A total of 89 elderly patients with heart failure and preserved ejection fraction were randomly divided into 2 groups:patients in control group received conventional medication,those in exercise group receive conventional medication plus aerobic exercise training,which was lasted for 6 weeks.The changes in VO2max,maximum heart rate (HRmax),VO2max/HRmax,exercise time,6-minute walk and quality of life (QOL) were evaluated after 16 weeks.The VO2max,HRmax,VO2max/HRmax,exercise time,6-minute walk and QOL had increased significantly in exercise group,compared with the control group.The results indicate that aerobic exercise can improve cardiopulmonary function of elderly patients with heart failure and preserved ejection fraction.

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.

This article was to discuss the effectiveness of medial sural artery perforator pedicled flap or muscle flap in the treatment of soft tissue defect. Since 2002, 21 patients(14 males and 7 females)with prepatellar(n=7)or pretibial(n=14)defect had underwent soft tissue reconstruction. Ten of them obtained medial sural artery perforator pedicled flap and the rest received muscle flap. All the medial sural artery perforator pedicled flaps and muscle flaps survived well and the clinical outcomes were satisfactory. No remarkable donor site morbidity was found. According to our data. medial sural artery perforator pedicled flap or muscle flap may seem to be highly vascularized and have constant vascular anatomy and long vascular pedicle. They could be useful in the treatment of prepatellar or pretibial soft tissue defect.

Objective To summarize clinical application of the medial sural artery perforator pedicled flap for the coverage of soft tissue defects around the knee and upper one third of lower leg.Methods From May 2003 tO January 2007,16 patients(11 men,5 women)with soft tissue defects around the knee and upper one third of lower leg underwent reconstruction with the medial sural artery perforator pedicled flap.Of them,4 eases recipient site were located on the prepatellar region,2 cases were located on the anterolateral pateflar,1 case was located on the anteromedial patellar,and 9 cases upper one third oflowerleg.They ranged in age from 23 to 52 years(mean,36 years).The donor leg was ipsilateral in all cages. Results One ca8e sustained superficial infection postoperative and the gradual wound healed by daily wound dressings.All the flaps had survived completely without major complication with satisfactory clinical results. Follow-up period ranged from 3.0 months to 3.5 years(mean, 1.7 years)postoperatively.There was no remarkable donor site morbidity.All cases had good appearance and function in recipient site.There was no remarkable donor site morbidity. Conclusion The medial sural artery perforator flap is nourished by the musculocutaneous perforater of the medial sural artery.The flaps seem to has highly vascularize,a constant vascular anatomy and a long vascular pedicle.The flap is thin and suitable for the coverage of soft tissue defects around the knee and upper one third of lower leg.

Objective Discussing the role of Yunnan baiyao in the newborn umbilical cord.Methods 120 cases newborns were selected and randomly divided into the control group of 60cases and the observation group of 60 cases according to birth order.The two kinds of newborns were both used single valve care,and were disinfected with 75%alcohol twice a day,Newborns of the observation group were dipped in Yunnan baiyao cream which was taken 75%alcohol to apply the root of umbilical and around after each nursing time.Observed the umbilical cord healing of two groups of newborns and take notes.Results In the observation group newborns,umbilical cord on the drying time [(3.1 ±1.1)d]and off time[(6.6 ±1.8)d]were better than the control group[(3.1 ±1.1)d,(8.0 ±3.2)d](t =7.8,2.95,all P <0.05);6 cases occurred redness and swelling around the belly button,2 cases occurred hemor-rhage,17 cases occurred secretions.which were better than that in control group(18 cases,6 cases,35 cases).The statistical analysis showed significant difference in the data of the two groups.Conclusion Yunnan baiyao can promote healing of umbilical cord,it should be popularize in clinical use.

Objective To investigate the effect of MALAT1 expressions on cell proliferation and apoptosis in astrocytes by regulating mitogen-activated protein kinase(MAPK)/extracellular signal-regulated kinase(ERK1,2)pathway.Methods The MALAT1 gene was knocked down and over-expressed in C8-D1A cells by lentiviral and plasmid vectors,respectively.The expressions of MALAT1,cell proliferation-related markers(Ki67,MCM2,PCNA)and apoptosis-related proteins(Caspase-3,Bax,Bcl-2)were detected by quantitative real-time polymerase chain reaction(qPCR).CCK-8 assay and flow cytometry were used for cell proliferation and apoptosis in C8-D1A cells.Immunofluorescence was adopted to detect the protein expressions of Caspase-3 and Ki67.Western blotting was used to detect the protein expressions of Caspase-3,Bax,Bcl-2,ERK1/2,p-ERK1/2,p38MAPK and p-p38MAPK.Results Compared with the control group,over-expressed MALAT1 inhibited cell proliferation and induced cell apoptosis in C8-D1A cells while the knockdown of MALAT1 significantly enhanced cell proliferation and anti-apoptotic ability in C8-D1A cells.The proportion of C8-D1A cells in G0/G1-phase and G2/M-phase was higher than in the control group as evidenced by flow cytometry,but was lower in S-phase.Meanwhile,data showed that Caspase-3 was increased while p-ERK1/2 was decreased in terms of protein levels.The mRNA expressions of Ki67 and PCNA were decreased.After knockdown of MALAT1,the proportion of C8-D1A cells in S-phase was higher,but was lower in G2/M-phase.The protein expressions of Caspase-3 and Bax decreased while those of p-ERK1/2 and p-p38MAPK increased.The mRNA expressions of Ki67,MCM2 and PCNA were increased.The differences were all statistically significant(P＜0.05).Conclusion MALAT1 promotes astrocyte apoptosis and inhibits proliferation by regulating the MAPK/ERK1,2 signaling pathway.

Objective:To explore the talent cultivation model of nursing professional group under the 1+X certificate system, to build a talent cultivation system for nursing professional groups with "three progressions, four integrations, and five cocultivation"Methods:From 1 July 2021 to 31 December 2023, built a professional group course system of "mutual sharing of foundations, mutual generation of majors, mutual selection of positions, and progressive improvement of abilities". Aligned course content with X certificate content. Deepen the reform of the three education systems, create a "dual teacher" teaching team that combines full-time and part-time work, and build teaching resources that connect the cloud and the ground. The application effect of this model was evaluated in 2021 nursing majors in Cangzhou Medical College by cluster sampling.Results:There were 748 students majoring in nursing in class of 2021, 150 boys aged 19-22(20.00 ± 1.23), 598 girls, aged 19-21(19.00 ± 2.57). There were 118 students majoring in midwifery in class of 2021, all of them were girls, aged 18-20(18.00 ± 2.11). There were 128 students majoring in rehabilitation therapy technology in class of 2021, 66 boys aged 19-21(19.00 ± 2.11), 62 girls aged 19-21(19.00 ± 2.54). Nursing professional group completed the "Basic Nursing Technology Training Guidance", "Elderly Care" and other 5 self-compiled textbooks, 730 students had participated in the X certificate assessment, 729 students e passed the assessment, the passing rate was 99.9%.Conclusions:The talent cultivation model of "three progressions, four integrations, and five co cultivation" in the nursing professional group can cultivate students′ professional abilities, and cultivate a composite technical and skilled talent with multiple abilities and interconnections in one job.

AIM:To evaluate the efficacy,safety,and economy of camrelizumab(CAM)combined with platinum-containing chemotherapy(CT)for the first-line treatment of locally advanced/meta-static non-small cell lung cancer(NSCLC).METH-ODS:Chinese and English databases such as Pubmed,the Cochrane Library,China Knowledge Network,Wanfang Data,and other related web-sites were systematically searched.After literature screening,quality assessment,and data extraction of the literature according to the inclusion and ex-clusion criteria,two researchers conducted a rapid health technology assessment(HTA).RESULTS:A total of 7 systematic evaluations/Meta-analyses and 17 economics evaluations were included.In terms of effectiveness,compared to docetaxel che-motherapy,CAM+CT significantly prolonged the overall survival(OS),progression-free survival(PFS),and improved the objective remission rate(ORR)of mutation-negative patients with locally ad-vanced/metastatic NSCLC.Compared with CT and pembrolizumab(PEM),CAM+CT significantly pro-longed the PFS,and improved the ORR of mutation-negative patients with locally advanced/metastatic NSCLC.Subgroup analysis showed that CAM+CT significantly prolonged PFS in patients with PD-L1 ≥1％and PD-L1 ≥ 50％compared with CT.Compared with CT,CAM+CT significantly prolonged the OS and PFS of mutation-negative patients with locally advanced/metastatic squamous NSCLC.Compared with sintilimab(SIN),CAM+CT significantly pro-longed the PFS of mutation-negative patients with locally advanced/metastatic squamous NSCLC.Sub-group analysis showed that CAM+CT significantly prolonged OS in patients with PD-L1＜1％com-pared with CT.In terms of safety,CAM+CT was comparable in terms of the occurrence of all grades of adverse events,but the incidence of grade 3 or higher treatment-related adverse events was significantly increased compared with CT and PEM for mutation-negative locally advanced/meta-static NSCLC patients.CAM+CT was significantly in-creased the occurrence of all grades of adverse events compared with CT,but was comparable in terms of the occurrence of grade 3 or higher treat-ment-related adverse events.In terms of economy,CAM+CT has a cost-effectiveness advantage over CT for patients with mutation-negative advanced/metastatic squamous NSCLC.CAM+CT has a cost-effectiveness advantage over CT and PEM+CT;and CAM+CT does not have a cost-effectiveness ad-vantage over SIN+CT for patients with mutation-negative locally advanced/metastatic non-squa-mous NSCLC.CONCLUSION:CAM+CT has good ef-ficacy and cost-effectiveness for the first-line treat-ment of locally advanced/metastatic NSCLC,and the safety aspect is compared with CT,PEM or slightly worse.

Objective: To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO. Methods: Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×10⁹/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×10⁹/L. Results: A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×10⁹/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×10⁹/L) at 4^th week, 8^th week and 12^th week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×10⁹/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild. Conclusion Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China