple intersecting biological signaling pathways. Consequently, the study of its molecular mechanisms is crucial for the development and treatment of cartilage-related diseases. Long non-coding RNAs （lncRNAs） are a class of regulatory non-coding RNAs with transcript lengths exceeding 200 nucleotides. They play a complex and precise role in biological development, gene expression and epigenetics, and are closely associated with the onset, progression and prevention of human diseases. In recent years, numerous lncRNAs related to cartilage growth and disease have been discovered. This article systematically reviews the classification, function and mechanisms of action of lncRNAs in cartilage development and disease. It reveals that various lncRNAs are involved in the onset and progression of cartilage growth and diseases. Regulating the expression of relevant lncRNAs can alleviate cartilage inflammation and slow disease progression. This paper aims to provide a scientific basis for basic research and clinical application of lncRNAs in cartilage growth and disease.
The growth and disease progression of cartilage are highly complex, influenced by various growth factors, cytokines, and both internal and external environmental factors. This process is regulated by multiple intersecting biological signaling pathways. Consequently, the study of its molecular mechanisms is crucial for the development and treatment of cartilage-related diseases. Long non-coding RNAs （lncRNAs） are a class of regulatory non-coding RNAs with transcript lengths exceeding 200 nucleotides. They play a complex and precise role in biological development, gene expression and epigenetics, and are closely associated with the onset, progression and prevention of human diseases. In recent years, numerous lncRNAs related to cartilage growth and disease have been discovered. This article systematically reviews the classification, function and mechanisms of action of lncRNAs in cartilage development and disease. It reveals that various lncRNAs are involved in the onset and progression of cartilage growth and diseases. Regulating the expression of relevant lncRNAs can alleviate cartilage inflammation and slow disease progression. This paper aims to provide a scientific basis for basic research and clinical application of lncRNAs in cartilage growth and disease.
2024, 45(10): 8-16.
doi: 10.12259/j.issn.2095-610X.S20241002
Abstract:
Objective To explore the mechanism of Dendrobium nobium polysaccharide on myocardial injury in diabetic rats by regulating the fatty acid β oxidation signaling pathway of cardiomyocytes from Plin5. Methods A total of 72 male SD rats of a clean grade were divided into a control group （n = 10） and a modeling group （n = 62）. The control group was fed regular diet, while the modeling group was given a high-fat, high-sugar diet for two months, along with a single STZ injection to establish a diabetic myocardial injury animal model. After successfully creating the model, the modeling group of SD rats was further divided into five subgroups: the model group, the isosorbide mononitrate tablet group, the low-dose Dendrobium nobium polysaccharide group, the medium-dose group, and the high-dose group （n = 10）. After 4 weeks of drug treatment, rats were euthanized, and their hearts were collected to detect the myocardial hemopathology （using HE and Masson staining）, lipid levels （TG, TC, HDL-C and LDL-C）, inflammatory factors （IL-1α, IL-1β, IL-6 and TNF-α） and antioxidant indexes （SOD, GSH, MDA and ROS）. Blood samples were taken to assess cardiac function, insulin and blood sugar levels, and Western blot was used to detect the expression characteristics of Plin5, SCD1, CPT1A, ACOX1 and PPARα proteins. Results Histopathology with HE and Masson staining showed that in the normal group, the myocardial fibers of rats were neatly arranged, whereas in the model group, there was fibrous rupture. Compared to the model group, different degrees of improvement were seen in all treatment groups with Dendrobium polysaccharides. Blood sugar and insulin resistance index increased in the model group compared to the normal group （P < 0.05）, with insulin levels decreasing （P < 0.05）. Compared to the model group, the three groups treated with Dendrobium polysaccharides showed reduced blood sugar and insulin resistance index （P < 0.05）. In the low-dose, mid-dose, and isosorbide dinitrate tablet groups, insulin levels did not increase （P > 0.05）, while the high-dose Dendrobium polysaccharides group exhibited an increase in insulin content （P < 0.05）. Compared to the normal group, TG, TC and LDL-C in the model group were remarkably increased （P < 0.05）, while HDL-C was remarkably decreased （P < 0.05）. Compared to the model group, TG, TC and LDL-C in the three Dendrobium polysaccharide groups and the positive drug group were remarkably decreased （P < 0.05）, while HDL-C was remarkably increased （P < 0.05）. Compared to the normal group, AST, CK, CK-MB, LDH, a-HBDH and CTnl in the model group were remarkably increased （P < 0.05）. Compared to the model group, the above 6 indexes in the 3 Dendrobium polysaccharide treatment groups and positive drug group were remarkably decreased （P < 0.05）. Compared to the normal group, IL-1α, IL-1β, IL-6 and TNF-α in the the model group were remarkably increased （P < 0.05）, and they were remarkably decreased in the three Dendrobium polysaccharide treatment groups and the positive drug group compared to the model group （P < 0.05）; compared to normal group, SOD and GSH in model group were remarkably decreased （P < 0.05）, MDA and ROS were remarkably increased （P < 0.05）, compared to the model group, SOD and GSH in the three treatment groups and the positive drug group were increased （P < 0.05）, while MDA and ROS were decreased （P < 0.05）. Compared to normal group, Plin5 and SCD1 in model group were increased （P < 0.05）, and protein expressions of PPARα, CPT1 and ACOX1 were decreased （P < 0.05）. Compared to model group, Plin5 and SCD1 were remarkably increased （P < 0.05）. Compared to the model group, Plin5 and SCD1 were remarkably decreased in all treatment groups and positive drug groups （P < 0.05）, while PPARα, CPT1 and ACOX1 were remarkably increased （P < 0.05）. Conclusion Dendrobium nobium polysaccharide can regulate fatty acid β oxidation through Plin5, thereby reducing myocardial lipid content, inflammation, and oxidative stress, protecting diabetic myocardial injury in rats, and improving heart function.
2024, 45(10): 17-21.
doi: 10.12259/j.issn.2095-610X.S20241003
Abstract:
Objective To explore the establishment of in vitro model of coronary artery bypass venous bridge in coronary artery bypass graft （CABG）. Methods Rat venous smooth muscle cells were cultured in vitro and divided into 4 groups. The cells were stretched by cell stretching device in order to simulate the mechanical environment of vein bridge. The changes of cell morphology were observed by CCK-8 detection, cell activity was observed by Edu staining, and cell migration ability was observed by scratch test. Results Compared to the normal control group, 5% tensile stress had no significant effect on cell viability （P > 0.05）; 10% tensile stress significantly enhanced cell vitality （P < 0.05）; while 15% tensile stress significantly suppressed cell vitality （P < 0.01）. In terms of cell proliferation, 5% tensile stress showed no significant effect compared to the normal control group （P > 0.05）; 10% tensile stress significantly promoted cell proliferation （P < 0.01）; and 15% tensile stress significantly inhibited cell proliferation （P < 0.05）. Compared to the normal group, 5% tensile stress had no obvious impact on cell migration capability （P > 0.05）; 10% tensile stress promoted cell migration ability （P < 0.05）; and 15% tensile stress significantly inhibited cell migration ability （P < 0.05）. Conclusion Under establishment the parameters of 1 Hz frequency and 10% stretch deformation, the biological behavior of vascular smooth muscle cells is consistent with that of clinical stenosis-restenosis cells.
2024, 45(10): 22-28.
doi: 10.12259/j.issn.2095-610X.S20241004
Abstract:
Objectives To investigate the effects of FGF2 on the proliferation and collagen production of hypoxia-induced scleral fibroblasts （SF） and explore the downstream signaling pathways it regulates. Methods 5% O2 was used to stimulate the SF to induce myopia SF model for 24 hours. RT-qPCR was used to detect FGF2 mRNA expression, and Western blot analysis was used to check FGF2 protein expression. The Cell Counting Kit-8 （CCK-8）, flow cytometry, and Western blot were used to assess cell proliferation vitality, cell apoptosis, and the expression of collagen metabolism-related proteins collagen I, MMP2, and pathway proteins PERK, p-PERK, EIF2α, EIF2α, and ATF4. Results Hypoxia increased FGF2 mRNA and protein expression （P < 0.01） , activated the PERK/EIF2α/ATF4 pathway （P < 0.001）, inhibited SF cell proliferation （P < 0.001） and collagen I expression （P < 0.001）, while induced MMP2 expression （P < 0.001） and apoptosis （P < 0.001）. Knocking down FGF2 or treating with PERK inhibitor GSK2606414 reversed the effect of hypoxia on SF cells, increased cell proliferation （P < 0.001） and collagen Ⅰ expression （P < 0.01）, and suppressed cell apoptosis （P < 0.01）. Mechanism study revealed that FGF2 knockdown dampened the activation of PERK/EIF2α/ATF4 pathway. Conclusion FGF2 affects hypoxia-induced SF proliferation and collagen metabolism by regulating the activation of PERK/EIF2α/ATF4 signaling pathway.
2024, 45(10): 29-35.
doi: 10.12259/j.issn.2095-610X.S20241005
Abstract:
Objective To explore the effect of compound probiotic powder on enhancing related immune function of organism, so as to provide theoretical basis and experimental support for further exploration and application of compound probiotic powder in the future. Methods 160 ICR mice were randomly divided into control group, low, medium and high dose groups, and divided into groups by random parallel control grouping method, with 40 mice in each group. The experimental period lasts 30 days, the control group was given normal saline for the same time, and the other groups were given compound probiotic powder for 30 days. After the gavage, the mice were killed alive, and their organ index, delayed allergic reaction, lymphocyte transformation, serum hemolysin, antibody-producing cells, NK cell activity and macrophage phagocytosis were observed to evaluate the influence of compound probiotic powder on the immunity of mice. Results Compared with the control group, there was no significant difference in body weight and organ index of mice in each dose group （F = 0.885, P = 0.458; F = 0.844, P = 0.479; F = 0.732, P = 0.540）; The difference of toe swelling degree was statistically significant （F = 3.252, P = 0.03）.The difference of optical density of spleen lymphocyte proliferation in mice with different doses increased, and the difference was statistically significant （F = 48.786, P = 0.000）. The number of hemolytic plaque increased with statistical significance （F = 22.095, P = 0.000）. The half hemolysis value of middle and high dose groups increased, and the difference was statistically significant （F = 30.544, P = 0.000）. The clearance index and phagocytosis index increased, and the difference was statistically significant and dose-dependent （F = 338.79, P = 0.000; F = 120.271, P = 0.000）; NK cell activity also increased, and the difference was statistically significant and dose-dependent （F = 466.491, P = 0.000）. Conclusion The compound probiotic powder can improve the immunity of mice, and the results meet the evaluation standard of "having the function of enhancing immunity" in the Technical Specification for Inspection and Evaluation of Health Food.
2024, 45(10): 36-44.
doi: 10.12259/j.issn.2095-610X.S20241006
Abstract:
Objective To compare the efficacy and safety of Infliximab （IFX） and Vedolizumab （VDZ） in the treatment of moderate-to-severe ulcerative colitis （UC）. Methods A total of 110 patients diagnosed with moderate-to-severe ulcerative colitis and treated with IFX/VDZ in the First Affiliated Hospital of Kunming Medical University from January 2020 to December 2023 were retrospectively collected. Including 55 in the IFX treatment group and 55 in the VDZ treatment group. Clinical symptoms, indicators related to disease activity, endoscopic manifestations and adverse reactions occurred during treatment were recorded before treatment （0 weeks） and 14, 30, and 54 weeks of treatment, and whether there were differences in the efficacy and safety of the two drugs in the treatment of moderate to severe UC was analyzed. Results There were no significant differences in baseline indexes between the two groups （P > 0.05）. The levels of inflammatory indicators （WBC, PLT, ESR, CRP） in IFX treatment group were higher than those in VDZ treatment group at week 14, and the level of nutrition indicator ALB was lower than those in VDZ treatment group at week 30, with statistical significance （P < 0.05）. There was no significant difference in other laboratory indexes among follow-up time points （P > 0.05）. The clinical response rate of IFX treatment group and VDZ treatment group was not significantly different at week 14 （81.8% vs 85.5%）, week 30 （80.8% vs 92.5%） and week 54 （91.3% vs 90.0%） （P > 0.05）. There was no significant difference in clinical response rate at week 14 （41.8% vs 49.1%）, week 30 （50.0% vs 67.5%） and week 54 （65.2% vs 63.3%） （P > 0.05）. There was no significant difference in endoscopic response rate at week 14 （54.3% vs 72.2%）, week 30 （41.2% vs 73.3%） and week 54 （60.0% vs 75.0%） （P > 0.05）. There was no significant difference in the endoscopic remission rate at week 14 （34.3% vs 55.6%） and week 54 （53.3% vs 54.2%） （P > 0.05）. The endoscopic remission rate at week 30 （23.5% vs 73.3%） in IFX treatment group was lower than that in VDZ treatment group, the difference was statistically significant （P = 0.005）. There was no significant difference between IFX group and VDZ group （7.3% vs 1.8%） during 14 to 30 weeks of treatment （P > 0.05）, and IFX group had higher non-response rate during 30 to 54 weeks of treatment （16.4% vs 0） than VDZ group. The difference was statistically significant （P = 0.005）. There was no significant difference in the incidence of adverse reactions between IFX treatment group and VDZ treatment group （10.9% vs 5.5%） （P > 0.05）. Conclusion During the treatment of moderate to severe UC, no significant difference was observed in the clinical response rate, clinical remission rate, endoscopic response rate and endoscopic remission rate between the IFX treatment group and the VDZ treatment group at week 14 and week 54, and the endoscopic remission rate in the IFX treatment group was lower than that in the VDZ treatment group at week 30. The non-response rateof IFX treatment group was higher than that of VDZ treatment group during maintenance treatment, suggesting that IFX treatment group may have a higher long-term drug resistance rate. There was no significant difference in the incidence of adverse reactions between the two drugs.
2024, 45(10): 45-49.
doi: 10.12259/j.issn.2095-610X.S20241007
Abstract:
Objective To explore a new method for assessing disease activity in patients with systemic lupus erythematosus （SLE） by evaluating the relationship between the level of the systemic immune-inflammatory index （SII） and disease activity in SLE patients. Methods Clinical data of SLE patients who treated in the Department of Rheumatology and Immunology of First Affiliated Hospital of Kunming Medical University were collected. Patients were grouped based on the Systemic Lupus Erythematosus Disease Activity Index （SLEDAI）. The correlation between SII level and disease activity was compared and analyzed, and Receiver operating characteristic curve （ROC） was plotted to evaluate the predictive value of SII for SLE disease activity. Results The SII levels in the mild active group of SLE patients were significantly lower than that in the severe active group （Bonferroni correction, P < 0.05/3 = 0.017）. There was a correlation between SII levels and SLEDAI scores （r = 0.130, P < 0.05）, with an area under the ROC curve of 0.581 （P < 0.05）. Conclusion SII can serve as a simple and quick reference indicator for reflecting disease activity in SLE.
2024, 45(10): 50-54.
doi: 10.12259/j.issn.2095-610X.S20241008
Abstract:
Objective To investigate the clinical efficacy of microvascular decompression for moderate-to-severe hemifacial spasm and the influencing factors of delayed resolution. Methods Sixty patients with moderate-to-severe hemifacial spasm who underwent microvascular decompression at the Neurosurgery Department of Ankang Central hospital from May 2018 to May 2023 were selected. Then the clinical efficacy and postoperative complications were were studied, and they were categorized into an immediate cure group and a delayed cure group based on clinical outcomes. Multivariate logistic regression analysis was used to determine the factors affecting delayed recovery in patients. Results Among the 60 patients, 47 were cured immediately, while 13 were cured later. There were 2 cases of infection, 2 cases of hearing impairment, 1 case of low cerebrospinal fluid pressure syndrome, and 2 cases of facial paralysis after the procedure, resulting in a complication rate of 11.67%. There were statistically significant differences （P < 0.05） in the duration of illness, long-term use of carbamazepine, severity of symptoms, injections of Botox, and degree of vascular compression between the immediate cure group and the delayed cure group. Logistic regression analysis indicated that severity of symptoms, duration of illness, and degree of vascular compression are factors influencing delayed cure. Conclusion The course of the disease, severity of symptoms, and degree of intraoperative vascular compression are influencing factors for delayed recovery in patients with moderate-to-severe hemifacial spasm undergoing microvascular decompression of the facial nerve. Clinically, it's important to closely monitor these indicators and take appropriate measures to improve the prognosis and quality of life for patients.
2024, 45(10): 55-60.
doi: 10.12259/j.issn.2095-610X.S20241009
Abstract:
Objectives To evaluate the application value of carcinoembryonic antigen （CEA）, ferritin （FRT）, neuron-specific enolase （NSE）, squamous cell carcinoma-related antigen （SCC）, carbohydrate antigen 50 （CA50）, carbohydrate antigen 125 （CA125）, and cytokeratin 19 fragment （CY21-1） in serum （S-） and pleural effusion （P-） for differentiating malignant pleural effusion of lung cancer （LC-MPE） from benign pleural effusion （BPE）. We aim to establish a diagnostic model for LC-MPE using tumor markers and analyze the data using logistic regression and artificial neural network （ANN） techniques. Methods The serum and pleural effusion tumor marker results of patients with newly diagnosed LC-MPE and BPE were analyzed, and diagnostic models for LC-MPE were established using Logistic regression analysis and ANN technology. Results The indicators S-NSE, S-CY21-1, P-CEA, and P-NSE were selected and used for modeling. The Logistic regression model for diagnosing LC-MPE established in this study had a sensitivity of 93.23% and a specificity of 97.46%, with an area under the ROC curve of 0.992. The established ANN model had a sensitivity of 95.35%, a specificity of 97.22%, and an area under the ROC curve of 0.990 （P < 0.05）. Conclusions In diagnosing LC-MPE through tumor markers, both the Logistic regression model and the ANN model established in this study showed good diagnostic efficacy. These two models can assist clinicians in improving diagnostic accuracy.
2024, 45(10): 61-66.
doi: 10.12259/j.issn.2095-610X.S20241010
Abstract:
Objective To understand the current state of research, hot topics, and future trends in the treatment of critically ill patients based on CiteSpace. Methods Relevant literatures in CNKI database from 2020 to 2023 were retrieved and CiteSpace was used to analyze the research status, hot spots and trends in the treatment of critically ill patients. Results This study reviewed a total of 199 papers; the research collaboration wasn't very close, and the keywords were focused on pre-hospital emergency care, transportation, and stepwise treatment, with pre-hospital emergency care and patient transfer being the forefront of the research. Conclusion In recent years, as the number of critically ill patients has risen, related rescue research has also been on the rise. Moving forward, we need to strengthen research collaboration, improve the quality of studies, and continue to promote the establishment and enhancement of rescue systems to advance the field of critical care.
2024, 45(10): 67-74.
doi: 10.12259/j.issn.2095-610X.S20241011
Abstract:
Objective To explore the clinical efficacy of BFMC vertebroplasty versus PKP in treating OVCF. Methods A total of 290 patients diagnosed with OVCF at the First Affiliated Hospital of Kunming Medical University from September 2022 to November 2023 were selected, including 216 in the PKP group and 74 in the BFMCs group. All patients received regular osteoporosis treatment. Baseline data, surgical indexes, follow-up and imaging data were compared. Results There was no statistically significant difference between the two groups regarding age, gender, T-values, and the distribution of fractured vertebrae （P > 0.05）. All 290 patients successfully completed the surgery. Compared to the BFMCs group, there was no significant difference in operation durationand the amount of bone cement injected in the PKP group （P > 0.05）. The incidence of bone cement leakage in the BFMCs group was significantly lower than that in the PKP group （P < 0.05）, with 7 cases （9.50%） of leakage in the BFMCs group—3 cases in the anterior vertebral body and 4 cases in the intervertebral space; the PKP group had 85 cases （39.40%） of leakage, with 16 cases in the anterior vertebral body, 44 cases in the intervertebral space, 16 cases adjacent to the vertebral body, and 9 cases in the spinal canal （along the posterior longitudinal ligament）, all without neurological spine and cord symptoms. There was a statistically significant difference in the distribution type of the bone cement blocks post-surgery between the two groups （P <0.05）. All 290 patients were followed up for 6 months post-surgery. At the 1-month follow-up, the VAS scores of the BFMCs group were significantly better than those of the PKP group, with a statistically significant difference（P < 0.05）. At both the 1-month follow-up and the final follow-up, the ODI scores of the BFMCs group were significantly better than those of the PKP group, with statistically significant differences（P < 0.05）.VAS and ODI scores for both groups on the first day post-surgery, at 1 month post-surgery, and at the last follow-up were all significantly lower than pre-surgery, with statistically significant differences （P < 0. 05）. In terms of imaging, there were no statistically significant differences between the two groups regarding pre-surgery anterior edge height of the injured vertebrae, the vertebral body height recovery rate, and the Cobb angle of spinal kyphosis （P > 0.05）, but the anterior edge height of the injured vertebrae, the vertebral body height recovery rate, and the Cobb angle of spinal kyphosis showed improvement at the final follow-up compared to pre-surgery （P < 0.05）. Conclusion BFMCs and PKP have similar clinical efficacy in treating OVCFs; both effectively relieve patients’ symptoms and restore vertebral height. However, BFMCs significantly reduce cement leakage, making it a safe and effective option.
2024, 45(10): 75-84.
doi: 10.12259/j.issn.2095-610X.S20241012
Abstract:
Objective To explore the clinical characteristics and prognosis of acute B lymphocytic leukemia in children with abnormal adrenal corticotropic hormone （ACTH）. Methods A total of 154 children with B-ALL admitted to the hematology Department of Kunming Children’ s Hospital from January 2019 to January 2023 were collected as the study objects. According to whether ACTH decreased, they were divided into the reduced group （75 cases） and the normal group （79 cases）. Clinical data of the patients were collected for comparison, and the risk factors affecting the prognosis were analyzed. Results The baseline data from two groups （gender, ethnicity, age）, number of chemotherapy sessions, severity of illness, hemoglobin levels, platelet counts, percentage of blast cells, relapse rates, mortality rates, event-free survival rates, overall survival rates, and both univariate and multivariate COX regression analyses of clinical factors affecting OS rates showed no statistical significance （P > 0.05）. However, peripheral blood leukocyte counts and groupings, glucocorticoid （GC） resistance rates, MRD positivity rates, and in the univariate Cox regression analysis, age ≥10 years, presence of central nervous system leukemia, leukocyte counts, and leukocyte groupings （50×109/L vs ≥50×109/L） had a statistically significant impact on the EFS rates of newly diagnosed B-ALL patients （P < 0.05）. Testicular infiltration, platelet counts, hemoglobin levels, bone marrow blast cell counts, cortisol levels, ACTH levels, gender, MRD, ethnicity, groupings （normal ACTH group vs reduced ACTH group）, and severity of illness on the EFS rates of newly diagnosed B-ALL patients was not statistically significant （P > 0.05）. Further multivariate Cox stepwise regression analysis （method: forward, conditional） revealed that leukocyte counts ≥50×109/L and age ≥10 years are independent adverse prognostic factors for the EFS rates in these patients （P < 0.05）. Conclusion Children with B-ALL with reduced ACTH had higher rates of GC resistance, MRD positivity, and white blood cell count, ≥50×109/L and age≥ 10 years were independent adverse prognostic factors for the EFS rate in children.
2024, 45(10): 85-90.
doi: 10.12259/j.issn.2095-610X.S20241013
Abstract:
Objective To investigate the relationship between serum interleukin-6 （IL-6）, cystatin C （Cys C）, tumor necrosis factor-α （TNF-α） and sarcopenia in patients with chronic kidney disease （CKD）, and its impact on mortality risk. Methods A retrospective study was conducted on the clinical data of 105 CKD patients undergoing maintenance hemodialysis （MHD） in a hospital from July 2019 to June 2021. The patients were divided into two groups based on whether they had sarcopenia during MHD, namely the sarcopenia group （n = 27） and the non- sarcopenia group （n = 78）. The clinical data of the two groups were compared, and the correlation between serum IL-6, Cys C, TNF-α levels and human data such as SMI and HGS was analyzed. The relationship between serum IL-6, Cys C, TNF-α and sarcopenia during MHD in CKD patients was analyzed, and the survival of CKD MHD patients was analyzed. And The effects of serum levels of IL-6, CysC, and TNF-α on the risk of death in patients with CKD were evaluated. Results In the sarcopenia group, SMI, HGS, and GS were all lower than in the non-sarcopenia group, while serum levels of IL-6, Cys C, and TNF-α were higher （P < 0.05）. In sarcopenia patients, serum IL-6, Cys C, and TNF-α levels showed a negative correlation with SMI, HGS, and GS （P < 0.05）. Elevated levels of serum IL-6, Cys C, and TNF-α were associated with the occurrence of sarcopenia in CKD patients during MHD （P < 0.05）. As serum levels of IL-6, Cys C, and TNF-α increased, the risk of developing sarcopenia during MHD in CKD patients gradually rose （P < 0.05）, and when serum levels of IL-6, Cys C, and TNF-α were high, the risk of death for CKD patients was 9.900 times, 10.688 times, and 4.936 times higher, respectively, compared to low levels. Conclusion In CKD patients, higher pre-MHD serum levels of IL-6, Cys C, and TNF-α are related to the occurrence of sarcopenia. Testing all three levels together can be used to assess the mortality risk in patients with muscle loss.
2024, 45(10): 91-95.
doi: 10.12259/j.issn.2095-610X.S20241014
Abstract:
Objective To study the psychological state and self-management skills of peritoneal dialysis patients and to examine the factors influencing them and their interrelationships. Methods A convenience sampling method was used, and general information surveys, the Hospital Anxiety and Depression Scale （HADS）, the Self-Esteem Scale, and the Self-Management Scale were employed to conduct a questionnaire survey of 158 patients undergoing peritoneal dialysis. Results The HADS score of peritoneal dialysis patients was （7.46±4.14）, which was higher than the norm; the self-esteem level score was （26.40±5.17）, which was lower than the norm （P < 0.05）; and the self-management ability score was （62.60±9.22）, which was at an average level （P < 0.05）. Factors such as education level, average monthly income, type of health insurance, and the psychological state of patients had a certain effect on the self-management ability of peritoneal dialysis patients （all P < 0.05）. Conclusion There is a correlation between the psychological state of peritoneal dialysis patients and their self-management skills. Targeted interventions to reduce anxiety and depression in patients, while enhancing their self-esteem and self-management abilities, are fundamental to clinical care.
2024, 45(10): 96-104.
doi: 10.12259/j.issn.2095-610X.S20241015
Abstract:
Objective To investigate the application of Ommaya capsule in the treatment of cerebral hemorrhage complicated with acute hydrocephalus and its effect on blood-brain barrier function and prognosis. Methods A total of 80 patients with cerebral hemorrhage complicated with acute hydrocephalus from January 2021 to January 2023 were selected and divided into 40 cases each according to random number table method. The control group was given lumbocisterna interventional therapy, and the observation group was given Ommaya capsule interventional therapy. Compare the therapeutic effect of the two groups, as well as blood-brain barrier （BBB） index, serum S100β protein （S100β）, cerebrospinal fluid cell count, glucose, myelin basic protein （MBP）, National Institutes of Health Stroke Scale （NIHSS）, specific enolase （NSE）, chloride, Chinese Stroke Clinical Neurological Deficit Scale （CSS） score and occurrence of complications before and after treatment, were followed up for 6 months, and the prognosis of the two groups was statistically compared, after 6 months of follow-up, the prognosis of the two groups was statistically compared. Results The total effective rate of observation group was 90.00% （36/40）, which is higher than that of control group （72.50% （29/40） （P < 0.05）. The levels of serum S100β, MBP, BBB index, NSE and CSF cell number in observation group were lower than those in control group 1 week and 2 weeks after treatment, and the levels of CSF glucose and chloride were higher than those in control group （P < 0.05）. The CSS and NIHSS scores of observation group were lower than those of control group 1 and 2 weeks after treatment （P < 0.05）; The complication rate of the observation group was 7.50% （3/40） lower than that of the control group （25.00% （10/40） （P < 0.05）. The prognosis of observation group was better than control group （P < 0.05） after 6 months of follow-up. Conclusion The application of Ommaya capsule therapy in patients with cerebral hemorrhage complicated with acute hydrocephalus can regulate the level of nerve injury factors, restore the blood-brain barrier, improve nerve function, and reduce the risk of complications, so as to improve the treatment effect and promote the prognosis.
2024, 45(10): 105-110.
doi: 10.12259/j.issn.2095-610X.S20241016
Abstract:
Objective To explore the predictive value of serum and tissue miR-205 for postoperative recurrence of ovarian-type endometriosis （EMT）. Methods A total of 100 patients with ovarian-type EMT who were treated at Shijiazhuang People's Hospital from June 2019 to June 2021 were selected. All patients underwent laparoscopic surgery and were divided into a recurrence group （n = 24） and a non-recurrence group （n = 76） based on their recurrence status 24 months post-surgery. The general information, serum, and endometrial tissue cancer antigen 125 （CA125）, and miR-205 levels were compared between the two groups. Spearman's correlation was used to analyze the correlation between CA125 and miR-205. Receiver operating characteristic （ROC） curves and area under the curve （AUC） were plotted to analyze the predictive efficacy of miR-205 and CA125 for postoperative recurrence of ovarian EMT. The DeLong test was used to compare the differences in AUC between miR-205 and CA125 for predicting postoperative recurrence of ovarian EMT. Results There was no significant difference in the general data between the two groups （P > 0.05）. The CA125 levels in serum and ectopic endometrial tissue of the recurrent group were higher than those in the non-recurrent group, while the expression of miR-205 in serum and ectopic endometrial tissue was lower than that in the non-recurrent group （P < 0.05）. There was a negative correlation between miR-205 and CA125 in serum and endometrial tissue of patients with ovarian EMT recurrence after surgery （r = -0.728, -0.713, both P < 0.001）. The ROC curve showed that the AUC of miR-205 in serum and ectopic endometrial tissue for predicting ovarian EMT recurrence after surgery was 0.741 and 0.809, respectively. The DeLong test showed no significant difference in the AUC of miR-205 in serum and ectopic endometrial tissue compared with CA125 for predicting ovarian EMT recurrence after surgery （Z = 0.020, P = 0.951）. Conclusion The low expression of miR-205 in serum and ectopic endometrial tissue of patients with ovarian EMT recurrence after surgery is negatively correlated with CA125. Measuring miR-205 in serum and ectopic endometrial tissue can help improve the predictive efficacy and guide clinical treatment.
2024, 45(10): 111-115.
doi: 10.12259/j.issn.2095-610X.S20241017
Abstract:
Objective To compare the expression levels of KL-6 and IL-17 in CTD-ILD and CTD, to explore the diagnostic value of KL-6 and IL-17 in CTD-ILD, and to analyze the correlation between KL-6 and IL-17 and pulmonary diffusion function, provide a basis for the diagnosis and severity assessment of CTD-ILD. Methods Patients who visited Kunming First People's Hospital between September 1, 2022, and January 31, 2024, were selected. A total of 30 patients with connective tissue diseases combined with interstitial lung disease were collected for the experimental group, referred to as the CTD-ILD group. 39 patients with connective tissue diseases were collected for the control group, referred to as the CTD group. The ELISA double-sandwich antibody method was used to detect KL-6 and IL-17, and correlation analysis was performed on the collected data. Results （1） Serum KL-6 and IL-17 levels in the CTD-ILD group were higher than those in the CTD group, and the difference was statistically significant （P < 0.05）. （2） There is a negative correlation between KL-6 and DLCO%pred, while there is no correlation between IL-17 and DLCO%pred（P < 0.05）. （3） The receiver operating characteristic curve （ROC） analysis showed that the AUC for KL-6 and IL-17 in diagnosing CTD-ILD were 0.902 and 0.656, respectively. Conclusion KL-6 and IL-17 can serve as indicators for diagnosing CTD-ILD, with KL-6 having a higher diagnostic value than IL-17. KL-6 can be used to assess the severity of lung diffusion function, while IL-17 is not suitable for evaluating the severity of lung diffusion function.
2024, 45(10): 116-121.
doi: 10.12259/j.issn.2095-610X.S20241018
Abstract:
Objective To investigate the relationship between heparin binding protein （HBP） and platelet-to-lymphocyte ratio （PLR） and acute exacerbation of chronic obstructive pulmonary disease （AECOPD）, and evaluate their clinical value in the prediction and diagnosis of AECOPD. Methods Patients with chronic obstructive pulmonary disease （COPD） who visited the inpatient department and outpatient department of Respiratory and Critical Care Medicine of Ganmei Hospital Affiliated to Kunming Medical University from November 2022 to December 2023 were selected as the study objects. Symptoms such as cough, sputum and wheezing were aggravated. COPD patients requiring hospitalization or change of treatment regimen were classified as acute COPD plus recombination （AECOPD group）, and COPD patients with no exacerbation of respiratory symptoms were classified as COPD stabilization group （SCOPD group）. Lymphocyte count and platelet values measured on the day of admission were collected, PLR values were calculated, and HBP values were measured by immunofluorescence dry quantification. The levels of HBP and PLR between the two groups and whether there were differences between the two groups were compared. Binary logistic regression analysis was used to analyze whether HBP and PLR were independent risk factors for the occurrence of AECOPD, and whether HBP and PLR had application value in predicting the occurrence of AECOPD and assisting diagnosis according to ROC curve. Results There were no significant differences in gender, age, smoking status, hypertension, diabetes, coronary heart disease and other general data between the two groups. Serum levels of HBP and PLR in AECOPD group were significantly higher than those in SCOPD group, and both HBP and PLR were independent risk factors for AECOPD. When the truncation value of HBP was 30.09 ng/mL, the sensitivity and specificity were 97.9% and 98%, respectively. When PLR truncation value is 164.0835 , the sensitivity and specificity are 57.3% and 90%, respectively. The AUC value of HBP and PLR combined detection is higher than that of single index. Conclusions HBP and PLR can predict and assist the diagnosis of AECOPD, and the combined detection of HBP and PLR has a higher value in predicting and assisting the diagnosis of AECOPD.
2024, 45(10): 122-129.
doi: 10.12259/j.issn.2095-610X.S20241019
Abstract:
Objective To explore the association between body mass index （BMI） and cognitive impairment in the elderly in Guandu district of Yunnan province. Methods The data were collected from the community health check-ups for elderly individuals in Guandu District, Yunnan Province, from 2021 to 2023. It includes cross-sectional data from the Mini-Mental State Examination （MMSE） and physical examinations for those over 65 years （n = 17, 352）. Results Among 17, 352 participants, elderly individuals in this region had a low level of education, with a prevalence of cognitive impairment at 22.31%. Women had higher rates than men, and the higher the education level, the lower the prevalence. At baseline, the proportions of underweight, normal weight, overweight, and obese individuals were 2.5%, 41.9%, 40.7%, and 14.9% respectively. When controlling for factors like age, gender, education level, smoking, diabetes, hypertension, and stroke, those with a BMI of 25-27.9 kg/m2 had the lowest risk of cognitive impairment and the highest MMSE value. Compared to those with a normal BMI, their risk decreased by 11%. In contrast, participants with a BMI less than 18.5 kg/m2 or greater than or equal to 28 kg/m2 had a 50% and 60% increase in the risk of cognitive impairment, respectively. Elderly women with a BMI greater than 25 kg/m2 had a 12% higher incidence of cognitive dysfunction compared to similarly weighted men, and those with a BMI greater than or equal to 28 kg/m2 had a 42% higher rate compared to men of the same weight. Conclusion This study suggests that the prevalence of cognitive impairment among the elderly surveyed in Guandu District, Kunming, is not low. Those who are underweight or obese have a higher risk of cognitive impairment. Maintaining an appropriate weight, especially a BMI between 25 and 27, is a protective factor against cognitive impairment for the elderly in this region, particularly for women.
2024, 45(10): 130-134.
doi: 10.12259/j.issn.2095-610X.S20241020
Abstract:
Objective To understand the frailty of elderly patients with chronic pain and its related influencing factors. Methods A face-to-face survey using a simple random sampling method was conducted for elderly patients with chronic pain at a grade-A tertiary hospital in Yuxi City from January to June 2023. The NIPRO Painvision （PS-2100 ） and the Visual Analog Scale （VAS） were used for comprehensive pain assessment. The investigation of depression, anxiety, and frailty was conducted using the Beck Depression Inventory （BDI）, the Beck Anxiety Inventory （BAI）, and the FRAIL scale, respectively. Logistic regression analysis was performed to identify factors associated with frailty in elderly patients with chronic pain. Results Among the 272 elderly patients with chronic pain, the prevalence of frailty was 21.32% （95%CI 16.46%-26.19%）. The median age of the frail group was [69 （65-72） years], which was higher than that of the non-frail group [66 （62-69） years], and this difference was statistically significant （Z = 2.962, P = 0.003）. The results of the multivariate logistic regression model showed that older age was associated with a higher risk of frailty among elderly patients with chronic pain （OR = 1.08, 95%CI 1.02-1.14）. Those with severe pain （OR = 3.12, 95%CI: 1.42-6.88）, multiple pain locations （OR = 4.47, 95%CI 2.23-8.94）, and those experiencing depression （OR = 4.76, 95%CI 2.34-9.68） had a significantly higher risk of frailty compared to those with mild/moderate pain, single pain location, and no depression. Conclusion In Yuxi City, elderly patients with chronic pain have a high prevalence of frailty. Factors such as age, pain intensity, pain location, and depression are associated with the risk of frailty. It is recommended to conduct regular frailty screenings and timely interventions to improve the quality of life for older adults.
2024, 45(10): 135-139.
doi: 10.12259/j.issn.2095-610X.S20241021
Abstract:
Objective To analyze the data of the artificial intelligence cervical cancer screening project in Baoding in 2021, understand the effect and existing problems of cervical cancer screening in Baoding, and provide a basis for improving the prevention and treatment of cervical cancer in the rural women population. Methods Screening data for married rural women aged 35-64 from three counties in Baoding City in 2021 were collected, and the data of precancerous lesions and cervical cancer screening was analyzed. Results The results show that artificial intelligence-assisted cervical cancer screening identified 863 cases of positive cytology, with a positivity rate of 7.94%. Additionally, 542 women with positive cytology underwent colposcopy, which revealed 18 cases of low-grade lesions, 20 cases of high-grade lesions, and 1 case of cervical cancer. There were statistically significant differences in the detection rates of AUSCS+, low-grade lesions, and high-grade lesions across three counties in Baoding from 2019 to 2021 （χ2 = 858.90, P < 0.001; χ2 = 14.28, P=0.003; χ2 = 10.75, P = 0.013）. Conclusion The artificial intelligence cervical cancer screening project has shown some success, but there are still issues like a high rate of missed abnormal cases. The screening and prevention efforts for cervical cancer in Baoding City need further improvement.
2024, 45(10): 140-146.
doi: 10.12259/j.issn.2095-610X.S20241022
Abstract:
Objective To assess the risk of cardiovascular disease （CVD） in patients undergoing antiretroviral therapy （ART）, to understand the differences among patients with different risk levels in Kunming, and to analyze the risk factors affecting CVD. Methods From July to December 2023, a questionnaire was conducted with patients already on ART, and relevant data were collected. The D:A:D model was used to assess CVD risk, and patients were classified into low-risk, medium-risk, and high-risk groups. Chi-square tests and rank-sum tests were used to compare differences among groups, and logistic regression was performed to analyze factors influencing CVD. Results A total of 4, 139 patients were included, with 3, 119 （75.4%） in the low-risk group, 1, 020 （24.6%） in the medium- to high-risk groups [756 （18.3%） in the medium-risk group and 264 （6.3%） in the high-risk group]. Univariate logistic regression analysis showed that being male, aged ≥50 years, having a history of smoking, hypertension, a family history of CVD, homosexual transmission, being underweight, overweight, or obese, having a history of diabetes, high blood glucose, higher education （college and above）, dyslipidemia, ART duration ≥10 years, CD4 count ≥200 cells/μL, and use of ART drugs were all associated with a CVD risk ≥10% （all P < 0.05）. Multivariate logistic regression analysis showed that, among these variables, only same-sex transmission did not have a statistically significant difference （P > 0.05）. Conclusion Male gender, older age, comorbid non-AIDS-defining illnesses （such as diabetes and hypertension）, smoking history, family history of CVD, being overweight or obese, ART duration over 10 years, abnormal lipid metabolism, low CD4 cell count, and ART drug use are associated with higher CVD risk. Comprehensive HIV management should emphasize monitoring of lipid levels, blood pressure, and blood glucose to assess CVD risk, and timely intervention and treatment adjustments should be made.
2024, 45(10): 147-154.
doi: 10.12259/j.issn.2095-610X.S20241023
Abstract:
Inflammatory bowel disease （IBD） is a chronic, non-specific inflammatory condition of the intestines, and its mechanisms are still unclear, with effective treatments lacking. The advent of biologics has opened a new chapter in the treatment of IBD, with some patients achieving clinical remission or even mucosal healing. However, in clinical practice, there are still quite a few patients who either do not respond to initial treatment or experience secondary loss of response, making it difficult to fully control disease progression. Research shows that changes in the gut microbiota play a crucial role in the onset and progression of IBD, and they may serve as predictive factors for assessing the efficacy of biologics. Fecal microbiota transplantation （FMT）, as a new treatment method to restore the gut microecology of patients, has shown some effectiveness in improving IBD symptoms, inducing and maintaining mucosal healing, and even achieving histological remission. What does the future hold for the application of FMT in IBD patients in the era of biologics? This review will summarize relevant research results from both domestic and international sources to provide a theoretical basis for the potential and feasibility of using FMT in treating IBD during the biologics era.
Inflammatory bowel disease （IBD） is a chronic, non-specific inflammatory condition of the intestines, and its mechanisms are still unclear, with effective treatments lacking. The advent of biologics has opened a new chapter in the treatment of IBD, with some patients achieving clinical remission or even mucosal healing. However, in clinical practice, there are still quite a few patients who either do not respond to initial treatment or experience secondary loss of response, making it difficult to fully control disease progression. Research shows that changes in the gut microbiota play a crucial role in the onset and progression of IBD, and they may serve as predictive factors for assessing the efficacy of biologics. Fecal microbiota transplantation （FMT）, as a new treatment method to restore the gut microecology of patients, has shown some effectiveness in improving IBD symptoms, inducing and maintaining mucosal healing, and even achieving histological remission. What does the future hold for the application of FMT in IBD patients in the era of biologics? This review will summarize relevant research results from both domestic and international sources to provide a theoretical basis for the potential and feasibility of using FMT in treating IBD during the biologics era.
2024, 45(10): 155-159.
doi: 10.12259/j.issn.2095-610X.S20241024
Abstract:
Colonoscopy allows observing the condition of the intestinal mucosa and diagnose and treat abnormal lesions inside the colon early. And intestinal preparation can provide a clear intestinal view by clearing feces and other residual impurities in the intestine through laxatives before colonoscopy, further improving the accuracy of the examination and the comfort of the patient, reducing the risk of examination. In recent years, with the widespread application of colonoscopy in children, the important value of laxatives in pediatric intestinal preparation has also been further recognized. However, At present, there is a lack of specialized systematic review on the safety and effectiveness of different laxatives and their regimens for children. This article will provide an overview of the application and research status of different laxatives in intestinal preparation before colonoscopy in children, in order to provide a basis for clinical doctors to choose drugs for children's intestines.
Colonoscopy allows observing the condition of the intestinal mucosa and diagnose and treat abnormal lesions inside the colon early. And intestinal preparation can provide a clear intestinal view by clearing feces and other residual impurities in the intestine through laxatives before colonoscopy, further improving the accuracy of the examination and the comfort of the patient, reducing the risk of examination. In recent years, with the widespread application of colonoscopy in children, the important value of laxatives in pediatric intestinal preparation has also been further recognized. However, At present, there is a lack of specialized systematic review on the safety and effectiveness of different laxatives and their regimens for children. This article will provide an overview of the application and research status of different laxatives in intestinal preparation before colonoscopy in children, in order to provide a basis for clinical doctors to choose drugs for children's intestines.
2024, 45(10): 160-165.
doi: 10.12259/j.issn.2095-610X.S20241025
Abstract:
Objective To explore the effectiveness of the "four-in-one" teaching model in clinical practice teaching of emergency medicine. Methods A total of 200 students from the Class of 2022 in the Clinical Medicine program at Kunming Medical University were selected as research subjects. They were divided into two groups: the traditional teaching group and the new teaching model group, each with 100 students. The traditional group received conventional teaching methods, while the new model group experienced the "four-in-one" teaching model, which organically combines traditional lecturing with PBL methods, utilizing high-fidelity simulators as teaching tools and online platforms as carriers. After the course concluded, both groups were assessed on their theoretical knowledge and practical skills to objectively evaluate the teaching effectiveness. A questionnaire was distributed to gauge students' subjective evaluations and satisfaction regarding the practical teaching outcomes, as well as teachers' assessments of students' clinical competencies. Results The students in the new teaching model group scored significantly better in practical skills assessments compared to those in the traditional model group（P = 0.01）, but there was no statistically significant difference in theoretical assessment scores between the two groups （P = 0.67）. Survey results showed that the new model group students had significantly higher interest in learning, ability to integrate knowledge, and self-directed learning skills than the traditional model students （P < 0.01）. However, there was no significant difference in clinical thinking and communication skills scores between the two groups. Teacher evaluations indicated that the new model students had significantly better literature search skills than those in the traditional model （P < 0.01）, but the differences in responsiveness, analytical skills, and problem-solving abilities between the two groups were not statistically significant. Conclusions Compared to traditional teaching methods, the "four-in-one" teaching model has advantages in enhancing students' practical skills, learning interest, knowledge integration ability, self-directed learning capabilities, and literature retrieval skills. It improves the clinical practice teaching effectiveness for emergency medicine students and can provide insights for the reform and quality enhancement of emergency medicine practice teaching models.
2024, 45(10): 166-172.
doi: 10.12259/j.issn.2095-610X.S20241026
Abstract:
Objective To investigate the impact of continued care education on knowledge, attitude, and behavior after radiochemotherapy in patients with nasopharyngeal carcinoma （NPC） on their nutritional status, limited mouth opening, and quality of life. Methods A total of 160 NPC patients who underwent radiotherapy and chemotherapy at a tertiary hospital in Yunnan Province from June 2022 to June 2023 were randomly divided into a control group and an experimental group, with 80 patients in each group. The control group received standard discharge follow-up care, while the experimental group received follow-up care education based on the knowledge, attitude, and behaviors of nasopharyngeal carcinoma patients after treatment. The nutritional status, mouth opening limitations, and quality of life differences between the two groups were compared before and after the intervention. Results The results show that the experimental group had less restriction in mouth opening compared to the control group, and the difference is statistically significant （P < 0.05）. Hematological nutritional indicators such as hemoglobin （Hb）, albumin （ALB）, and prealbumin （PA） were all higher in the experimental group than in the control group, and this difference is also statistically significant （P < 0.05）. Furthermore, the quality of life （FACT-H&N） scores for physical health, social/family health, emotional well-being, and functional status, as well as additional concern scores, were all higher in the experimental group compared to the control group, with statistically significant differences （P < 0.05）. Conclusion Knowledge-attitude-behavior continuing nursing education can reduce the degree of limitation of mouth opening in NPC patients after radiotherapy and chemotherapy, improve their nutritional status and improve their quality of life.
2024, 45(10): 173-178.
doi: 10.12259/j.issn.2095-610X.S20241027
Abstract:
Objective To investigate the impact of diverse health education on patients' quality of life and anxiety after periodontally accelerated osteogenic orthodontics （PAOO） surgery, providing clinical evidence for exploring better health education models. Methods Patients who visited the Orthodontics Department of Kunming Medical University's Affiliated Stomatology Hospital and required PAOO surgery from April 2022 to December 2023 were selected for this study. They were randomly assigned into a control group and an experimental group, each consisting of 42 patients. The control group received standard health education, which included preoperative verbal guidance, intraoperative communication, and postoperative instructions. In contrast, the experimental group, in addition to the regular health education, had a diversified health education group established, providing one-on-one guidance during the perisurgical period. Anxiety （SAS, MDAS）, pain （VAS）, postoperative clinical manifestations （such as bleeding, nausea, sleep issues, etc.）, self-management efficacy for oral health （SESS）, and dental plaque index （PLI） were assessed and compared between the two groups before and after surgery. Before and after the PAOO surgery, comparisons were also made regarding anxiety, fear, pain, quality of life, and self-management abilities for oral health between the two groups. Results The patients in the observation group had significantly lower SAS scores three days post-surgery compared to the control group, with MDAS scores also showing a significant decrease （P < 0.001）. Seven days post-surgery, the VAS scores indicated a significant reduction in the observation group compared to the control group （P < 0.001）. The level of post-operative bleeding and nausea in the observation group was significantly lower than in the control group （P < 0.001）. Additionally, the self-efficacy regarding oral health in the observation group significantly improved one month after surgery （P < 0.001）, with a notable reduction in the plaque index （P < 0.05）. In terms of quality of life, the overall quality of life scores for the observation group were significantly higher than those for the control group one month after surgery （P < 0.001）. Conclusion In the perioperative care of PAOO, incorporating diverse health education measures can effectively reduce patient discomfort, alleviate anxiety, and improve patients' quality of life during the perioperative period as well as their ability to manage oral health independently.
2024, 45(10): 179-188.
doi: 10.12259/j.issn.2095-610X.S20241028
Abstract:
Objective To explore the relationship between emotional labor, work engagement, and burnout among ward nurses, and the mediating role of resilience. Methods From October to November 2022, a stratified random sampling method was used to select 240 ward nurses from a Grade A tertiary hospital in Shenzhen. Questionnaires were conducted using a general information survey, emotional labor scale, resilience scale, work engagement resilience scale, and burnout scale as research tools. Pearson correlation analysis and multiple stratified regression analysis were employed to understand the relationships between emotional labor, resilience, work engagement, and occupational burnout among ward nurses. Amos 27.0 was used to construct a structural equation model to analyze the mediating role of resilience between emotional labor and work engagement, as well as burnout. Results Monthly average income has a significant impact on deep acting （F = 4.993, P < 0.01）. There is a negative correlation between surface acting among ward nurses and work engagement （r = −0.140, P < 0.05）. Surface acting is positively correlated with burnout （r = 0.275, P < 0.001）. Deep acting and resilience are positively correlated （r = 0.327, P < 0.001）, as well as Nature acting and resilience （r = 0.34, P < 0.001）. Resilience is positively correlated with work engagement （r = 0.64, P < 0.001） and negatively correlated with job burnout （r = −0.557, P < 0.001）. Resilience has a partial mediating effect between ward nurse’nature acting and burnout （β = −0.136, P < 0.001）, with the mediating effect accounting for 58.62% of the total effect. Conclusion There is a partial mediating effect of resilience between the natural behavior of ward nurses and their job burnout. Nursing managers can enhance the resilience of ward nurses through training in emotional labor and resilience, which can boost their work engagement and reduce burnout.
