Technology and Health Care - Volume 32, issue 3

Authors: Chen, Jiaqi | Zhang, Xiaohong | Wu, Wenjing | Yuan, Youyuan | Xue, Wupemg | Cao, Wendong | Du, Rongxin

Article Type: Research Article

Abstract: BACKGROUND: Endoluminal interventions have become one of the main options for the treatment of arteriosclerosis obliterans (ASO). OBJECTIVE: To explore the effect of hydration therapy and nursing intervention on the prevention of contrast-induced nephropathy (CIN) after interventional treatment of lower extremity ASO. METHODS: A convenience sampling method was used to select 94 patients who received ASO treatment in our hospital from March 2019 to May 2021 as the study subjects. All patients underwent endovascular interventional therapy and were randomly divided into two groups by the random number table method, with odd numbers entering …the observation group (n = 47) and even numbers entering the control group (n = 47). The control group received routine nursing intervention, while the observation group underwent hydration therapy and had a corresponding nursing intervention scheme. The clinical efficacy of the two groups and the incidence of contrast-induced nephropathy after interventional therapy were compared, and an evaluation of satisfaction within the two groups was performed via a questionnaire. RESULTS: The total effective rate of patients in the observation group was higher after hydration treatment (97.87% vs 87.23%, p < 0.05). The blood urea nitrogen, creatinine, and β 2 microglobulin levels in the observation group were significantly lower than those in the control group after the intervention (p < 0.05). Patients in the observation group had higher nursing satisfaction after using preventive measures of hydration therapy combined with nursing interventions (100% vs 89.36%, p < 0.05). CONCLUSION: Hydration therapy and nursing intervention can effectively prevent CIN after interventional treatment of lower extremity ASO. After interventional therapy, patients had better clinical outcomes, lower biochemical indexes and improved satisfaction evaluations. The therapy is worthy of clinical promotion and application. Show more

Keywords: Lower extremity arteriosclerosis obliterans, interventional therapy, contrast nephropathy, nursing, hydration therapy

DOI: 10.3233/THC-230256

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1361-1369, 2024

Authors: Liu, Xiuping | Li, Ping | Yang, Yuemin | Tian, Cheng

Article Type: Research Article

Abstract: BACKGROUND: Currently, there are a variety of methods for ultrasound to localize the conus medullaris. A concern is that measured values can be influenced by variations in spinal flexion and extension. OBJECTIVE: To overcome this limitation, the present study measures the horizontal distance (HD) between the end of the conus medullaris and the caudal edge of last vertebral body ossification in normal fetus at different gestational weeks, and analyzes the relationship between the measured value and fetal growth, as well as the utility of these measurements in assessing the position of the conus medullaris. …METHODS: A total of 655 fetuses at gestational weeks 18–40, who underwent routine prenatal ultrasound, were selected in the study. We measured the distance between the end of the cone of the fetal spinal cord and the caudal end of the final vertebral ossification center (Distance1, D1), the distance between the end of the spinal cord cone and the intersection of the extension of D1 with the caudal skin (Distance2, D2), and HD. We analyzed the correlation between the measurements and gestational weeks, established normal reference values, the ratio of D1, D2 and HD to the commonly used growth parameters was calculated. The ratios of D1, D2, HD and the application value of each ratio phase were analyzed, and the reliability analysis of repeated measurement results among physicians was performed. RESULTS: D1, D2 and HD exhibited strong linear correlations with gestational weeks. Among the ratios of D1, D2 and HD to common growth parameters, D2/FL stabilized after 20 weeks of gestation and consistently exceeded 1. Repeatability tests between D1, D2 and HD showed good reliability (P > 0.05). CONCLUSION: D1, D2 and HD are significantly correlated with gestational age. Horizontal distance measurement can effectively determine the position of fetal conus medullaris, enabling rapid prenatal evaluation of low position of conus medullaris and excluding the possibility of tethered cord. Show more

Keywords: Fetus, ultrasonic examination, conus medullaris, tethered spinal cord

DOI: 10.3233/THC-230332

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1371-1382, 2024

Authors: Wang, Yanxia | Li, Yaqing | Wang, Xiaoqing | Niu, Zhancong | Zhou, Lixia

Article Type: Research Article

Abstract: BACKGROUND: Stroke is the second reason for global deaths and a major reason for disabilities. OBJECTIVE: To unravel the clinical value of the coagulation index and serum inflammatory cytokines in hemorrhagic stroke patients with pulmonary infection in the sequelae stage. METHODS: Altogether, 130 hemorrhagic stroke patients who received treatment in Hebei General Hospital from April 2019 to December 2020 were selected. Patients were classified into the infection group (n = 65) and non-infection group (n = 65) according to whether they had a …pulmonary infection in the sequelae stage of hemorrhagic stroke. Levels of coagulation index and serum inflammatory cytokines of patients in two groups were compared. Multiple linear regression analysis was used to analyze pulmonary infection-related factors of hemorrhagic stroke patients. The diagnostic value of the coagulation index and serum inflammatory cytokines in pulmonary infection was analyzed by the receiver operating characteristic (ROC) curve. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT) related to coagulation function levels and interleukin 1β (IL-1β ), interleukin 17 (IL-17) related to serum inflammatory cytokines levels of patients in the infection group were higher than those in non-infection groups (p < 0.05). Multiple linear regression analysis uncovered that FIB, D-D, PLT, and IL-17 were influencing factors of pulmonary infection in the sequelae of patients with hemorrhagic stroke (p < 0.05). Area under the curve (AUC) values of pulmonary infection in the sequelae stage of patients with hemorrhagic stroke diagnosed by FIB, D-D, PLT, and IL-17 were 0.823, 0.758, 0.660, and 0.755, respectively. CONCLUSION: FIB, D-D, PLT, and IL-17 levels could be used for pulmonary infection diagnosis in the sequelae stage of hemorrhagic stroke patients. Show more

Keywords: Coagulation index, inflammatory factor, hemorrhagic stroke, sequelae stage, pulmonary infection, diagnosis

DOI: 10.3233/THC-230345

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1383-1391, 2024

Authors: Yang, Li | Song, Ling-Xia | Zhang, Yong-Mei | Liu, Han-Mei

Article Type: Research Article

Abstract: BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in …Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P < 0.05). NEWS values correlated positively with illness severity (r = 0.605, P < 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden’s index, with statistically significant differences (P < 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration. Show more

Keywords: Gastrointestinal illness, geriatric, illness severity assessment, National Early Warning Score

DOI: 10.3233/THC-230369

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1393-1402, 2024

Authors: Zeng, Ling-Zhi | Cui, Ji | Jiang, Tao | Tu, Li-Ping | Liu, Hai-Dan | Gong, Ya-Bin | Xu, Ling | Xu, Jia-Tuo

Article Type: Research Article

Abstract: BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T …-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue’s image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process. Show more

Keywords: Non-small cell lung cancer, tongue image, image features, pathological staging, traditional Chinese medicine

DOI: 10.3233/THC-230372

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1403-1420, 2024

Authors: Huang, Nannan | Fu, Min | Gao, Fumei | Wang, Yanbing | Lu, Man | Li, Xin | Wang, Dandan | Wang, Jing

Article Type: Research Article

Abstract: BACKGROUND: The success of assisted pregnancy relies heavily on the effectiveness of the embryo transfer process. Currently, embryo transfer is typically conducted with the assistance of abdominal ultrasound. OBJECTIVE: The primary aim of this study was to evaluate the influence of targeted nursing interventions on the embryo transfer procedure, its impact on pregnancy outcomes, and the level of patient comfort concerning bladder management throughout the procedure. METHODS: A total of 247 patients who underwent embryo transfer at the Reproductive Center of Peking University People’s Hospital from December 2019 to August 2020 were included …in this study. These patients were categorized into two groups: the control group (n = 124) and the experimental group (n = 123). Within the control group, patients received conventional preoperative education, whereas those within the experimental group were subjected to targeted nursing interventions. Furthermore, patients in the experimental group were furnished with explicit instructions pertaining to the volume and timing of water intake. Multiple factors were assessed in this study, encompassing bladder filling, the quality of uterine imaging, the utilization of assistive devices during the surgical procedure, and pregnancy outcomes. Additionally, a post-operative questionnaire was administered to both groups to gauge their comfort levels regarding urinary retention. RESULTS: Following the targeted nursing intervention, ultrasound scans indicated an increase in bladder depth (5.91 ± 1.76 vs. 5.40 ± 1.61, P = 0.02), resulting in clearer endometrial imaging (96.74% vs. 88.71%, P = 0.02). Additionally, the experimental group reported significantly higher levels of comfort with urine retention (P = 0.01) compared to the control group, and these differences held statistical significance. Furthermore, the pregnancy rate in the experimental group was greater than that in the control group (52.85% vs. 50.8%, P > 0.05). CONCLUSION: Based on the premise that pregnancy rates remain unaffected, the implementation of targeted nursing care has the potential to augment bladder filling, enhance the quality of endometrial imaging, reduce the requirement for instrument-assisted embryo transfers, and notably enhance the comfort of patients in relation to urine retention. Show more

Keywords: Bladder filling, comfort with urine retention, embryo transfer, IVF, targeted nursing

DOI: 10.3233/THC-230380

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1421-1429, 2024

Authors: Qiu, Bin | Chen, Hang | Zhang, Enke | Ma, Fuchun | An, Gaili | Zong, Yuan | Shang, Liang | Zhang, Yulian | Zhu, Huolan

Article Type: Research Article

Abstract: BACKGROUND: The incidence of type 2 diabetes is rapidly increasing worldwide. Studies have shown that it is also associated with cancer-related morbidities. Early detection of cancer in patients with type 2 diabetes is crucial. OBJECTIVE: This study aimed to construct a model to predict cancer risk in patients with type 2 diabetes. METHODS: This study collected clinical data from a total of 5198 patients. A cancer risk prediction model was established by analyzing 261 items from routine laboratory tests. We screened 107 risk factors from 261 clinical tests based on the importance of …the characteristic variables, significance of differences between groups (P < 0.05), and minimum description length algorithm. RESULTS: Compared with 16 machine learning classifiers, five classifiers based on the decision tree algorithm (CatBoost, light gradient boosting, random forest, XGBoost, and gradient boosting) had an area under the receiver operating characteristic curve (AUC) of > 0.80. The AUC for CatBoost was 0.852 (sensitivity: 79.6%; specificity: 83.2%). CONCLUSION: The constructed model can predict the risk of cancer in patients with type 2 diabetes based on tumor biomarkers and routine tests using machine learning algorithms. This is helpful for early cancer risk screening and prevention to improve patient outcomes. Show more

Keywords: Type 2 diabetes, cancer risk, machine learning, prediction model

DOI: 10.3233/THC-230385

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1431-1443, 2024

Authors: Yu, Yong Ming | Hu, Yang

Article Type: Research Article

Abstract: BACKGROUND: As a critical m6A RNA methylation regulator, HNRNPC has been revealed to serve as potential biomarkers in various human cancers. The specific expression and significance of HNRNPC in colorectal cancer remain unknown. OBJECTIVE: This study aimed to confirm HNRNPC expression level and evaluate its function in colorectal cancer progression. METHODS: 101 paired tissue samples were collected from colorectal cancer patients. HNRNPC levels in colorectal cancer were detected using PCR. CCK8 and transwell assays were conducted to estimate the effect of HNRNPC on cell growth and metastasis with the regulation of HNRNPC by …cell transfection. RESULTS: Upregulated HNRNPC was observed in colorectal cancer compared with normal tissues and cells. The higher HNRNPC levels in tumor tissues were associated with the advanced TNM stage and positive lymph node metastasis. Meanwhile, HNRNPC upregulation could indicate adverse outcomes of colorectal cancer patients. In vitro , the knockdown of HNRNPC significantly suppressed the proliferation, migration, and invasion of colorectal cancer cells. CONCLUSIONS: Upregulated HNRNPC served as a biomarker for the prognosis and development of colorectal cancer, which provides a novel therapeutic target for colorectal cancer. Show more

Keywords: N6-methyladenosine (m6A), HNRNPC, colorectal cancer, prognosis, progression

DOI: 10.3233/THC-230429

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1445-1453, 2024

Authors: Cui, Ling | Gao, Lina | Geng, Huanhuan | Zhang, Huiru | Wei, Hongyan

Article Type: Research Article

Abstract: BACKGROUND: Mild cognitive impairment (MCI) is a mild memory or cognitive impairment. OBJECTIVE: To explore the relationship between serum klotho (K1) protein and insulin-like growth factor-1 and mild cognitive impairment in the elderly in order to provide accurate and appropriate indicators for clinical diagnosis and treatment of MCI. METHODS: This randomized stratified study adopted a multistage cluster sampling method. 161 elderly patients with mild cognitive impairment were included as the MCI group, and 161 healthy people matched with the MCI group in gender, age and education were selected as the control group. …RESULTS: The levels of serum K1 protein and insulin-like growth factor-1 in the MCI group were lower than those in the control group (P < 0.05). Both IGF-1 and K1 had predictive value for MCI (P < 0.05). The area under the curve (AUC) of IGF-1 for predicting MCI was 0.859 (95% CI: 0.790∼ 0.929), and the AUC of K1 for predicting MCI was 0.793 (95% CI: 0.694∼ 0.892). The value of joint prediction of the two indicators was the highest, with an AUC of 0.939 (95% CI: 0.896–0.993). CONCLUSION: High serum K1 and insulin-like growth factor-1 are the protective factors of cognitive impairment in MCI patients. Both IGF-1 and serum K1 proteins have predictive value for MCI, and the combination of the two indicators has the highest predictive value. Show more

Keywords: Mild cognitive impairment, klotho protein, serum insulin-like growth factor-1

DOI: 10.3233/THC-230462

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1455-1462, 2024

Authors: Seget, Sebastian | Chobot, Agata | Rusak, Ewa | Ochab, Agnieszka | Bielawska, Anna | Polanska, Joanna | Jarosz-Chobot, Przemysława

Article Type: Research Article

Abstract: BACKGROUND: Given the steadily rising incidence of type 1 diabetes (T1D), particularly among the youngest preschool children, coupled with well-documented challenges of achieving and maintaining optimal metabolic control in this age group, there is a growing need for advanced technological devices. OBJECTIVE: To evaluate glycaemic control in children below the age of seven with type 1 diabetes (T1D) and assess the safety of the advanced hybrid closed loop (AHCL) system in comparison to the previous treatment method, a sensor-augmented pump with predictive low-glucose suspend (SAP-PLGS). METHOD: Data from 10 children (aged 2.60–6.98 years) …with T1D who transitioned to the AHCL system from SAP-PLGS were analysed. SAP-PLGS records from two weeks prior to the initiation of AHCL were compared with records from the initial four weeks post-switch (excluding the training period). These data were examined at two 2-week intervals and compared with records from two weeks post six-month usage of the AHCL. RESULTS: A significant decrease in the average nighttime glucose concentration was observed compared to pre-AHCL values (p = 0.001, concordance W = 0.53). The Glucose Management Indicator (GMI) value significantly decreased from 6.88 ± 0.37% to 6.52 ± 0.32% (p = 0.018, rbc = 0.93) immediately following the device switch and stabilized at 6.50 ± 0.28% (p = 0.001, W = 0.53) and 6.55 ± 0.41% (p = 0.001, W = 0.53) at subsequent stages of the study. An improvement was also observed in mean glucose values for time spent < 54 mg/dl, while the proportion of time within this range was maintained, both during the day (p < 0.001, W = 0.58) and at night (p = 0.002, W = 0.83). CONCLUSION: The AHCL MiniMed 780GTM system improved glycaemic control in the studied group of children under seven years of age with T1D compared to previous SAP-PLGS therapy. It proved to be safe for delivering insulin in this age group. Show more

Keywords: Type 1 diabetes, advanced hybrid closed-loop system, young children, hybrid closed-loop

DOI: 10.3233/THC-230490

Citation: Technology and Health Care, vol. 32, no. 3, pp. 1463-1472, 2024