Purpose: Anxiety, depression, and poor quality of life (QOL) were considered important concerns that hindered the rehabilitation of breast cancer survivors. A number of studies have investigated the effects of physical activity, but they have not reached the same conclusions. This review aimed to identify the effects of physical activity on QOL, anxiety, and depression in breast cancer survivors. Methods: PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SinoMed, CNKI, Vip, and WanFang databases were searched for the time period between January 1, 2012, and April 30, 2022. Studies were included if they were randomized controlled trials of the effects of physical activity on QOL, anxiety, or depression in breast cancer survivors. The tools of the Joanna Briggs Institute were used to assess the quality of the included studies. R software version 4.3.1 was used for meta-analysis. Results: A total of 26 studies, involving 2105 participants, were included in the systematic review. Among these, 20 studies involving 1228 participants were included in the meta-analysis. Compared with the control group, the results indicated that physical activity can significantly improve QOL(Hedges' g = 0.67; 95% CI 0.41–0.92) and reduce anxiety (Hedges' g = −0.28; 95% CI −0.46 to −0.10) in breast cancer survivors. However, the effect of physical activity on depression (Hedges' g = −0.46; 95% CI −0.99 to 0.06) was not statistically significant. Conclusions Physical activity was an effective intervention to improve QOL and reduce anxiety in breast cancer survivors, as well as showed positive trends in depression, although without statistical significance. More well-designed studies are required to clarify the effects of different types of physical activities on the QOL, anxiety, and depression among breast cancer survivors.

Objective To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with Helicobacter pylori (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Methods Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. Results The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Conclusions Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.

Objective:To conduct a scoping review of studies on the needs assessment based on decision needs assessment workbook and to provide a reference for conducting related studies in China.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as a methodological framework, PubMed, Web of Science, Embase, CINAHL, CNKI, Wanfang, VIP and China Biology Medicine disc were searched from establishment of the databases to March 31, 2023.Results:A total of 12 studies were included and the basic information, study objective, type of study, participants, collection method, evaluation guidance tools and results of the included literature were summarized and analyzed.Conclusions:In the future, when medical staff use workbooks for needs assessment, they should pay attention to fully incorporating the core elements of the workbooks, evaluating the decision-making needs of patients from multiple perspectives such as spouses and peer helper, and developing or utilizing existing patient decision aids to provide decision support for patients based on the results of needs assessment, thereby improving the quality of shared decision-making.

Returning to work is an important evaluation index for the recovery of physical function in patients with myocardial infarction. With the incidence of myocardial infarction in younger population and the prolongation of working age, young and middle-aged patients with myocardial infarction may become a population that needs to be paid attention to returning to work. This article reviews the status quo, influencing factors, evaluation tools and related intervention studies of young and middle-aged patients with myocardial infarction returning to work at home and abroad, aiming to provide a reference for the follow-up research of young and middle-aged patients with myocardial infarction returning to work.

Objective:To explore the current status and training needs of nurses' knowledge, belief, and behavior regarding the good limb positioning in stroke patients with hemiplegia.Methods:From November to December 2023, convenience sampling was used to select 1 708 nurses from 30 ClassⅢ hospitals in 17 provinces across the country, who worked in departments such as Neurology and Rehabilitation. The self-designed General Information Questionnaire, Knowledge, Belief and Behavior Questionnaire for Putting Good Limb Position in Clinical Nurses, and self-designed Training Status and Needs Questionnaire for Good Limb Positioning were used for online surveys. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, belief, and behavior in good limb positioning.Results:A total of 1 622 valid questionnaires were collected. Nurses scored (135.64±25.93) on the Knowledge, Belief and Behavior Questionnaire for Putting Good Limb Position in Clinical Nurses, with the lowest score rate of 65.65% in the knowledge subscale and the highest score rate of 88.16% in the belief subscale. Multiple linear regression analysis showed that education level, working years, department, and whether they received training were the influencing factors of nurses' knowledge, belief, and behavior in good limb positioning ( P<0.05). 92.23% (1 496/1 622) of nurses were willing to receive training on good limb positioning, and 70.10% (1 137/1 622) of nurses participated in training on good limb positioning. Conclusions:Nurses generally have a moderate level of knowledge, belief, and behavior towards the good limb positioning, with room for improvement in their knowledge and behavior. However, their belief is relatively positive. Nursing managers should actively carry out training on good limb positioning based on the different characteristics and needs of nurses, improve their ability to good limb positioning.

Objective:To explore the influencing factors of drug application deviation in elderly diabetes mellitus patients during hospital-family transition period.Methods:A total of 278 elderly diabetes mellitus patients in Henan Provincial People's Hospital from March 2019 to March 2021 were selected as the study subjects.All patients were followed up by telephone 1 week after discharge.The drug deviation evaluation tool(MDT)was used to evaluate the drug application deviation in patients during the hospital-family transition period.They were divided into drug application deviation group and non-drug application deviation group.Sociodemographic and disease-related data and medication management data were compared between the two groups.Logistic regression analysis was used to analyze the influencing factors of drug application deviation in elderly patients with diabetes mellitus during hospital-family transition period.Results:Of the 278 elderly patients with diabetes, 162(58.27%)had at least one drug application deviation during hospital-family transition period.The family care index was lower in drug application deviation group than non-drug application deviation group( Z=6.578, P<0.001).As compared with non-drug application deviation group, drug application deviation group had the higher number of drugs at discharge, and had lower scores of Morisky Medication Adherence Scale with Eight-Item(MMAS-8), had lower scores of Summary of Diabetes Self Care Activities(SDSCA)and had lower scores of Self-efficacy for Appropriate Medication Use Scale(SEAMS), with statistically significant differences( Z=10.971, 6.077, t=5.947, 14.105, all P<0.001).Binary Logistic regression analysis and forest map showed that the more number of discharge medication was a risk factor for drug application deviation during hospital-family transition period in elderly patients with diabetes mellitus( OR=4.128, P<0.001); family care index, MMAS-8 score, SDSCA score and SEAMS score were its protective factors( OR=0.343, 0.523, 0.922, 0.568, all P<0.05). Conclusions:The incidence of drug application deviation during hospital-family transition period is higher in elderly patients with diabetes mellitus.The possible protective factors are high scores of family care index, MMAS-8, SDSCA and SEAMS, and the risk factor is large number of drugs ordered by discharged doctors.Therefore, targeted intervention measures can be implemented to reduce the occurrence of drug application deviation during hospital-family transition period.

In order to learn from the advanced experience of postgraduate education in foreign first-class universities, Harvard University, Johns Hopkins University and London School of Hygiene and Tropical Medicine were selected as the objects in this study to analyze and compare the advantages and characteristics of their postgraduate training model, curriculum setting and teaching resources, thereby providing suggestions for the reform and development in the cultivation of master of public health and preventive medicine in China.

Objective:To systematically search, extract, summarize, and analyze the best evidence for perioperative gastrointestinal function management in patients with gynecological benign diseases undergoing laparoscopy, providing evidence-based basis for the implementation of relevant evidence.Methods:According to the 6S evidence pyramid model, all evidence on perioperative gastrointestinal function management in patients with gynecological benign diseases undergoing laparoscopy in domestic and foreign databases was retrieved layer by layer from top to bottom, including clinical practice guidelines, evidence summary, clinical decision-making, expert consensus, systematic reviews and so on. The search period was from database establishment to December 31, 2021. Two researchers independently conducted literature screening and quality evaluation, extracting, concluding, and summarizing evidence based on the topic. Eight experts determined the recommended strength of evidence.Results:A total of 21 articles were ultimately included, including two clinical decision-making, one evidence summary, two guidelines, three expert consensuses, two systematic reviews, one Meta-analysis, 9 randomized controlled trials, and one quasi experimental study. Through a discussion between two researchers, a total of 20 pieces of evidence on perioperative gastrointestinal function management in patients with gynecological benign diseases undergoing laparoscopy were extracted and summarized, including preoperative preparation, intraoperative measures, and postoperative nursing (early eating, posture and activity, multimodal analgesia, traditional Chinese medicine prevention and treatment measures, chewing gum, and drinking coffee) .Conclusions:Medical and nursing staff can adopt evidence-based practical recommendations for perioperative gastrointestinal function management in patients undergoing laparoscopy for gynecological benign diseases, so as to promote the recovery of gastrointestinal function.

The social problems and medical burdens caused by obesity have become more serious in recent years. Obesity is mainly caused by the imbalance of energy intake and consumption in the body. The central nervous system and related neurons regulate the balance of energy metabolism. The hypothalamic arcuate nucleus (ARC) contains anorexigenic proopiomelanocortin (POMC) neurons and orexigenic neuropeptid Y(NPY)/agouti-related protein (AgRP) neurons that regulate the feeding behavior of body. High-fat diet induces phosphorylation of Rb protein in POMC neurons, and inactivation of Rb phosphorylation leads to re-entry of POMC neurons from the resting-state into the cell cycle, which rapidly shifts to apoptosis. High-fat diet also causes the inhibition of neuronal regeneration, induces inflammation and neuronal damage, loss of neuronal homeostasis, leptin resistance, and ultimately leads to obesity. This review discusses the relationship between loss of neuronal homeostasis and dietary obesity, as well as the underlying mechanisms, which might provide the evidence for prevention and treatment of these diseases.
Arcuate Nucleus of Hypothalamus ; Homeostasis ; Humans ; Leptin ; Obesity ; Pro-Opiomelanocortin

Objective To provide pharmaceutical care for patients with hepatitis B cirrhosis by using the medication therapy management(MTM)model combined with Pharmaceutical Care Network Europe(PCNE),and to analyze the effectiveness of pharmaceutical care from clinical efficacy,safety,humanistic effect and drug-related problems(DRPs).Methods Patients with hepatitis B cirrhosis were randomly divided into the pharmaceutical care group and the control group who received only conventional treatment.Clinical pharmacists used MTM combined with PCNE to provide pharmaceutical care in the pharmaceutical care group.Economic effects,clinical indicators,safety,medication compliance and quality of life were compared between the two groups during the treatment and follow-up period.DRPs were analyzed in the pharmaceutical care group.Results The cost-utility ratio and clinical indicators in the pharmaceutical care group were better than those in the control group,and the adverse drug reactions of the former were statistically significant compared with the latter at the three months follow-up,and medication compliance and quality of life were statistically significant after intervention and during follow-up(P＜0.05).There were 52 DRPs in the pharmaceutical care group,mainly in the category of poor treatment outcome.The main reasons were poor drug selection and excessive usage and dosage.There were 46 DRPs accepted by intervention,and 45 DRPs were completely and partially solved.Conclusion The pharmaceutical care model of MTM combined with PCNE classification system for patients with hepatitis B cirrhosis played a positive role in the treatment and follow-up period.