Objective To assess the serum level of stromal-cell-derived factor 1 (SDF-1) in patients with congenital heart disease (CHD) and pulmonary arterial hypertension. Methods The heart color Doppler ultrasound was conducted to measure the tricuspid regurgitation velocity, in order to estimate pulmonary artery systolic pressure. According to the existing standards, a total of 86 patients were divided into CHD without pulmonary hypertension group (n=16), mild pulmonary hypertension group (n=18), moderate pulmonary hypertension group (n=17), severe pulmonary hypertension group (n=15). Another 20 healthy chil-dren were recruited as control group (n=20), The serum level of SDF-1 was detected by the ELISA method. Results The serum SDF-1 levels were signiifcantly lower in CHD groups than in control group (F=27.793, P<0.001). In CHD groups, CHD with se-vere pulmonary hypertension group had the lowest SDF-1 level, and CHD without pulmonary hypertension group had the highest SDF-1 level. There were signiifcant differences between CHD groups (P<0.05). The pulmonary artery systolic pressure was cor-related with serum SDF-1 levels (r=-0.737, P<0.001). Conclusions The serum level of SDF-1 is decreased in patients with CHD, and is negatively correlated with the severity of pulmonary arterial hypertension.

Objective To explore the mechanisms of coronary artery lesions in patients with Kawasaki disease by detecting thrombomodulin level in both acute and convalescence stages. Methods Fifty-eight patients were recruited in which 34 were male and 24 were female. This group was further divided into coronary artery lesion group(25 cases) and non-coronary artery lesion group(33 cases). Normal control group was consisted of 30 healthy children in which 17 were male and 13 were female. Thrombomodulin was measured by enzyme linked immunosorbent assay. Results Compared with the control group, TM level was increased in the Kawasaki disease group. TM level in the acute stage group and convalescence group was higher than that of the control group, TM level in acute stage group was higher than that of the convalescence group (P<0.05). Compared with non-coronary artery lesion group, TM level of the coronary artery lesion group was increased and the difference was significant (P<0.01). Correlation analysis showed that the TM level was positively related with coronary complications of the Kawasaki disease (r=0.855, P<0.01 ). Conclusion TM increases significantly in Kawasaki disease. It is correlated with the development of coronary artery lesions. In addition, it is also associated with apparent hypereoagulation and thrombocytophilia. TM can predict the development of coronary artery lesions.

Objective To assess the effect of PRISMA statement on intervention-related systematic reviews and meta-analyses published in Evidence-based medicine .Methods Intervention-related systematic reviews and meta-analyses published in Evidence-based medicine from 2001 to 2011 were assessed according to the PRISMA scale and analyzed by Meta Analysist software.Results Seventy intervention-related systematic reviews and meta-analyses involving 14-disease spectra were included in this study.PRISMA statement and systematic reviews and meta-analysespublished by au-thors in colleges and universities could improve their academic level (P<0.05), fund support and the number of authors showed no significant effect on their academic level.Conclusion Literature retrieval methods,literature screening methods,bias assessment methods, and other analyzing methods used systematic reviews and meta-analyses published in Evidence-based medicine and their academic level can be improved by PRISMA statement.

Objective:To observe the clinical effects of conservative sequence method in the treatment of anterior disk displacement without reduction(ADDWR).Methods:300 patients with ADDWR were included.200 patients were treated by conservative sequence method (including upper articular cavity lavage with single needle + injection of sodium hyaluronate gel + physical therapy + gimmick reset + oral exercise) (group 1);the other 100 were treated by injection of sodium hyaluronate gel(group 2).Maximum mouth opening (MM0) and pain visual analogue scale(VAS) were measured and compared before and after treatment.Results:In group 1 the effective rate was 95.5％,before treatment MMO was (22.90 ± 3.18) mm,VAS (5.81 ± 0.32);3 months after treatment MMO (37.05 ± 4.43) mm,VAS (1.29 ± 0.19);6 months after treatment MMO (36.29 ± 4.08) mm,VAS (1.37 ± 0.22);12 months after treatment MMO (35.76 ±3.87) mm,VAS (1.52 ±0.28),respectively.In group 2,the effective rate was 78％,before treatment MMO was(23.12 ±4.02) mm,VAS (6.11 ±0.67);3 months after treatment MMO (36.11 ±4.02),VAS (1.89 ±0.21);6 months after treatment MMO (35.49 ±3.78),VAS (2.21 ±0.32);12 months after treatment MMO (31.53 ±4.87) mm,VAS (3.88 ±0.51)mm,respectively.By statistics,all the measurments showed statistical significance(P ＜ 0.05) between 2 groups.Conclusion:Conservative sequence method is more effective in the treatment of ADDWR.

Objective: To investigate the prognostic value of prognostic nutritional index (PNI) in patients with diffuse large B-cell lym-phoma (DLBCL). Methods: We retrospectively reviewed the medical records of 82 patients with DLBCL treated at Tianjin Union Medi-cal Center between June 2010 and June 2016. The optimal cutoff value of PNI was determined using a receiver operating characteristic (ROC) curve and the Youden index. The relationship of high and low PNI with the clinical characteristics of the patients, therapeutic ef-ficacy, and prognosis were analyzed. Results: Overall, mean PNI of the patients was 46.17±8.8. When the PNI was 44.15, the Youden in-dex was found to be maximal, with a sensitivity of 74.6% and specificity of 67.2%. There were 38 patients (46.3%) in the low PNI group (<44.15) and 44 patients (53.7%) in the high PNI group (≥44.15). Data analysis showed that PNI was correlated with Eastern Coopera-tive Oncology Group performance status (ECOG PS), Ann Arbor stage, international prognostic index (IPI) score, and lactic acid dehydro-genase (LDH) level (P<0.05). The total effective rate of the low PNI group was significantly lower than that of the high PNI group (65.8% vs. 86.4%; χ2=4.848; P=0.028). The 3-year overall survival (OS) rate of the entire group of patients was 69.1%. The 1-, 2-, and 3-year OS rates of the low PNI group (86.8%, 67.8%, and 56.9%, respectively) were significantly lower than that of the high PNI group (96.7%, 89.5%, and 80.2%, respectively; χ2=9.421, P=0.002). Univariate analysis showed that PNI<44.15, ECOG PS≥2, IPI>2, stageⅢ/Ⅳ, and lymphocyte count<1.0×109/L had a significant impact on predicting OS (P<0.05). Multivariate analysis showed that PNI<44.15 (P=0.006) and stageⅢ/Ⅳ(P=0.011) were independent factors for predicting OS. Conclusions: PNI might be used as a simple and feasible clinical prognostic indicator in patients with DLBCL.

Objective:To explore the mediating role of illness perception in the relationship between fear of disease progression and sleep quality in patients with ovarian cancer during chemotherapy, and to provide a theoretical basis for improving sleep quality in patients with ovarian cancer during chemotherapy.Methods:From January to August 2022, 300 patients with ovarian cancer undergoing chemotherapy in Shandong First Medical University Affiliated Provincial Hospital, Qilu Hospital of Shandong University, Shandong Cancer Hospital were included by convenient sampling. A cross-sectional questionnaire survey included the Chinese version of the Fear of Progression Questionnaire Short Form for cancer patients, the Brief Illness Perception Questionnaire, and the Pittsburgh Sleep Quality Index. Bivariate factor analysis, Spearman correlation analysis, and the Bootstrap confidence interval evaluation method were used.Results:A total of 287 valid questionnaires were collected. The scores of fear disease progression, illness perception, and sleep quality were 30.00 (22.00, 36.00), 37.00 (32.00, 44.00), and 6.00 (3.00, 11.00), respectively. Sleep quality was positively correlated with fear disease progression ( r=0.250, P<0.001) and illness perception ( r=0.326, P<0.001). Illness perception played a partial mediating role in the relationship between fear of disease progression and sleep quality, accounting for 41.4% of the total effect. Conclusions:Ovarian cancer patients during chemotherapy reported poor sleep quality. In clinical practice, health care providers including nurses can take interventions aimed at reducing fear of disease and improving illness perception level to improve the sleep quality of ovarian cancer patients during chemotherapy.

Objective : To study the correlation between cerebral white matter structure with cognitive function and blood biochemical indexes in patients with end stage renal disease (ESRD) . Methods : The diffusion tensor imaging (DTI) data of 64 ESRD patients and 47 age and sex matched healthy people were collected. Tract⁃based spatial statistics (TBSS) and XTRACT analysis methods were used to compare the differences in diffusion parameters between the two groups. Pearson correlation analysis was used to detect the correlation between various diffusion parameters and blood biochemical indexes and cognitive related scales. Results : The values of FA in the ESRD group generally decreased (P < 0. 05) . The values of MD, AD and RD obviously increased (P < 0. 05) . The scores of mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA) decreased (P < 0. 01), while that of trail making test A part (TMT⁃A) increased (P < 0. 05) . In the ESRD group, the values of FA in the right anterior thalamic radiation, optic radiation, acoustic radiation, and cingulum were negatively correlated with the levels of creatinine and urea nitrogen, and positively correlated with MoCA′s scores, and the values of MD and RD of these tracts were positively correlated with the concentration of urea. The values of FA in optic radiation, acoustic radiation and left temporal of cingulum were negatively correlated with the scores of TMT⁃A. The values of FA in the vertical occipital fasciculus, inferior fronto⁃occipital fasciculus, left middle longitudinal fasciculus and forceps major were negatively correlated with the concentration of creatinine. The values of FA in the left arcuate fasciculus were positively correlated with the MoCA′s score, the values of MD and RD of these tracts were positively correlated with the concentration of creatinine, and negatively correlated with the scores of MMSE and MoCA. The values of FA in the right superior longitudinal fasciculus, the right corticospinal tract and the right frontal aslant tract werepositively correlated with the MoCA′s score, the values of MD and RD of these tracts were positively correlated with the concentration of urea; the values of MD and RD in the left fornix were positively correlated with the level of creatinine and urea. Conclusion The structural integrity of white matter in ESRD patients is extensively damaged, which is significantly associated with a variety of cognitive impairments. Serum creatinine and urea nitrogen may be risk factors for the changes in white matter.