ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

OBJECTIVE To evaluate the efficacy， safety， and cost-effectiveness of posaconazole for the prevention of invasive fungal infections （IFIs）. METHODS PubMed， Embase， CNKI， Wanfang data and other Chinese and English databases were searched， as well as the official websites of related health technology assessment （HTA）. Systematic review （SR）/meta-analysis， pharmacoeconomic studies， and HTA reports of posaconazole for the prevention of IFIs were collected. The retrieval time limit was from the establishment of the database to November 1， 2025. After screening the literature， extracting the data， and evaluating the quality of the literature， the results of the included studies were descriptively analyzed. RESULTS A total of 45 studies were included， involving 17 SR/meta-analyses， 26 pharmacoeconomic studies， 1 SR/meta-analysis combined with a pharmacoeconomic study， and 1 HTA report. In terms of effectiveness， posaconazole was significantly superior to other antifungal drugs （eg.， fluconazole， itraconazole） in reducing the incidence of IFIs， the incidence of invasive aspergillosis， all-cause mortality， and IFI-related mortality （ P ＜0.05）. In terms of safety， posaconazole was significantly superior to other antifungal drugs in the incidence of total adverse reactions （ P ＜0.05）， but there was no significant difference in the incidence of serious adverse reactions， the incidence of gastrointestinal advers e reactions， drug-induced liver injury， and the withdrawal rate due to adverse drug reactions （ P ＞0.05）. In terms of cost-effectiveness， most studies have shown that posaconazole possesses more cost-effectiveness advantages. CONCLUSIONS Posaconazole demonstrates favorable efficacy， safety， and cost-effectiveness in preventing IFIs.

Objective To investigate the effect of activating α7 nicotinic acetylcholine receptor （α7nAChR） on calcium chloride （CaCl₂）-induced abdominal aortic aneurysm （AAA） injury in mice. Methods AAA model was induced by CaCl₂ in wild type （WT） mice and α7nAChR knockout （α7nAChR^−/−） mice. The effects of knockout of α7nAChR on histological damage in CaCl₂-induced AAA mice and expression of inflammatory factors were assessed by HE staining, Elasticavan Gieson （EVG） staining and IHC staining. Rat-derived primary vascular smooth muscle cells （VSMC） were stimulated with tumor necrosis factor-α （TNF-α）, which mimicked the inflammatory environment of AAA. The expressions of inflammation-related proteins were detected by using Western-blot （WB） with or without PNU-282987 to activate α7nAChR. Results Aortic dilatation was obvious, and the aortic structure was disrupted in CaCl₂-induced AAA mice. Knockout of α7nAChR further exacerbated the histological injury and significantly up-regulated the expression of inflammation-related proteins in aorta of AAA mice. It was showed that TNF-α stimulation of VSMC increased inflammation-related protein expression, whereas activation of α7nAChR prevented the phenomenon. Conclusion Activation of α7nAChR could attenuate CaCl₂-induced AAA injury in mice by suppressing the inflammatory response.

Objective To systematically evaluate the similarities between six-gene-modified pig red blood cells and human red blood cells in multiple dimensions, including cell morphology, hematological parameters, microbial safety and serological compatibility, and to verify the feasibility of using six-gene-modified pig red blood cells as an alternative for blood transfusion in cases of traumatic hemorrhage. Methods Blood samples from O-type human donor, six-gene-modified O-type pig and wild-type O-type pig were collected. The pig gene-modified phenotype was identified by flow cytometry. The morphology was observed using field emission scanning electron microscopy and the diameter was measured. Hematological tests, including blood routine, osmotic fragility test, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) content and partial pressure of oxygen at 50% hemoglobin saturation (P50), were conducted to assess the deformability of red blood cells. Real-time fluorescent quantitative polymerase chain reaction was used to screen for zoonotic viruses, and cross-matching was performed using column gel method, condensation amine method and saline tube method. Results The six-gene-modified pig red blood cells successfully knocked out the α-Gal, Neu5Gc and Sda antigens and expressed hCD55. Wild-type pig red blood cells expressed these three antigens but did not express human complement regulatory proteins. All three types of red blood cells presented a biconcave discoid morphology. The diameter of O-type human red blood cells was larger than that of the six-gene-modified porcine red blood cells and wild-type pig red blood cells (all P < 0.05). The average red blood cell volume and average red blood cell hemoglobin of O-type humans were higher than those of the six-gene-modified pig red blood cells, and the distribution width-variable coefficient of O-type human red blood cells was lower than that of the six-gene-modified pig red blood cells (all P < 0.05). There were no statistically significant differences in the permeability fragility, ATP content, 2,3-DPG content, P50 and red blood cell deformability indicators of the three types of red blood cells (all P > 0.05). The screening for zoonotic viruses in human and animal cells of the six-gene-modified pigs and wild-type pigs was negative. The cross-matching results showed that in the column gel method and condensation amine method, the primary and secondary sides of the six-gene-modified pig red blood cells did not agglutinate with human red blood cells, while the wild-type pig red blood cells agglutinated with human red blood cells in all cross-matching methods. Conclusions The six-gene-modified pig red blood cells are highly similar to human red blood cells in terms of morphology, key hematological parameters, energy metabolism, oxygen-carrying capacity, mechanical properties, microbial safety and serological compatibility, providing an experimental basis for the clinical transformation of xenotransfusion.

Objective:To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and helical tomotherapy(HT)in undergoing protective plan for pelvic bones of patients with cervical cancer.Methods:A total of 40 patients with cervical cancer,who underwent radiotherapy at the First Affiliated Hospital of Bengbu Medical University from January 2023 to February 2024,were selected for this study.The target volumes and organs at risk(OARs)were delineated after the information of computed tomography(CT)simulation images were acquired from each patient.The pelvic bone was alone delineated as OAR.Two kinds of bone marrow dose-limiting radiotherapy plans,coplanar dual-arc VMAT and HT,were respectively designed for each patient by using the treatment planning system(TPS)of radiotherapy.A statistical analysis was conducted to compare the dose parameters of target volume,conformity,homogeneity,OAR dose-volume,mean dose,and maximum dose of point between the two kinds of plans.Results:Both the VMAT and HT plans could meet the requirements of target volume and OARs for dose.For general OARs,the dose-volume percentage(V40 Gy)of V40 Gy at bladder,mean dose(Dmean),rectal V40 Gy,maximum dose(Dmax)at small intestine point of HT plan were respectively(38.97±2.29)%,(38.06±0.45)Gy,(61.50±2.51)%and(50.82±0.36)Gy.The differences of them between HT plan and VMAT plan were statistically significant(t=25.46,13.99,1.56,10.93,P<0.05).The V10 Gy,V20 Gy,V30 Gy and Dmean of VMAT plan were respectively(70.76±2.51)%,(60.84±3.29)%,(52.40±2.56)%and(32.02±4.33)Gy for pelvic bones,which were significantly lower than those of HT plan,and the differences of them between two kinds of plans were also statistically significant(t=-20.68,-13.23,-7.73,-10.26,P<0.05).Conclusion:The HT plan can provide the optimal dose distribution for target region in radiotherapy for patients with cervical cancer,which can better protect OAR nearby target region.VMAT plan has a significant advantage in low-dose regions of protecting pelvis.Thus,individualized treatment design should be conducted according to the conditions of each patient in clinical treatment.

Inappropriate polypharmacy is common in older patients with co-morbidities, and prescription streamlining can help to ensure the safety of medications for older patients with co-morbidities.In 2023, The Alliance of European Geriatrics Societies(AEGS)summarized the literature on medication review and prescription streamlining to propose 33 recommendations for optimizing polypharmacy and prescription streamlining in older patients with co-morbidities.The strategy suggests incorporating prescription streamlining into the daily practice of geriatricians and clinical pharmacists, and provides recommendations about education and training of clinical staff, development of disease guidelines, policy support, and clinical trial research in older adults aiming to improve the management of polypharmacy.This article explains the key elements of this strategy to provide reference for high-quality healthcare for elderly patients with co-morbid in China.

Objective:To analyze the clinical characteristics, diagnosis and prognosis of pregnant women with fetomaternal hemorrhage (FMH) syndrome, and to guide the management of pregnant women with FMH syndrome.Methods:The clinical data of 33 pregnant women with FMH syndrome admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 2010 to December 2024 were collected, and the general information, diagnostic characteristics, treatment and maternal and fetal prognosis were retrospectively analyzed.Results:The incidence of FMH syndrome in our hospital was 1.7/10 000 (33/194 272). The gestational age of onset of FMH syndrome in 33 pregnant women was (35.6±3.1) weeks, 15 cases (45%, 15/33) were full-term delivery and 18 cases (55%, 18/33) were preterm delivery. Decreased fetal movement (51%, 17/33) was the most common initial symptom, followed by abnormal electronic fetal monitoring (33%, 11/33). Thirty-two cases (97%, 32/33) underwent cesarean section, and only one case had spontaneous delivery. Postpartum hemorrhage occurred in 11 cases (33%, 11/33). All the neonates were transferred to neonatal intensive care unit for treatment. Two of them were treated with intrauterine blood transfusion, and the neonates did not receive blood transfusion after birth. The neonatal mortality rate was 6% (2/33), and the remaining 31 cases (94%, 31/33) survived. Complications occurred in 3 premature infants, including 1 case of neonatal neurodevelopmental disorder with cochlear implantation, 1 case of pulmonary artery stenosis, and 1 case of retinopathy of prematurity. Three pregnant women were pregnant again, and none of them had FMH syndrome.Conclusions:Decreased fetal movement or abnormal electronic fetal monitoring in late pregnancy should be alert to the occurrence of FMH syndrome. Early diagnosis and intervention are critical to improve the prognosis of FMH syndrome.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.