Objective To explore the mechanism of Fuke Zhixuexiaotong Keli in rats model of incomplete puerperal involution of uterus by detecting the expression of metalloproteinases-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) in the uterine redintegration incomplete model.Methods Seventy-two SD female rats were randomly divided into 6 groups:blank group,model group,Chanfukang group,and high-,middle-,low-dose of Fuke Zhixuexiaotong Keli group.The model of incomplete puerperal involution of uterus was established,and MMP-9,TIMP-1 gene expression level in each group were detected by in situ hybridization detection of uterine tissue.Results The expression of MMP-9 and TIMP-1 could be successfully detected in each group.The expression of MMP-9 in model group was significantly higher than the control group,and the expression of TIMP-1 was lower.The mRNA of MMP-9 gene was significantly decreased in both high-,middle-and low-dose of Fuke Zhixuexiaotong Keli group and Chanfukang group(P

005), while iron overload occurred in 8 of 57 cases of ?-thalassemia (14.0%) and 89 out of 386 cases of ?-thalassemia (23.1%). Although the occurrence rate of iron overload in ?-thalassemia appeared higher than that in ?-thalassemia, no significant difference existed. Homozygote ?-thalassemia was prone to iron overload, followed by non-deletion HbH diseases, at the occurrence rate of 79.2% and 27.3% respectively. Iron deficiency was inclined to be associated with silent ?-thalassemia at the occurrence rate of 45.5%, followed by heterozygote ?-thalassemia (30.3%). Conclusion Both iron overload and iron deficiency can be found in thalassemia. Therefore, special treatments should be carried out according to given cases.

BACKGROUND: The effects of low-level laser biostimulation have been proved by various experimental studies and clinical application, which are manifested as tissue repairing, analgesia, antiinflammation, etc.OBJECTIVE: To observe the effects of He-Ne laser and low-level CO2 laser irradiation on fracture healing.DESIGN: A randomized controlled animal experiment. SETTING: Research Room of Laser Medicine, Chengde Medical College.MATERIALS: Forty-eight healthy male New Zealand rabbits, weighing 2.0-2.5 kg, were used.METHODS: The experiments were carried out in the Research Room of Laser Medicine, Chengde Medical College from 1998 to 2003. ①The 48 rabbits were induced into models of experimental fracture of the left radius, and then they were divided into three groups with 16 rabbits in each group: control group, He-Ne laser irradiation group and CO2 laser irradiation group. The fracture areas of the animals in the He-Ne and CO2 laser irradiation groups were respectively irradiated with 28 mW/cm2 He-Ne laser and 150 mW/cm2 CO2 laser for 10 minutes, once a day. ② The animals were killed on the 15th and 35th days after taking roentgenogram respectively. At 15 days, the collagen and calcium contents in callus were detected. At 35 days, the biomechanic anti-torsion strength was examined.MAIN OUTCOME MEASURES: ①Results of roentgenogram in each group; ② Collagen and calcium contents in callus; ③ Results of biomechanic anti-torsion strength.RESULTS: Totally 45 rabbits were involved in the analysis of results. ① On the 15th and day after fracture, the roentgenogram, collagen and calcium contents in callus in the He-Ne and CO2 laser irradiation groups were better than those in the control group, and the collagen and calcium contents in callus were higher in the CO2 laser irradiation group than in the He-Ne laser irradiation group [(341.9±30.1) vs (302.1±28.7) mg/g; (197.1±19.7)vs (156.5±17.6) mg/g, P＜ 0.05]. ②On the 35th days after fracture, the biomechanic anti-torsion functions in the He-Ne and CO2 laser irradiation groups were superior to that in the control group, and there were no significant difference between the two laser irradiation groups. ③ The results of roentgenogram in the He-Ne and CO2 laser irradiation groups were better than that in the control group both on the 15th and 35th days after fracture, and there was no significant difference between the two irradiation groups.CONCLUSION: Both CO2 laser and He-Ne laser irradiations can accelerate the process of fracture healing, and the curative effect of CO2 laser is better than that of He-Ne laser on the 15th day after fracture, but there is no significant difference clinically between the CO2 laser and the He-Ne laser irradiations on the 35th day after fracture.

AIM:This study investigates the apoptotic and autophagic effects of atractylodin on lung cancer cells,elucidating the underlying molecular mechanisms.METHODS:Non-small cell lung cancer(NSCLC)A549 and H460 cells,in addition to non-cancerous HBE cells,were cultured in vitro.The effects of atractylodin at various concen-trations on cell viability were assessed using CCK-8 assay.Apoptotic effects were evaluated through Hoechst staining and flow cytometry,while Western blot analysis was performed to detect changes in protein expressions associated with apopto-sis and autophagy,including P62,beclin-1,microtubule-associated protein 1 light chain 3(LC3),Kelch-like epichloro-hydrin(ECH)-associated protein-1(Keap-1),nuclear factor E2-related factor 2(Nrf2),heme oxygenase-1(HO-1),and NAD(P)H:quinone oxidoreductase 1(NQO1).Autophagic flux was further analyzed using acridine orange(AO)stain-ing,and immunofluorescence for LC3 and Nrf2.Additionally,autophagy inhibition experiments were conducted using chloroquine(CQ),followed by analyses of autophagy and apoptosis.Reactive oxygen species(ROS)levels were quanti-fied using DCFH-DA.RESULTS:Treatment with atractylodin significantly reduced the viability of A549 and H460 lung cancer cells,promoting apoptosis and inducing autophagy.This was evidenced by an increase in acidic autophagic vesi-cles,upregulation of LC3 and beclin-1,and downregulation of P62.Inhibition of autophagy by chloroquine reversed atrac-tylodin-induced apoptosis.Moreover,atractylodin heightened ROS production,inhibited Keap-1,and stimulated the ex-pression of Nrf2,HO-1 and NQO1.CONCLUSION:Atractylodin effectively inhibits the proliferation of lung cancer cells by inducing apoptosis and autophagy.These effects are mediated through the modulation of the ROS/Nrf2/HO-1 sig-naling pathway,underscoring its potential as a therapeutic agent in lung cancer treatment.

Objective:To summarize the best evidence of rehabilitation exercise in patients with lumbar spinal stenosis surgery.Methods:The evidence-based questions were established based on PIPOST's principles, and Wanfang data, China National Knowledge Infrastructure, China Biology Medicine disc, UpToDate, PubMed, Embase, Web of Science, American Medical Association, Orthopedic Branch of Chinese Medical Doctor Association and other databases and websites were searched by computer. The search period was from the establishment of the databases to October 31, 2022. Two researchers conducted quality evaluation, evidence extraction, and summarization of the included literature.Results:A total of 10 articles were included, including six expert consensus articles, three systematic review articles, and one meta-analysis article. A total of 16 pieces of evidence were summarized from nine aspects of rehabilitation exercise evaluation, principles, timing, methods, health education, psychotherapy, pain management, evaluation and post discharge follow-up.Conclusions:This study summarizes the best evidence for rehabilitation exercise in patients with lumbar spinal stenosis after surgery, and it suggests that healthcare professionals apply evidence based on clinical context and patient willingness.

A novel technology is proposed for non-contact and real-time detection of atrial fibrillation using millimeter-wave radar.A 60 GHz PCR millimeter wave radar is used to continuously detect the chest echo signal of the subject.After signal acquisition,I-Q signal is generated through I-Q demodulation,and the signal phase information is extracted using effective points phase trend evaluation for obtaining the signals from oscillations in the chest wall,from which the respiratory signals and cardiac signals are extracted through digital filtering for the analysis of cardiac movement.Whether the atrial fibrillation occurs or not is determined by the characteristics of atrial fibrillation wave in the time domain.The effective points phase trend evaluation for extracting more accurate signal phase information and the time-domain method for real-time atrial fibrillation detection are the innovations of the study.The experimental results show that the proposed method achieves a detection accuracy of 99.2%in clinic.

Background::The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.Methods::This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.Results::The optimal cut-off values of L3-SMI were 39.50 cm 2/m 2 for male patients and 33.06 cm 2/m 2 for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis ( Wald = 6.347, P = 0.012). Conclusions::This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.

This study investigated the primary pathogenesis and syndrome evolution of different heart failure with preserved ejection fraction(HFpEF)stages based on the classical and clinical experience of traditional Chinese medicine(TCM),combined with the clinical characteristics of pre-heart failure,symptomatic heart failure,and advanced heart failure.This study summarizes and refines the three core syndrome factors:water,deficiency and blood stasis.Water-fluid retention was observed throughout these three stages,from the beginning to the end.With the advancement of the disease,the heart yang changes from stagnation to deficiency,water-fluid retention gradually increases,blood stasis becomes increasingly prominent,and the disease location develops dynamically from the upper to the middle and lower jiao.This study proposes three methods of treating HFpEF.The main pathogenesis of pre-heart failure is lung qi dysfunction-induced water retention,which can be treated by dispersing lung qi and transforming water retention using Fuling Xingren Gancao Decoction.The primary pathogenesis of symptomatic heart failure is yang and qi deficiency-induced water retention,which can be treated with tonifying yang,supplementing qi,and transforming water retention using Shengxian Decoction combined with Linggui Zhugan Decoction.The primary pathogenesis of advanced heart failure is yang deficiency with blood stasis and water retention affecting the heart,which can be treated with tonifying yang,circulating blood,and expelling water retention using Zhenwu Tingli Decoction.Chinese medicine can be flexibly added or subtracted according to the patients'concurrent patterns.However,the daily care of patients should be considered.This study explores the staging treatment of HFpEF from water,deficiency and blood stasis to provide a TCM clinical reference for treating HFpEF.

Objective:To understand the current rehabilitation status and existing problems of patients with degenerative scoliosis after surgery, and analyze the needs of continuous health education for patients.Methods:A total of 15 patients with degenerative scoliosis undergoing surgical treatment in Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from December 2021 to June 2022 were selected by the convenient sampling method. The semi-structured interview was used to understand the patient's feelings on the operation effect, experience on the postoperative life impact, thoughts on rehabilitation exercise, self-cognition of home status and future development planning. Based on the rooted theory, Colaizzi 7-step analysis was applied to extract the topic.Results:The four themes related to the continuous health education needs of patients with degenerative scoliosis after surgery were summarized, which were unacceptable movement limitation of lower back or lower extremity, blind area of continuous rehabilitation exercise, lack of knowledge of self-management of spinal disease after surgery and need for social and psychological support.Conclusions:Patients with degenerative scoliosis lack of postoperative rehabilitation knowledge and skills, and the need for health education is strong. Medical staff can meet the patients' transitional care needs by educating them to adapt to the current situation, providing personalized rehabilitation goals, guiding patients in managing risk factors that affect their own rehabilitation and improving social and family support systems, thereby promoting rapid recovery of patients.

Objective:To explore the clinical effects of the best evidence-based practice plan for rehabilitation exercises in patients undergoing surgery for lumbar spinal stenosis (LSS) .Methods:Guided by the evidence-based practice model of the Joanna Briggs Institute (JBI) Center for Evidence-Based Healthcare in Australia, the best evidence was combined with the clinical context to develop quality review indicators for clinical practice. In December 2022, a baseline review was conducted with 30 patients undergoing surgery for LSS (before evidence application). From December 2022 to February 2023, the baseline review results were analyzed to identify facilitating and obstructive factors between the current status and the review indicators, and improvement strategies were implemented based on available resources. In February 2023, another 30 patients (after evidence application) were selected to evaluate the post-application effects. The Japanese Orthopedic Association (JOA) score, Oswestry Disability Index (ODI), Tampa Scale for Kinesiophobia (TSK) score, General Self-Efficacy Scale (GSES) score, and quality of life scores were compared between the two groups at 24 hours, 1 month, 3 months, and 6 months postoperatively. The execution rate of clinical quality review indicators and the knowledge scores on rehabilitation exercises of 25 nurses before and after training were also compared.Results:There were no statistically significant differences in JOA scores, ODI, TSK scores, GSES scores, and quality of life scores between the two groups at 24 hours postoperatively ( P > 0.05). However, there were statistically significant differences in these scores at 1, 3, and 6 months postoperatively ( P< 0.01). After evidence application, the execution rate of seven clinical quality review indicators improved, and the knowledge scores on rehabilitation exercises of the 25 nurses increased significantly ( P< 0.05) . Conclusions:The evidence-based practice for rehabilitation exercises in patients undergoing surgery for LSS is safe and feasible. It standardizes evidence-based nursing practice behavior, enhances nurses' knowledge levels, effectively improves postoperative lumbar function, promotes physical rehabilitation, and enhances the quality of life.