Tag: nevin manimala

Altern Ther Health Med. 2024 Jul 19:AT10104. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the risk factors contributing to the development of premature coronary artery disease (PCAD) in patients with ankylosing spondylitis (AS) and assess the clinical implications of this association.

METHODS: The study used a retrospective analysis design to investigate the risk factors and clinical significance of ankylosing spondylitis (AS) combined with early-onset coronary heart disease (AS-PCAD). A total of 80 patients diagnosed with AS and coronary heart disease who were admitted to the hospital between February 2019 and February 2022 were included in the analysis. The patients were divided into two groups based on the age of onset of coronary heart disease – the PCAD group (n=42, mean age 41.48±2.69 years) and the non-early-onset coronary heart disease (NPCAD) group (n=38, mean age 69.13±4.50 years). Relevant clinical data, including demographics, medical history, laboratory results, and imaging findings, were extracted from electronic health records. Binary logistic regression analysis was employed to identify risk factors influencing the incidence of AS-PCAD. The study aimed to uncover the distinctive clinical features and risk factors associated with AS patients who experience early-onset coronary heart disease, in order to guide diagnosis and treatment strategies for this patient population.

RESULTS: The results of the study revealed several notable findings. Significant differences were observed between the PCAD and NPCAD groups in terms of age and age at AS onset (P < .05). Specifically, patients in the PCAD group had a younger mean age at AS onset compared to the NPCAD group (41.48±2.69 years vs 69.13±4.50 years, respectively). Additionally, the two groups exhibited statistically significant differences in several laboratory parameters. Levels of C-reactive protein (CRP) were found to be markedly higher in the PCAD group compared to the NPCAD group (P < .05). Hemoglobin levels and the prevalence of anemia also showed significant variations between the two cohorts (both P < .05). Importantly, the binary logistic regression analysis identified two key risk factors that independently influenced the incidence of PCAD in AS patients: younger age at AS onset and elevated levels of C-reactive protein.

CONCLUSIONS: The key findings of this study underscore the heightened risk of premature coronary artery disease in patients with ankylosing spondylitis, particularly those with a younger age of AS onset and elevated levels of systemic inflammation as marked by C-reactive protein. These results have important clinical implications. Identifying AS patients at increased risk for PCAD, based on factors such as younger disease onset and higher inflammatory burden, enables targeted screening and early intervention strategies. Comprehensive cardiovascular risk assessment and management should be an integral part of the care approach for this patient population. Early recognition of PCAD risk, followed by aggressive management of modifiable risk factors and implementation of appropriate therapeutic measures, can help mitigate the burden of premature cardiovascular complications in individuals with ankylosing spondylitis.

PMID:39038351

Altern Ther Health Med. 2024 Jul 19:AT11070. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effectiveness of abdominal ultrasound and magnetic resonance imaging (MRI) in diagnosing congenital choledochal cysts (CCC) in children.

METHODS: This retrospective analysis included 186 pediatric cases diagnosed with CCC through abdominal ultrasound and MRI examinations at our hospital between July 15, 2015, and November 29, 2023. Inclusion and exclusion criteria were applied to ensure the study’s objectivity. Chi-square and t-tests were used to compare the diagnostic performance of ultrasound and MRI.

RESULTS: MRI demonstrated a superior detection rate of bile duct dilation compared to ultrasound (P < .001). Compared to ultrasound, a lesser number of nonspecific cysts was reported by MRI, indicating its higher specificity (P = .008). Although the rate of misdiagnosis was slightly higher in ultrasound, the difference was not statistically significant (P = .123). Regarding consistency with postoperative pathological diagnosis results, MRI exhibited higher accuracy, with sensitivity and specificity both exceeding 75%.

CONCLUSION: MRI exhibits higher sensitivity, specificity, and accuracy in diagnosing pediatric CCC. Despite the strong correlation in diagnostic consistency between MRI and ultrasound, MRI remains the superior diagnostic tool and should be prioritized for diagnosis and preoperative planning.

PMID:39038350

Altern Ther Health Med. 2024 Jul 19:AT11000. Online ahead of print.

ABSTRACT

BACKGROUND: Non-small cell lung cancer (NSCLC) represents a significant portion of lung cancer cases, with a poor prognosis and limited treatment options for advanced stages. Enhancing the effectiveness of chemotherapy through adjunctive therapies is a critical area of research.

OBJECTIVE: To evaluate the effect of Shenmai injection combined with chemotherapy on T-cell subsets and cytokine expression in patients with advanced NSCLC.

METHODS: A comparative prospective study was conducted, and a total of 96 patients with advanced NSCLC were selected. Patients were divided into two groups based on different chemotherapy regimens: an observation group (48 patients) receiving Shenmai injection combined with chemotherapy and a control group (48 patients) receiving chemotherapy alone. The study measures and compares the levels of T-cell subsets (CD3+, CD4+, CD4+/CD8+) and cytokines (IL-2, IL-4, IL-5, IL-6, TNF-α, IFN-γ, VEGF, bFGF, CA125, and CEA) before and after treatment in both groups. Statistical analysis was performed on the collected data.

RESULTS: Significant changes were observed in the levels of T-cell subsets and cytokines before and after chemotherapy in both groups (P < .05). Compared with the control group, the observation group exhibited significant improvement in T-cell subsets CD3+, CD4+, and CD4+/CD8+ (P < .05). Furthermore, the levels of cytokines IL-2, IL-4, IL-5, IL-6, TNF-α, IFN-γ, VEGF, bFGF, CA125, and CEA were significantly lower in the observation group compared to the control group (all P < .05).

CONCLUSIONS: Shenmai injection combined with chemotherapy enhances the cellular immune function in patients with advanced NSCLC. This combination therapy not only reverses tumor progression but also improves the overall therapeutic effect, suggesting a promising adjunctive treatment strategy for advanced NSCLC.

PMID:39038349

Altern Ther Health Med. 2024 Jul 19:AT10385. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the association of serum MMP-2, Siglec-1, and Th1/Th2 cell ratio with disease activity in rheumatoid arthritis (RA).

METHODS: Between August and November 2020, Peking University People’s Hospital recruited 40 patients with RA and 40 healthy individuals. Various methods such as ELISA, flow cytometry, and RT-PCR were used to assess the levels of sCR1, MMP-2, MMP-9, and Siglec-1 in the participants. Correlation analysis was conducted between Siglec-1 expression and DAS28 and hs-CRP. T lymphocyte subsets; cytokines IFN-γ and IL-4, were assessed using flow cytometry and ELISA in both patient groups.

RESULTS: Rheumatoid arthritis was linked to lower levels of serum sCR1 and higher levels of MMP-2 and MMP-9 compared to healthy individuals (P < .05). The percentage of Siglec-1-positive cells in PBMCs was significantly higher in patients with RA than in the healthy group (P < .05), with monocytes being the predominant cells expressing Siglec-1. Patients with RA exhibited a significantly higher expression of Siglec-1 mRNA compared to those in a healthy condition (P < .05), and the expression of Siglec-1 in these patients was positively correlated with DAS28 and hs-CRP (P < .05). Study patients demonstrated a notably lower level of peripheral blood CD8+ cells and a higher CD4+/CD8+ ratio when compared to healthy individuals (P < .05). There was no statistically significant difference in CD3+CD4+ levels between the 2 groups (P > .05). Rheumatoid arthritis was associated with a higher level of peripheral blood IFN-γ and a lower IL-4 level than healthy individuals (P < .05).

CONCLUSION: There was a strong link between sCRl, MMP-2, and MMP-9 and the progression of rheumatoid arthritis. These markers can effectively monitor disease activity in patients with rheumatoid arthritis. Siglec-1 is highly expressed in peripheral blood and can be used to track disease activity and inflammation in these patients. Regulating Th1/Th2-mediated homeostasis may help alleviate symptoms in individuals with rheumatoid arthritis.

PMID:39038345

Altern Ther Health Med. 2024 Jul 19:AT10714. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to assess the impact of death education on college students’ sense of meaning in life and ability to cope with death.

METHOD: A questionnaire survey was conducted among a randomly selected sample of 320 undergraduate students from a specific city. The survey, administered through the paper questionnaire, collected data on students’ demographic characteristics, their awareness of death, and their demand for death education. Linear regression analysis was performed to identify factors influencing the demand for death education and assess its impact on college students’ attitudes towards death, sense of meaning in life, and coping abilities.

RESULTS: The results revealed that participants’ personality traits and family status significantly influenced their need for death education (P < .05). The overall score for death education needs among participants was (37.40±6.57). Notably, the statement “I think death education can help me understand death” received the highest mean rating (3.85), while the statement “I think death education will help me engage in nursing work in the future” received the lowest mean rating (3.55). Personal factors such as personality, family status, being an only child, and family experiences with serious illness were found to impact college students’ demand for death education (P < .05). Post-death education, significant differences were observed in scores related to death fear and escape acceptance dimensions (P < .05). Moreover, there were statistically significant improvements in students’ sense of meaning in life, quality of life, and life goals following death education (P < .05). Additionally, all dimensions of death coping ability showed higher scores after death education (P < .05). Factors such as current psychological state, being an only child, family experiences with serious illness, and attendance at funerals were found to be statistically significant in relation to college students’ sense of meaning in life (P < .05). Multiple regression analysis indicated that the sense of meaning in life was influenced by the current psychological state and family experiences with serious illness (P < .05).

CONCLUSION: The study highlights the importance of integrating death education into college curriculums to address students’ fear of death and enhance their appreciation of life. Providing death education can help students develop a healthier perspective on death, improve their well-being, reduce avoidance attitudes towards death-related events, and strengthen their sense of meaning in life and ability to cope with death. These findings emphasize the need for educational institutions to implement comprehensive death education programs, considering individual factors such as personality and family background, and contribute to the development of effective educational policies and curricula.

PMID:39038343

Altern Ther Health Med. 2024 Jul 19:AT10474. Online ahead of print.

ABSTRACT

OBJECTIVE: To appraise the application value of psychological counseling based on the concept of solution-focused brief therapy (SFBT) concept in patients with premature ovarian failure.

METHODS: A total of 176 patients with premature ovarian failure admitted to China-Japan Union Hospital hospital between January 2020 and February 2021 were enrolled for prospective analysis and were randomly assigned to the control group and the experimental group using the random number table method, with 88 cases in each group. The control group received the normal psychological counseling intervention, whereas the experimental group received the SFBT-based counseling intervention. The serum indexes follicle-stimulating hormone (FSH), luteinizing hormone (LH), Estradiol (E2), Fertility Quality of Life (FertiQoL) score, Symptom Checklist 90 (SCL-90) score, Memorial University of Newfoundland Scale of Happiness (MUNSH) score, self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, and the satisfaction rate were recorded and compared between the two groups of patients.

RESULTS: After the intervention, patients in the experimental group achieved lower FSH and LH levels and higher E2 levels than the control group (P < .05). After the intervention, the scores of emotional response, mind-body relationship, and tolerability and overall scores increased in both groups, with the experimental group scoring significantly higher than the control group (P < .05). After the intervention, the differences in hostility and compulsion scores between the two groups were not statistically significant (P > .05). Compared with the control group, patients in the experimental group scored lower on somatization, interpersonal relationship, and psychosis and overall score, while positive factor scores were higher (P < .05). Before the intervention, SDS and SAS scores were comparable in both groups. In contrast, SDS and SAS scores decreased in both groups and in the experimental group compared to the control group after the intervention. (P < .05).

CONCLUSION: Psychological counseling based on the SFBT concept in patients with premature ovarian failure could improve the patients’ serum indexes, quality of life, and sense of well-being, which is worthy of clinical promotion. It is recommended that most researchers conduct studies with larger samples in our hospital to provide better evidence-based evidence.

PMID:39038342

Altern Ther Health Med. 2024 Jul 19:AT10771. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the diagnostic value of combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing in ovarian tumors.

METHODS: Sixty-four patients suspected of having ovarian tumors, admitted to our hospital from July 2021 to July 2023, were selected for the study. All patients underwent ultrasound-guided percutaneous biopsy and serum tumor markers CA125 and CEA level testing. Surgical pathology results were used as the gold standard for comparison. The diagnostic performance of ultrasound-guided percutaneous biopsy alone, serum CA125, serum CEA, and their combination were evaluated. Receiver operating characteristic (ROC) curve analysis was performed, and the sensitivity, specificity, and accuracy were calculated. The differences in diagnostic performance were compared using the chi-square test, with a P < .05 considered statistically significant.

RESULTS: The results of this study demonstrate that combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing significantly improved the diagnostic accuracy for ovarian tumors compared to individual testing modalities. Surgical pathology, the gold standard, confirmed 52 malignant and 12 benign tumors among the 64 patients examined. When evaluated individually, the concordance rate between ultrasound-guided biopsy and surgical pathology was 90.63%, while serum CA125 and CEA had diagnostic accuracies of 73.44% and 64.06%, respectively. However, when the two serum markers were used in combination, the diagnostic accuracy increased to 81.25%. Notably, the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing produced the highest diagnostic accuracy at 95.31%. Statistical analysis confirmed this combined approach had significantly better accuracy, sensitivity, and specificity compared to individual tests (P < .05). ROC curve analysis further substantiated the superior diagnostic value of this integrated testing strategy.

CONCLUSION: The findings of this study demonstrate that the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing markedly enhances diagnostic accuracy for ovarian tumors, with a combined accuracy exceeding 95%. This integrated diagnostic protocol represents a robust and clinically valuable approach that should be more widely adopted to improve early detection and optimize the management of ovarian neoplasms. The implementation of this combined testing strategy has the potential to significantly impact clinical decision-making and patient outcomes in the diagnosis and treatment of ovarian tumors.

PMID:39038341

Altern Ther Health Med. 2024 Jul 19:AT10332. Online ahead of print.

ABSTRACT

OBJECTIVE: Our aim was to study the clinical effect of a foot correction exerciser used for postoperative rehabilitation in external fixation in high-energy Pilon fracture.

METHODS: From March 2017 to November 2019, 43 patients with AO/OTA type C closed Pilon fractures treated with external fixation were retrospectively analyzed. A total of 23 patients were rehabilitated by foot correction exerciser (1 patient fell off the study), and 20 patients were treated by conventional rehabilitation (2 patients fell off the study). During postoperative hospitalization and regular follow-up after discharge, various indicators were recorded for statistical comparison and evaluation through angle measurement, imaging and questionnaire surveys.

RESULTS: There was no significant difference in postoperative complications in the 2 groups (P > .05). The fracture healing time and stent wearing time in the study group were shorter than in the control group, and the comfort score and functional exercise compliance were higher in the study group than in the control group. The ankle joint mobility was higher in the study group than in the control group at all time points in the first 6 months, and the excellent and good rate of ankle joint function was higher than in the control group, with statistical significance (P < .05).

CONCLUSION: Use of the orthopedic exerciser in the high-energy Pilon fracture external fixation postoperative rehabilitation process and the early introduction of resistance training can reduce pain and soft tissue edema and improve the degree of patient comfort and exercise compliance, accurately measure the force load of the limbs, contribute to the dataization and standardization of rehabilitation exercise programs, accelerate the recovery of joint mobility and improve long-term limb function.

PMID:39038340

Altern Ther Health Med. 2024 Jul 19:AT9793. Online ahead of print.

ABSTRACT

BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) is a surgical procedure that replaces only the damaged medial compartment of the knee joint, preserving the healthy lateral compartment. Previous studies have investigated the impact of body mass index (BMI) on the efficacy of UKA for knee osteoarthritis, but the effect of the ratio of waist circumference to thigh circumference in obese patients has not been reported. This study aimed to explore the impact of the waist-to-thigh ratio on the efficacy of medial UKA in obese patients with knee osteoarthritis.

METHODS: A retrospective analysis was conducted on the clinical data of 99 patients with knee osteoarthritis who underwent medial UKA at our hospital from February 2021 to March 2023. Patients were grouped based on their waist-to-thigh ratio, with a ratio ≤1.7 classified as the normal group and >1.7 as the obese group. Continuous variables such as age, height, weight, surgical indicators, and pain scores were compared between the two groups using the independent samples t test or Mann-Whitney U test, depending on the normality of data distribution. Categorical variables like gender, comorbidities, and patient satisfaction were analyzed using the chi-square test or Fisher’s exact test. Repeated measures ANOVA was used to compare changes in outcome measures over time between the two groups. P < .05 was considered statistically significant. Surgical indicators, hematological indicators, pain status, postoperative recovery, daily living abilities, risk of pressure ulcers and falls, nutritional status, and patient satisfaction were compared between the two groups using the appropriate statistical tests.

RESULTS: This study included 51 patients in the normal group and 48 in the obese group, with no significant differences in baseline characteristics except for gender, BMI, thigh circumference, waist circumference, and waist-to-thigh ratio. The normal group had significantly shorter hospitalization time (5.2 ± 1.3 vs 7.1 ± 2.1 days, P < .001) and surgical time (65.3 ± 11.4 vs 78.6 ± 14.2 minutes, P < .001) compared to the obese group. There were no differences in intraoperative blood loss or time to achieve 90° flexion-extension. Postoperatively, the normal group had lower Visual Analog Scale (VAS) pain scores at all timepoints up to 2 months (P < .05). They also ambulated sooner (2.1 ± 0.6 vs 3.5 ± 1.1 days, P < .001) and discontinued crutches earlier (22.4 ± 4.2 vs 29.1 ± 5.3 days, P < .001) compared to the obese group. Within 1 year, a higher proportion of normal group patients could squat (84.3% vs 62.5%, P = .012). The normal group also had a lower incidence of patellofemoral pain (5.9% vs 18.8%, P = .045).

CONCLUSION: Patients with a high waist-to-thigh ratio (>1.7) experienced poorer outcomes after medial UKA, including higher postoperative pain, slower recovery, and greater incidence of patellofemoral pain compared to those with a normal ratio. These findings suggest that medial UKA may not be the optimal treatment for obese patients with a disproportionately large waist circumference relative to thigh size. Preoperative weight loss or alternative surgical approaches may be considered for these high-risk patients to improve their outcomes. Further research is needed to develop targeted interventions for this patient population.

PMID:39038335

Altern Ther Health Med. 2024 Jul 19:AT9304. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the risk factors and dietary status of middle-aged and elderly people at high risk of stroke in urban and rural areas of Xiangtan City, with a view to providing a basis for formulating stroke prevention and control strategies in urban and rural areas of Xiangtan City.

METHODS: Using the cluster sampling method, a total of 8,453 permanent residents aged ≥40 years old were selected from Yuetang Street, Yuetang District, and Jiangshe Town, Yuhu District, Xiangtan City in 2020 and 2021 for face-to-face questionnaire surveys to collect their demographic information, daily life Method, family history, height, weight, waist circumference, blood pressure, blood sugar, blood lipids, glycosylated hemoglobin, homocysteine and other indicators, and analyze them.

RESULTS: A total of 8453 permanent residents were screened in this study, and a total of 1804 stroke high-risk patients (including stroke and TIA, 21.34%) were screened out, including 973 urban residents (23.53%), and 831 rural residents (19.25%), and the distinction had statistical significance (P < .05); 263 stroke sufferers were screened out, and the prevalence ratio was 3.11%. The exposure rates of risk factors for high-risk groups in urban and rural areas of Xiangtan City from high to low are hypertension, dyslipidemia, smoking, family history of stroke, diabetes, obesity, lack of exercise and atrial fibrillation or heart valve disease. The high-risk groups for urban strokes The proportions of lack of exercise (23.54%) and obesity (38.44%) were significantly higher than the proportions of lack of exercise (17.09%) and obesity (22.64%) in rural areas. The high-risk groups in rural areas had hypertension (87.73%) and a history of TIA (2.89%). The proportion of patients with hypertension (82.43%) and TIA history (1.34%) was significantly higher than those in urban areas, and the differences were statistically significant (P < .05). The proportion of rural residents who eat a salty diet (17.93%) and eat fruits ≤2 days/week (93.98%) is significantly higher than that of urban residents who eat a salty diet (14.49%) and eat fruits ≤2 days/week (59.61%). There are differences. Statistically significant (P < .05), the proportion of urban residents who consume vegetables ≤2 days/week (11.91%) is significantly lower than the proportion of urban residents who consume vegetables ≤2 days/week (28.98%) (P < .01).

CONCLUSION: The high-risk factors for stroke in Xiangtan City are mainly hypertension, dyslipidemia, smoking history, family history of stroke, and diabetes. Tailored public health measures should be taken by residents to address the different risk status and dietary habits of urban and rural populations. Especially dietary intervention for rural residents.

PMID:39038328