Objective To determine relationships between daily activities measured as modified version of Pulmonary Functional status and Dyspnea Questionaire (PFSDQ-M) and functional capacity and symptoms experienced in patients with chronic obstructive pulmonary disease (COPD). Methods Convenience sample of 94 COPD patients with stable condition were assessed by interview with PFSDQ-M Chinese version and modified Medical Research council dyspnea scale (MMRC) respectively. Pulmonary function test (PFT) and 6-minute walking test (6MWT) were undergone on the same day or within one week as interview. PFSDQ-M has three subscales,i.e.,change experienced by patient with activities (CA),dyspnea with activities (DA) and fatigue with activities (FA). Results Scores of CA,DA and FA correlated to 6-minute walking distancer= (-0.37)- (-0.42),FEV_1 r=(-0.27)-(-0.32),FEV_1/FVC r= (-0.27)- (-0.32),dyspnea rated by MMRC (r=0.55-0.60) and BODE index (r=0.35-0.40),respectively (all P<0.01). dyspnea explained 26% of the variance in changes of activities. Conclusions Physical activities moderately changed in patients with stable COPD;Dyspnea is the best predictor of limitation of daily activities.

BACKGROUND: The study indicated that directed neural differentiation of bone marrow stromal cells (BMSCs) was associated with changes in local micro-environment in injured spinal cord following cerebral ischemia, in particular neurotrophic factor induction. Group pre-test has confirmed that acupuncture can increase the expression of vadous cytokines and neurotrophic factors to promote nerve regeneration and repair.OBJECTIVE: To observe the effects of electro-acupuncture combined with BMSC kansplantaUon on recovery of neurological function in rats with spinal cord injury.DESIGN, TIME AND SETTING: Randomized controlled animal experiments were performed at the Laboratory of Cell Biology,Harbin Medical University from March 2005 to July 2006.MATERIALS: A total of 80 pure healthy Sprague Dawley rats were selected. Eight were used for the isolation and culture of BMSCs, and the remaining 72 rats were equally and randomly divided into 4 groups: blank control group, cell transplantation group, electro-acupuncture group, and combination group. KWD-80811 pulse-type apparatus was produced by the third radio factory in Jiangsu Wujin production.METHODS: In vitro isolation and culture of the third passage of BMSCs were obtained and labeled by BrdU at hour 72 before transplantation, and BMSCs at 1 ×10 11/L were harvested for usa. Rat models of spinal cord injury were established in each group.Following model establishment, BMSC suspension was injected into the injured spinal cord near the junction of the gray matter and white matter in the cell transplantation group, totally 6 × 10<'5> cells. The same volume of phosphate buffer saline was infused into rats of the blank control group by the same method. In the electro-acupuncture group, at hour 24 after the successful model establishment, Jiaji Electroacupuncture Electroacupuncture instrument treatment was performed by pulse electro-acupuncture apparatus at 3.0-4.0 mm from median line in the upper and lower end of the spinous process vertebral body adjacent to open space for 20 minutes, once a day. In the combination group, rats underwent BMSC transplantation + Jiaji electro-acupuncture treatment. MAIN OUTCOME MEASURES: After transplantation for 3, 7, 14 days, neurological conditions were assessed by combined behavioral scores in rats with spinal cord injury. Glial fibrillary acidic protein and neuron-specific enolase expression was measured in BrdU-labeled BMSCs by immuno-double-labeling method.RESULTS: 3, 7, 14 days after injury, compared with the blank control group, significant differences in combined behavioral scores were determined in the call transplantation group, electro-acupuncture group, and combination group (P <0.05, 0.05, 0.01).The recovery of neurological function was significantly greater in the combination group than in the cell transplantation and electro-acupuncture groups (P < 0.05). No significant difference was detected between the cell transplantation group and the electro-acupunctura group (P > 0.05). Compared with blank control group, spinal cord structure was relatively complete in the cell transplantation group and electro-acupuncture group. The structure was more integrity in the combination group. Bone marrow stromal cell transplantation presented the organization BrdU-labeled cells in the lesion and the surrounding area, with obvious aggregation and survival. At day 14 following cell transplantation, positive rates of neuron-specific enolase and glial fibrillary acidic protein were respectively 7.2% and 1.5% in the call transplantation group, 7.9% and 2.1% in the combination group.CONCLUSION: The BMSCs after transplantation can survive in the host body. Electro-acupuncture could promote the differentiation of BMSCs into neural cells. Combination of electro-acupuncture and BMSC transplantation can significantly improve the motor and sensory function in rats with spinal cord injury.

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.

Objective To investigate the diagnostic value of the ratio of % Micro to % Hypo in the diagnosis of three kinds of common thalassemia and iron‐deficiency anemia (IDA ) .Methods Forty‐nine cases of IDA ,24 cases of mildα‐thalassemia ,24 cases of mildβ‐thalassemia ,24 cases of silent α‐thalassemia and 120 individuals undergoing healthy physical examination were selected as the research subjects and divided into 6 groups:normal group ,IDA group ,mildα‐thalassemia group ,mildβ‐thalassemia group ,silentα‐thalassemia and mild thalassemia group(in duding mild α‐thalassemia group and mild β‐thalassemia group) .The % Micro and %Hypo were deteced in each group and their ratio was calculated .The results were performed the analysis and comparison .Results The % Micro/% Hypo ratio had statistical difference between the mild thalassemia group and IDA group ,between the mild thalasse‐mia and IDA group with the normal group(P<0 .01) .The% Micro/% Hypo ratio had no statistical difference between the silent α‐thalassemia group and normal group ,and between the mild α‐thalassemia group and mildβ‐thalassemia group (P>0 .05) .With the% Micro/% Hypo ratio of 0 .9 as the discriminant value to diagnose mild thalassemia and IDA ,its sensitivity ,specificity and accuracy for diagnosing mild thalassemia were 91 .67% ,91 .89% and 91 .72% respectively ,the sensitivity ,specificity and accuracy in diagno‐sing IDA were 91 .94% ,91 .25% and 91 .18% respectively .Conclusion The ratio of % Micro/% Hypo has good differential diagno‐sis and assisted diagnosis screening value ,but has little value for diagnosing silent α‐thalassemia .

Objective: To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM. Methods: Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant. Results: At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/m², and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/m², respectively. There were significant differences between the two groups (t=-4.63, 0.00, P< 0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P<0.05). Conclusion Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.

[Objective]To explore the predictive value of preoperative serum inflammatory indicators in endometrial cancer.[Methods]The laboratory and clinical pathological data of patients with endometrial atypical hyperplasia and endometrial cancer diagnosed by pathology from January 2020 to December 2023 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The differences in basic information between the two groups of patients were analyzed. The Mann-Whitney U test was used to compare the differences in preoperative serum inflammatory indicators and tumor markers between the two groups of patients. The ROC curve was used to analyze the specificity,sensitivity and optimal cutoff value of the different indicators. A total of 408 patients were included in the study,including 82 patients in the endometrial atypical hyperplasia group and 326 patients in the endometrial cancer group.[Results]There were statistical differences in preoperative serum leukocyte count (P=0.039),monocyte count (P=0.046),platelet count (P=0.0317),platelet/lymphocyte ratio (PLR) (P=0.017),CA-125 (P<0.0001),and HE4 (P<0.0001) between endometrial atypical hyperplasia and endometrial carcinoma. ROC curves were drawn for these different indicators,and the results showed that leukocyte (P=0.041),platelet (P=0.045),PLR (P=0.007),CA-125 (P<0.0001),and HE4 (P<0.0001) had statistically significant predictive values in endometrial carcinoma. Compared with single indicators,the combined indicator CA-125+HE4+PLR+leukocytes+monocytes had the largest AUC[0.76 (0.70-0.81)],and its predictive value is higher.[Conclusion]CA-125+HE4+PLR+leukocytes+monocytes combined screening can help to identify endometrial cancer,and provide effective information for patients with endometrial atypical hyperplasia and early endometrial cancer who are conservatively treated.

Objective To explore the effect of medical and nursing integration notification on the truth knowing rate,anxiety,depression and quality of life in cancer patients undergoing chemotherapy. Meth-ods From February to March 2017,34 patients for the first time needing chemotherapy were included as control group,using normal disclosure.From June to July 2017,35 cases for the first time needing chemother-apy were included as the experimental group. The experimental group was informed of the medical and nurs-ing integration notification. The truth knowing rate,anxiety,depression and quality of life were compared be-fore and after three cycles of chemotherapy. Results After three cycles of chemotherapy,the truth knowing rate of patients in the experimental group (completely 57.14%,partly 34.29% and none 8.57%) was signifi-cantly different with the control group (completely 29.42%,partly 35.29% and none 35.29%,P＜0.01). The scores of anxiety and depression in the experimental group(39.43±4.60,41.86±5.23) were significantly low-er than those before chemotherapy(42.37±4.76,45.69±5.49,P＜0.01). The scores of anxiety and depression in the control group (45.74±5.20,49.74±5.42) were significantly higher than those before chemotherapy (42.77±5.62,45.56±6.27,P＜0.01).After three cycles of chemotherapy,the scores of anxiety and depression in the experimental group were lower than the control group (P＜0.01). After three cycles of chemotherapy, the total health status,body function,role function,emotional function,cognitive function,social function,fa-tigue,nausea and vomiting,and loss of appetite were statistically significant between the experimental group and control group (P＜0.05). Conclusion The medical and nursing integration notification has a positive effect on the truth knowing rate,anxiety,depression and quality of life in cancer patients undergoing chemo-therapy.

Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .

Objective To explore the expression of liver fatty acid binding protein (L-FABP) in tissues of hilar cholangiocarcinoma and the relationship between expression of L-FABP and clinicopathological factors and prognosis of the patients.Methods The retrospective case-control study was conducted.The clinicopathological data of 132 patients with hilar cholangiocarcinoma who were admitted to the Navy General Hospital between January 2003 and January 2013 were collected.The expression of L-FABP in tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues were respectively detected by immunohistochemistry.Observation indicators:(1) expression of L-FABP by immunohistochemistry;(2) relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues;(3) follow-up and survival situations;(4) prognostic analysis of patients after radical resection of hilar cholangiocarcinoma.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival time up to June 2017.Count data were described as percentage and compared using the chi-square test.The survival time was calculated by the Kaplan-Meier method.Measurement data with skewed distribution were described as M (range).The univariate analysis and multivariate analysis were respectively done using the nonparametric test and COX regression model.Results (1) Expression of L-FABP by immunohistochemistry:the positive expressions of L-FABP were located in the cytoplasm.The low,moderate and high expression rates of L-FABP in tumor tissues were respectively 11.36％ (15/132),71.97％ (95/132) and 16.67％ (22/132),and positive-staining cells showed platy and / or diffuse distribution;the low,moderate and high expression rates of L-FABP in adjacent tissues of hilar cholangiocarcinoma were respectively 77.27％ (102/132),7.58％ (10/132) and 15.15％ (20/132),and positive-staining cells showed scattered or platy distribution,with a weaker staining intensity compared with tumor tissues;there was no positive expression in normal bile duct tissues.There was a statistically significant difference in expressions of L-FABP among tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues (x2=5.423,P ＜ 0.05).(2) Relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues:cases with low,moderate and high expressions of L-FABP in tumor tissues were respectively 10,30,5 in 45 patients with tumor diameter ＜ 3 cm and 4,29,9 in 42 patients with 3 cm ≤ tumor diameter ≤ 5 cm and 1,36,8 in 45 patients with tumor diameter ＞ 5 cm,with a statistically significant difference (x2 =10.171,P＜ 0.05).(3) Follow-up and survival situations:132 patients were followed up for 5-90 months,with a median time of 33 months.During the followup,postoperative overall median survival time of 132 patients was 31 months.(4) Prognostic analysis of patients after radical resection of hilar cholangiocarcinoma:results of univariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were related factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (Z =1.845,3.156,1.243,P＜0.05).Results of multivariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (odds ratio =0.431,1.806,3.692,95％ confidence interval:0.292-0.693,0.974-2.973,1.875-11.364,P＜0.05).Conclusions The high expression of L-FABP in tumor tissues is significantly correlated with the tumor diameter.Tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues are independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma.

Objective:To conduct a scoping review of the characteristics, functions, risk of bias and applications of home-based self-management behavior assessment tools for lung transplant patients, so as to provide references for clinical medical staff to conduct further related research.Methods:The relevant literatures were systematically searched in China National Knowledge Infrastructure, Wanfang Database, VIP, China Biology Medicine disc, PubMed, Web of Science Core Collection, Embase, Cochrane Library and CINAHL databases. The search period was from the establishment of the databases to June 30, 2023. The scoping review method framework was used to screen the literature, extract information and standardize the report.Results:A total of 10 167 Chinese and English literatures were searched, and after deduplication and screening, 23 articles that met the criteria were finally included, involving 13 home-based self-management behavior assessment tools for lung transplant patients, including nine specific tools and four universal tools. There were eight kinds of lung transplantation patients whose reliability and validity were not verified. Of the 13 tools, those with single-dimensional assessments and single measures predominate. The level of home self-management behavior of lung transplant patients was reflected mainly through compliance, and medication management was the most frequently assessed content.Conclusions:At present, the measurement of home-based self-management behavior of lung transplant patients is mainly based on questionnaire surveys, and the evaluation tools are mostly single dimensional. The reliability and validity of most evaluation tools in the population of lung transplant patients are not yet clear, and there is a certain risk of bias. It is recommended that researchers pay attention to the reliability and validity verification report of the evaluation tool in the target population when selecting it, and integrate multiple measurement methods to reduce measurement errors.