ObjectiveTo conduct a systematic review of the effect of active music therapy on cognitive function for older adults with cognitive impairment based on International Classification of Diseases, the 11th Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). MethodsA PICO framework was constructed. Thematic keyword searches were conducted in databases including PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang data, for literature on the effect of active music therapy on cognitive function for older adults with cognitive impairment, published up to November 5th, 2023. Information on authors, countries, publication date, sample characteristics, study designs, intervention methods, measurement tools and outcomes were extracted. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. ResultsEight researches from six countries were included, which were all randomized controlled trials involving 356 older adults with mild cognitive impairment and dementia. The articles were published from 2014 to 2020, with an average of 7.4 of the PEDro scale. Active music therapy was used by singing and playing instruments. Interventions took place in hospitals, nursing homes, and health centers. The intervention duration ranged from mostly 30 to 60 minutes a time, with a few 120 minutes a time. Interventions were implemented mostly one to three times a week, lasting from eight to twelve weeks. Health outcomes focused on cognitive function, including overall cognitive function, executive function, attention function and memory function. ConclusionA theoretical framework for the benefits of active music therapy on the cognitive function for older adults with cognitive impairment has been constructed based on ICD-11 and ICF. Active music therapy can improve overall cognitive function, executive function, attention function and memory function for older adults with cognitive impairment.

Objective To investigate the radiosensitizating effect of quercetin(QU)loaded manganese dioxide nanoparticles[Mn(QU)]on breast cancer cell line 4T1 and tumour-bearing mice.Methods Mang anese dioxide(MnO2)nanoparticles were synthesized by oleic acid template method.The morphology and chemical composition of MnO2 nanoparticles were characterized by transmission electron microscopy(TEM),scanning electron microscopy(SEM)and X-ray photoelectron spectroscopy.Then QU nanomaterials were encapsulated by using physical adsorption.The composition was characterized by ultraviolet spectrophotometer,and the ability of Mn(QU)nanoparticles reacting with different doses of hydrogen peroxide to produce oxygen at different pH values was detected by dissolved oxygen analyzer.CCK-8 assay was employed to detect the effects of different concentrations of Mn(QU)nanoparticles on the viability of 4T1 cells.Colony formation,γ-H2AX fluorescence staining,ROS fluorescence staining,LIVE/DEAD cell viability assay and flow cytometry were used to evaluate the radiosensitizing and pro-apoptotic effects of Mn(QU)nanoparticles on 4T1 cells.Finally,the effect of Mn(QU)nanoparticles combined with radiotherapy on tumor growth inhibition was evaluated in mouse model of 4T1 cell transplanted tumor.Results MnO2 nanoparticles with particle size of about 120 nm were successfully synthesized and encapsulated with QU.The oxygen generation capacity of the prepared Mn(QU)nanoparticles reacting with hydrogen peroxide was negatively correlated with pH value and positively with hydrogen peroxide concentration.The results of cell experiments showed that Mn(QU)nanoparticles at a concentration of 50 μg/mL had no obvious toxicity to 4T1 cells,but could significantly enhance the X-ray-induced killing effect on 4T1 cells,at a radiotherapy sensitization ratio of 1.61,improve DNA double-strand breaks and ROS production,and induce apoptosis of 4T1 cells.The results of tumor xenograft model experiment indicated that the inhibition of tumor volume was Mn(QU)nanoparticles combined with radiotherapy＞MnO2 nanoparticles combined radiotherapy＞QU combined radiotherapy＞Radiotherapy＞Control.Conclusion Mn(QU)nanoparticles combined with radiotherapy can significantly inhibit the proliferation and show radiosensitization of breast cancer 4T1 cells,and also exert a significant inhibitory effect on the growth of the transplanted tumor.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

According to the world epidemic report, the mortality of patients with severe coronavirus disease 2019 (COVID-19) is high. Diabetic patients are more susceptible to COVID-19. Since the mortality of COVID-19 patients with diabetes is on the top of list, hyperglycemia is considered an independent risk factor for severe COVID-19. Up to now, there is few effective treatment for severe patients infected with 2019 novel coronavirus (2019-nCoV). Clinical studies observed that cytokine storms existed in patients with severe COVID-19. Sustained high levels of cytokines cause diffuse damage to pulmonary capillary endothelial cells and alveolar epithelial cells, resulting in acute respiratory distress syndrome (ARDS). ARDS is the main cause of death in COVID-19 patients. Host-directed therapy (HDT) is an emerging therapeutic method in the field of anti-infection, which can activate the self-protective immune response, suppress excessive inflammatory response, and be used to assist the treatment of traditional drugs to shorten the course of disease. Metformin has been shown to be effective in HDT and can assist in the treatment of the viral and bacterial infectious disease. This paper discusses the rationality and potential therapeutic mechanism of metformin in the treatment of severe COVID-19. It was speculated that the use of metformin for controlling blood glucose in severe COVID-19 patients with diabetes may prevent or inhibit the occurrence of ARDS, thereby reducing the mortality of COVID-19 patients. The possible mechanism is that metformin could inhibit cytokine storm via suppressing interleukin-6 (IL-6) signaling, prevent the process of lung fibrosis, suppress endocytosis, thereby elevating angiotensin converting enzyme 2 (ACE2) expression.

A fitting method of calculating local helix parameters of proteins based on dual quaternions registration fitting (DQRFit) is proposed in this paper. First, the C and N atom coordinates of each residue in the protein structure data are extracted. Then the unregistered data and reference data are constructed using the sliding windows. The square sum of the distance of the data points before and after registration is regarded as an optimization goal. We calculate the optimal rotation matrix and the translation vector using the dual quaternion registration algorithm, and get the helix parameters of the secondary structure which contain the number of residues per turn( ), helix radius( )and helix pitch( ). Furthermore, we can achieve the fitting of three-helix parameters of , , simultaneously with the dual quaternion registration, and can adjust the sliding windows to adapt to different error levels. Compared with the traditional helix fitting method, DQRFit has some advantages such as low computational complexity, strong anti-interference, and high fitting accuracy. It is proven that the precision of proposed DQRFit for α helix detection is comparable to that of the dictionary of secondary structure of proteins (DSSP), and is better than that of other traditional methods. This is of great significance for the protein structure classification and functional prediction, drug design, protein structure visualization and other fields in the future.

Objective To study the effect of improved GIF grading intervention program on gastrointestinal dysfunction in critically ill patients.Methods A total of 78 patients with gastrointestinal dysfunction were randomly divided into the experimental group and control group.The patients in the experimental group were treated with modified GIF classification program to evaluate the gravitational status of patients with severe gastrointestinal dysfunction and the control group received routine nursing and treatment.The levels of serum albumin(ALB),nitrogen balance(NB) and total protein(TP) were recorded in two groups,and the feeding rate of the patients was recorded at 24 and 48 hours.The calorie qualifying rate at 7d,duration of mechanical ventilation,ICU length of stay,total length of stay in hospital,ICU mortality,ICU acquired infection rate were recorded.Results Feeding rate at 24h and 48 h,calorie qualifying rate at 7d in the experimental group were significantly higher than those in the controlgroup (P＜0.05);there were significant differences between two groups in TP,NB,and ALB (P＜0.05).Mechanical ventilation duration,ICU length of stay,and total length of stay in hospital were significantly shortened in the experimental group(P＜0.05);there were no significant differences between two groups in ICU mortality and ICU acquired infection rate(P＞0.05).Conclusion The improvement of AGI grading intervention in patients with severe gastrointestinal dysfunction can improve at 24 h,48 h,calorie qualifying rate at 7 d and TP,NB and ALB levels,reduce the time of mechanical ventilation,reduce total length of stay in hospital.

Objective To evaluate the left ventricular systolic circumferential strain by layer specific speckle tracking imaging in healthy volunteers and patients with left bundle branch block (LBBB).Methods Forty patients with LBBB were divided into two groups,LBBB1 group [left ventricular ejection fraction (LVEF≥50％] and LBBB2 group (LVEF＜50％),and 25 healthy subjects were selected as the control group.High frame rate two dimensional images were recorded from the left ventricular short-axis views at the levels of the mitral annulus,papillary muscle and apex respectively.The peak systolic circumferential strain of the endocardium,myocardium and epicardium were measured using layer-specific strain software.Results The circumferential strain of the epicardium and myocardium at the level of the apex showed a statistically significant difference between the LBBB1 group and the control group (P =0.004),while there was no statistically significant difference demonstrated at the levels of the mitral annulus and papillary muscle(P ＞0.01).The circumferential strain of the endocardium at the levels of the papillary muscle and apex showed a statistically significant difference between the LBBB1 group and the control group (P =0.000),while there was no statistically significant difference demonstrated at the level of the mitral annulus (P ＞0.01).The circumferential strain of the endocardium,myocardium and epicardium at the three short axis view levels showed statistically significant differences between the LBBB2 group and the control or LBBB1 groups respectively(P =0.000).Conclusions The circumferential strain of the endocardium at the level of the apex can provide more information about disease prognosis,especially in LBBB patients with a LVEF of ≥50％.

Objective: To explore the synergistic effect of silibinin combined with crizotinib on anaplastic lymphoma kinase positive (ALK+ ) non-small cell lung cancer (NSCLC) cells and its mechanism. Methods: H2228 and H3122 cells were treated with silibinin, crizotinib alone or in combination. Cell proliferation was measured by 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and colony formation assay. Migration or invasion ability was tested by wound healing assay or transwell assay, respectively. Expressions of E-Cadherin and vimentin protein were examined by immunofluorescence staining. The protein expressions of ALK, p-ALK, E-Cadherin and Vimentin were detected by western blotting.The anti-cancer effect of silibinin combined with crizotinib in vivo was determined by subcutaneously injecting 2×10⁶ H2228 cells into immunodeficient nude mice. Results: The result of MTT assay showed that the cell viability of H2228 or H3122 treated with 100 μmol/L silibinin was (88.38±4.10)% or (72.27±3.62)%, respectively, marginally decreased compared with that of the control. The 50% inhibitory concentration (IC₅₀) of H2228 cells treated with crizotinib alone or combined with 100 μmol/L silibinin was (917.10±7.75) nmol/L or (238.73±7.67) nmol/L, respectively. The IC₅₀ of H3122 cells treated with crizotinib alone or combined with 100 μmol/L silibinin was (472.50±15.70) nmol/L or (206.10±12.01) nmol/L, respectively. The IC_50s of H2228 and H3122 cells were significantly decreased by combined treatment of crizotinib and silibinin compared to crizotinib treatment alone (P<0.01). When compared with the control group, colony forming ratios of H2228 cells were (83.34±2.72)% in 100 μmol/L silibinin treatment group, (69.42±3.06)% in 400 nmol/L crizotinib treatment group and (27.32±1.42)% in combined treatment group. When compared with the control group, colony forming ratios of H3122 cells were (84.45±5.67)% in 100 μmol/L silibinin treatment group, (45.02±5.83)% in 400 nmol/L crizotinib treatment group and (17.43±3.83)% in combined treatment group. Silibinin combined with crizotinib treatment significantly inhibited the colony formation ability of H2228 and H3122 cells (P<0.01). Migration and invasion results showed that combined treatment of crizotinib and silibinin markedly inhibited the migration and invasion ability of H2228 cells (P<0.01). Western blot results indicated that treated with silibinin alone or in combination of crozitinib for 48 hours, the protein level of E-cadherin in H2228 cells was upregulated, while the expressions of p-ALK and vimentin were downregulated, without obvious alteration of ALK protein expression. In the xenograft model, the mean tumor weight was (9.40±2.58)g in crizotinib treatment group and (4.58±1.07)g in the combined treatment group. The inhibitory effect of tumor growth in vivo of combined treatment was significantly superior to that of crizotinib treatment alone (P<0.05). Conclusion Silibinin enhances the inhibitory effect of crizotinib on ALK positive NSCLC cells, which may be associated with suppression of ALK activity and mesenchymal-epithelial transition.

Objective To compare the left ventricular function parameters of patients with sick sinus syndrome ( SSS ) and DDD pacemaker implantation during atrioventricular conduction ( AVC ) and right ventricular apex pacing ( RVAP ) mode . Methods Forty‐six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied . Fifty volunteers were included as control group . Changing from AVC to RVAP mode ,the acute effect on echocardiographic parameters ,including LVEF , parameters of aortic/pulmonary artery pulse wave Doppler ,and parameters of left ventricular twist by speckle tracking imaging were measured respectively . Pacemaker implantation duration and cumulative ventricular pacing proportion ( Cum% VP) were recorded . The relationships of pacemaker parameter and above left ventricular function parameters were analyzed . Results Compared with control group ,values of peak rotation in LV apex and LV twist were significantly lower during AVC and RVAP mode . The value of peak rotation in LV base showed no significant difference between three groups .Apical‐basal rotation delay during RVAP was significantly longer than those during AVC and in control group respectively ( P <0 .05) . LVEF during RVAP decreased statistically ( P< 0 .05 ) ,but showed no difference during AVC , compared with the control group . The peak LV twist related positively with LVEF ,and negatively with Cum% VP . Conclusions RVA pacing decreases left ventricular function , which is independent of asynchrony contraction patterns caused by pacing . LVEF ,apical rotation and LV twist are more sensitive to demonstrate the LV dysfunction in patients with pacemaker implantation . LV twist related negatively with Cum% VP .