Objective To learn the effects of crude herb moxibustion combined with rehabilitation training on the recovery of pulmonary functions and quality of life of patients with stable-stage chronic obstructive pulmonary diseases (COPD) in Nanning communities. Methods Two hundred patients with stable-stage COPD, sampled from Nanning communities and used as the subjects of this study, were divided into the experiment group and the control group by the random number table method. Patients in the control group were given conventional medication and community health care education and guides;Patients in the experiment group were not only offered the same treatment as mentioned above, but treated during dog days and the coldest days of winter with moxibustion medicine cakes which were applied accurately on selected acupuncture points, together with moxibustion with moxa cone done on the cakes. Treatment was done 6 times in each course of treatment, and 2 courses were given, combined with rehabilitation training. Examination of pulmonary functions was conducted for all patients before and after the treatment and St. George′s Respiratory Questionnaires (SGRQ) were distributed to them. Results Forced vital capacity patients, forced expiratory volume in first second, the percentage of forced expiratory volume in first second and forced vital capacity of experimental group before the intervention were (2.27 ± 0.36) L, (1.56 ± 0.30) L, (44.81 ± 5.35) %, while six months after the intervention were (3.36 ± 0.42) L, (2.25 ± 0.27) L, (65.38 ±8.08)%. The difference was statistically significant (t=18.90, 16.40, 20.36, P<0.01);The above indexes of control group respectively before intervention were (2.28±0.43) L, (1.58±0.33) L, (45.17 ± 4.97) %, while six months after the intervention were (2.57 ± 0.57) L, (1.71 ± 0.35) L, (46.94 ± 8.42)%. Difference was not statistically significant (t = 1.81, 2.04, 1.70, P > 0.05). Differences between two groups before intervention had no statistical significance (t = 0.17, 0.43, 0.47, P > 0.05), and differences between two groups after the intervention were statistically significant (t=10.62, 11.62, 14.99, P < 0.01). In the experimental group,before intervention the total score of SGRQ and the part scores of symptom, the activity ability and the influence of the disease were (16.56 ± 1.76) points, (10.44 ± 1.57) points, (18.55±2.17) points, (45.73 ± 2.53) points, 6 months after the intervention the scores were (10.77 ± 1.56) points, (7.28±1.23) points, (14.33 ±1.66) points, (32.98 ± 2.35) points. The difference was significant (t=14.82-35.50, P<0.01);In the control group before intervention the total scores of SGRQ and the part score of symptom, the activity ability and the influence of the disease were (16.47 ±1.81) points, (10.39 ± 1.66) points, (18.52 ± 2.16) points, (45.79 ± 2.49) points, 6 months after the intervention the scores were (16.12 ±1.36) points, (9.89 ±1.38) points, (16.96 ±1.58) points, (42.15±2.34) points. The lower score was not obvious, there was no statistically significant difference (t=1.45-2.17, P > 0.05). Intervention before comparing differences between two groups had no statistical significance (t=0.09-0.34, P > 0.05). Intervention after comparing differences between two groups was statistically significant (t=10.88-26.22, P<0.01). Conclusions Clinically, crude herb moxibustion combined with rehabilitation training is to some extent conducive to delaying the decrease in pulmonary functions, reducing complications, and improving the quality of life of patients with stable-stage COPD.

Objective To study the effect of metformin on the growth of megakaryocytic leukemia cell line Dami and to explore the molecular mechanisms of the inhibitory effect of metformin on the proliferation of Dami. Methods The Dami cells were cultured and divided into control and 1,2,4,8,16 and 32 mmol·L-1 metformin groups.Then MTT test was performed to detect the inhitory rate of proliferation of Dami cells after treated with different concentrations of metformin. Flow cytometry was used to examine the distribution of cell cycle, and Western blotting was carried out to analyze the expressions of Cdc2 and CylinB1 and the phosphorylation of Cdc2. Results The MTT results showed that compared with control group,the inhibitory rates of proliferation of the Dami cells in 32 mmol·L-1 metformin groups at 0,24,48,72 and 96 h (35.1%±2.3%,49.7%±5.1%, 78.85±0.9%,79.1%± 3.0%%,and 85.2%± 3.2%)were significantly increased(P<0.01),Furthermore, after metformin treatment for 72 h,the inhibitory rates of proliferation of the Dami cells in 1,2,4,8,16 and 32 mmol·L-1 metformin groups were (33.8 ± 0.3)%,(51.9 ± 0.2)%,(59.4 ± 1.6)%,(65.5 ± 2.0)%, (75.5±0.9)%,and (79.1±3.0)%,respectively. Metformin inhibited the growth of Dami cells in a time-and dose-dependent manner. The flow cytometry results results revealed that compared with control group, the percentages of Dami cells in G2/M phase in 1,2 and 4 mmol·L-1 metformin groups were increased from (26.0± 0.5)% to (38.5 ± 1.5 )%, (48.4 ± 1.1 )%, and (58.2 ± 2.7 )%;there was significant difference in the percentages of Dami cells in G2/M phase between control group and 4 mmol·L-1 metformin group (P<0.01). Western blotting analysis showed that compared with control group, the expressions of Cdc2 and CyclinB were evidently reduced, the phosophorylation of Cdc2 at Tyr1 5 was up-regulated, and the phosphorylation at Thr1 6 1 was down-regulated.Conclusion Metformin can inhibit the growth of Dami cells and induce G2/M arrest,and its mechanism may be related to inhibiting the activation of Cdc2/CyclinB1 complex.

Immunotherapy is a therapeutic method that uses the immune system to inhibit tumor activity and kill tumor cells.It has been proved to be effective in the treatment of various malignant tumors.In general, the immune system can recognize and kill the abnormal cells,while the tumor cells can produce a variety of mechanisms to inhibit the immune system,resulting into the incomplete death of the cells.TIGIT is a type of inhibitory receptor containing T cell immunoglobulin and immunoreceptor protein tyrosine inhibitory motif (ITIM)protein domain.This paper discusses the role of TIGIT in limiting antitumor responses and reviews the mechanisms of action during the cancer immunity cycles.

Objective: To investigate the protective effect of glucose regulatory protein 78 (GRP78) on cardiomyocytes in atrial fibrillation and its mechanism. Methods: HL-1 cardiomyocyte cell line was cultured from June 2016 to March 2017 at Harbin Medical University Central Laboratory.The cells were randomly divided into 4 groups: control group, pacing group, pacing+ GRP78cDNA group, pacing+ GRP78siRNA group.The following indicators were detected: (1)oxidative stress: flow cytometry was used to detect the content of reactive oxygen species (ROS) in each group; (2)Ca²⁺ overload and cell electrophysiology: flow cytometry was used to detect Ca²⁺ content in each group; (3)cell structure reconstruction: cell apoptosis was detected by flow cytometry. Results: The ROS production in the pacing group was significantly higher than that in the control group [(28.8±0.5)% vs.(4.5±0.8)%, F=27.91, P<0.01]. The number of ROS in the GRP78siRNA group was significantly higher than that in the pacing group [(71.1±0.3%) vs.(28.8±0.5)%, F=34.12, P<0.01]. The ROS content of the GRP78cDNA group was lower than that of the pacing group [(26.1±2.7)% vs.(28.8±0.5)%, F=26.60, P<0.01]. Pacing significantly increased Ca²⁺ concentration in HL-1 cells; GRP concentration in HL-1 cells in the GRP78siRNA group was significantly higher than that in the pacing group [(72.53±2.5)AM vs.(39.23±1.9)AM, F=19.50, P<0.05]. The intracellular Ca²⁺ concentration in the GRP78cDNA group was significantly lower than that in the pacing group [(31.23±0.57)AM vs.(39.23±1.9)AM, F=28.17, P<0.01]. The survival rate of the GRP78cDNA group was significantly higher than that of the pacing group [(87.9±0.4)% vs.(80.1±0.5)%, F=19, P<0.05]. Conclusion GRP78 protein reduces intracellular calcium overload by reducing ROS production in myocardial cells during atrial fibrillation.It can alleviate the oxidative stress of cardiomyocytes and improve the survival rate of cardiomyocytes, and has protective effect on cardiomyocytes.

OBJECTIVE:To observe clinical efficacy and safety of Bufeihuayu decoction combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC)and its effects on vascular endothelial growth factor(VEGF)and immune func-tion. METHODS:A total of 120 NSCLC patients in our hospital during Oct. 2013 to Jun. 2015 selected as research object were di-vided into observation group and control group according to random number table,with 60 cases in each group. Control group was given GP(gemcitabine combined with cisplatin)chemotherapy. Observation group was additionally given Bufei huayu decoction, one dose a day,decocted to 400 mL,morning and night,on the basis of control group. Clinical efficacies of 2 groups were com-pared,and VEGF-A,VEGF-B,VEGF-C and immune indexes (CD3+,CD4+,CD8+,CD4+/CD8+) levels were compared before and after treatment. The occurrence of toxic reaction was recorded. RESULTS:Response rate and disease control rate of observa-tion group were 58.33％ and 85.00％,significantly higher than 40.00％ and 68.33％ of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in levels of VEGF or immune indexes between 2 groups (P>0.05). After treatment,VEGF of 2 groups were decreased significantly,and observation group was significantly lower than the con-trol group,with statistical significance(P<0.05);CD4+and CD4+/CD8+of 2 groups were decreased significantly,while CD8+was increased significantly,with statistical significance(P<0.05);CD4+ and CD4+/CD8+ of observation group were significantly higher than those of control group,while CD8+ was decreased significantly;CD3+ of control group was decreased significantly and lower than observation group,with statistical significance (P<0.05). The incidence of leucopenia,thrombocytopenia,decrease of hemo-globin,elevation of transaminase,increase of bilirubin and digestive tract reaction in observation group was significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Bufei huayu decoction combined with chemotherapy shows significant therapeutic efficacy for NSCLC,can effectively inhibit VEGF,improve immune function and relieve toxic reaction.

Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Objective To explore the dilemmas faced by surrogate decision-makers of severe stroke patients in treatment decision-making,and to provide a basis for developing decision support strategies.Methods From April to December 2023,through phenomenological qualitative research with 16 surrogate decision-makers with severe stroke patients from ICU of the department of neurology in a tertiary hospital in Jing'an District,Shanghai.semi-structured in-depth interviews were used to examine the perceptions of decision-making on surrogate.Data were analyzed via Braun's style of thematic analysis.Results 4 themes and 10 sub-themes were identified.Theme 1:negative emotional dilemmas(urgent decision-making leads to anxiety,fear,and unknown stroke trajectory increases the sense of uncertainty).Theme 2:supportive environment dilemmas(lack of information support delays decision-making;lack of family support increases decision-making stress;insufficient economic support increases the burden of decision-making).Theme 3:the dilemma of weighing the pros and cons(difficult trade-offs between risk and reward,tough decisions between reality and ethics,conflicting choices of life and dignity).Theme 4:preference management dilemmas(practical difficulties in adhering to patient preferences,impediments to decision-making due to unknown patient preferences).Conclusion Surrogate decision-makers of severe stroke patients face multiple decision-making dilemmas.Healthcare professionals should provide emotional support in multiple ways and comprehensive support to reduce the decision-making dilemmas experienced by surrogate decision-makers,as well as implement death education for surrogate decision-makers and promote advance care planning to reduce their decision-making stress.

Objective:To explore the effects of quality control circle activity in the respiratory function exercise in patients with esophageal cancer.Methods:From June 2018 to June 2019, convenience sampling was used to select 96 patients with esophageal cancer admitted to the Cancer Hospital Affiliated to Zhengzhou University as the research object. According to the principle of computer randomization, patients were divided into experimental group and control group, with 48 cases in each group. Patients in control group were given nursing case based on enhanced recovery after surgery, and experimental group carried out quality control circle activity on the basis of the control group. The correct rate of breathing exercise and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) were compared between the two groups of patients. Results:After intervention, the correct rate of respiratory function exercise in experimental group was higher than that in control group, and the difference was statistically significant ( P<0.05) . The FEV 1/FVC of experimental group was higher than that of control group one day before discharge, and the difference was also statistically significant ( P<0.05) . Conclusions:Quality control circle activity applied to patients after esophageal cancer surgery can increase the correct rate of patients' respiratory function exercise and effectively improve the patient's lung function.