Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of subsequent radiotherapy (RT) following first-line treatment with durvalumab plus chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC). METHODS: A total of 122 patients with ES-SCLC from three hospitals during July 2019 to December 2021 were retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to address potential confounding factors. The primary focus of our evaluation was to assess the impact of RT on progression-free survival (PFS) and overall survival (OS). RESULTS: After IPTW analysis, 49 patients received durvalumab plus platinum-etoposide (EP) chemotherapy followed by RT (Durva + EP + RT) and 72 patients received immunochemotherapy (Durva + EP). The median OS was 17.2 months vs . 12.3 months (hazard ratio [HR]: 0.38, 95% confidence interval [CI]: 0.17-0.85, P = 0.020), and the median PFS was 8.9 months vs . 5.9 months (HR: 0.56, 95% CI: 0.32-0.97, P = 0.030) in Durva + EP + RT and Durva + EP groups, respectively. Thoracic radiation therapy (TRT) resulted in longer OS (17.2 months vs . 14.7 months) and PFS (9.1 months vs . 7.2 months) compared to RT directed to other metastatic sites. Among patients with oligo-metastasis, RT also showed significant benefits, with a median OS of 17.4 months vs . 13.7 months and median PFS of 9.8 months vs . 5.9 months compared to no RT. Continuous durvalumab treatment beyond progression (TBP) prolonged OS compared to patients without TBP, in both the Durva + EP + RT (NA vs . 15.8 months, HR: 0.48, 95% CI: 0.14-1.63, P = 0.238) and Durva + EP groups (12.3 months vs . 4.3 months, HR: 0.29, 95% CI: 0.10-0.81, P = 0.018). Grade 3 or 4 adverse events occurred in 13 (26.5%) and 13 (18.1%) patients, respectively, in the two groups; pneumonitis was mostly low-grade. CONCLUSION Addition of RT after first-line immunochemotherapy significantly improved survival outcomes with manageable toxicity in ES-SCLC.
Humans ; Small Cell Lung Carcinoma/therapy* ; Retrospective Studies ; Male ; Female ; Middle Aged ; Lung Neoplasms/therapy* ; Aged ; Antibodies, Monoclonal/therapeutic use* ; Adult ; Immunotherapy/methods* ; Aged, 80 and over

Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

[Abstract]? Objective? To explore the position and responsibilities of stroke emergency specialist nurses. Methods? The interviewing method in qualitative studies was adopted and in-depth semi-structured interviews were conducted on four doctors, four nurses, two technicians and six managers. Claizzi's seven-step phenomenological data analysis method was used to encode, assemble, categorize, analyze and refine the content theme. Results? The position of stroke emergency specialist nurses is compound specialist and team coordinator. Its duties include accurate identification of stroke patients, early warning for CT room and rapid preparation before thrombolysis, assisting family members in clinical decision-making, ensuring seamless connection of all steps, handing over with rescue room and digital subtraction angiography (DSA) room and ward, ensuring adequate material supply, establishing and maintaining database and continuing patient return visit. Conclusions? The post setting of stroke emergency specialist nurses laid a foundation for the rapid treatment of stroke patients. Their role was positioned as senior practical nurses, and their post setting faced a series of challenges. Promoting the mature experience of post setting of stroke emergency specialist nursess can train a group of stroke emergency specialist nursess and lead the development of specialized stroke nursing.

[Abstract]? Objective? To explore medical staff's attitude towards in-hospital treatment mode among patients with acute ischemic stroke(AIS),and the optimizable factors of the mode,so as to provide reference for further optimization of the treatment mode. Methods? From November of 2017 to January of 2018, 15 medical staff from the AIS team in Changhai Hospital Affiliated to the Second Military Medical University were selected by purposive sampling and interviewed by semi-structured interviewing method. Data was collected in the way of handwriting and recording. Colaizzi data analysis was used to analyze the materials. Results? The experience of medical staff in optimizing the treatment mode of AIS hospital included five themes: (1)the treatment mode of AIS hospital was basically reasonable; (2)the need for early warning of neurointerventional treatment team;(3)the need for the construction of specialist nursing team for the emergency treatment of stroke; (4)the need for supervision of the treatment process of AIS by information technology; (5)the need for pre-hospital warning. Conclusions? It is necessary to make preparations in advance for invasive treatment team, construct the specialist stroke first aid nursing team for the whole process guiding and quality control, promote the integration of pre-hospital and in-hospital treatment so as to activate the in-hospital treatment system as soon as possible, improve the construction of AIS treatment informatization in order to assist the supervision of treatment efficiency, and further shorten the time of in-hospital treatment of AIS.

?? [Abstract]? Acute ischemic stroke is the main type of stroke and its treatment highly relies on time. Thus how to conduct treatment effectively is the current research hotpot. This article summarizes the treatment methods, treatment modes and specialized nursing of acute ischemic stroke aiming to provide some references for the treatment of ischemic stroke in China.

Objective Pulmonary fibrosis ( PF) is a group of pulmonary interstitial pathological changes caused by various factors, and its pathogenesis is not yet fully elucidated .This article discussed the effect of lycium barbarum polysaccharide ( LBP) on ble-omycin-induced PF in mice and its action mechanisms . Methods The C57/BL6 mice were randomly divided into 6 groups:sham-opera-tion, PF model, dexamethasone ( DM), high-dose LBP, medium-dose LBP, and low-dose LBP.The mice in the sham-operation group were injected into the trachea with isotonic saline and those in the oth-er groups with 5 bleomycin at mg/kg for establishing the PF model . Two days after modeling , the mice in the DM and high-, medium-,and low-dose LBP groups were treated with DM at 5 mg/kg and LBP at 0.8, 0.4, and 0.2 g/kg, while those in the sham-operation and PF model groups with the same volume of isotonic saline , respectively , qd, for 4 consecutive weeks .Then, the pathological chan-ges of the lung tissue were observed and the hydroxyproline ( HYP) content in the lung tissue was detected for all the animals .RT-PCR was used to determine the relative expressions of the PF-related COL1A1 and α-SMA genes. Results Compared with the PF mod-els, the the high-, medium-, and low-dose LBP groups showed significant increased body weight after 4 weeks of medication ([14.29 ±0.38] vs [16.12 ±0.37], [15.58 ±0.25] and [15.07 ±0.21] g, P<0.01), the high-and medium-dose groups ex-hibited remarkably decreased lung indexes ([0.887 ±0.13] vs [0.847 ±0.22] and [0.859 ±0.18]%, P<0.05), and the high-dose group presented markedly reduced alveolitis score (3.40 ±0.23 vs 3.09 ±0.22, P<0.05), PF score (3.57 ±0.27 vs 3.07 ± 0.31, P<0.01) and HYP content ([0.831 ±0.05] vs [0.786 ±0.07] μg/mg wet weight, P<0.05).In comparison with the mod-el group, the DM, high-dose LBP and medium-dose LBP groups showed significantly decreased gene expressions of COL 1A1 (1.53 ± 0.13 vs 1.26 ±0.10 and 0.98 ±0.17, P<0.05) and α-SMA (5.67 ±0.47 vs 4.19 ±0.28 and 2.29 ±0.31, P<0.05). Conclusion LBP can suppress the progression of bleomycin-induced pulmonary fibrosis by inhibiting the gene expressions of COL 1A1 andα-SMA and decreasing the HYP content in the lung tissue .

Objective To explore the effect of SFI in radiation-induced mice brain injury after 20 Gy cranial radiation.Methods The mice were divided into three groups:(1) control group,(2) RT-only group:the whole brain was irradiated with a dose of 20 Gy,(3) RT and SFI group:SFI at 20 ml/kg/d from 4 weeks after 20 Gy cranial radiation theraty(CRT).Results Morris water maze test showed that the latency of the irradiated group was longer than control group and SFI improved the cognitive function of mice (t =6.34,6.70,P ＜0.05).The expression of TNF-α reached to the highest level at 3 h after irradiation,and then it decreased but got the second higher level again at 4 weeks after irradiation.The expression of IL-1 β reached to the highest level at 72 h after irradiation and decreased until 4 weeks after irradiation.SFI decreased both expressions of TNF-α (t =11.34,9.70,6.07,P ＜ 0.05) and IL-1 β (t =12.27,5.70,7.52,P ＜ 0.05).Immune florescence staining showed that SFI reduced the number of activated microglia (t =12.35,8.64,7.82,P ＜ 0.05)and inhibited the translocation of p65 of microglia after irradiation.Conclusions Findings suggest that SFI may decrease microglial activation and suppress the expression of TNF-α and IL-1β by inhibiting the translocation of NF-κB p65 and then attenuate irradiation-induced brain injury.

OBJECTIVETo detect the expression of pan-neuronal marker protein gene product (PGP)9.5 and its clinicopathologic significance in breast cancer.

METHODSThe expression of PGP9.5 was examined by immunohistochemistry EnVision method in 196 cases during 2007 to 2011, including 20 normal tissues, 14 cases of fibroadenoma, 18 cases of ductal carcinoma in situ (DCIS) and 144 cases of invasive ductal carcinoma (IDC) of the breast. The relationship between PGP9.5 expression and clinicopathologic characteristics of IDC was assessed.

RESULTSPGP9.5 expression was localized in the stroma of all normal breast tissues, but there was no expression observed in all fibroadenomas and DCIS. Overall, the expression rate of PGP9.5 in IDC was 61.8% (89/144). PGP9.5 expression increased from grade 1 tumors (29.4%, 10/34) to grade 2-3 tumors (71.8%, 79/110; P = 0.000). In addition, patients with less than 3 years disease-free survival tended to show higher PGP9.5 expression (64.8%, 35/54), compared to patients with equal to and/or more than 3 years disease-free survival (46.7%, 42/90; P = 0.035). However, there was no correlation between PGP9.5 expression and tumor size, tumor stage, lymph metastasis, hormone receptor expression.

CONCLUSIONPGP9.5 expression is correlated with tumor grade and prognosis in IDC of the breast.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; Disease-Free Survival ; Female ; Fibroadenoma ; metabolism ; pathology ; Humans ; Middle Aged ; Neoplasm Grading ; Ubiquitin Thiolesterase ; metabolism

Objective To detect the expression of pan-neuronal marker protein gene product ( PGP)9.5 and its clinicopathologic significance in breast cancer .Methods The expression of PGP9.5 was examined by immunohistochemistry EnVision method in 196 cases during 2007 to 2011, including 20 normal tissues, 14 cases of fibroadenoma , 18 cases of ductal carcinoma in situ ( DCIS) and 144 cases of invasive ductal carcinoma (IDC) of the breast.The relationship between PGP9.5 expression and clinicopathologic characteristics of IDC was assessed.Results PGP9.5 expression was localized in the stroma of all normal breast tissues, but there was no expression observed in all fibroadenomas and DCIS.Overall, the expression rate of PGP9.5 in IDC was 61.8%(89/144).PGP9.5 expression increased from grade 1 tumors (29.4%, 10/34) to grade 2-3 tumors (71.8%, 79/110; P=0.000).In addition, patients with less than 3 years disease-free survival tended to show higher PGP9.5 expression (64.8%, 35/54), compared to patients with equal to and/or more than 3 years disease-free survival (46.7%, 42/90;P=0.035).However, there was no correlation between PGP 9.5 expression and tumor size , tumor stage , lymph metastasis , hormone receptor expression.Conclusion PGP9.5 expression is correlated with tumor grade and prognosis in IDC of the breast.