Objective:To explore the views of adolescents with asthma on factors affecting disease self-management, so as to provide a basis for improving self-management of asthma children, and propose improvement suggestions.Methods:This study was a descriptive qualitative study. From February to June 2023, 10 to 17 year old children with asthma were recruited at the Asthma Clinic of the Children's Hospital affiliated to Capital Institute of Pediatrics through purposive sampling. One-on-one semi-structured interviews were conducted around self-management and its related factors, and the thematic analysis was used to analyse interview materials.Results:A total of 17 adolescents with asthma, aged (13.00±2.03) years, with a course of disease of (5.00±2.85) years, were included. The interview materials included two aspects, namely facilitators and barriers of self-management. The facilitators were coded into three themes and seven sub-themes, including the individual management awareness of children with asthma (sense of responsibility, compliance awareness), social support (parental care and compensation, teacher and classmate support, patient interaction), and health education (health guidance from doctors and nurses, school health propaganda). Barriers were encoded into three themes and six sub-themes, including disease cognition (demand competition, importance), social environment (interpersonal interaction, physical environment), and healthcare services (accessibility of medical services, school related medical resources) .Conclusions:The self-management of adolescents with asthma is affected by multiple factors. Individual management awareness, social support, and health education can promote self-management in children with asthma, while unfavorable factors in disease cognition, social environment, and healthcare services can hinder self-management in children with asthma. Medical and nursing staff should develop and implement empowerment plans for self-management of asthma children, by mobilizing multi-channel medical resources, providing multi-dimensional full process empowerment, and helping asthma children build a diverse interpersonal support network system, in order to promote effective health management transition for adolescents with asthma.

Objective:To explore the process and content of family management of asthma children and their caregivers, so as to provide basis for improving the health outcomes of asthma children.Methods:This study is qualitative research. From March to April 2022, 26 children and 26 main caregivers from the Asthma Clinic of the Children's Hospital affiliated to the Capital Institute of Pediatrics were selected by objective sampling for semi-structured interviews. QSR Nvivo 12 software and subject analysis method were used to analyze the data.Results:A total of 4 themes and 13 sub-themes were extracted, including the content on family management of asthma children (inducement prevention, drug management, disease monitoring), the family management style of asthma children (disease management concept, asthma management expectation, disease management life routine, disease essence understanding, disease management difficulty), and the family factors affecting the transition of family management of asthma children to self-management (promoting transition factors, obstructing transition factors), psychosocial state (numbness, optimism and stigma) .Conclusions:The family management of asthma children needs the intervention and support of professional nursing staff to improve the family management and the health outcomes of asthma children.

Objective: To investigate the risk factors affecting the occurrence of complications in patients with vaginal bleeding after in vitro fertilization/intracytoplasmic sperm injection embryo transfer(IVF/ICSI-ET) and the construction of nomogram prediction model. Methods: A total of 272 patients with threatened abortion after IVF/ICSI-ET were retrospectively analyzed in this study. They were divided into the live birth group and abortion group according to the final outcome of pregnancy. Patient characteristics were evaluated using the chi-square test, independent-samples Student's t-test or Wilcoxon rank sum test. A nomogram was created to predict the pregnancy outcome of women with threatened abortion who received IVF/ICSI using multivariate logistic regression coefficients. Results: There was no significant difference in the basic data, percentage of frozen embryos, treatment method, number of embryos transferred, high-quality embryo rate, and embryo implantation rate of the live birth group and abortion group(P>0.05). There were significant differences in body mass index, the onset of vaginal bleeding time after transplantation, serum levels of hCG and progesterone on 14 th day after embryo-transfer, and the number of gestational sacs between the two groups(P<0.05). After multivariate logistic regression analysis, the onset of vaginal bleeding time after transplantation and serum hCG levels on 14 th day after transfer were statistically significant(P<0.05). The nomogram was established based on the above indicators, with an area under the curve of 0.710 for the nomogram. The area under the ROC curve of our nomogram was better than the area under the ROC curve of a single risk factor(AUC of bleeding time after embryo-transfer: 0.644, AUC of serum hCG14:0.625). Conclusion The nomogram model established based on the onset of vaginal bleeding time after embryo-transfer and serum hCG value on 14 th day after embryo-transfer can better predict pregnancy outcome of patients with threatened abortion after IVF/ICSI-ET.

Objective:To evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on sleep quality in patients with post-stroke sleep disorder (PSSD).Methods:The clinical randomized controlled trials involving PSSD patients who received rTMS were retrieved from nine medical databases. After excluding duplicated references, screening for independent references and risk evaluation, the remaining references were input into RevMan5.4 software for meta-analysis.Results:Twelve eligible literatures were included in the final analysis. Meta-analysis results revealed that after rTMS intervention, there were significant differences in the following terms between the treatment and control groups (all P < 0.05): Pittsburgh sleep quality index score [MD = -2.60, 95% CI (-3.03, -2.17), P < 0.000 01]; sleep latency [MD = -9.69, 95% CI (- 16.87, - 2.50), P < 0.01], sleep efficiency [MD = 8.90, 95% CI (5.41, 12.39), P < 0.01], number of awakenings [MD = -1.15, 95% CI (- 2.26, - 0.04), P = 0.04], awakening duration [MD = -10.95, 95% CI (- 13.30, -8.61), P < 0.01], and rapid eye movement [MD = 4.54, 95% CI (2.24, 6.85), P < 0.01] in polysomnography; brain-derived neurotrophic factor score [MD = 5.29, 95% CI (2.47, 8.11), P = 0.0002]; clinical curative rate [ OR = 4.46, 95% CI (2.75, 7.23), P < 0.000 01]. Conclusion:rTMS can improve the sleep quality in patients with PSSD, which is worthy of clinical promotion.

Radiotherapy is one of the most common treatments for oral cancer. However, in the clinic, recurrence and metastasis of oral cancer occur after radiotherapy, and the underlying mechanism remains unclear. Cancer stem cells (CSCs), considered the "seeds" of cancer, have been confirmed to be in a quiescent state in most established tumours, with their innate radioresistance helping them survive more easily when exposed to radiation than differentiated cancer cells. There is increasing evidence that CSCs play an important role in recurrence and metastasis post-radiotherapy in many cancers. However, little is known about how oral CSCs cause tumour recurrence and metastasis post-radiotherapy. In this review article, we will first summarise methods for the identification of oral CSCs and then focus on the characteristics of a CSC subpopulation induced by radiation, hereafter referred to as "awakened" CSCs, to highlight their response to radiotherapy and potential role in tumour recurrence and metastasis post-radiotherapy as well as potential therapeutics targeting CSCs. In addition, we explore potential therapeutic strategies targeting these "awakened" CSCs to solve the serious clinical challenges of recurrence and metastasis in oral cancer after radiotherapy.
Humans ; Mouth Neoplasms ; pathology ; radiotherapy ; Neoplasm Recurrence, Local ; radiotherapy ; Neoplastic Stem Cells ; pathology ; radiation effects ; Radiotherapy ; methods ; Recurrence

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.

Objective To investigate the effects of transient receptor potential melastatin (TRPM) 7 on dexamethasone (Dex)-mediated cytoskeleton remodeling in human trabecular meshwork.Methods Human trabecular meshwork cells (HTMs) were primarily cultured and the cells of generation 3 to 6 were used in this study.The expression of TRPM7 protein in the cells was located using immunofluorescence technology.Dex at the dose of 0.2 mg was added into culture medium for 4 days with the final concentration of 1×10-5,1×10-6 and 1×10-7 mol/L,respectively.Western blot assay was employed to detect the relative expression level of TRPM7 protein.Cultured cells were divided into non-transfected group,siRNA transfected group,TRPM7-siRNA1 transfected group and TRPM7-siRNA2 transfected group,and the expressions of TRPM7 protein and p-cofilin protein in the cells were assayed by Western blot method.Cultured cells were divided into normal control group,Dex-treated group,siRNA transfected group and TRPM7-siRNA transfected group,and the expression of phalloidin (a cytoskeletal protein) and Vinculin (focal adhesion protein) was detected by immunofluorescence staining.In addition,cultured cells were divided into normal control group,Dex-treated group,2-APB (a Ca2+ inhibitor) treated group,ethylene glycol tetraacetic acid (EGTA) (a calcium chelator)-treated group,TRPM7-siRNA transfected group and TRPM7-siRNA+Dex group,and the [Ca2+] i in the cells was observed by Fluo-3AM immunofluorescence staining.Western blot assay was used to detect the expression of p-cofilin in the cells.Results TRPM7 was positively expressed on the cell membrane.The relative expression of TRPM7 was gradually reduced with an increase of Dex dose (F=4.210,P＜0.05),and the expression of TRPM7 was significantly decreased in 1 × 10-5 mol/L Dex group compared with the normal control group (P＜ 0.05).Western blot assay revealed that the relative expression levels of TRPM7 in the TRPM7-siRNA1 and TRPM7-siRNA2 group were significantly lower than those of non-siRNA transfected group and siRNA transfected group (all at P＜0.05).In the Dex-treated group and TRPM7-siRNA transfected group,the cells were enlarged in size with the lessened processes in comparison with the normal control group.Immunofluorescence staining showed that the actin fiber and vinculin increased in the Dex-treated group,and more spread but depolymerized actin fiber was seen in the TRPM7-siRNA transfected group.Compared with the normal control group,the fluorescence intensity of [Ca2×] i was weak in the Dex-treated group and TRPM7-siRNA transfected group.The relative expression levels of p-confilin protein was lower in the TRPM7-siRNA transfected group than that in the siRNA transfected group (0.317 ±0.031 vs.0.092±0.071) (t =5.030,P =0.007).Conclusions Dex induces the downregulation of TRPM7 expression in HTMs.The downregulation of TRPM7 probably participates in Dex-induced cytoskeletal remodeling by causing the depolymerization of actin cytoskeleton and reduction of [Ca2+] i in HTMs.

Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.

Objective To evaluated the value of myocardial perfusion before delayed percutaneous coronary intervention (PCI) for predicting the recovery of systolic function of patients with acute myocardial infarction (AMI).Methods A total of 64 patients with AMI receiving delayed PCI treatment in the First People's Hospital of Foshan from January 2014 to June 2015 were selected.One day prior to delayed PCI,all of the patients underwent two dimensional strain to measure the longitudinal peak systolic strain (LPSS) of each left ventricular segment and the global longitudinal strain (GLS) of the left ventricle.The myocardial perfusion score (MPS) and the perfusion score index (PSI) were measured by myocardial contrast echocardiography (MCE).Left ventricular myocardial perfusions were classified as good,reduced,or absent.The two dimensional strain measurements were again conducted at 6 months after the delayed PCI to assess LPSS and GLS.The change of GLS and LPSS between one day prior to delayed PCI and six months after delayed PCI was assessed by paired t-test.The differences of LPSS among good,reduced,or absent myocardial perfusion groups were analyzed by one-way ANOVA.LSD-t test was used to compare in pairs of groups that had different values.The correlations between PSI and GLS,MPS and LPSS were assessed by Spearman's rank-correlation test.Results The GLS of all patients were higher at six months after delayed PCI than at one day prior to delayed PCI [(-15.39±7.80)％ vs (-12.44±8.38)％,t=14.398,P ＜ 0.001].The LPSS of myocardial perfusion in good,reduced and absent groups at one day prior to delayed PCI were (-2.64±5.60)％,(-6.19±6.87)％ and (-12.07±5.86)％,respectively.The LPSS of myocardial perfusion in good,reduced and absent groups at six months after delayed PCI were (-2.97 ± 4.93)％,(-11.38± 7.26)％ and (-15.82 ± 5.97)％,respectively.The myocardial LPSS of left ventricular segment with good or reduced perfusion was significantly higher at six months after delayed PCI (t=13.013,10.821,both P ＜ 0.001),but the LPSS of left ventricular segment with absent perfusion was similar to that of pre-PCI.Whether at one day prior to delayed PCI or six months after delayed PCI,there were significant differences in LPSS parameters among the three groups (at one day prior to delayed PCI,myocardial perfusion absent vs reduced or good,t=4.201 and 11.771,both P ＜ 0.001;myocardial perfusion reduced vs good,t=12.561,P ＜ 0.001;at six months after delayed PCI,myocardial perfusion absent vs reduced or good,t=9.714 and 15.646,both P ＜ 0.001;myocardial perfusion reduced vs good,t=9.254,P ＜ 0.001).The LPSS both at one day prior to delayed PCI and six months after delayed PCI in myocardial perfusion good group ＞ those of myocardial perfusion reduced group ＞ those of myocardial perfusion absent group.PSI was positively correlated with GLS at both one day prior to delayed PCI and six months after delayed PCI (r=0.69,0.72,both P ＜ 0.001).MPS was positively correlated with LPSS at both one day prior to delayed PCI and six months after delayed PCI (r=0.49 and 0.45,both P ＜ 0.001).Conclusion Myocardial perfusion before delayed PCI,monitored by MCE,is correlated well with myocardial systolic function,and may be used to predict the recovery of myocardial systolic function after delayed PCI.

Objective To explore the distribution characteristics of ankle-brachial index ( ABI) examination for peripheral arterial dis-ease in diabetic patients, and to provide basis for clinical diagnosis. Methods Randomly selected 110 cases of patients who were admitted into our hospital from February 2014 to January 2015, and divided them into the observation group (34 cases with diabetic lower extremity peripheral vascular lesions) and the control group (76 cases without diabetic lower extremity peripheral vascular lesions). Measured the ABI of the two groups, and analyzed the value of ABI data range for the diagnosis of diabetic lower extremity peripheral vascular lesions. Mean-while, analyzed the risk factors of peripheral arterial disease in diabetic patients according to ABI. Results The sensitivity of ABI for diag-nosis of diabetic lower extremity peripheral vascular lesions was 91. 18%, and the coincidence rate was 95. 36%, the specificity was 98. 68%, the misdiagnosis rate was 8. 82%, and the omission diagnostic rate was 8. 82%. ABI of the observation group was obviously lower than that of the control group, and the difference was statistically significant (P<0. 05). Conclusion ABI examination could be basis of clinical diagnosis and important standard of disease assessment for peripheral arterial disease in diabetic patients. It is suggested to strengthen the control of blood glucose, blood pressure and weight of patients with diabetes in order to reduce the risk of morbidity.