Objective To study the application effect of Snyder hope theory combined with Satir model in the rehabilitation therapy of young and middle-aged patients with stroke. Methods A total of 224 young and middle-aged patients with stroke admitted to Zhongshan Hospital of Fudan University between August 2018 and August 2020 were divided into four groups (control group, Satir group, Snyder group, and combined group) according to the random number table method by taking admission time as sequence. All patients were given rehabilitation training on the basis of conventional treatment, and the Satir group was given group guidance of Satir model, the Snyder group was given hope therapy based on Snyder hope theory, and the combined group was given intervention combined Snyder hope theory with Satir model. All patients were continuously treated for six weeks. The scores of Herth Hope Index (HHI), Self-perceived Burden Scale (SPBS), exercise rehabilitation willingness questionnaire, Health Promoting Lifestyle Profile Ⅱ (HPLP Ⅱ), and Simplified Coping Style Questionnaire (SCSQ) were compared among the four groups before and after intervention. Results There were 53, 52, 54, and 52 patients enrolled in the control group, the Satir group, the Snyder group, and the combined group, respectively. The differences among the four groups in basic information such as sex, age, and type of stroke and the scores of the above scales before intervention were not statistically significant (P>0.05). After intervention, the total scores of HHI scale (27.65±6.34, 30.54±6.85, 32.79±7.12, 35.08±7.63), scores of exercise rehabilitation willingness (39.85±8.16, 40.52±7.93, 40.17±8.25, 43.81±7.46), total scores of HPLP Ⅱ scale (149.87±26.08, 159.32±26.73, 165.89±28.01, 173.18±28.54), and scores of positive coping style of SCSQ scale (19.65±5.08, 22.46±5.29, 25.04±4.91, 28.45±5.12) of the four groups significantly increased compared with those before intervention (P<0.05), while the total scores of SPBS scale (27.35±4.92, 23.74±5.02, 25.16±4.98, 21.49±5.27) and scores of negative coping style of SCSQ scale (4.83±1.25, 3.71±1.02, 3.94±1.08, 4.13±0.96) significantly decreased compared with those before intervention (P<0.05); the scores of HHI scale, exercise rehabilitation willingness, HPLP Ⅱ scale, and positive coping style of SCSQ scale of the combined group were higher than those of the other three groups (P<0.05), while the score of SPBS scale was lower than that of the other three groups (P<0.05). Conclusions Snyder hope theory combined with Satir model for rehabilitation therapy of young and middle-aged patients with stroke can help to improve the hope level, reduce the self-perceived burden, and improve the exercise rehabilitation willingness, health behaviors and coping styles. In addition, it is of great significance for promoting the rehabilitation of patients.
Objective To review the changes of gut microbiota after bariatric surgery and the related mechanisms of improving metabolism. Method Domestic and international literatures in recent ten years on the changes of gut microbiota in bariatric surgery and the mechanisms of improving metabolism were collated and summarized. Result The common bariatric procedures performed to date were vertical sleeve gastrectomy (VSG) and laparoscopic Roux-en-Y gastric bypass (RYGB). The changes of gut microbiota vary in different surgical procedures, which were related to the changes of diet habits, gastrointestinal anatomy, gastrointestinal hormone levels and metabolic complications. The gut microbiota might improve the body metabolism by regulating the levels of short chain fatty acids, branched chain amino acids and bacterial endotoxin in the intestinal lumen. Conclusions Significant changes are found in gut microbiota after bariatric surgery, which may be involved in the improvement of body metabolism by regulating the level of bacterial endotoxin and microbial metabolite. However, more in-depth mechanisms need to be further clarified.
Objective To evaluate the effectiveness of lymphaticovenular anastomosis (LVA) combined with perioperative targeted multi-layer circular lymphatic drainage in the treatment of secondary lower limb lymphedema using a prospective randomized controlled trial. Methods In a prospective randomized controlled trial, 80 patients with secondary lower limb lymphedema admitted between January 2023 and September 2025 were initially enrolled and allocated to either the trial group (LVA+targeted lymphatic drainage) or the control group (LVA+conventional lymphatic drainage), 40 in each group. After 2 dropouts in the control group, 78 patients (40 in the trial group, 38 in the control group) were included for analysis. There was no significant difference in the baseline data (P>0.05), such as age, gender, disease duration, and preoperative lower limb circumference difference, functional scores, and levels of vascular endothelial growth factor C (VEGF-C), transforming growth factor β1 (TGF-β1), and interleukin 6 (IL-6). Both groups underwent LVA. The trial group received perioperative targeted multi-layer circular lymphatic drainage, while the control group received conventional manual lymphatic drainage. Changes in lower limb circumference difference, functional scores, and levels of VEGF-C, TGF-β1, and IL-6 were compared between the two groups at various time points before and after operation. Overall effectiveness and safety were also assessed. Results All patients were followed up 3-12 months (mean, 6.5 months). Postoperatively, the trial group demonstrated significantly better functional recovery and a superior trend in lower limb circumference reduction at all time points compared to the control group (P<0.05). Serological analysis indicated a more pronounced increase in VEGF-C level in the trial group (P<0.05), and a downward trend in TGF-β1 and IL-6 levels in both groups (P<0.05); no significant difference was observed in TGF-β1 and IL-6 levels between groups (P>0.05). At 3 months after operation, indocyanine green fluorescence (ICG) lymphography showed an anastomosis patency rate of 95.0% (38/40) in the trial group, significantly higher than the 68.4% (26/38) in the control group (P<0.05). The overall effectiveness was rated as significantly effective in 30 cases and effective in 15 cases in the trial group, while as significantly effective in 15 cases, effective in 15 cases, and ineffective in 8 cases in the control group. The difference between groups was significant (P<0.05). The incidence of complications showed no significant difference between trial group and control group (2.5% vs 7.9%, P>0.05). ConclusionThe application of targeted multi-layer circular lymphatic drainage during the perioperative period of LVA is safe and effective. It significantly promotes lower limb circumference reduction and functional recovery without increasing the risk of complications.
[Abstract]Acute cardiac tamponade after thoracoscopic lobectomy is extremely rare and highly lethal once it occurs. This paper reports a case of a 64-year-old male with preoperative hypertension and coronary heart disease who underwent video-assisted thoracoscopic right upper lung wedge resection for early-stage lung adenocarcinoma. Three hours postoperatively, he suddenly developed hypotension and loss of consciousness. Ultrasound indicated a large amount of pericardial effusion, suggesting cardiac tamponade. Despite emergency pericardiocentesis, his hemodynamics did not improve, and the patient went into cardiac arrest. Subsequent veno-arterial extracorporeal membrane oxygenation was performed to support systemic circulation, and emergency thoracotomy was carried out. During the surgery, a needle-like tear in the anterior wall of the ascending aorta was found, corresponding exactly to a prominent staple at the lung resection margin, suggesting a stapler malfunction. After vascular repair, the patient recovered smoothly and was discharged. This case suggests that during lung resection, great attention should be paid to the integrity of staples and anatomical variations of large vessels, and vigilance is needed for rare but potentially fatal stapler-related complications.