Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective To understand the factors that affect the pulmonary rehabilitation behavior of elderly patients with lung cancer during the post-operative transitional period,and provide reference bases for formulating the pulmonary rehabilitation plan of elderly patients with lung cancer during the transitional period and improving the compliance of pulmonary rehabilitation.Methods Based on the capability,opportunity,and motivation-behavior model(COM-B model),12 elderly lung cancer patients who underwent surgery at a tertiary A tumor hospital in Tianjin from March to July 2022 were selected for semi-structured interviews using descriptive research methods and purposive sampling method.The data were analyzed using directed content analysis.Results The ability factors(physical strength and postoperative discomfort symptoms of the elderly limit lung rehabilitation exercise,lack of pulmonary rehabilitation knowledge and awareness of the importance of exercise in lung rehabilitation knowledge),opportunity factors(lack of grassroots medical and health services,limiting lung rehabilitation exercise;family and friends are important resources for promoting lung rehabilitation exercise;medical support is a guarantee for promoting lung rehabilitation exercise),motivational factors(high self-efficacy in exercise is the foundation for lung rehabilitation exercise,perception of lung rehabilitation effects increases motivation for lung rehabilitation exercise)and 7 sub themes were extracted.Conclusion There are certain obstacles and promoting factors in the transitional lung rehabilitation process for elderly lung cancer patients after surgery.It is necessary to improve their postoperative discomfort symptoms,increase their knowledge of lung rehabilitation,enhance their awareness of lung rehabilitation,face the social support role of family,friends,and medical staff,improve the infrastructure and lung rehabilitation system,increase community lung rehabilitation support,provide multi-channel high-quality lung rehabilitation resources,and promote the development of smart medical services,constructing a transitional lung rehabilitation strategy for elderly patients with lung cancer.

Currently, there is still no effective curative treatment for the development of late-stage liver fibrosis. Here, we have illustrated that TB001, a dual glucagon-like peptide-1 receptor/glucagon receptor (GLP-1R/GCGR) agonist with higher affinity towards GCGR, could retard the progression of liver fibrosis in various rodent models, with remarkable potency, selectivity, extended half-life and low toxicity. Four types of liver fibrosis animal models which were induced by CCl₄, α-naphthyl-isothiocyanate (ANIT), bile duct ligation (BDL) and Schistosoma japonicum were used in our study. We found that TB001 treatment dose-dependently significantly attenuated liver injury and collagen accumulation in these animal models. In addition to decreased levels of extracellular matrix (ECM) accumulation during hepatic injury, activation of hepatic stellate cells was also inhibited via suppression of TGF-β expression as well as downstream Smad signaling pathways particularly in CCl₄-and S. japonicum-induced liver fibrosis. Moreover, TB001 attenuated liver fibrosis through blocking downstream activation of pro-inflammatory nuclear factor kappa B/NF-kappa-B inhibitor alpha (NFκB/IKBα) pathways as well as c-Jun N-terminal kinase (JNK)-dependent induction of hepatocyte apoptosis. Furthermore, GLP-1R and/or GCGR knock-down results represented GCGR played an important role in ameliorating CCl₄-induced hepatic fibrosis. Therefore, TB001 can be used as a promising therapeutic candidate for the treatment of multiple causes of hepatic fibrosis demonstrated by our extensive pre-clinical evaluation of TB001.

OBJECTIVE: To explore the clinical characteristics and genetic basis for a pair of twins affected with hyaline fibromatosis syndrome (HFS). METHODS: Clinical data of the twins were retrospectively analyzed. High-throughput sequencing was carried out to detect potential pathogenic variants. CLUSTALX was employed to analyze cross-species conservation of the mutant amino acids. Impact of the mutations was predicted by using software including PolyPhen-2 and Mutation taster. RESULTS: The pair of twins have featured growth and intelligence retardation, and were found to carry compound heterozygous variants of the ANTXR2 gene including c.1214G>A and c.1074delT, among which c.1214G>A was unreported previously. Both variants were predicted to be pathogenic. In addition to growth and mental delay, the pair of twins also featured hyperplasia of the gum and soft tissue-like masses of the auricle. The younger brother had rupture of the auricle mass during follow-up. CONCLUSION The patients' condition can probably be attributed to the compound heterozygous variants of the ANTXR2 gene. Above finding has facilitated molecular diagnosis of the patients.
Asian Continental Ancestry Group/genetics* ; China ; Humans ; Hyalinosis, Systemic/genetics* ; Male ; Mutation ; Pedigree ; Receptors, Peptide/genetics* ; Retrospective Studies

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

Objective:To understand the correlation between systemic and local (at the maternal-fetal interface) oxidative stress in women with early pregnancy and the influencing factors of indicators, and to explore the associations between early pregnancy loss (EPL) and biomarkers of lipid peroxidation and total antioxidant capacity (T-AOC).Methods:A case-control study was performed. From December 2017 to July 2018, cases of EPL and controls of normal early pregnant women requesting induced abortions due to unintended pregnancies were recruited in the Family Planning Department of the Second Hospital of Tianjin Medical University. The levels of malondialdehyde (MDA) and T-AOC in serum of 103 participants and chorionic villous tissue of 60 participants in each group were measured. The influencing factors and the correlations between the levels of each biomarker in serum and villous were analyzed. The differences in the levels of each biomarker between the two groups were compared.Results:The levels of MDA and T-AOC in villi of case group and control group were both positively correlated with their serum markers, their correlation coefficients were r=0.744, P<0.001; r=0.312, P=0.015; r=0.712, P<0.001; r=0.650, P<0.001, respectively. Except for villus MDA in case group, serum and villus MDA and T-AOC increased with the increasing of gestational days in both groups. For each additional week of gestation in case group, serum MDA increased by 8.3% ( P=0.005), serum T-AOC increased by 4.2% ( P=0.002), villus T-AOC increased by 2.6% ( P=0.010), all of which were statistically significant; in control group, the serum MDA, serum T-AOC, villus MDA and villus T-AOC increased by 11.3% ( P=0.004), 5.4% ( P=0.007), 18.7% ( P=0.017) and 8.4% ( P=0.009) respectively for each additional week of gestation. After adjusting the gestational days, the serum T-AOC of the case group was 13.4% lower than that of control group ( P<0.001), the villus T-AOC was 33.7% lower than that of control group ( P<0.001), while the villus MDA was 30.1% higher than that of control group ( P=0.012). The serum MDA of the two groups had no statistic significance. Conclusion:The status of systemic oxidative stress is synchronized with that in the maternal-fetal interface in early pregnant women. Gestational age is an important factor affecting oxidative stress in serum and villous. EPL is associated with the reduction of systemic and maternal-fetal interface antioxidant capacity and maternal-fetal interface lipid peroxidation damage.

Objective:To understand the correlation between systemic and local (at the maternal-fetal interface) oxidative stress in women with early pregnancy and the influencing factors of indicators, and to explore the associations between early pregnancy loss (EPL) and biomarkers of lipid peroxidation and total antioxidant capacity (T-AOC).Methods:A case-control study was performed. From December 2017 to July 2018, cases of EPL and controls of normal early pregnant women requesting induced abortions due to unintended pregnancies were recruited in the Family Planning Department of the Second Hospital of Tianjin Medical University. The levels of malondialdehyde (MDA) and T-AOC in serum of 103 participants and chorionic villous tissue of 60 participants in each group were measured. The influencing factors and the correlations between the levels of each biomarker in serum and villous were analyzed. The differences in the levels of each biomarker between the two groups were compared.Results:The levels of MDA and T-AOC in villi of case group and control group were both positively correlated with their serum markers, their correlation coefficients were r=0.744, P<0.001; r=0.312, P=0.015; r=0.712, P<0.001; r=0.650, P<0.001, respectively. Except for villus MDA in case group, serum and villus MDA and T-AOC increased with the increasing of gestational days in both groups. For each additional week of gestation in case group, serum MDA increased by 8.3% ( P=0.005), serum T-AOC increased by 4.2% ( P=0.002), villus T-AOC increased by 2.6% ( P=0.010), all of which were statistically significant; in control group, the serum MDA, serum T-AOC, villus MDA and villus T-AOC increased by 11.3% ( P=0.004), 5.4% ( P=0.007), 18.7% ( P=0.017) and 8.4% ( P=0.009) respectively for each additional week of gestation. After adjusting the gestational days, the serum T-AOC of the case group was 13.4% lower than that of control group ( P<0.001), the villus T-AOC was 33.7% lower than that of control group ( P<0.001), while the villus MDA was 30.1% higher than that of control group ( P=0.012). The serum MDA of the two groups had no statistic significance. Conclusion:The status of systemic oxidative stress is synchronized with that in the maternal-fetal interface in early pregnant women. Gestational age is an important factor affecting oxidative stress in serum and villous. EPL is associated with the reduction of systemic and maternal-fetal interface antioxidant capacity and maternal-fetal interface lipid peroxidation damage.

Objective: To evaluate the efficacy of fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation (manipulation of balance and muscle tendon relaxing) in the treatment of chirospasm after stroke. Methods: A total of 104 patients with chirospasm after stroke who metthe inclusion criteria from July 2016 to June 2018 were selectedand divided into tow groups with the digital table methodwith 52 cases in each group. The control group was given routine rehabilitation training while the observation group was given fumigation with Shujin-Jieluan decoction combined with Pingheng-Shujin manipulation based oncontrol group, and the two groups both were treated for 8 weeks. The Modified Ashworth Scale (MAS) was used for chirospasm classification, and Key Point tabletop electromyography device was used to record the frequency, average amplitude and the shortest latency of F wave of median nerve. Fugl-Meyer motor function rating scale was used to evaluate hand motor function, and modified Barthel Index (BI) was used to evaluate life functionand clinical efficacy. Results: The effective rate was 88.5% (46/52) in observation group and was 65.4% (34/52) in control group (χ²=7.800, P=0.005). After treatment, the frequency (15.11 ± 2.06 vs. 16.72 ± 1.95, t=4.093), average amplitude (0.52 ± 0.04 mV vs. 0.59 ± 0.05 mV, t=7.883) and the shortest latency (24.37 ± 2.85 ms vs. 25.88 ± 2.43 ms, t=2.907) of F wave in observation group were significantly lower than the control group (P<0.01). Fugl-Meyer hand function score (6.51 ± 1.45 vs. 5.09 ± 1.22, t=5.404) and BI index score (60.87 ± 5.16 vs. 56.54 ± 4.25, t=4.671) were significantly higher than the control group (P<0.01). The distribution of MAS classification in observation group was significantly lower than that of control group (Z=8.410, P=0.004). Conclusions Fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation can improve the neuromuscular transmission of patients with chirospasm after stroke, and facilitate the recovery of hand function and viability.

Objective: To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs. Methods: The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom. Results: A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73). Conclusions Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.