OBJECTIVE:A great deal of evidence indicates that regular exercise can improve the health status of elderly individuals,including reducing overall and abdominal fat levels,increasing muscle mass and bone mineral density of the limbs,thereby preventing or delaying the onset of sarcopenia and its comorbidities.This study aims to determine the most reliable type,duration,and intensity of exercise interventions through meta-analysis to prevent,delay,and alleviate sarcopenia and its comorbidities in elderly individuals.METHODS:Randomized controlled trials examining the effects of exercise interventions on elderly individuals with sarcopenia and its comorbidities were searched in the PubMed,Embase,Web of Science,Cochrane Library,CNKI,and WanFang databases.The Cochrane Risk of Bias Tool was used to assess the quality of the included studies,and RevMan 5.3 software was employed for meta-analysis.Subgroup analyses were conducted to explore the effects of different exercise intervention protocols on various outcome measures.In addition,Stata 16.0 software was used to perform sensitivity analysis to assess the stability of the results,and funnel plots and Egger's test were employed to evaluate publication bias,ensuring the comprehensiveness and reliability of the results.RESULTS:(1)Sixteen studies involving 861 patients with sarcopenia and its comorbidities were included.(2)The meta-analysis results indicated that,compared with the control group,exercise significantly improved grip strength,knee muscle strength,appendicular skeletal muscle mass,skeletal muscle index,Timed Up and Go test results,gait speed,and insulin-like growth factor 1 levels(P＜0.05).However,the effect of exercise intervention on the sit-to-stand test was not significantly improved(P＞0.05).(3)Based on the results of subgroup analysis,it is recommended that elderly patients with sarcopenia and its comorbidities engage in exercise at least three times per week,with each session lasting no more than 30 minutes or exceeding 45 minutes,for at least 12 weeks.The exercise protocol should be flexibly adjusted according to the patient's health status and individual needs.CONCLUSION:Exercise interventions significantly improve muscle mass,muscle strength,physical function,and insulin-like growth factor 1 levels in elderly individuals with sarcopenia and its comorbidities,thereby enhancing their quality of life.However,further research is needed to validate these findings and optimize specific intervention protocols.

OBJECTIVE:A great deal of evidence indicates that regular exercise can improve the health status of elderly individuals,including reducing overall and abdominal fat levels,increasing muscle mass and bone mineral density of the limbs,thereby preventing or delaying the onset of sarcopenia and its comorbidities.This study aims to determine the most reliable type,duration,and intensity of exercise interventions through meta-analysis to prevent,delay,and alleviate sarcopenia and its comorbidities in elderly individuals.METHODS:Randomized controlled trials examining the effects of exercise interventions on elderly individuals with sarcopenia and its comorbidities were searched in the PubMed,Embase,Web of Science,Cochrane Library,CNKI,and WanFang databases.The Cochrane Risk of Bias Tool was used to assess the quality of the included studies,and RevMan 5.3 software was employed for meta-analysis.Subgroup analyses were conducted to explore the effects of different exercise intervention protocols on various outcome measures.In addition,Stata 16.0 software was used to perform sensitivity analysis to assess the stability of the results,and funnel plots and Egger's test were employed to evaluate publication bias,ensuring the comprehensiveness and reliability of the results.RESULTS:(1)Sixteen studies involving 861 patients with sarcopenia and its comorbidities were included.(2)The meta-analysis results indicated that,compared with the control group,exercise significantly improved grip strength,knee muscle strength,appendicular skeletal muscle mass,skeletal muscle index,Timed Up and Go test results,gait speed,and insulin-like growth factor 1 levels(P＜0.05).However,the effect of exercise intervention on the sit-to-stand test was not significantly improved(P＞0.05).(3)Based on the results of subgroup analysis,it is recommended that elderly patients with sarcopenia and its comorbidities engage in exercise at least three times per week,with each session lasting no more than 30 minutes or exceeding 45 minutes,for at least 12 weeks.The exercise protocol should be flexibly adjusted according to the patient's health status and individual needs.CONCLUSION:Exercise interventions significantly improve muscle mass,muscle strength,physical function,and insulin-like growth factor 1 levels in elderly individuals with sarcopenia and its comorbidities,thereby enhancing their quality of life.However,further research is needed to validate these findings and optimize specific intervention protocols.

Objective The efficacy of prophylactic aneurysmal sac embolization is still unclear.The purpose of this study is to evaluate the safety and efficacy of prophylactic aneurysmal sac embolization with N-butyl cyanoacrylate(NBCA)during endovascular aortic repair(EVAR)in patients with abdominal aortic aneurysms(AAA)so as to prevent the occurrence of type Ⅱ endoleak.Methods The clinical data of patients with AAA,who received EVAR from January 2019 to January 2022 at Gansu Provincial Hospital,were retrospectively analyzed.According to the strict inclusion and exclusion criteria,a total of 74 AAA patients were enrolled in this study.Of the 74 AAA patients,intraoperative prophylactic injection of NBCA into the aneurysmal sac to embolize the sac cavity during EVAR was performed in 36(study group),while standard EVAR treatment was carried out in 38(control group).The clinical data of the 74 patients,mainly including age,gender,underlying diseases,diameter of the aneurysm,hospitalization cost,time spent for surgery,type of stent,mode of anesthesia,etc.were collected.The primary endpoint was the incidence of endoleak during follow-up period,and the secondary endpoints included the rate of endoleak-related re-intervention,adverse events,and mortality during follow-up period.Results Before surgery,there were no statistically significant differences in gender,age,diameter of the aneurysm[55.46(15.60)mm vs 63.15(24.00)mm],and underlying diseases between the study group and the control group,and no intraoperative complications occurred.The technical success rate was 100％in both groups.Three months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group was significantly lower than that in the control group(2.86％vs 21.05％,P＜0.01);six months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group and the control group was 8.82％and 28.95％respectively(P＜0.01);and 12 months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group and the control group was 8.82％and 31.43％respectively(P＜0.01).In the study group a total of 4 times of re-intervention were carried out,one of which was associated with type Ⅱ endoleak.In the control group a total of 8 times of re-intervention were conducted,6 of which were associated with type Ⅱ endoleak.No statistically significant difference in the overall re-intervention rate existed between the two groups(P=0.224).The type Ⅱ endoleak-related re-intervention rate in the study group was slightly lower than that in the control group,but the difference was not statistically significant(P=0.106).Conclusion Prophylactic injection of NBCA into the aneurysmal sac cavity of AAA during EV AR procedure is a simple,safe and effective method,which can significantly reduce the occurrence of type Ⅱ endoleak in the early-middle stage and prevent the enlargement of the aneurysmal sac after EVAR,besides,it has no significant effect on the re-intervention rate and mortality,does not significantly prolong the operation time,and does not increase the dosage of contrast agent.

Objective:To investigate variation and correlation of type 2 intrinsic lymphocyte(ILC2)and related factors in acute and chronic brucellosis,to identify immune role of ILC2 in chronic brucellosis.Methods:Forty-three patients with acute brucel-losis and 45 patients with chronic brucellosis were compared with 49 healthy controls.ILC2 level in each group was detected by flow cytometry.mRNA level of GATA3 in PBMC was detected by fluorescence quantitative PCR.Serum IL-33,ST2,IL-4 and IL-13 levels were detected by ELISA.ALT and AST levels were measured by fully automatic biochemical analyzer.Results:ILC2 level,GATA3 mRNA in PBMC,serum IL-33,IL-4 and IL-13 levels in chronic brucellosis group were significantly higher than healthy control group and acute brucellosis group(P<0.01).Correlation analysis showed that ILC2 level was positively correlated with GATA3 mRNA,IL-33,IL-4 and IL-13 levels,while negatively correlated with ST2 level.ROC curve suggested that ILC2,GATA3,IL-33 and ST2 had good predictive ability for severity of brucellosis patients(AUC>0.7).Conclusion:Increase of ILC2 and its related factors are closely related to chronic brucella infection,which may play an important immune role in pathogenesis of brucella infection.

OBJECTIVE: Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms. METHODS: In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods (GNRs) and tetrahedral framework nucleic acids (tFNA) loaded with the anti-tumor drug doxorubicin (DOX). RESULTS: Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation. CONCLUSION This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.
Doxorubicin/chemistry* ; Gold/chemistry* ; Nanotubes/chemistry* ; Humans ; Nanocomposites/chemistry* ; Cell Line, Tumor ; Nucleic Acids/chemistry* ; Antibiotics, Antineoplastic/pharmacology* ; Antineoplastic Agents/administration & dosage*

Activated specific T cells possess the capability to directly recognize and eradicate tumor cells, a process pivotal in the anti-tumor immune response. In recent years, the field of tumor immunotherapy, particularly T cell-based strategies, has seen rapid advancements, resulting in several drugs receiving clinical approval and the initiation of numerous basic research endeavors and clinical trials. Among these strategies, adoptive T cell transfer therapy emerges as a principal focus, encompassing approaches such as chimeric antigen receptor T-cell (CAR-T), T-cell receptor-engineered T cell (TCR-T), tumor-infiltrating lymphocytes (TILs), and cytotoxic T lymphocytes (CTLs) therapies. This review endeavors to encapsulate the global research and development strides made in four categories of adoptive T cell therapies, while also dissecting their individual merits and limitations. The objective is to furnish insights that may bolster the development of tumor immunotherapy pharmacopeia and their efficacious clinical application in cancer treatment.

Objective To compare the clinical efficacy and safety of transurethral 450 nm semiconductor blue laser vaporization enucleation and transurethral resection of bladder tumor(TURBT)in the treatment of non-muscle invasive bladder cancer(NMIBC).Methods The clinical data of 85 NMIBC patients undergoing surgical treatment at Yingsheng Branch of Taian Central Hospital during Dec.2022 and Feb.2024 were retrospectively collected.The patients were divided into the blue laser group(n=40)and TURBT group(n=45).The operation time,intraoperative blood loss,postoperative bladder irrigation time,postoperative catheter indwelling time,postoperative hospital stay,intraoperative complications,wound healing 3 and 6 months after operation,and tumor recurrence 1 year after operation were compared between the two groups.Results Patients in both groups successfully completed the operation without blood transfusion or conversion to open surgery.Compared with the TURBT group,the blue laser group had shorter operation time[(23.68±9.98)min vs.(29.11±14.27)min],less blood loss[(1.43±0.87)g/L vs.(3.27±0.96)g/L],and shorter postoperative bladder irrigation time[0.5(0.5,0.5)d vs.0.5(0.5,1.5)d](P＜0.05).No cases developed obturator nerve reflexes in the blue laser group,but 7 cases in the TURBT group(P＜0.05).Three months after operation,the bladder wounds healed in 24 cases in the blue laser group,but only in 7 cases in the TURBT group(P＜0.01).Conclusion Compared with TURBT,transurethral 450 nm semiconductor blue laser vaporization enucleation for the treatment of NMIBC can shorten the operation time,reduce the amount of bleeding,shorten the postoperative healing time,and cause fewer complications.It is a safe and efficient minimally invasive surgery.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To examine the influence of physical function status on supportive care needs (SCNS) in patients with primary liver cancer (PLC) and to explore the mediating roles of perceived social support and anxiety-depression, with the aim of providing evidence for nursing interventions to improve patients' care experience.Methods:A convenience sampling method was used to select PLC inpatients admitted to The First Affiliated Hospital of Jinan University between December 2022 and February 2024. Data were collected using a general information questionnaire, the 34-item Supportive Care Needs Survey-Short Form, the Hospital Anxiety and Depression Scale, the Perceived Social Support Scale, and the Karnofsky Performance Status Scale to conduct a cross-sectional survey. Pearson correlation analysis was performed to examine associations among SCNS, perceived social support, anxiety-depression, and physical function status. Structural equation modeling was used to assess the mediating effects of perceived social support and anxiety-depression on the relationship between physical function status and SCNS.Results:A total of 304 patients were enrolled, including 260 males and 44 females, 31 cases aged 18-40 years old, 160 cases aged 41 to 60 years old, and 113 cases over 60 years old. The mean total SCNS score was (98.32 ± 21.75) points, the mean anxiety-depression score was (23.31 ± 9.64) points, the mean perceived social support score was (56.62 ± 13.05) points, and the mean physical function status score was (66.28 ± 12.31) points. Pearson correlation analysis showed that physical function status was negatively correlated with SCNS and anxiety-depression ( r =-0.509, -0.447; both P<0.05) and positively correlated with perceived social support ( r =0.439, P<0.05). Physical function status had a direct effect of 60.74% on SCNS, with specific mediating effects of perceived social support and anxiety-depression accounting for 23.15% and 11.85%, respectively, and a chain mediating effect of 4.26%. Conclusions:Patients with PLC exhibited a moderately high level of supportive care needs. Physical function status not only exerted a direct negative effect on SCNS but also indirectly influenced SCNS through the chain mediation of perceived social support and anxiety-depression. Clinical medical staff should focus on enhancing patients' perception of social support and effectively alleviating anxiety and depressive symptoms, thereby reducing supportive care needs to some extent.

In vitro fertilization and embryo transfer (IVF-ET) with egg donation can help women who are unable to conceive by their own egg due to advanced age or the other various reasons. This technique could fulfill their desire to become mothers. Although this technique is well developed and has been widely used, there are still many ethical issues waiting to address, such as the sources of donor eggs, the criteria for donors and recipients, the number donated and receipted eggs, compensation for donation, disclosure of the information of donor and recipient. It is necessary to thoroughly discuss and carefully consider these issues to provide new insights for adjusting management policies and resolving ethical controversies in reproductive medicine.