ObjectiveTo investigate the effect of modified Baduanjin exercise, as an rehabilitation exercise, on cardiopulmonary function, motor function and activities of daily living in patients with stroke. MethodsFrom January to September, 2023, 42 stroke patients in the Nanjing Qixia District Hospital were randomly divided into control group (n = 21) and experimental group (n = 21). The control group received routine rehabilitation, and the experimental group received modified Baduanjin exercise in addition, for four weeks. They were assessed with peak oxygen uptake (VO_2peak), anaerobic threshold (AT), peak oxygen pulse (VO_2peak/HR), forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), Fugl-Meyer Assessment-upper extremities (FMA-UE), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after intervention. ResultsVO_2peak, AT, and the scores of FMA-UE, BBS and MBI improved in the control group after intervention (|t| > 2.256, |Z| > 2.936, P < 0.05); while VO_2peak, AT, VO_2peak/HR, FVC, FEV₁, PEF, and the scores of FMA-UE, BBS and MBI improved in the experimental group (|t| > 4.390, |Z| > 3.451, P < 0.001); and all the indexes were better in the experimental group than in the control group (|t| > 4.136，|Z| > 2.751，P < 0.01), except the scores of BBS and MBI. ConclusionModified Baduanjin exercise can improve the cardiopulmonary function and upper limb motor function for stroke patients.

BACKGROUND: Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction (AAMI) is an important factor in occurrence of heart failure which additionally results in poor prognosis. Therefore, the treatment of ventricular remodeling needs to be further optimized. Compound Danshen Dripping Pills (CDDP), a traditional Chinese medicine, exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction. OBJECTIVE: This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale. METHODS: This study is a multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The total of 268 patients with AAMI after primary percutaneous coronary intervention (pPCI) will be randomly assigned 1:1 to the CDDP group (n=134) and control group (n=134) with a follow-up of 48 weeks. Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction (STEMI), with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI, and the control group treated with a placebo simultaneously. The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide (NT-proBNP) level, arrhythmias, and cardiovascular events (death, cardiac arrest, or cardiopulmonary resuscitation, rehospitalization due to heart failure or angina pectoris, deterioration of cardiac function, and stroke). Investigators and patients are both blinded to the allocated treatment. DISCUSSION This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI. Patients in the CDDP group will be compared with those in the control group. If certified to be effective, CDDP treatment in AAMI will probably be advised on a larger scale. (Trial registration No. NCT05000411).
Humans ; ST Elevation Myocardial Infarction/therapy* ; Stroke Volume ; Ventricular Remodeling ; Prospective Studies ; Microcirculation ; Ventricular Function, Left ; Myocardial Infarction/etiology* ; Treatment Outcome ; Percutaneous Coronary Intervention/adverse effects* ; Heart Failure/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

Objective:To systematically review the risk factors of delayed healing of venous leg ulcer (VLU) so as to provide a guide for developing the personalized nursing strategies.Methods:The Cochrane Library, PubMed, Web of Science, ScienceDirect, Clinicaltrials.gov, ProQuest and Open Grey was retrieved with the English keywords of "varicose ulcer/venous ulcer, non-healing/delayed healing/poor healing, factor/risk factor/influence factor"; the China Biological Medicine (CBM) , Chinese National Knowledge Infrastructure (CNKI) , WanFang Data and VIP was retrieved with the English keywords of "venous leg ulcer/venous ulcer, delayed healing/refractory, risk factors/influencing factors"; the retrieval time ranged from building database to 1st April 2019. Two researchers independently screened literatures, extracted data and assessed the quality of included literatures. The RevMan 5.3 was used to the meta-analysis.Results:Finally, a total of 11 literatures were included and involved 3 894 subjects, 520 cases lost to follow up, 914 cases in case group and 2 460 in control group. Meta-analysis showed that there were 7 risk factors related to delayed healing of VLU including the ages [ OR=1.02, 95% CI (1.01, 1.03) , P<0.01], range of motion of ankle [ OR=4.77, 95% CI (1.79, 12.73) , P<0.01], size of ulcer [ OR=1.27, 95% CI (1.10, 1.47) , P<0.01], duration of ulcer [ OR=1.08, 95% CI (1.01, 1.16) , P=0.03], history of deep vein thrombosis (DVT) [ OR=2.21, 95% CI (1.06, 4.63) , P=0.03], ankle-brachial index<0.8 [ OR=8.71, 95% CI (4.22, 17.99) , P<0.01]and rheumatoid arthritis [ OR=1.37, 95% CI (1.08, 1.73) , P<0.01]with statistical differences, and factors irrelevant to delayed healing of VLU including the body mass index (BMI) [ OR=0.98, 95% CI (0.83, 1.16) , P=0.82], >50% wound covered with fibrin [ OR=1.88, 95% CI (0.99, 3.57) , P=0.06], diabetes mellitus [ OR=1.10, 95% CI (0.70, 1.75) , P=0.67], history of hip or knee replacement [ OR=1.73, 95% CI (0.50, 6.00) , P=0.39]. Conclusions:Evidence shows that the independent risk factors of delayed healing of VLU include the ages, range of motion of ankle, size of ulcer, duration of ulcer, history of DVT, ankle-brachial index<0.8 and rheumatoid arthritis. Those evidences can help to identify the clinical high-risk population of delayed healing of VLU and provide targeted nursing intervention to reduce the healing time of VLU and improve patients' quality of life.

Objective To understand the patients of congenital microtia malformation families knowledge of skin expander and influencing factors. Methods Self-made questionnaire to sample survey of 500 cases of our department (Plastic Surgery Hospital, Chinese Academy of Medical Sciences, the second microtia concer) patients′ families. Results 47.8％(239/500) of 500 patients of expander knowledge level is high, 41.2％(206/500) pass the exam, 11.0％(55/500) fall the exam, only 13.4％(67/500) really have a comprehensive understanding on expander achieve excellent. Scores of male and female were (16.06 ± 1.99) points and (16.39 ± 2.16) points, t = 1.752, P > 0.05, there was no statistically significant difference comparing the 2 group. Patients′ families score of different cultural levels, respectively (14.06 ± 2.36), (14.98 ± 2.02), (16.54 ± 2.00), (16.73 ± 1.88) points, F = 21.736, P < 0.01, difference of four groups was statistically significant. Different age patients′families score ( 16.21 ± 1.96), (16.62 ± 2.14), (14.86 ± 2.11), (13.98 ± 2.02), (13.73 ± 1.88) points, F = 15.685, P > 0.05, there was no statistically significant difference comparing the 5 groups. Patients with different professional families score (13.25 ± 2.19), (13.79±2.27), (16.08±1.89), (14.10±2.08), (14.13±2.35), (14.45±2.09), (14.56±1.75), (16.84± 1.81) points, F = 2.737, P < 0.01, difference of eight groups was statistically significant. Conclusions Congenital microtia patients′families skin expander knowledge needs to be improved, it is necessary to take various forms, conduct for families of expander knowledge through propaganda and education.

Objective To analyze the prevention condition of skin tears of inpatients in level-III hospitals, so as to provide basis for making prevention strategies.Methods 14 level-III hospitals were involved in the cross-section survey. Within the same time period, using the same research tools, methods and procedure, 964 trained nurses inspected patients from head to toes, who were selected by convenience sampling, with hospital stay ≥24 h, with age≥18 years old, and with signature on the informed consent documents, and also investigated implementation of prevention measures. Results A total of 18 806 effective cases were obtained, with 238 locations of skin tears in 199 patients found. Incidence of hospital-acquired skin tears was 1. 06%. Implementation rate of risk assessment and nutrients and water supplement was 3. 92% and 10. 35%. Implementation rate of prevention of falling and falling down from bed was 51. 58% and 47. 20%. Usage of assistant tools and emollients accounted for 28. 23% and 2. 69%. Adopting suitable moving techniques and wearing long sleeves, trousers or long stockings accounted for 8.07% and 6.95%. Differences of incidence rate, risk assessment and implementation of prevention measures of skin tears among teaching hospitals, comprehensive hospitals and specialty hospitals were statistically meaningful ( P < 0. 05 for all ) . Conclusions Risk assessment and prevention of skin tears in these 14 level-III hospitals were not satisfactory. Prevention measures vary from different types of the hospitals. In future, nurses should be trained to strengthen awareness of risk assessment and prevention, and implementation rate and consistency of preventive measures should be improved.

Objective To investigate the effect of a nurse-training program of theory combined with practice training methods on pressure ulcer .Methods Forty-two nurse trainees were selected from different departments where the pressure sore was most likely to occur .A two-month training program was conducted based on multimedia, skill training, on-site training, patient rounds, typical case studies, mannequin, and problem analysis .Theoretical examinations were conducted both before and after the program and the skill tests were conducted by the way of on-site intervention .Results Among the forty-two nurses , the mean scores of theoretical examination before and after training were (88.52 ±2.31) and (97.16 ±3.20), respectively, and the difference was significant (t=-14.193,P<0.01).The mean scores of skill test before and after training were (86.19 ±4.68) and (93.35 ±2.41), respectively, and the difference was significant (t=-8.814, P<0.01).The forty-two nurse trainees all passed the tests .Conclusions The training program which combined with theory and practice skills can improve the knowledge and skills of the nurses .It can be served as a model for future training on pressure ulcer treatment by other general hospitals .

Objective To discuss the design of pedicled thoracodorsal artery perforator flap (TDAP flap),and to evaluate the aesthetic results and donor-site complications for immediate partial breast reconstruction (IPBR) after breast conserving surgery (BCS) for breast cancer patients.Method Clinical data of 13 breast cancer cases treated with BCS + IPBR using TDAP flap from November 2004 to November 2010 were retrospectively analyzed.Perforators were identified with Doppler preoperatively in all patients.Results All perforators originated within a median distance of 8.0 cm ( range,7.5 to 9.5 cm) from axillary plica at the posterior line of axilla.Median area of the flaps was 6.0 × 8.0 cm ( range,5.0 × 7.0 cm to 8.0 × 10.0 cm).One flap was muscle-sparing,while a small muscle strip was left embedding the perforators in other twelve flaps to increase the reliability of the vascular pedicle.Postoperatively patients were followedup from 4 to 71 months.Median follow-up time was 41 months.Flap necrosis and seroma in the donor-site were not found in all patients.Aesthetic results were graded as excellent or good in 9 patients,fair in 3,and poor in one.Conclusions TDAP flap is a good choice for IPBR after BCS for breast cancer patients whether lesions in outer quadrants or inner quadrants,especially for those patients with excisional biopsy.Preoperative mini-Doppler is helpful for determining the precise location of the main perforators,and decreasing the risk of vessels injury.

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.

Objective To explore the influencing factors for postoperative adjuvant chemotherapy effects in elderly patients with breast cancer. Methods Five hundred and ninety female patients aged 65 years or older with invasive breast cancer were treated in our hospital, and the influencing factors for postoperative adjuvant chemotherapy effects were analyzed by chi-square test and logistic regression. Results Two hundred and thirty-one (39.2%) patients received postoperative adjuvant chemotherapy. The results showed that diabetes, age, patterns of operation and pathological characteristics of tumor had significant influences on postoperative adjuvant chemotherapy effects (χ2=4.49,88. 27,23.49 and 9.40, all P<0.05). Logistic regression analysis showed that age, tumor size, lymph node status(pN) and estrogen receptor (ER) status were related to postoperative adjuvant chemotherapy effects(χ2=68.857,15. 284,43. 540 and 7.009 ,all P<0.01). Forty-four patients (66.7%) with pN(+)/ER(-) received adjuvant chemotherapy. Conclusions Age, tumor size, lymph node status and ER status were independent predictive factors for postoperative adjuvant chemotherapy effects in elderly patients with breast cancer.

Objective: To investigate the effect of cinobufacini on proliferation, celly cycle distribution, invasion capability of MDA-MB-231 breast cancer cell line in vitro and possible mechanism. Methods: The effect of cinobufacini on cell growth was measured by CCK-8 reagent kit. Cell cycle distribution was determined by flow cytometry. The invasion capability in vitro was detected by Transwell chamber assay. The mRNA expressions of cell cycle related factors (cyclin) and p21 were tested by RT-PCR. Results: Cinobufacini inhibited proliferation of MDA-MB-231 cells. The half inhibition concentration (IC50) was 0.31 mg/mL. The inhibitory effect was timE-dependent (P<0.05). Cinobufacini significantly decreased invasion capability of MDA-MB-231 cells in vitro compared with control group (P<0.05). Cinobufacini induced S-phase arrest of MDA-MB-231 cells in a concentration-dependent manner (P<0.000 1). Cinobufacini down-regulated the expression levels of cyclin A1, cyclin D1, and cyclin E1, while up-regulated that of p21 in MDA-MB-231 cell line. However, there was no marked change in the expression of cyclin B1. Conclusion: Cinobufacini inhibits cell proliferation and influences the cell cycle distribution in vitro by regulating the expression of cyclin A1, cyclin D1, cyclin E1 and p21 in breast can-cer cells.