The former editor-in-chief of the British Medical Journal once claimed that "dying of cancer is the best death". As a physician, the author harbors reservations concerning the unqualified acceptance of the stated perspective. Drawing upon personal experience with the death of family members from cancer, the author asserts that a good way of death should meet the following criteria: (1) minimal physical pain during the end-of-life phase; (2) presentiments of death from both the patient and their family along with minimal psychological suffering; (3) no unfulfilled desires; (4) the opportunity to bid farewell to family in advance; (5) prior arrangement of posthumous affairs. Suffering from cancer may merely serve as an opportunity to fulfill some of these conditions, but if the needs and wishes of terminally ill patients can be inquired about in advance and efforts are made to meet and realize them, even without the occurrence of cancer, terminally ill patients can depart with dignity in the manner they desire.

The former editor-in-chief of the British Medical Journal once claimed that "dying of cancer is the best death". As a physician, the author harbors reservations concerning the unqualified acceptance of the stated perspective. Drawing upon personal experience with the death of family members from cancer, the author asserts that a good way of death should meet the following criteria: (1) minimal physical pain during the end-of-life phase; (2) presentiments of death from both the patient and their family along with minimal psychological suffering; (3) no unfulfilled desires; (4) the opportunity to bid farewell to family in advance; (5) prior arrangement of posthumous affairs. Suffering from cancer may merely serve as an opportunity to fulfill some of these conditions, but if the needs and wishes of terminally ill patients can be inquired about in advance and efforts are made to meet and realize them, even without the occurrence of cancer, terminally ill patients can depart with dignity in the manner they desire.

Objective:To systematically estimate the effectiveness of physical activity intervention and Borg perceived exertion on the prevention of gestational diabetes mellitus (GDM), and to provide references for physical activity management during pregnancy.Methods:Databases such as PubMed, Cochrane Library Central Register of Controlled Trails, EMBASE, Scopus, CNKI and Wanfang were searched to collect randomized controlled trials (RCT) focusing on the effect of physical activity intervention on glucose control and pregnancy outcomes in pregnant women. The primary outcome was the incidence of GDM. The secondary outcomes included the 2 hour oral glucose tolerance test (2 h OGTT), gestational weight gain, gestational week of delivery, and neonatal weight. The statistical analysis was performed by R 4.0.2 software. The quality of the literatures was evaluated based on the Cochrane Risk of bias tool.Results:A total of 14 RCTs involving 4 509 participants were included in this meta-analysis. The results of meta-analysis showed that the incidence of GDM ( RR=0.74, 95% CI=0.59-0.93, P<0.01), 2 h OGTT (MD=-0.27, 95% CI=-0.48--0.07, P<0.01), and gestational weight gain (MD=-1.04, 95% CI=-1.91--0.18, P=0.02) in the experimental group were all significantly lower than those in control group, while the neonatal weight (MD=-27.43, 95% CI=-58.77-3.92, P=0.09) and gestational week of delivery (MD=-0.18, 95% CI=-0.93-0.57, P=0.64) showed no significant difference between the two groups. Subgroup analysis showed that Borg rating scale of perceived exertion scored higher than 12 ( RR=0.64, 95% CI=0.46-0.89, P<0.01), physical activity conducted in groups ( RR=0.66, 95% CI=0.46-0.94, P=0.02), intervention organized by fitness specialist ( RR=0.73, 95% CI=0.56-0.95, P=0.02) were associated with the decreased risk of GDM. In addition, the meta-regression result showed that total intervention time more than 2 hours per week (correlation coefficient=-1.06, 95% CI=-1.86--0.27, P<0.01) was the main source of study heterogeneity. Conclusions:Physical activity during pregnancy with Borg rating scale of perceived exertion scored higher than 12 had a positive effect on reducing the incidence of GDM.

Objective: To search for specific metabolites in the lungs of pneumonia rats fed with a high-calorie diet, as well as explore the changes in the lung metabolites of young rats treated with Yinlai Decoction (YD) and its effects on inflammation-related metabolic pathways.Methods: Lipopolysaccharides (LPS) and a special high-calorie diet were used to induce Sprague Dawley (SD) rats to simulate the intestinal state of infant pneumonia. Liquid chromatography-mass spectrometry technology (LC-MS/MS) was used to detect metabolites in each group. Supervised orthogonal partial least squares discriminant analysis (OPLS-DA) model values were used for the detection results to find the differential metabolites. The metabolic pathways that are involved with the differential metabolites were clarified through enrichment analysis and topological analysis. Finally, the T cell receptor signaling pathway (TCR) signal conversion was analyzed by the network pharmacology method. Results: In the high-calorie diet combined with pneumonia group (M3), a total of 55 metabolites were determined to be different from the normal group (N). A total of 36 metabolites were determined to be different from those in the lung metabolites of the YD treatment group (T1). YD had a regulatory effect on glutathione metabolism, arginine and proline metabolism, ascorbic acid and aldehyde metabolism and phenylalanine metabolism. And the small molecule metabolites could act on the FYN and lymphocyte-specific protein tyrosine kinase (LCK) target proteins in the TCR signaling pathway, thereby affecting the immune function of the lungs. Conclusion: A high-calorie diet can cause abnormal sphingolipid metabolism in the lungs of young rats, thereby creating chronic lung inflammation in young rats. YD has a beneficial effect when used to treat young rats with LPS-induced pneumonia fed on high-calorie diets. Its mechanisms of action may affect the body's immune pathways by regulating the oxidative stress pathway affected by glutathione metabolism.

Objective:To systematically evaluate the effect of exercise on blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension, and to provide theoretical basis for formulating accurate exercise prescriptions.Methods:Randomized controlled trials on the effect of exercise on blood pressure in middle-aged and elderly patients with prehypertension and hypertension were collected by PubMed, EMBASE, the Cochrane Library, Web of Science, CNKI and Wanfang Database.The quality of the included studies was evaluated by the Cochrane risk bias assessment tool, and the meta-analysis was performed with Stata 15.0 software.Results:A total of 23 articles and 2 095 subjects were included.Meta analysis showed that compared with the control group, aerobic exercise(WMD=-9.94, 95% CI=-12.59--7.29, P<0.001), resistance exercise(WMD=-11.15, 95% CI=-18.36--3.95, P=0.002) and aerobic combined resistance exercise(WMD=-6.09, 95% CI=-8.87--3.31, P=0.005) could reduce the systolic blood pressure level.Aerobic exercise(WMD=-6.46, 95% CI=-8.20--4.72, P<0.001) and resistance exercise(WMD=-4.38, 95% CI=-8.07--0.69, P=0.02) could reduce the level of diastolic blood pressure, while aerobic combined resistance exercise(WMD=-4.88, 95% CI=-12.87-3.11, P=0.232)had no significant effect on diastolic blood pressure.The results of subgroup analysis indicated that the differences of age, baseline blood pressure, exercise intensity, exercise time, exercise frequency, and motion cycle were the main sources of heterogeneity.The funnel plot and Egger's test indicated that there was no publication bias in this Meta-analysis. Conclusion:Aerobic exercise and resistance exercise both have positive effects on reducing blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension.

Radiation therapy is an effective method to kill cancer cells and shrink tumors using high-energy X-ray or γ-ray. Radiation pneumonitis (RP) is one of the most serious complications of radiation therapy for thoracic cancers, commonly leading to serious respiratory distress and poor prognosis. Here, we prepared curcumin-loaded mesoporous polydopamine nanoparticles (CMPN) for prevention and treatment of RP by pulmonary delivery. Mesoporous polydopamine nanoparticles (MPDA) were successfully synthesized with an emulsion-induced interface polymerization method and curcumin was loaded in MPDA via π‒π stacking and hydrogen bonding interaction. MPDA owned the uniform spherical morphology with numerous mesopores that disappeared after loading curcumin. More than 80% curcumin released from CMPN in 6 h and mesopores recovered. CMPN remarkably protected BEAS-2B cells from γ-ray radiation injury by inhibiting apoptosis. RP rat models were established after a single dose of 15 Gy ⁶⁰Co γ-ray radiation was performed on the chest area. Effective therapy of RP was achieved by intratracheal administration of CMPN due to free radical scavenging and anti-oxidation ability, and reduced proinflammatory cytokines, high superoxide dismutase, decreased malondialdehyde, and alleviated lung tissue damages were observed. Inhaled CMPN paves a new avenue for the treatment of RP.