Objective:To explore the influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study.Methods:Tirty-seven breast cancer patients underwent echocardiography at baseline before chemotherapy (T0) and after the second (T2), fourth (T4), sixth (T6) chemotheraphy cycles in Qilu Hospital of Shandong University from March 2017 to March 2018. According to different guidelines[ASE lower limit of normal left ventricular ejection fraction(LVEF-LLN) 53%, ESC LVEF-LLN 50% and the WASE study (Women LVEF-LLN 58%, Asian Women LVEF-LLN 59%)], the number of patients with myocardial injury during chemotherapy was evaluated, and compared with the global longitudinal strain(GLS) standard, the percentages of patients with myocardial injury in different standards were analyzed.Results:With the up-regulation of LVEF-LLN, more patients with early myocardial damage were found. During chemotherapy, 1 patient showed left ventricular ejection fraction (LVEF) fell by >10% from baseline to LVEF<50% (2016 ESC Guidelines), 3 patients showed LVEF fell by >10% from baseline to LVEF<53% (2014 ASE Guidelines), 7 patients for LVEF fell by >10% from baseline to LCVEF<58%, and 9 patients for LVEF fell by >10% from baseline to LVEF<59%, which was still less than the number of patients detected by GLS criteria (18 patients), but the sensitivity of LVEF fell of >10% from baseline to LVEF<59% was not statistically different from GLS standard ( P>0.05). Conclusions:With the up-regulation of LVEF-LLN, the sensitivity of LVEF in evaluating early myocardial damage was increased, but GLS was still the most sensitive index to monitor the cancer therapeutics-related myocardial damage.

Objective To compare the diagnostic value of CT and NE for lesions of nasal cavity and paranasal sinus area.Methods 80 cases of nasal and paranasal sinus diseases which were examined by both CT and NE at same period and proved by pathology.were reviewed.Results Compare with results of pathology,the accucy rate of both CT and NE was identical in diagnosing sinusitis and tumours of paranasal sinus,NE was higher than CT in nasal and paranasal sinus polyp and nasal cavity tumour,turbinate hyperplasia CT was higher than NE in paranasal sinus cyst and anatomic variations.Conclusion Pathologic biopsy can be taken under NE guide to understand the shape,texture and colour of the illness focus CT can show the size,shape and anatomy relation between lesion and its neighbor tissue.The diagnosis may more perfectly through NE combined with CT.

With the increasing incidence of breast cancer, the relationship between tumor and immune function has attracted more and more attention. This article reviews the relationship between breast cancer and T lymphocyte subsets, in order to explore the changes of immune function before and after operation in breast cancer patients, so as to select appropriate surgical methods, radiotherapy, chemotherapy and immunotherapy for the patients.

Objective To explore the current status and the correlation between learning burnout and family function among undergraduate nursing students in a non-governmental school.Methods A total of 460 undergraduate nursing students in a non-governmental medical school in Changsha were selected as study subjects by convenience sampling from September to October 2016. They were investigated with the learning burnout scale (LBS) and the McMaster family assessment device (FAD).Results The total scores of LBS and FAD of undergraduate nursing students in a non-governmental school were (56.94±9.60) and (137.11±15.80) respectively. The total score of LBS was positively correlated with the total score and the scores of all dimensions of FAD among undergraduate nursing students in a non-governmental school (P<0.01). The influencing factors of learning burnout included grades, whether they acted as a student cadre, attitudes towards nursing speciality, academic record and family function (P<0.05).Conclusions The level of learning burnout has a close correlation with family function in undergraduate nursing students in a non-governmental school. The better the family function is, the less the learning burnout will be. School should strengthen the affective education of students and improve the mental state so as to reduce the learning burnout.

Objective:To revise the family resilience assessment scale (FRAS) in patients with stroke and to evaluate its psychometric properties and applicability.Methods:FRAS was authorized and translated into Chinese.The scale items were revised based on the interview results of 13 patients with stroke and 11 caregivers and the opinions of 20 experts in related fields.A convenience sampling method was used to sample neurology and neurosurgery inpatients from 2 tertiary hospitals in Hangzhou twice from June to November 2022, with 325 questionnaires (sample 1) distributed the first time for item analysis and exploratory factor analysis, and 285 questionnaires (sample 2) distributed the second time for confirmatory factor analysis, criterion validity and reliability test.Data analysis was conducted by SPSS 26.0 and AMOS 24.0.Results:The exploratory factor analysis extracted 6 common factors(family beliefs, family spirit, family connection, family resources, family communication, family collaboration) with 32 items.Confirmatory factor analysis showed that the model fit well( χ2/ df=2.67, RMSEA=0.025, CFI=0.98, GFI=0.90, IFI=0.98, RMR=0.031). The cronbach's α coefficient of the total scale was 0.96, and 0.82-0.92 for the dimensions.The 2-week retest reliability was 0.99.The total scale score was positively correlated with the validity scale (family resilience scale) ( r=0.882, P<0.001). Conclusion:The family resilience scale for patients with stroke has good reliability and validity and can be used to assess the family resilience of patients with stroke.

Objective: To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography. Methods: A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared. Results: According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05). Conclusions Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.

Objective: To explore the molecular mechanism of Taoren-Honghua herb pair (THP) on syndrome of bloodstasis based on the network pharmacology. Methods: We collected THP's compounds from traditional Chinese Medicinedatabases and input them into Pharm Mapper to get their potential targets, and collected the known targets of compoundsby Scifinder. Then we did KEGG-pathway analysis by DAVID database. Finally draw and analyze the network byCytoscape by information above. Results: Seventeen compounds of THP acquired 74 known targets, which was associatedwith four modules: improving the hemodynamics, anticoagulation, anti-inflammation, regulating apoptosis andproliferation. We also got 317 potential targets through PharmMapper and got 128 signaling pathway through pathwayenrichment including 39 disease-related pathways, 25 endocrine-related pathways, 11 immune-related pathways and soon. Conclusion: The four modules of the known target are exactly related to the four characteristics of the syndrome ofblood stasis. The potential targets and the 128 signal pathways involve a variety of pathophysiological processes of thesyndrome of blood stasis. These reflect the molecular mechanism of THP intervention in the syndrome of blood stasis

Nonalcoholic fatty liver disease(NAFLD)has become the most common liver disease in the world and is an important risk factor for the progression to hepatocellular carcinoma.However,the pathogenesis of NAFLD remains unclear,and there is still a lack of specific treatment measures.Sterol regulatory element-binding proteins(SREBP)are an important nuclear transcription factor,which mainly maintains the balance of lipid metabolism inside the body by activating the genes associated with the synthesis and uptake of cholesterol,fatty acids,and triglycerides,and therefore,SREBP are a target for the treatment of metabolic diseases.This article reviews the latest advances in SREBP in the pathogenesis of NAFLD and the latest evidence of SREBP-targeted therapy for NAFLD.It is worth noting that recent studies have shown that SREBP inhibition can cause liver injury together with autophagy damage.Therefore,excessive inhibition of lipogenesis may exert a counterproductive effect on the treatment of NAFLD.In conclusion,SREBP is a promising therapeutic target for NAFLD;the molecular mechanism of SREBP in lipid metabolism is regulated by many factors,and these factors are being deeply explored and analyzed,which has an important clinical significance for the treatment of NAFLD.

Objective To assess the predictive value of computed tomography pulmonary angiography(CTPA)cardiovascular parame-ters for chronic thromboembolic pulmonary hypertension(CTEPH)under the 2022 European Society of Cardiology/European Respiratory Society(ESC/ERS)guidelines,and to compare with the 2021 Chinese guidelines.Methods A total of 201 suspected CTEPH patients were retrospectively selected.All patients underwent right heart catheterization(RHC)and CTPA evaluation.According to the Euro-pean guidelines,they were divided into three groups:mean pulmonary artery pressure(mPAP)≤20 mmHg control group(63 cases)(1 mmHg=0.133 kPa),mPAP＞20 mmHg CTEPH group(138 cases),and mPAP≥25 mmHg CTEPH group(123 cases).Inter-group comparison of CTPA cardiovascular parameters was performed,and receiver operating characteristic(ROC)curve analysis was performed for each parameter.Results Under the 2022 European guidelines,the diagnostic efficacy of the diameter of the main pulmonary artery trunk(MPAd)was the highest[area under the curne(AUC)was 0.933].The binary logistic regression analysis revealed that the MP Ad,right ventricular free wall thickness(RVWT),and interventricular septal angle(IVSA)were inde-pendent risk factors for the diagnosis of CTEPH(P＜0.05).Under both the Chinese and European guidelines,the MPAd,the transverse diameter and area of the right atrium,the transverse diameter and area of the bi-ventricle,the RVWT,and the IVSA showed significant statistical differences in CTEPH and control groups(P＜0.05).Conclusion Under both the Chinese and European guidelines,the MP Ad measured by CTPA has the highest diagnostic efficacy for CTEPH,while the IVSA has the strongest correlation with clinical prognostic indicators.The right atrium structure also has evaluation value.

Objective To explore method of establishing and evaluating an asthma rat model with phlegm and blood stasis syndrome.Methods 60 SD male rats were randomly divided into 5 groups,a normal group,asthma group,combination of disease and syndrome(combination)group,DM group,and KCLW group,with 12 rats in each group.Asthma models were established using ovalbumin(OVA).A syndrome model of phlegm and blood stasis was established using a high-fat diet combined with the ice water bath method.We evaluated the asthma model through animal behavior observation,pathological section observation,inflammation index detection,and airway reactivity measurements.The phlegm and blood stasis syndrome model was evaluated via measurements of rat body mass,blood glucose,blood lipids,coagulation function,and hemorheological indexes and by observing symptoms and syndrome determination by Kechuan Liuwei mixture.Results(1)After OVA induction,the rats in the asthma model group and combination group showed symptoms such as shortness of breath,open mouth breathing,abdominal movement,restlessness,and irritability.HE staining showed the disordered arrangement of the bronchial mucosa in lung tissue,local detachment,thickening of the basement membrane and the bronchial tube wall,narrowing of the lumen,extensive infiltration of inflammatory cells,and congestion of capillaries.Compared with the normal group,the asthma model group and combination group(P＜0.05)had increased serum IL-4,IL-6,and TGF-β1.Penh values were increased after stimulation with various concentrations of Mch(P＜0.05).(2)Rats in the combination group showed symptoms such as chills,curling up with minimal movement,purple and dark claws,purple and black bruises on the tail,loose stools,and unclean perianal area.Compared with the rats in the asthma model group,rats in the combination group had increased body mass(P＜0.05)and blood glucose,triglyceride,and total cholesterol levels(P＜0.05),a shortened thrombin time(P＜0.05),increased fibrinogen content(P＜0.05),and significantly increased whole-blood viscosity at low,medium,and high shear rates(P＜0.05).The indexes were significantly improved after Kechuan Liuwei mixture administration.Conclusions The asthma rat model with phlegm and blood stasis syndrome can be established through OVA induction and high-fat diet combined with ice water bath.The model can be evaluated through behavioral observation,index measurements,and syndrome determination via formulas.