Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning.Methods PubMed,Web of Science,Cochrane Library,Embase,CINAHL,Yimaitong,Wanfang Database,China National Know-ledge Network,VIP Database,and China Biomedical Literature Database were systematically searched.The search time limit is from database establishment to April 30,2024.Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened,and the"consensus based standards for the selection of health measurement instruments"was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools.The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion.Results A total of 14 articles were included,including 10 advance care planning readiness assessment tools suitable for the elderly.None of the articles reported cross-cultural validity,measurement error,and responsiveness.The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both"adequate",with A-level recommendations,and the remaining assessment tools were all B-level recommendations.Conclusion There are various types of advance care planning readiness assessment tools for the elderly,but the methodological quality needs to be improved and the measurement properties need to be further evaluated.It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.

Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning.Methods PubMed,Web of Science,Cochrane Library,Embase,CINAHL,Yimaitong,Wanfang Database,China National Know-ledge Network,VIP Database,and China Biomedical Literature Database were systematically searched.The search time limit is from database establishment to April 30,2024.Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened,and the"consensus based standards for the selection of health measurement instruments"was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools.The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion.Results A total of 14 articles were included,including 10 advance care planning readiness assessment tools suitable for the elderly.None of the articles reported cross-cultural validity,measurement error,and responsiveness.The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both"adequate",with A-level recommendations,and the remaining assessment tools were all B-level recommendations.Conclusion There are various types of advance care planning readiness assessment tools for the elderly,but the methodological quality needs to be improved and the measurement properties need to be further evaluated.It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.

Objective:To review the application of virtual reality in cardiac rehabilitation patients, identify intervention types, intervention elements, outcome indicators, and application effects.Methods:Electronic retrieval was implemented on PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Data, and China Biology Medicine disc, using the Joanna Briggs Institute (JBI) scoping review guideline as the methodological framework. The search period was from the establishment of the database to April 10, 2023. The literature was extracted, summarized, and analyzed.Results:A total of 16 articles were included. The main types of virtual reality interventions were immersive and non-immersive. The intervention population included patients at different stages of cardiac rehabilitation, with unrestricted intervention venues. The intervention frequency was mostly 2 to 3 times per week, with intervention duration mostly ranging from 30 to 60 minutes and intervention cycles mostly ranging from 3 weeks to 12 months. Virtual reality improved the physical function and mental health of cardiac rehabilitation patients to a certain extent, and patient feedback showed good participation and satisfaction.Conclusions:Virtual reality has a positive impact on cardiac rehabilitation patients, with good safety and feasibility, but the recovery of cardiac function is still controversial. It is still necessary to conduct large sample size, multi center research, and track long-term effects.

Angiosarcoma is a rare malignant tumor of soft tissue in adults. However, tumor ulcers caused by foot angiosarcoma are rarely reported in the literature. This paper outlines a case of foot angiosarcoma misdiagnosed as diabetic foot ulcer. It was treated as diabetic foot ulcer in other hospitals without notable improvement. In consideration of its special clinical characteristics and treatment process, pathological biopsy was performed after admission, and angiosarcoma was confirmed. The purpose of this article is to emphasize that foot angiosarcoma or other tumor ulcers in diabetes patients are easily misdiagnosed as diabetic foot ulcers. If there is no obvious improvement in treatment, pathological tissue biopsy should be performed as early as possible.

Objective:To compare the survival outcomes in patients of small cell lung cancer (SCLC) with brain-single metastasis and brain with organs-multiple metastasis.Methods:Using the US surveillance, epidemiology and final results database, 5 520 SCLC patients with complete clinical information from 2004 to 2015 were selected. SCLC patients were adjusted, stratified or matched according to the metastasis site after the stratification or matching of the propensity scores, and the lung cancer-specific survival (CSS) rate and overall survival (OS) rate were compared between brain-single metastasis group and brain with organs-multiple metastasis group. In addition, the effects of chemotherapy and radiotherapy in CSS between brain-single metastasis group and brain with organs-multiple metastasis group were compared.Results:Of the 5 520 SCLC patients, 2 658 cases was in the brain-single metastasis group, and 2 862 cases was in brain with organs-multiple metastasis group. After the stratification or matching of the propensity scores, the median survival time in brain-single metastasis group was significantly longer than that in brain with organs-multiple metastasis group (6 months vs. 4 months), and there was statistical difference ( P<0.05). The fatality rate in brain-single metastasis group was significantly lower than that in brain with organs-multiple metastasis group (80.66% vs. 85.96%), and there was statistical difference ( P<0.01). Kaplan-Meier survival curve analysis result showed that the OS rate and CSS rate in brain-single metastasis group were significantly higher than those in brain with organs-multiple metastasis group (14.72% vs. 9.50% and 19.34% vs. 14.04%), and there were statistical differences ( P<0.05). Cox analysis result showed that age, race, T stage, gender, N stage, radiotherapy, chemotherapy, tumor diameter, marriage and metastasis were the influencing factors of CSS rate in SCLC patients with brain metastasis ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that radiotherapy and chemotherapy can significantly improve the CSS rate ( HR = 0.668 and 0.671, 95% CI 0.570 to 0.783 and 0.573 to 0.786, P < 0.01). Conclusions:The survival rate in SCLC patients with brain-single metastasis is higher than that of SCLC patients with brain with organs-multiple metastasis; chemotherapy and radiotherapy can improve the survival rate in SCLC patients with brain metastasis.

From the perspective of clinical doctors, in the teaching idea, national policy, school policies and different stages of clinicians cultivation , the article introduced the concept of translational medicine in the process of the clinical doctors tralning in the United States. It described US medical schools' (U.S. Virginia University School of medicine, for example) implementation ap-proach of translational medicine ideas in different stages, such as before entering school, during the period of school, practice exam and physician clinician tralning. It provided the reference for the de-velopment of translational medicine education in the process of China clinician education and tralning, including:medical students' integration into the related clinical research in preschool through volunteer service, the choice of multiple combination model of clinical science and basic research, interdisci-plinary examination of medical practitioners and the provisions of the research work in resident and specialist tralning stage.

Adrenal Cortex Hormones ; Antibodies, Monoclonal, Murine-Derived ; Humans ; Rituximab ; Thrombocytopenia ; gamma-Globulins

Effects of traditional Chinese medicine salvianolate combined with alprostadil and reduced glutathione on delay of progression in patients with acute kidney injury has been confirmed, but the role of this combination therapy on the progression of chronic renal failure is uncertain.

Objective To compare the efficacy and adverse effects of 5 days' and 7 days' course of combination chemotherapy regimen HA in the treatment of chronic phase of chronic myelogenous leukemia (CML-CP). Methods 18 cases of CML-CP had received 5 days' course of combination chemotherapy regimen HA including homoharringtonine 4 mg/d and cytarabine 200 mg/d for 5 days. At the same time,another 18 patients diagnosed as CML-CP who were given 7 days' course of HA regimen including homoharringtonine 4 mg/d and cytarabine 200 mg/d for 7 days were compared on the efficacy including peripheral white blood cells, spleen size and cytogenetic responses and adverse effects. Results The complete remission(CR) rate was 50.0 % and 61.1 % in 5 days' and 7 days' treated groups, respectively (P >0.05). The incidence of severe bone marrow suppression in 7 days' group(16.7 %) was higher than that in 5 days' group(0)(P <0.05). Conclusion The 5 days' course of combination chemotherapy HA regimen is same as 7 days' course of HA regimen about their curative effects in CML-CP. But the incidence of severe bone marrow suppression in 7 days' group(16.7 %) was higher than that in 5 days' group (0).

Objective: To study the influence of recombinant human hepatocyte growth factor (rhHGF) on proliferation and extracellular matrix synthesis of autosomal dominant polycystic kidney disease (ADPKD) cyst lining epithelial cells in vitro . Methods: The effects of different concentration rhHGF (0.5,1,2.5,5 ng/ml)in 48 h and the optimal concentration rhHGF of different time (24,48,72 h ) on proliferation of ADPKD cyst lining epithelial cell lines were observed by the incorporation of 3H TdR, and synthesis of collagen and laminin were respectively observed by the incorporation of 3H proline and radioimmunoassay. Results: rhHGF stimulated the proliferation of ADPKD cyst lining epithelial cells and synthesis of collagen and laminin,the optimal concentration and time of rhHGF were 1 ng/ml and 48 h. Conclusion: rhHGF can significantly stimulate ADPKD cyst lining epithelial cells proliferation and extracellular matrix synthesis in vitro . [