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Objective To explore and analyze the effect of medical alliance health management model under the perspective of health ecology on mental health of patients with chronic heart failure. Methods Two communities under the jurisdiction of community health service centers in a grade A hospital in Nanjing were selected as the research communities and patients form two communities were randomly divided into the experimental group (n=115) and control group (n=103). The experimental group received medical alliance health management model under the perspective of health ecology; the control group was given routine health management education on chronic heart failure prevention and treatment. The intervention period was 12 months, and changes in patients’ levels of anxiety, depression and social support before and after the intervention were compared. Results At 12 months after intervention, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) scores were decreased in both experimental group and control group, and GAD-7 and PHQ-9 scores were lower in the experimental group than those in the control group(ITT vs. PP: -1. 07 vs. -1. 07; -0. 45 vs. -0. 49, P＜0. 05). The Social Support Rating Scale(SSRS) score was increased in both experimental group and control group, and SSRS score was higher in the experimental group than that in the control group(ITT vs. PP: 9. 30 vs. 9. 17, P＜0. 05). The generalized linear mixed model showed that the interaction effect of anxiety and social support scores were significant in time and group (P＜0. 05). Conclusion The medical alliance health management model helps to improve the mental health needs and social support of patients with chronic heart failure. (目的 探讨和分析健康生态学视域下的医联体健康管理对慢性心力衰竭患者心理健康需求的影响。方法 选取江苏省南京市某三级甲等医院技术辐射的两个社区卫生服务中心管辖社区作为研究社区, 随机分为试验组(n=115)和对照组(n=103)。试验组采用健康生态学视域下医联体介导的健康管理; 对照组采用慢性心力衰竭健康管理教育。干预周期为12个月, 比较干预前后患者心理健康需求中焦虑抑郁和社会支持水平的变化。结果 干预12个月后, 两组患者广泛性焦虑量表(GAD-7)评分和患者健康问卷抑郁量表(PHQ-9)评分均有所降低, 且试验组与对照组得分差异有统计学意义(ITT vs. PP: -1. 07 vs. -1. 07; -0. 45 vs. -0. 49, P＜0. 05); 社会支持评定量表(SSRS)得分有所提高, 试验组与对照组得分差异有统计学意义((ITT vs. PP: 9. 30 vs. 9. 17, P＜0. 05)。广义线性混合模型结果显示, 两组焦虑抑郁、社会支持得分差异在时间和分组的交互效应均有统计学意义(P＜0. 05)。结论 健康生态学视域下的医联体健康管理有助于改善慢性心力衰竭患者心理健康, 提高社会支持水平。)

Aim: To evaluate the effects of computerized cognitive training on the cognitive functions of stroke patients. Background: With increased publications on computerized cognitive training, a meta‐analysis is essential to determine the effects of computerized cognitive training among stroke patients. Design A systematic review and meta‐analysis of randomized controlled studies. Data Sources: Cochrane Library, Pubmed, EBSCO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc and Wanfang Database were explored to search for research studies from inception to January 2020. Review Methods: Six outcomes indicators were considered to determine the effects of computerized cognitive training. Two reviewers were selected to search and independently appraise the available articles from various databases. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 622 patients with 17 studies were included. Computerized cognitive training significantly improves global cognition, working memory, attention and executive function of stroke patients. However, there was inadequate evidence to demonstrate any effects of computerized cognitive training on activities of daily living and depression. Conclusion: Computerized cognitive training improves the cognitive functions of stroke patients. However, further research studies are needed to confirm its efficacy in activities of daily living as well as on alleviating depression. Summary statement: What is already known about this topic? Stroke commonly results in health impairments, particularly on cognitive functions, activities of daily living and depression, which may have a negative impact on a patient's quality of life.Previous studies indicated that computerized cognitive training is a safe and efficacious intervention for improving the cognition of older patients with dementia.Little is known about the efficacy of computerized cognitive training on improving cognitive functions, activities of daily living and depression among stroke patients. What this paper adds? Computerized cognitive training significantly improves global cognition, working memory, attention and executive function among stroke patients compared with control groups.No statistically significant effects were found on activities of daily living and depression.Subgroup analysis indicated that 4 and 12 weeks of medium‐high intensity computerized cognitive training showed significant improvement on global cognition for stroke patients. The implications of this paper: Healthcare providers should recognize the efficacy of computerized cognitive training on the cognitive rehabilitation of stroke patients.Cognitive outcome measurements vary between studies and further appraisal of reliability and validity is essential to avoid reporting bias and to validate research trials with uniform neuropsychological measurements.Further clinical trials are required with large samples and long‐term follow‐up of interventions and reporting adverse events. [ABSTRACT FROM AUTHOR]

Central venous catheters are widely used in clinical practice, and the incidence of central venous catheter occlusion is between 25 % and 38 %. The turbulence caused by the pulsatile flushing technique is harmful to the vascular endothelium and may lead to phlebitis. The low-speed continuous infusion catheter technique is a new type of continuous infusion that ensures that the catheter is always in a keep-vein-open state by continuous low-speed flushing; hence, avoiding the problem of catheter occlusion. To investigate the effectiveness of the low-speed continuous infusion catheter technique and the routine care of double-lumen central venous catheters. This was a prospective, randomized, controlled, open-label trial. Patients were recruited from 14 medical institutions in China between February and June 2023. In total, 251 patients were recruited, with 125 in the intervention group and 126 in the control group. Patients who used double-lumen central venous catheters for infusion treatment were selected, and those who met the sampling criteria were randomly divided into intervention and control groups using the random envelope method. The intervention group used the low-speed continuous infusion catheter technique to maintain catheter patency, whereas the control group used routine care with a trial period of 7 days. The primary outcome was the occlusion rate. The secondary outcomes included nursing satisfaction and complication rates of the two groups. After 7 days, the rate of catheter occlusion was 28.0 % (35/125, 95 % confidence interval (CI):0.203, 0.367) in the intervention group and 53.97 % (68/126, 95 % CI: 0.449–0.629) in the control group, with a statistically significant difference (χ2 = 17.488, p < 0.001); at 3 days of intervention, the rate of catheter blockage was 8.0 % (10/125, 95 % CI: 0.039–0.142) in the intervention group and 23.8 % (30/126, 0.167–0.322) in the control group, with a statistically significant difference (χ2 = 11.707, p < 0.001). Nurse satisfaction was significantly higher in the intervention group (115/125, 92.0 %, 95 % CI: 0.858–0.961) than in the control group (104/126, 82.54 %, 95 % CI: 0.748–0.887) (χ2 = 5.049, p = 0.025). There were no statistically significant complication rates in either group (p = 0.622). The low-speed continuous infusion catheter technique helps maintain catheter patency, improves nurse satisfaction, and provides a high level of safety. Chinese Clinical Trial Registry (ChiCTR2200064007, www.chictr.org.cn). The first recruitment was conducted in February. https://www.chictr.org.cn/showproj.html?proj=177311. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the multidrug resistance (MDR) reversal activity by magnetic nanoparticles of Fe3O4 (MNPs-Fe3O4) and 5-bromotetrandrine (BrTet) MDR cell line K562/A02 solitarily or symphysially. The proliferation of K562 and K562/A02 cells and the cytotoxicity on peripheral blood mononuclear cells (PMBCs) were evaluated by MTT assay. Cellular accumulation of daunorubicin (DNR) was analyzed by flow cytometry. Real-time polymerase chain reaction and Western blotting analyses were performed to examine the mRNA and protein levels of mdr1, respectively. The results showed that the combination of MNPs-Fe3O4 and BrTet with effective concentrations significantly increased cytotoxicity against MDR cell line K562/A02. Both BrTet and MNPs-Fe3O4 increased the intracellular DNR accumulation in the K562/A02 cell line, and downregulated the level of mdr1 gene and expression of P-glycoprotein. Furthermore, the combination did not have significant cytotoxicity in PMBCs. We propose that MNPs-Fe3O4 conjugated with DNR and BrTet probably have synergetic effects on MDR reversal.