ObjectiveTo study the relationship between qi stagnation constitution and suboptimal health status (SHS) or lifestyle.MethodsFrom 2012 to 2013, we conducted a cross-sectional survey of 24 159 Chinese individuals aged 12–80 years. The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire. Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0 (SHMS V1.0). Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile II (HPLP-II).ResultsOf the 24 159 participants, 16.1% and 15.2% were classified as “always” and “sometimes” having the qi stagnation constitution, respectively. Those classified as “rarely” having the qi stagnation constitution scored higher on both the HPLP-II and SHMS V1.0. The participants classified as “always” having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions. Those in the “always” category were approximately 21 times more likely to be classified as having SHS (odds ratio [OR]: 21.17, 95% confidence interval [CI]: 15.74–28.45), whereas those in the “sometimes” category were approximately six times more likely (OR: 5.89, 95% CI: 5.04–6.90). Accordingly, the qi stagnation constitution score was significantly associated with the diagnosis of SHS, with an area under the curve of 0.77 (P .001). A score of 18.75 yielded the highest Youden Index (0.407), with a sensitivity of 60.5% and a specificity of 80.3%. Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis (P .001). Protective factors included stress management (OR: 1.59), self-actualization (OR: 1.57), and exercise (OR: 1.36). In contrast, poorer interpersonal relationships (OR: 0.79), greater health responsibilities (OR: 0.86), and poorer nutrition (OR: 0.91) were associated with increased severity.ConclusionModulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease, which aligns with core preventive principles in traditional Chinese medicine.

Through comprehensive and systematic collection of existing evidence,systematic review adopts clinical epidemiological methods,strictly evaluates the quality of evidence,qualitatively or quantitatively combines research results,and finally provides a reliable basis for solving a focused clinical problem.The number of systematic reviews has increased rapidly.With references to the Checklist,this review discussed the typical issues with current systematic reviews in nursing,and highlighted the crucial components for reporting systematic reviews at every essential step.

Objective This study aims to analyze the relationship between reproductive tract microecological changes,metabolic differences,and pregnancy outcomes at different time points in the frozen-thawed embryo transfer cycle while patients are undergoing hormone replacement therapy,which will be a breakthrough point for improving outcomes.Methods A total of 20 women undergoing frozen-thawed single blastocyst transfer for the first time at the Reproductive Medicine Center of Fujian Maternal and Child Health Hospital between July 2022 and January 2023 were recruited for this study.Their vaginal and cervical secretions were collected for 16S rRNA sequencing and non-targeted metabolomics analysis on days 2-5 of menstruation,day 7 after estrogen replacement therapy started,the day when progesterone was added,and the day of transplantation.The subjects were divided into different groups according to their clinical pregnancy status and the sequencing results were analyzed using bioinformatics methods.Results 1)The alpha-diversity index of the vaginal and cervical microbiota was higher on days 2-5 of menstruation(P<0.01),but did not differ significantly on day 7 after oral estrogen replacement therapy started,the day of progesterone administration,and the day of transplantation(P≥0.1).2)Both the pregnant group and the non-pregnant group showed a variety of microorganisms and metabolites with significant differences in the lower reproductive tract at different time points.3)Microbial analysis at different time points showed that there were significant differences in vaginal flora,including Peptoniphilus,Enterocloster,Finegoldia,Klebsiella,Anaerobutyricum,Agathobaculum,Sporanaerobacter,Bilophila,Prevotella,and Anaerococcus in the pregnant group(P<0.05).4)Metabolite analysis at different time points showed that there were significant differences in 3-hydroxybenzoic acid,linatine,(R)-amphetamine,hydroxychloroquine,and L-altarate in the vaginal secretions of the pregnant group(P<0.05),and that there were significant differences in isocitric acid,quassin,citrinin,and 12(R)-HETE in the cervical secretions(P<0.05).5)Metabolite analysis at different time points showed that,in the non-pregnant group,there were significant differences in linatine,decanoyl-L-carnitine,aspartame,sphingosine,and hydroxychloroquine in the vaginal secretions(P<0.05),and the isocitric acid,quassin,ctrinin,and 12(R)-HETE in the cervical secretions(P<0.05).6)Combined microbiome and metabolomics analysis showed that certain metabolites were significantly associated with microbial communities,especially Klebsiella.Conclusions Significant differences in the microbiota genera and metabolites at different time points were found during the frozen-embryo transfer cycle of hormone replacement therapy,which may be used as potential biomarkers to predict pregnancy outcomes of embryo transfer.

OBJECTIVE To provide reference for strengthening the quality of pharmaceutical care in retail chain pharmacies and the professional capabilities of licensed pharmacists， and to meet the public’s pharmaceutical care needs. METHODS A combination of questionnaire survey and informant interview was used to investigate the general information of licensed pharmacists in retail chain pharmacies in Guangdong province， the implementation of pharmaceutical care， the competence and knowledge status of the surveyed licensed pharmacists， and the factors affecting the development of pharmaceutical care. RESULTS & CONCLUSIONS A total of 444 questionnaires were sent out and 326 effective questionnaires were collected， with an effective recovery rate of 73.42%. Among 326 surveyed licensed pharmacists， a college degree or higher accounted for 40.18%， and the pharmacy major or related accounted for 79.75%. A total of 185 （56.75%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked had established specified areas of pharmaceutical care； 320 （98.16%）， 137 （42.02%） and 181 （55.52%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked could provide services such as rational medication guidance for patients， decocting traditional Chinese medicines and establishing health records， etc. The self-assessment scores of the surveyed licensed pharmacists were significantly higher than 3 （median） for competence and knowledge level， but the self-assessment scores for medication therapy management competence and pharmaceutical care practice were relatively low. The surveyed licensed pharmacists believed that the main factors affecting the development of pharmaceutical care in retail chain pharmacies included patients’ lack of trust or cooperation （196， 60.12%）， sales performance requirements （170， 52.15%）， and heavy daily workload （165， 50.61%）. It is recommended that relevant authorities expedite the legislative process of the Pharmacist Law， optimize the continuing education system for licensed pharmacists， and implement a star-rating evaluation system for pharmaceutical care capabilities in pharmacies， so as to encourage retail chain pharmacies and licensed pharmacists to pursue a more specialized development path. At the same time， pharmaceutical retail chain enterprises should shift their business mindset， increase investment in pharmaceutical care， enhance the professional atmosphere in the pharmacies， optimize the compensation structure for licensed pharmacists， and elevate the pharmaceutical care capabilities of both the pharmacies and licensed pharmacists to fulfill the pharmaceutical care needs of the public.

Objective:To explore the effect of health belief model in the prevention of lower extremity deep vein thrombosis (DVT) in patients with lung cancer after operative.Methods:From January 2019 to June 2020, 80 lung cancer patients admitted to Henan Provincial Chest Hospital were selected as research objects by convenience sampling method. The patients were randomly divided into control group and research group with 40 cases each. The routine health education was used in the control group, and the health belief model was used in the research group on the basis of the control group. Both groups intervened until discharge. We compared the DVT prevention knowledge and health belief of the two groups of patients before and after the intervention, and counted the incidence of DVT in the two groups of patients.Results:After intervention, the scores of all dimensions of the DVT Health Questionnaire and DVT Health Belief Questionnaire in the research group were higher than those in the control group, with statistically significant differences ( P<0.05) . The incidence of DVT in the research group was lower than that in the control group with a statistical difference ( P<0.05) . Conclusions:The health belief model can improve the health knowledge and health belief of lung cancer patients to prevent DVT, reduce the occurrence of DVT, and is worthy of clinical promotion and application.

Acute lymphoblastic leukemia (ALL) accounts for 75%-85% of the cases of childhood leukemia. As a result of the progress made in diagnosis and treatment, an event-free survival rate of 70%–80% has been reported in our country. Consequently, research should focus on long-term physical function and quality of life of childhood ALL survivors. In the past 20 years, cancer rehabilitation has achieved rapid development in European and American countries, but gaps remain in clinical practice and academic research of rehabilitation for childhood leukemia. Specifically, rehabilitation for childhood leukemia in our country lags behind, compared with that in Western developed countries. In this commentary, we describe a relatively comprehensive childhood ALL survivorship care quality framework to improve patients' long-term quality of life.

Objective:To investigate the expression pattern of TCR variable region subfamily (Vβ and Vδ) in patients with mature T-cell lymphoma (TCL), and to compare the diagnostic value of TCRVβ and TCRVδ analysis in TCL.Methods:The TCRVβ flow cytometry kit was used to detect the expression of Vβ subtypes of αβT cell in 199 patients with αβ TCL and 398 patients with non-TCL, who hospitalized in Jiangsu Provincial People Hospital from 2011 to 2020. Among them, 185 cases of αβ TCL and 355 cases of non-TCL also underwent TCRβ and TCRγ gene rearrangement detection. The TCRVδ based 10-color protocol was used to detect the expression of Vδ subtypes in 24 cases of γδTCL, 10 cases of normal controls, and 15 cases with reactively higher CD4 and CD8 double-negative ratio from 2017 to 2020, and 24 cases of γδTCL and 15 cases with reactively higher CD4 and CD8 double-negative ratio underwent TCRβ, TCRγ and TCRδ gene rearrangement detection. The diagnostic performance and degree of coincidence for detecting malignant clonality were compared between TCRVβ and TCRVδ analysis and the TCR gene scanning method.Results:In the 199 cases of αβ TCL, 182 cases (91.5%) showed restricted expression or the sum of the positive percentages of the subgroups was less than 30% for the 24 TCRVβ subtypes. Among them, the subfamily members with the highest incidence of clonal T lymphocytes were TCRVβ13.2 (12.6%, 23/182) and TCRVβ3 (8.2%,15/182); the TCRVβ subtypes showed nonclonal results in 99.0% (394/398) of non-TCL. All 24 cases of γδTCL (100%) showed abnormal distribution patterns of Vδ1 and Vδ2, of which 19 cases showed restricted expression of Vδ1, and the remaining 5 cases had negative expression of either Vδ1 or Vδ2, and the positive rate of Vδ1 cells was significantly higher than that of Vδ2 cells (79.9%±10.8% vs 0.7%±0.3%, P<0.001). Among the normal control and cases with reactively higher CD4 and CD8 double-negative ratio, the positive rate of Vδ2 cells was significantly higher than that of Vδ1 cells (73.7%±6.7% vs 15.6%±4.2%, P<0.001), and all cases (25/25) showed a normal distribution pattern. In terms of the diagnostic performance of TCL, there was no significant difference of sensitivity and specificity between TCR variable region subfamily detection by flow cytometry and TCR gene scanning technology (the sensitivity was 92.4% and 91.4% respectively; the specificity was 99.0% and 95.9% respectively, P=0.065), and the coincidence rate of the two diagnostic methods is high (Kappa=0.809, P<0.001). Conclusion:Detection of TCR variable region subfamily by flow cytometry could quickly and effectively diagnose mature TCL.

Objective To examine the predictive value of fetal umbilical artery Doppler in preterm birth in pregnant women with systemic lupus erythematosus(SLE).Methods The clinical data from 160 live births of SLE patients were analyzed retrospectively.Results The mean age of SLE patients at pregnancy was(29.7 ± 3.7) years(20 ~ 37 years). Totally,56 patients(32.5%)were preterm births and 76(47.5%)were full-term births without any other adverse pregnancy outcomes. The rate of preterm birth before 34 weeks was 26.9% and that was 73.1% for those preterm deliveries after 34 weeks. Iatrogenic preterm birth was the most common cause of preterm birth(32 cases),followed by spontaneous preterm birth(12 cases)and preterm premature rupture of membranes (10 cases).The pulsatility index(PI),resistance index(RI)as well as S/D value of SLE patients with pre-term delivery was higher than those of patients with full-term delivery(P<0.05).The area below the ROC curve for PI, RI and S/D was 0.6(95% CI 0.5~0.7),0.7(95% CI 0.6~0.8)and 0.6(95% CI 0.5~0.7),respectively.PI with cut-off value of 1.0 indicated the highest risk of preterm birth,with sensitivities of 34.6% and 84.2.The optimal cut-off value for RI and S/D was 0.7 and 2.8 respectivly,at which sensitivity and specificity had the best combination. Conclusions Pregnancies in lupus still have an increased risk of preterm birth. Umbilical artery Doppler was a useful monitoring tool for preterm birth in lupus pregnancies.

Objective To discuss the change trends of pathogen of severe hand,foot and mouth dis-ease(HFMD) in Chaoshan area during 2011 to 2015. Methods All 1410 throat swabs of cases who were diagnosed as HFMD were collected from children hospitalized in our hospital during May 2011 to August 2015. Enterovirus were detected by nest RT-PCR,and the results of these positive cases diagnosed as severe HFMD were analyzed. Results (1) There were 216 positive cases(67. 29％,216/321) diagnosed as severe HFMD,including 53. 70％ ( 116/216 ) enterovirus 71 ( EV71 ), 19. 91％ ( 43/216 ) coxsackievirus A16 (CA16),12. 04％(26/216) CA6,8. 80％(19/216) CA10,3. 24％(7/216) CA4,0. 93％(2/216) coxsack-ievirus B5, 0. 46％ ( 1/216 ) enteric cytopathogenic human orphan virus and 0. 93％ ( 2/216 ) unclassified samples were unclassified to species. (2) Five cases of critical HFMD were all caused by EV71. (3) The EV71 positive samples were given priority to severe cases ( 51. 79％,116/224 ) and the non EV71 positive samples were given priority to mild cases ( 82. 08％, 458/558 ) , the difference was statistically significant (χ2 =91. 68,P<0. 001). (4) The change trends of severe HFMD year by year were consistent with the change trends of EV71 composition,and were highly correlated(Rs=0. 9,P=0. 037). (5) Severe HFMD caused by non EV71 virus gradually increased. Conclusion Severe HFMD in Chaoshan area during 2011 to 2015 were mainly caused by EV71,non EV71 viruses including CA16,CA6,CA10,CA4,coxsackievirus B5, enteric cytopathogenic human orphan virus 6 could also develop to severe HFMD. The composition ratio of severe HFMD increased accordingly in the year of EV71 as the dominant pathogen. The proportion of severe HFMD caused by non EV71 virus gradually increased after 2013 year.

Pulmonary cyst is a relatively common benign lesion.It is easy to be misdiagnosed when the cyst complicated with infection.Tnis paper reported a case of a giant traumatic pulmonary cyst (diameter 10 cm) combined with chronic infection.Firstly,the patient was diagnosed as cholesterol pleurisy after undergoing thoracoscopic biopsy.With repeated pleural effusion,the patient was scheduled for right anterolateral thoracotomy,which showed a thin-walled cyst (10 cm in diameter) attached to parietal and diaphragm,with the stem of cavity originated from the right lower lobe after the cyst cavity was dissociated.Pathological examination revealed that it was apseudocyst,which could be diagnosed as traumatic pulmonary cyst combined with chronic infection according to history of trauma.After undergoing right lower lobectomy and stripping of fiberboard,the prognosis was good.Traumatic pulmonary cyst,which was discovered interval 10 years after chest trauma,was rare.Traumatic pulmonary cyst combined with cholesterol cystic fluid was very rare.Huge pulmonary cyst complicated with infection was easily misdiagnosed as loculated pleural effusion.Therefore,to be correct diagnosis and treatment,clinician must carefully ask medical history.In addition,early image examination should be considered in those patients with chest trauma whether there are clinical symptoms or not.