Objective To systematically evaluate the effect of inspiratory muscle training(IMT)on weaning outcomes in patients with weaning failure.Methods Literatures in Chinese and English were retrieved from databases such as PubMed,Cochrane Library,Web of Science,Embase,CNKI,VIP,Wanfang data and CBM for researches on the effect of IMT in mechanical ventila-tion weaning failure,from the inception of the databases to October 22,2024.The methodological quality of the researches was evaluated with PEDro scale,and data were extracted for a systematic review.Results Nine randomized controlled trials were included,published between 2011 and 2023,from Brazil,China,the United States,Iran and Australia,with a total of 499 patients.The scores of the PEDro scale ranged five to eight.The population included patients with prolonged weaning,difficult weaning and tracheostomy.The IMT methods included threshold load training and tapered flow resistance training.The training intensity was 30%to 80%of maximal inspiratory pressure(MIP),and some researches did not set the training intensity based on MIP.The pro-gression of intensity varied widely across researches.The intervention frequency ranged from five to 30 breaths per set,with at least one minute rest between sets,two to six sets per session,one to two sessions per day,and five to seven days per week.The duration of the intervention ranged from successful weaning,one week after weaning,extubation,or four days to eight weeks.Regarding the efficacy of the intervention,IMT was not benefi-cial for the duration of mechanical ventilation and intensive care unit(ICU)length of stay on weaning failure pa-tients.However,the effect of IMT on weaning successful rates,duration of weaning,MIP and mortality was in-consistent.Conclusion IMT can not improve the duration of mechanical ventilation and ICU length of stay for weaning failure pa-tients,and there is still debate regarding its effect on successful rate of weaning,duration of weaning,MIP and mortality.

Objective To investigate the clinical efficacy of Guhong Injection for the treatment of patients with coronary microvascular dysfunction(CMD)of qi stagnation and blood stasis syndrome.Methods Sixty cases of patients with CMD of qi stagnation and blood stasis syndrome who were admitted to Guangdong Provincial Hospital of Chinese Medicine from June 2021 to August 2022 were randomly divided into the control group and the trial group according to the random number table method,with 30 cases in each group.The control group was treated with conventional western medicine,and the trial group was treated with Guhong Injection on the basis of treatment for the control group.The course of treatment for the two groups covered 10 days.The changes in traditional Chinese medicine(TCM)syndrome scores,and levels of lipid indicators,serum inflammatory factors and endothelial factors in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)During the trial,three cases in the control group and two cases in the trial group fell off and a total of 55 cases were finally included in the statistical analysis of efficacy,including 27 cases in the control group and 28 cases in the trial group.(2)After 10 days of treatment,the total effective rate of the trial group was 89.29%(25/28),and that of the control group was 40.74%(11/27),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group(P<0.01).(3)After treatment,the TCM syndrome scores of patients in both groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(4)After treatment,the levels of lipid indicators triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)in the two groups of patients were decreased compared with those before treatment(P<0.05),and the level of high-density lipoprotein cholesterol(HDL-C)was increased compared with that before treatment(P<0.05).The intergroup comparison showed that the decrease of TG,TC,and LDL-C levels as well as the increase of HDL-C level in the trial group was significantly superior to that in the control group(P<0.05 or P<0.01).(5)After treatment,the serum levels of inflammatory factors high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)in the two groups of patients were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(6)After treatment,the serum level of endothelial factor nitric oxide(NO)in the two groups of patients was increased(P<0.05)and the serum endothelin 1(ET-1)level was decreased compared with that before treatment(P<0.05),and the increase of serum NO level,as well as the decrease of serum ET-1 level in the trial group was significantly superior to that in the control group(P<0.05 or P<0.01).Conclusion Based on the conventional treatment in western medicine,the application of Guhong Injection in the treatment of patients with CMD of qi stagnation and blood stasis syndrome exerts remarkable efficacy,which can effectively alleviate the symptoms,regulate the levels of blood lipids,reduce the inflammatory response,and improve the endothelial function.

Objective To systematically evaluate the effect of inspiratory muscle training(IMT)on weaning outcomes in patients with weaning failure.Methods Literatures in Chinese and English were retrieved from databases such as PubMed,Cochrane Library,Web of Science,Embase,CNKI,VIP,Wanfang data and CBM for researches on the effect of IMT in mechanical ventila-tion weaning failure,from the inception of the databases to October 22,2024.The methodological quality of the researches was evaluated with PEDro scale,and data were extracted for a systematic review.Results Nine randomized controlled trials were included,published between 2011 and 2023,from Brazil,China,the United States,Iran and Australia,with a total of 499 patients.The scores of the PEDro scale ranged five to eight.The population included patients with prolonged weaning,difficult weaning and tracheostomy.The IMT methods included threshold load training and tapered flow resistance training.The training intensity was 30%to 80%of maximal inspiratory pressure(MIP),and some researches did not set the training intensity based on MIP.The pro-gression of intensity varied widely across researches.The intervention frequency ranged from five to 30 breaths per set,with at least one minute rest between sets,two to six sets per session,one to two sessions per day,and five to seven days per week.The duration of the intervention ranged from successful weaning,one week after weaning,extubation,or four days to eight weeks.Regarding the efficacy of the intervention,IMT was not benefi-cial for the duration of mechanical ventilation and intensive care unit(ICU)length of stay on weaning failure pa-tients.However,the effect of IMT on weaning successful rates,duration of weaning,MIP and mortality was in-consistent.Conclusion IMT can not improve the duration of mechanical ventilation and ICU length of stay for weaning failure pa-tients,and there is still debate regarding its effect on successful rate of weaning,duration of weaning,MIP and mortality.

Objective: To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas. Methods: Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan. 2010 to Dec. 2018. The primary endpoint was progression-free survival, and the secondary endpoint was overall survival. Correlative analyses of prognosis by age, gender, initial resection status, the maximum diameter of the lesions, bi-hemisphere, astrocytoma, chemoradiation, adjuvant chemotherapy were conducted. Results: A total of 109 cases with grade Ⅱ glioma were enrolled. The follow-up rate was 91.75%, including 10 cases dead and 27 relapsed. There were 24 cases (88.9%) of in-field failure, and 3 cases (11.1%) of out-field failure. 14 cases of recurrence occurred in 81 cases of total resection group, accounting for 17.3%, and 13 in 28 cases of subtotal resection group, accounting for 46.4%. The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (χ ²=9.484, P<0.05). The 1-, 2-, 3-, 4- and 5-year progression-free survival rates were 92.5%, 86.0%, 80.6%, 77.5% and 66.8%, respectively. The 2-, 3-, 4- and 5-year overall survival rates were 97.2%, 90.8%, 87.7% and 84.5%, respectively. Multivariate analysis showed that patients with subtotal resection(HR=3.608, P<0.05) and bi-hemisphere(HR=3.183, P<0.05)were significantly correlated with the progression free survival. Conclusions Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS. Recurrence in the radiation field is the main failure mode. Initial resection status and bi-hemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.

Objective: To understand snack food consumption among students of grade four and grade five in six cities of China, and to provide evidence for conducting nutritional education and making intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 primary school students in grade four and grade five from 72 primary schools in Beijing,Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire survey on dietary behaviors. Results: The proportion of pupils who consumed snack food at home, school and elsewhere was 96.4%, 59.4% and 75.5% respectively. The most popular snacks at home were fruits & vegetables, milk, cereals (72.0%, 71.1%, 68.6%), the most popular snacks at school were fruits & vegetables, milk, cereals (30.0%, 28.2%, 23.8%), the most popular snacks in other places were sugars, cereals and beverages (36.6%, 36.2%, 35.7%). The top five reasons for snack food was being delicious, healthy/nutritious, clean, choices of peers and family members (68.5%, 49.3%, 42.2%, 24.7%, 17.8%, respectively). Conclusion Snack food consumption is popular among primary students, most of which are unhealthy. Nutrition education for students and parents should be encouraged to promote students to consume snacks reasonably and develop healthy eating behaviors.

Objective: To understand the status on beverages consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors. Results: The proportion of students who consumed beverages at home, school and elsewhere was 92.5%, 51.4% and 70.6% respectively. The most popular beverages at home were milk, fruit & vegetable drinks, tea drinks (69.4%, 46.6%, 39.6%); the most popular beverages at school were milk, fruit & vegetable drinks, tea drinks (30.5%, 13.0%, 12.7%) while the most popular beverages in other places were milk, tea drinks, fruit & vegetable drinks(37.4%, 29.6%, 28.1%). The top five reasons for choosing beverages were taste delicious, healthy & nutritious, clean, choice of peers and family members(72.3%, 50.8%, 38.4%, 21.9%, 21.6%, respectively). Conclusion Consumption of drinking beverages is popular among students, most of which are unhealthy. Therefore, nutrition education for students and parents should be encouraged aiming to help students choose healthy drinks and eating behaviors.

Objective: To investigate students’ satisfaction on school feeding program in 8 cities in China, and to provide the basis for improving school feeding management and lunch quality. Methods: Multi-stage random cluster sampling method was used to randomly select the second, fifth and eighth-grade students from 67 primary and middle schools in 8 cities including Beijing, Shanghai, Harbin, Shijiazhuang, Guangzhou, Changsha, Bengbu and Pinghu. Results: A total of 15 475 students participated in the survey, 15 170(98.0%) of which were valid questionnaires. A total of 13 297(87.7%) students had lunch in school. Twenty-six(38.8%), 14(20.9%) and 27(40.3%) schools served lunch by self-run canteens, custody canteens, and food delivery companies respectively. Twenty-one schools provided milk or yogurt for lunch, accounting for 31.3%. The reported rates of very satisfied, satisfied, moderate, dissatisfied, and extremely dissatisfied among students were 40.8%, 28.1%, 20.1%, 7.3%, and 3.6%, respectively. The satisfaction rate of the eighth-grade students was lower than that of the second-and fifth-grade(56.9% vs 77.1% vs 73.5%). The satisfaction rate among students from schools with self-run canteen was higher than that of custody canteens and food delivery companies(73.8% vs 60.5% vs 66.2%). The satisfaction rate of school lunch is highest in dining surrounding (75.3%), followed by amount of meals(71.6%), food hygiene(71.1%), food combination(65.4%), and the appearance of the food(60.5%), and food taste(55.9%). Conclusion The satisfaction rate of students for school lunch was acceptable. The food taste is the main factor for students’ dissatisfaction. Schools should be encouraged to provide lunch in the self-run canteens with tasty food while meeting the nutritional standard.

Objective: To understand rural students’ perception and satisfaction of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide basis for promoting students’ participation in the school feeding program and improving the acceptability of school feeding. Methods: In 3 national pilot counties and 2 local pilot counties of NIPRCES, 1 middle school and 1 primary school were randomly selected. Two classes of 2 364 students from grade 4 to grade 9 were randomly selected and investigated with questionnaires. Results: Students were aware of the policy, with 78.9% of the students reported to be familiar with NIPRCES. The awareness rate of students at the national pilot areas was higher than that in local pilot areas(P<0.05). Students showed positive attitude towards NIPRCES. The median score of students’ understandings of the influence of NIPRCES was 20.0 (18.0, 20.0) points. Students in national pilot areas showed a more positive attitude toward the program than those in local pilot areas(P<0.05). Moderate satisfaction was reported in school feeding, 78.7% of students thought that school provided adequate amount of food, and 60.9% of the students enjoyed the food very much. The main reasons for leftovers were too much in amount(27.4%), repetition of food types (22.8%) and food aversions(9.2%). Conclusion Students are quite aware of NIPRCES and show moderate satisfaction in school feeding. The awareness and satisfaction are relatively higher among students in national pilot areas than those in local pilot areas. Health promoting schools should be established and students and parents should be advocated to take part in the program, health education need to be promoted in schools. Experiences sharing between different places could help improve the quality and acceptability of school feeding program.

Objective: To understand nutrition knowledge,related attitude and behavior among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in 6 cities of China, whom were administered with a questionnaire survey on nutrition knowledge, practice and practice. Results: Average nutritional knowledge was relatively low (12.0±6.4), practice score was moderate(11.4±2.4), while nutritional attitude was relatively high(17.0±2.4). The nutritional KAP scores of girls were higher than those of boys; the nutritional knowledge and practice scores of urban students were higher than those of suburban students; the nutritional knowledge score of fifth-grade students was higher than that of fourth-grade students(P<0.05). The overall nutritional knowledge awareness rate was 26.1%, with the highest in knowledge of whole grains(73.9%). About 83.5% of the students held positive nutritional attitude, 97.6% considered nutritional knowledge important. The overall rate of healthy eating behavior of students was 88.1%. Most students had breakfast almost every day(88.5%). About 34.9%, 38.0%,46.1% and 50.5% were reported of rarely consumption in snacks, fast food and drinks. Students in urban area and grade 5 were more likely have breakfast. Girls reported higher rates of having breastfast and low consumption of snack food and beverage while boys reported higher consumption of fast food. Students from suburban areas reported high consumption of western fast food but lower beverage(P<0.05). The score of students’ nutritional knowledge was positively correlated to attitude, so as attitude and practice(P<0.05). Conclusion Insufficient nutritional knowledge and unhealthy dietary behavior is observed in primary school students in China. Nutritional K-A-P varies in students with different gender, area and grade. Specific nutritional education in school-setting should be developed accordingly to culture healthy lifestyle among primary school students.

Objective: To understand food intake frequency among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing，Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire on dietary behaviors. Results: For the fourth and fifth grade primary school students, the highest proportion of "almost every day" was fresh vegetable(83.2%), and the highest proportion of "nearly eaten" was oat (50.2%). There was a remarkable difference between children of different genders, areas and grades. The intake of whole grains, meat and poultry, fishery products, eggs, soybeans and nutritional supplements of boys was higher than that of girls, while the intake of oats, fresh vegetables, fruits, fungi and algae of girls was higher than that of boys. The intake of oats, vegetables, fruits, fungi and algae, meat and poultry, milk of central urban areas students was higher than that of suburban areas students, while the intake of fishery products, soybeans and nutritional supplements of suburban areas students was higher than that of central urban areas students. The intake of oats, fresh vegetables, fruits, meat and poultry, eggs, milk and soybeans of fifth grade students was higher than that of fourth grade students, while the intake of whole grains, fishery foods and nutritional supplements of grade 4 students was higher than that of grade 5 students. The differences were all statistically significant(P<0.05). Conclusion The frequency of food intake varies among students of different genders, urbanities and grades. School teachers, parents and community workers should make efforts targeting at students with different characteristics to enhance nutritional literacy and cultivate healthy eating behaviors.