1.Hippo (YAP)-autophagy axis protects against hepatic ischemia-reperfusion injury through JNK signaling
Shuguang ZHU ; Xiaowen WANG ; Haoqi CHEN ; Wenfeng ZHU ; Xuejiao LI ; Ruiwen CUI ; Xiaomeng YI ; Xiaolong CHEN ; Hua LI ; Genshu WANG
Chinese Medical Journal 2024;137(6):657-668
Background::Hepatic ischemia-reperfusion injury (HIRI) remains a common complication during liver transplantation (LT) in patients. As a key downstream effector of the Hippo pathway, Yes-associated protein (YAP) has been reported to be involved in various physiological and pathological processes. However, it remains elusive whether and how YAP may control autophagy activation during ischemia-reperfusion.Methods::Human liver tissues from patients who had undergone LT were obtained to evaluate the correlation between YAP and autophagy activation. Both an in vitro hepatocyte cell line and in vivo liver-specific YAP knockdown mice were used to establish the hepatic ischemia-reperfusion models to determine the role of YAP in the activation of autophagy and the mechanism of regulation. Results::Autophagy was activated in the post-perfusion liver grafts during LT in patients, and the expression of YAP positively correlated with the autophagic level of hepatocytes. Liver-specific knockdown of YAP inhibited hepatocytes autophagy upon hypoxia-reoxygenation and HIRI ( P <0.05). YAP deficiency aggravated HIRI by promoting the apoptosis of hepatocytes both in the in vitro and in vivo models ( P <0.05). Attenuated HIRI by overexpression of YAP was diminished after the inhibition of autophagy with 3-methyladenine. In addition, inhibiting autophagy activation by YAP knockdown exacerbated mitochondrial damage through increasing reactive oxygen species ( P <0.05). Moreover, the regulation of autophagy by YAP during HIRI was mediated by AP1 (c-Jun) N-terminal kinase (JNK) signaling through binding to the transcriptional enhanced associate domain (TEAD). Conclusions::YAP protects against HIRI by inducing autophagy via JNK signaling that suppresses the apoptosis of hepatocytes. Targeting Hippo (YAP)-JNK-autophagy axis may provide a novel strategy for the prevention and treatment of HIRI.
2.Status and development of hospice care services
Huimin BAO ; Binghe ZHU ; Xuejiao ZHU ; Shulan YANG
Chinese Journal of Modern Nursing 2024;30(7):841-847
A rapid growth and steady expansion has been witnessed in hospice care with initial effects in recent years, however, there are significant differences in practice among different regions, and a systematic and comprehensive summary and analysis are needed. Based on the consolidated framework for implementation research, this paper comprehensively analyzes and summarizes the implementation status of hospice care services from five aspects, including innovation, external setting, internal setting, individual characteristics and implementation process. This paper finds that the main factors contributing to the implementation of this service are the varied and individualized services, active implementation of training, clear division of labor among multidisciplinary teams, diversified service models, and emphasis on service publicity. The main challenges faced by the service are insufficient internal and external incentives, insufficient resources available for manpower and medicines, the level of knowledge, attitude, and practice of service providers needs to be improved, the service process needs to be harmonized, and the quality evaluation system needs to be improved. Relevant institutions at all levels should work together to play a positive role in facilitating factors, overcome obstacles, and further promote the development of hospice care in China.
3.Research on medication patterns for treating breast hyperplasia based on data mining
Liming ZHU ; Xuejiao XIANG ; Tianxiang MA ; Guangwei SHI ; Zhen MA ; Zhiwen GUO ; Aizhong RU
China Modern Doctor 2024;62(17):76-79,83
Objective To analyze and study the prescriptions of Chief Physician Chang Yalin for treating breast hyperplasia patients in the outpatient department,explores and summarizes the medication patterns for treating breast hyperplasia,and provides reference and dialectical medication ideas for clinical treatment of breast hyperplasia by using data mining technology.Methods Collect the prescriptions of Dr.Chang Yalin for treating breast hyperplasia patients at the Outpatient Department of Jiuquan Traditional Chinese Medicine Hospital from January 1,2017 to December 31,2022.After induction and organization,establish a data table,use Excel 2019 to statistically analyze the drug frequency and gender,taste,and meridian.Use SPSS Modoler 18.0 software April algorithm to analyze the association rules of the drugs,and use SPSS Statistics for cluster analysis.Results A total of 184 prescriptions were included,covering 140 types of traditional Chinese medicine,with a total frequency of use of 4059 times.Among them,Cornus officinalis,dried ginger,roasted licorice,Poria cocos,and jujube are commonly used drugs for the treatment of breast hyperplasia.The top three types of Chinese medicine that are commonly used are tonifying deficiency,warming internal medicine,and relieving external symptoms.The medicinal properties are mainly warm and mild;The medicinal taste is characterized by sweetness,bitterness,and bitterness;The main meridians of drugs are spleen,lung,and heart meridians.Association rule analysis shows that roasted licorice white peony,poria cocos,licorice,and cornus flesh white peony,jujube,and ginger are equivalent.Classify commonly used drugs into 4 categories using Euclidean distance clustering and segmentation with 5.Conclusion Dr.Chang Yalin has always implemented the core idea of treating breast hyperplasia through the coordination of liver and spleen,the simultaneous application of attack and tonifying,and the simultaneous treatment of phlegm and blood stasis.In terms of the combination of latent drugs,the main focus is on tonifying qi and spleen,tonifying yin/blood and regulating liver,and resolving stasis/resolving phlegm and dispersing stagnation.In terms of the combination of"cold phlegm"and"blood stasis and toxin",as well as the combination of"eighteen contraindications"and"nineteen contraindications",his principles and methods are more distinctive and worthy of further research and promotion.
4.Construction, reliability and validity of a scale for self-management of patients with dry eye
Xuejiao LIU ; Shuxian LIU ; Haiying LI ; Lijuan ZHOU ; Lei ZHU ; Mengnan ZHAO ; Zhangfang MA ; Wanxia ZHANG
Chinese Journal of Practical Nursing 2024;40(33):2603-2611
Objective:To construct and test the reliability and validity of an assessment scale for self-management of patients with dry eye, so as to help patients establish dry eye related health behaviors.Methods:Based on the knowledge attitude and practice theory, the initial scale was constructed on the basis of literature review and qualitative interview, and revised through Delphi expert consultation and expert argumentation. After the preliminary investigation, 211 dry eye patients treated in the dry eye nursing outpatient department of Beijing Tongren Hospital from August 2023 to January 2024 were selected by convenience sampling method for questionnaire investigation to test the reliability and validity of the scale.Results:Among 211 dry eye patients, there were 58 males and 153 females, aged (39.31 ± 12.81) years old. The scale of self-management of patients with dry eye included 27 items in 3 dimensions: knowledge, attitude and behavior. The authority coefficient of the two rounds of expert consultation was 0.86, and the Kendall coordination index increased from 0.175 to 0.223 (both P < 0.01). The cumulative variance contribution rates of the three dimensions were 41.843%, 54.219% and 44.273%, respectively. The Cronbach α coefficient of the scale was 0.787, and the Spearman-Brown coefficient was 0.641. Conclusions:The scale of self-management of patients with dry eye has good reliability and validity and can be used in the assessment of dry eye patients to provide a reference basis for targeted guidance and intervention.
5.Association between preschoolers physical activity levels and parental sports concept and behavior
Chinese Journal of School Health 2024;45(7):1036-1039
Objective:
To analyze the impact of parental sports concept and behavior on physical activity in preschool children, so as to provide a foundation for future guidance on fostering childrens physical activity within the family context.
Methods:
From November to December 2020, a clustered convenience sampling method was employed to conduct surveys, and a total of 283 children were selectal from one kindergarten each in Beijing, Shenyang, and Xian. Participating children wore ActiGraph GT9X accelerometers continuously for one week to collect data on different intensity levels of physical activity. Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) was utilized to assess parental sports concept and behavior. The gender differences in physical activity level and physical activity compliance rate were analyzed by using ttest, Mann-Whitney U test, and Chisquare test; and the relationship between parental exercise concepts and behaviors and physical activity of preschool children was analyzed using Spearman rank correlation analysis and multiple linear regression analysis.
Results:
Parental sports concept was significantly positively correlated with average daily moderatetovigorous physical activity (MVPA) and total physical activity (TPA) in children (r=0.12-0.16, P<0.05). Parental sports behavior was significantly positively correlated with childrens average daily TPA (r=0.25, P<0.05). Multiple linear regression revealed that parental sports concept was positively correlated with average daily MVPA and TPA in both boys and girls (B=0.65-0.83), while parental sports behavior only was positively correlated with boys average daily MVPA and TPA (B=0.24-0.25)(P<0.05).
Conclusions
Parental sports concept and behavior can impact physical activity levels in preschool children, exhibiting gender differences. Future guidance on physical activity in family upbringing should consider both parental sports concept and behavior, and pay attention to the influence of childrens gender.
6.Chinese expert consensus on the diagnosis and treatment of chronic cough after lung surgery
Gaoxiang WANG ; Junqiang ZHANG ; Mingsheng WU ; Sheng WANG ; Yongfu ZHU ; Xuejiao LI ; Zhengwei CHEN ; Mingran XIE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(01):1-10
In recent years, the number of lung surgeries has increased year by year, and the number of patients with postoperative cough has also increased gradually. Chronic cough after lung surgery seriously affects patients' quality of life and surgical outcome, and has become one of the clinical problems that clinicians need to solve. However, there is currently no guideline or consensus for the treatment of chronic cough after lung surgery in China, and there is no standardized treatment method. Therefore, we searched databases such as PubMed, Web of Science, CNKI, and Wanfang databases ect. from 2000 to 2023 to collected relevant literatures and research data, and produced the first expert consensus on chronic cough after lung surgery in China by Delphi method. We gave 11 recommendations from five perspectives including timing of chronic cough treatment, risk factors (surgical method, lymph node dissection method, anesthesia method), prevention methods (preoperative, intraoperative, postoperative), and treatment methods (etiological treatment, cough suppressive drug treatment, traditional Chinese medicine treatment, and postoperative physical therapy). We hope that this consensus can improve the standardization and effectiveness of chronic cough treatment after lung surgery, provide reference for clinical doctors, and ultimately improve the quality of life of patients with chronic cough after lung surgery.
7.The norm of the Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) in urban areas of China
Chinese Journal of School Health 2023;44(9):1328-1332
Objective:
To establish the norm of the Physical Activity afterschool Questionnaire for Preschooler(P-PAQ) in urban areas of China, so as to provide a basis for graded guidance from the family perspective and to improve children s physical activity levels.
Methods:
From October 2020 to January 2021, 6 267 children aged 3-6 years old were recruited from 40 kindergartens in eight cities across six major administrative regions by stratified cluster sampling, and the P-PAQ initially developed by the researchers of this study were completed by the primary caregivers. The questionnaire was administered to collect data relating to the amount of physical activity undertaken by the preschoolers, and the norm was determined by quartiles. Data relating to parental concepts of sports and parental behavior were assessed by calculating mean scores in order to establish the norm.
Results:
Among preschoolers in urban areas, the M(P 25 ,P 75 ) of total physical activity time (min/day), moderate-to-vigorous physical activity time (min/day), outdoor time (min/day) and screen time (min/day) on school days outside kindergarten and on weekends were 84 (54,120), 22 (8,40), 12 (0,24) and 18 (6,30), and 170 (115,240), 60 (30,95), 90 (35,120) and 30 (20,60), respectively. When the score of parents sports concept and behavior (total score of 40) were≥34, 29-<34, 24-<29, <24, it was defined as four levels about above medium, medium, lower medium and lower, respectively. And for two dimensions,when the score of parental sports concept were ≥19, 17-<19, 15-<17, <15,and the score of parental behaviors were ≥16, 12-<16, 8-<12, <8, it was defined as four levels about upper medium, medium, lower medium and lower, respectively.
Conclusion
The norm of extracurricular activities among preschool children in Chinese cities has good representativeness and appropriate threshold values, which could provide a valuable reference for early assessment, as well as guidance in relation to out-of-school physical activity behaviors among children aged 3-6 years old.
8.Summary of the best evidence and practical suggestions on strategies for maintaining physical activity ability of the elderly in the community
Shulan YANG ; Biyan JIANG ; Xiaoqing JIN ; Wanqi YU ; Frances WONG ; Arkers WONG ; Xuejiao ZHU ; Caixia LIU
Chinese Journal of Modern Nursing 2023;29(7):847-853
Objective:To focus on the physical activity strategy to maintain the activity ability of the elderly in the community, comprehensively retrieve and integrate the best evidence, form practical suggestions with the goal of the transformation and practice of evidence, so as to provide scientific, reliable and up-to-date basis for the implementation of relevant evidence.Methods:According to the 6S pyramid model, the British Medical Journal (BMJ) Best Practice, UpToDate, DynaMed, World Health Organization, Chinese Medical Association, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, PubMed, SinoMed and other databases were retrieved layer by layer from top to bottom. This study obtained all articles of evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review and other types related to physical activity strategies to maintain the activity ability of the elderly in the community from January 1, 2017 to March 1, 2022. According to the inclusion and exclusion criteria of the article, 2 to 4 researchers conducted independent methodological quality evaluation on different types of article according to the tool requirements, extracted and summarized the best evidence, and formed practical suggestions.Results:A total of 14 articles were included, including 2 evidence-based decision-making, 6 guidelines, 1 expert consensus, 3 systematic reviews, and 2 overviews of systematic review. Seven dimensions such as "overall advice, health benefits, diversified sports training, aerobic training, balance training, muscle strengthening/resistance training, flexibility training" and 22 best pieces of evidence were extracted and summarized, and practical suggestions were formed.Conclusions:Medical and nursing staff should adopt evidence-based methodological practical suggestions to provide management guidance and consultation for the maintenance of physical activity ability of the elderly in the community, so as to help the elderly to maintain physical activity ability and gain health benefits.
9.Visual analysis of the current status and hotspots of polypharmacy research at home and abroad based on CiteSpace software
Xin'an WANG ; Hongting ZHOU ; Liebin HUANG ; Xuejiao ZHU
Chinese Journal of Modern Nursing 2023;29(17):2294-2300
Objective:To compare the hotspots and frontiers related to polypharmacy research at home and abroad, understand the current research status of polypharmacy and provide reference for improving the current situation of polypharmacy.Methods:Taking "polypharmacy" and "polymedication" as search terms in both Chinese and English, CiteSpace 5.8.R3 software was used to analyze the publication volume, national and institutional cooperation network analysis, and publication journal analysis of the relevant literature included in the CNKI and the core collection database of Web of Science from September 1st, 2006 to September 1st, 2022. The keywords were conducted co-occurrence, clustering and burst analysis.Results:A total of 412 valid Chinese literatures and 1 447 English literatures were retrieved, and the literature focused on the field of geriatrics. The overall number of publications at home and abroad increased, showing a trend of multi-disciplinary cooperation, but the cooperation among domestic organizations was weaker than that of foreign countries. Foreign research focused on the health outcomes and control strategies of polypharmacy, and the influence of polypharmacy on social psychology and quality of life was a trend. Domestic research focused on the influencing factors of polypharmacy and medication compliance.Conclusions:Domestic scholars should pay more attention to the hotspots and trends in the field of polypharmacy and carry out deeper scientific research.
10.Research progress on the effect of transitional care on readmission rate of COPD patients
Liang SHEN ; Xuejiao ZHU ; Xuting CHANG
Chinese Journal of Modern Nursing 2023;29(29):3929-3935
This article reviewed the effect of transitional care on the readmission rate of chronic obstructive pulmonary disease (COPD) patients, and summarized the intervention methods and contents of transitional care, aiming to provide references and basis for establishing strategies and plans to reduce readmission rate of COPD patients.


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