Objective:To conduct a scoping review of studies on the application of exercise interventions in the rehabilitation of patients with hemophilic arthropathy (HA) .Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from the database inception to March 1, 2024. Relevant literature was screened, summarized, and analyzed.Results:A total of 31 studies were included. The study population mainly consisted of adult patients with moderate to severe hemophilia suffering from elbow, knee, and ankle arthropathy, who were in a stable bleeding phase without coagulation factor inhibitors. Exercise types included resistance training, aerobic exercise, balance/proprioceptive exercises, and flexibility training. The exercise intensity was predominantly low to moderate. The duration of each session was mostly 30-60 minutes, with a frequency of 2-5 times per week and a total intervention period of 4-12 weeks. Exercises were mostly conducted in medical institutions under face-to-face supervision. Exercise interventions led to varying degrees of improvement in mobility, balance/proprioceptive function, joint function, cardiopulmonary fitness, psychological well-being, and quality of life.Conclusions:Exercise interventions for patients with hemophilic arthropathy are diverse, demonstrating safety, feasibility, and efficacy. Future research should focus on a multidisciplinary, exercise-centered rehabilitation approach, standardizing evaluation criteria, and dynamically monitoring the rehabilitation process to develop standardized exercise rehabilitation protocols.

Objective:To explore the influence of LIN28B on chemosensitivity of colon cancer by regulating GSH.Methods:Functional enrichment analysis of LIN28B target genes was performed using database. The primary tumor tissues of colon cancer patients who received neoadjuvant chemotherapy at Department of Gastroenterology, Peking University International Hospital from Nov 2017 to May 2020 were collected, and their LIN28B levels were detected by immunohistochemistry. According to the tumor regression grade, they were divided into chemotherapy sensitive group and chemotherapy resistant group, and the difference of LIN28B expression between the two groups was compared. LIN28B overexpression and knockdown colon cancer cell lines were constructed, and the effect of LIN28B on the chemosensitivity of colon cancer cells was detected by MTT assay. Double luciferase reporting experiment and Western blot were used to detect the direct binding and regulation of LIN28B to mRNA of four GSH related enzymes. At the same time, the regulation of LIN28B on total GSH and reduced GSH was tested. Finally, by detecting the level of reactive oxygen species (ROS) γ-H2AX and Comet assay to analyze the potential impact of LIN28B on genomic instability.Results:GSH-related enzymes were highly enriched in LIN28B target genes. The expression of LIN28B was heterogeneous in colon cancer patients. Compared with the low expression group, the average survival time of patients with high expression of LIN28B was significantly increased [(50.2±2.9 )months vs. (31.1±4.0 )months, P=0.001], and the proportion of tumor regression grade 0-1 was significantly different (48.0% vs. 16.0%, P=0.032). The expression level of LIN28B in chemotherapy sensitive group was significantly higher than that in drug resistant group ( P<0.01). LIN28B overexpression significantly increased the chemosensitivity of HCT116 cells to 5-fluorouracil (5-Fu) and oxaliplatin (L-OPH). The synthesis and activity of GSH were further inhibited (all P<0.01). At the same time, the ROS level of LIN28B overexpression cells was significantly increased after treatment with L-OPH. The level of γ-H2AX was significantly increased, and the content of comet tail DNA was also significantly increased ( P<0.01). Conclusion:LIN28B may increase the chemosensitivity of colon cancer cells by directly inhibiting the expression of GSH related enzymes, resulting in the decrease of GSH synthesis and activity, the increase of ROS level and genomic instability.

Objective:To conduct a scoping review of studies on the application of exercise interventions in the rehabilitation of patients with hemophilic arthropathy (HA) .Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from the database inception to March 1, 2024. Relevant literature was screened, summarized, and analyzed.Results:A total of 31 studies were included. The study population mainly consisted of adult patients with moderate to severe hemophilia suffering from elbow, knee, and ankle arthropathy, who were in a stable bleeding phase without coagulation factor inhibitors. Exercise types included resistance training, aerobic exercise, balance/proprioceptive exercises, and flexibility training. The exercise intensity was predominantly low to moderate. The duration of each session was mostly 30-60 minutes, with a frequency of 2-5 times per week and a total intervention period of 4-12 weeks. Exercises were mostly conducted in medical institutions under face-to-face supervision. Exercise interventions led to varying degrees of improvement in mobility, balance/proprioceptive function, joint function, cardiopulmonary fitness, psychological well-being, and quality of life.Conclusions:Exercise interventions for patients with hemophilic arthropathy are diverse, demonstrating safety, feasibility, and efficacy. Future research should focus on a multidisciplinary, exercise-centered rehabilitation approach, standardizing evaluation criteria, and dynamically monitoring the rehabilitation process to develop standardized exercise rehabilitation protocols.

Objective:To explore the influence of LIN28B on chemosensitivity of colon cancer by regulating GSH.Methods:Functional enrichment analysis of LIN28B target genes was performed using database. The primary tumor tissues of colon cancer patients who received neoadjuvant chemotherapy at Department of Gastroenterology, Peking University International Hospital from Nov 2017 to May 2020 were collected, and their LIN28B levels were detected by immunohistochemistry. According to the tumor regression grade, they were divided into chemotherapy sensitive group and chemotherapy resistant group, and the difference of LIN28B expression between the two groups was compared. LIN28B overexpression and knockdown colon cancer cell lines were constructed, and the effect of LIN28B on the chemosensitivity of colon cancer cells was detected by MTT assay. Double luciferase reporting experiment and Western blot were used to detect the direct binding and regulation of LIN28B to mRNA of four GSH related enzymes. At the same time, the regulation of LIN28B on total GSH and reduced GSH was tested. Finally, by detecting the level of reactive oxygen species (ROS) γ-H2AX and Comet assay to analyze the potential impact of LIN28B on genomic instability.Results:GSH-related enzymes were highly enriched in LIN28B target genes. The expression of LIN28B was heterogeneous in colon cancer patients. Compared with the low expression group, the average survival time of patients with high expression of LIN28B was significantly increased [(50.2±2.9 )months vs. (31.1±4.0 )months, P=0.001], and the proportion of tumor regression grade 0-1 was significantly different (48.0% vs. 16.0%, P=0.032). The expression level of LIN28B in chemotherapy sensitive group was significantly higher than that in drug resistant group ( P<0.01). LIN28B overexpression significantly increased the chemosensitivity of HCT116 cells to 5-fluorouracil (5-Fu) and oxaliplatin (L-OPH). The synthesis and activity of GSH were further inhibited (all P<0.01). At the same time, the ROS level of LIN28B overexpression cells was significantly increased after treatment with L-OPH. The level of γ-H2AX was significantly increased, and the content of comet tail DNA was also significantly increased ( P<0.01). Conclusion:LIN28B may increase the chemosensitivity of colon cancer cells by directly inhibiting the expression of GSH related enzymes, resulting in the decrease of GSH synthesis and activity, the increase of ROS level and genomic instability.

Objective:To explore the research status of artificial intelligence in nursing in China, so as to provide reference for conducting research domestically.Methods:The relevant literature collected from January 1, 2003 to May 1, 2023 was searched on China National Knowledge Infrastructure, WanFang Data, and VIP. CiteSpace and VOS viewer were used to visually analyze the research status, hotspots, and frontiers of artificial intelligence in nursing in China from the aspects of annual publication volume, region, institution, author, high-frequency keywords, and emerging words.Results:A total of 494 articles were included. In terms of publication volume, domestic research showed an overall upward trend, with publishing institutions mostly concentrated in economically developed and medically advanced regions. The authors of the articles often collaborated with research groups, with a co-authorship rate of 81.17% (401/494), but there was relatively little collaboration between groups. Research hotspots were focused on the application of artificial intelligence in geriatric nursing, rehabilitation nursing, Operating Rooms, and drug formulation, with a majority of research related to robots.Conclusions:The research enthusiasm in related fields in China is currently on the rise. Research on artificial intelligence in nursing management, nursing education, and psychological nursing can be strengthened, and the application of artificial intelligence can be enriched. At the same time, research institutions and personnel should strengthen mutual cooperation, and relevant national departments should improve laws and regulations to promote the vigorous development of this research field.

Objective To observe the correlations of two-dimensional speckle tracking imaging(2D-STI)parameters of healthy fetal heart and gestational age in middle and late pregnancy.Methods Fetal echocardiography was prospectively performed in 279 healthy singleton fetuses in middle and late pregnancy.The fetuses were divided into group A(20-23+6 weeks of pregnancy,n=49),B(24-27+6 weeks of pregnancy,n=112),C(28-31+6 weeks of pregnancy,n=63),D(32-35+6 weeks of pregnancy,n=30)and group E(≥36 weeks of pregnancy,n=25)according to gestational age.Fetal left ventricle(LV)ejection fraction,LV and right ventricle(RV)area change fraction,LV and RV global radial strain(GRS),LV and RV myocardium and endocardium global longitudinal strain(MyoGLS,EndoGLS),LV myocardium and endocardium global circumferential strain(MyoGCS,EndoGCS)were obtained with 2D-STI and compared among 5 groups,and the correlations with gestational age were analyzed.Results Significant differences of fetal LV EndoGLS was found among 5 groups(P=0.044).Fetal LV GRS and RV GRS were positively correlated with gestational age(r=0.165,0.122,both P＜0.05)in middle and late pregnancy,while the absolute value of LV EndoGLS was negatively correlated with gestational age(r=-0.133,P=0.026).Conclusion LV GRS and RV GRS were positively correlated with gestational age in healthy fetuses in middle and late pregnancy,while the absolute value of LV EndoGLS was negatively correlated with gestational age.

Objective:To evaluate the morphological characteristics of the fetal heart and the contractile function of the left and right ventricles in fetuses with pulmonary stenosis (PS) and pulmonary atresia (PA) using fetal heart quantitative analysis technology (fetal HQ), and to assess the impact of different degrees of right ventricular outflow tract obstruction (RVOTO) on the contractile function of the fetal left and right ventricles. To accumulate early data and explore parameters for constructing a predictive model and clinical decision-making tool for the progression of fetal PS and PA.Methods:A retrospective analysis was conducted on 42 cases of mild to moderate PS and 23 cases of severe PS or PA detected through fetal echocardiography in the Department of Ultrasound, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from July 2020 to December 2021. A control group of 195 normal fetal cases matching gestational weeks was selected. The fetal HQ technique was employed to measure the global sphericity index (GSI), left ventricular ejection fraction (EF), left/right ventricular area change percentage (LVFAC, RVFAC), and left/right ventricular longitudinal strain (LVGLS, RVGLS). Additionally, 24-segment sphericity index (SI) and fractional shortening (FS) for both left and right ventricles were measured. Comparative analyses were performed between the case and control groups, as well as within the case group.Results:In comparison with the control group, the case group exhibited significantly decreased GSI, LVGLS, LVEF, LVFAC, RVGLS, and RVFAC.The differences were statistically significant in the mild to moderate PS group (all P<0.05) and highly significant in the severe PS/PA group (all P<0.01). In the mild to moderate PS group, the left ventricle′s 2nd segment, right ventricle′s 24th segment SI, and the left ventricle′s 1st-13th segments, right ventricle′s 1st-16th and 20th-24th segments FS showed statistically significant differences compared to the control group (all P<0.05). In the severe PS/PA group, the right ventricle′s 1st-22nd segment SI, and the left ventricle′s 6th-13th, 21st-24th segments, and the right ventricle′s 1st-14th segments FS were reduced, showing statistically significant differences compared to the control group (all P<0.05). The severe PS/PA group showed lower RVGLS, RVFAC, and SI for the right ventricle′s 1st to 17th segments when compared to the mild to moderate PS group, with statistically significant differences (all P<0.05). Conclusions:Quantitative indices derived by fetal HQ is capable of evaluating the cardiac morphology and function of fetuses with PS/PA, which may provide for reference information for comprehensive understanding of cardiac morphological and functional changes in such fetuses.

Objective:To analyze the correlation between left and right atrial diameters and fetal biological growth parameters of normal fetuses in middle and late trimester, and to establish normal reference and Z-score model for left and right atria.Methods:Three hundred and ninety-two fetuses in middle and late trimester were prospectively selected from July 2022 to October 2022 in Sir Run Run Shaw Hospital.Non-cardiac biometric parameters included biparietal diameter (BPD), femoral length (FL), and gestational age (GA) based on menstrual age were assessed.Left and right atrial widths (LAW, RAW) and atrial lengths (LAL, RAL) at end-systole, left and right atrial areas (LAA, RAA) at end-systole and the heart area (HA) at end-diastole were measured in standard apical four-chamber or basal four-chamber view. The ratio of RA and LA transverse diameters (RAW/LAW), the ratio of RA and LA length diameters (RAL/LAL), ratio of RA and LA area (RAA/LAA), spherical index of the ratio of RA and LA length to transverse diameter (RASI, LASI), ratio of LA and RA area to heart area (LAA/HA, RAA/HA) were calculated. The best regression equation was established using GA, BPD and FL as independent variables and LAL, LAW, LAA, RAL, RAW, RAA as dependent variable. The correlation between the standard deviation (SD) and the independent variables GA, BPD and FL was analyzed, and then the above statistics were used to calculate the corresponding Z-score for each variable of RA and LA using the regression equation.Results:①Significant positive correlations were found between LAW, RAW, LAL, RAL, LAA and RAA with the increase of GA, BPD and FL, and the highest degree of correlation between RAA, LAA and GA was denoted ( r=0.927, 0.920, all P<0.001). ②Taking GA as an example, there was no significant correlation between RAL/LAL, RAW/LAW and GA ( r=-0.064, 0.077; all P>0.05). RAA/LAA showed a very weak positive correlation with GA ( r=0.106, P=0.037), with normal reference values of 1.002±0.091, 1.091±0.093, 1.059±0.090, respectively. Interestingly RAL/LAL was found close to 1, while RAW/LAW and RAA/LAA were always >1. No significant correlations were found between LAA/HA, RAA/HA and GA ( r=0.003, 0.056; all P>0.05), with normal reference values of 0.155±0.026, 0.163±0.026, respectively, and RAA/HA was found larger than LAA/HA. LASI showed a very weak positive correlation with GA ( r=0.112, P=0.027), while there was no significant correlation between RASI and GA ( r=0.003, P>0.05), the normal reference values were 1.068±0.113, 0.980±0.105, respectively. ③The SD of LAL, LAW, etc.showed a simple linear relationship with the independent variables. Taking RAA and GA as examples, the linear regression equation for RAA was Y=-1.690+ 0.107 0GA ( r=0.927, P<0.001) and the linear regression equation for RAA-SD was Y=-0.107+ 0.010 4GA ( r=0.320, P<0.001). The Z-scores for LAL, LAW, LAA, RAL, RAW and RAA were relatively constant with the growth of GA, BPD and FL, with the corresponding Z-scores for GA were -1.817~3.631( r=0.000 3), -1.605~2.995( r<-0.000 1), -1.700~3.107( r<0.000 1), -1.617~3.466( r=0.000 1), -1.491~3.025( r<-0.000 1), -1.566~3.104( r=0.000 2), respectively. Conclusions:This study preliminarily establish the reference value ranges and Z-score of atrial diameters in normal fetuses during middle and late trimester, providing a reference basis for accurate quantitative evaluation of fetal atrial development and analysis of fetal congenital heart abnormalities, and contributing to the early detection of pathological conditions leading to abnormal atrial size.

Objective:This study aimed to evaluate the effect of enhanced external counterpulsation(EECP)on left ventricular function in elderly patients with coronary slow flow phenomenon(CSFP)using two-dimensional speckle tracking echocardiography(2D-STE).Methods:This prospective case-control study included 30 patients aged ≥60 years with no stenotic lesions in the coronary arteries but with slow blood flow phenomenon in more than one major coronary artery who were treated at the Department of Geriatrics, Qilu Hospital, Shandong University, between December 2017 and December 2018, and were divided into a medication group with 16 participants and a medication plus EECP group with 14 participants, using the numerical lottery method.Patients in the group treated with EECP received 6-week 36-h EECP therapy in addition to lifestyle modification and drug treatment.Fourteen patients with normal coronary blood flow served as the control group.Conventional echocardiography and 2D-STE were used to evaluate changes in left ventricular function in the CSF patients before and after drug treatment and EECP.Results:Compared with the control group before treatment, patients in the drug treatment group and the drug treatment plus EECP group showed a decrease in mitral annular early diastolic velocity( P<0.01), an increase in the ratio of peak mitral early diastolic blood flow velocity to the mean peak mitral annular early diastolic velocity( P<0.05), and a decrease in left ventricular longitudinal strain during systole( P<0.01), the longitudinal systolic myocardial strain rate( P<0.01)and the early diastolic longitudinal peak strain rate( P<0.01).There was no statistically significant difference in values from conventional echocardiographic parameters before and after treatment in CSF patients of the medication group(all P>0.05).In the group receiving EECP, there were statistically significant differences in pre-and post-treatment values in ventricular septal early diastolic velocity[(6.22 ± 0.64)cm/s vs.(6.69 ± 0.44)cm/s], lateral wall early diastolic velocity[(8.01±0.68)cm/s vs.(8.41±0.29)cm/s], mitral valve to mitral annulus early diastolic peak velocity ratio[(10.51±1.38) vs.(9.74±0.37)], longitudinal left ventricular systolic strain[(-16.21±0.46)% vs.(-16.80±0.48)%], left ventricular systolic longitudinal strain rate[(-1.29±0.03)s -1vs.(-1.35±0.04)s -1], and early diastolic longitudinal strain rate[(1.35±0.03)s -1vs.(1.40±0.03)s -1](t-values were -3.70、-2.74、2.23、10.25、12.30、-19.15, all P<0.05). Conclusions:2D-STE can evaluate subclinical myocardial dysfunction early and quantitatively in elderly patients with CSF, and objectively reflect changes in left ventricular function before and after clinical intervention with EECP.

【Objective】 To investigate the clinical efficacy of human acellular allogeneic dermis (HADM) in the repair of urinary fistula. 【Methods】 The clinical data of 12 female patients with complex vesicovaginal fistula treated during Jun.2021 and Nov.2022 were retrospectively analyzed. The patients’ average age was 47.3 years, ranging from 38 to 56 years. The body mass index (BMI) ranged from 16.6 to 25.2, with an average of 21.3. HADM was inserted between vagina and bladder wall fistula to repair fistula in all 12 patients. 【Results】 All operations were successful. After the operation, the vaginal urine leakage stopped and the urinary tube was retained for 2 weeks. During the postoperative follow-up of 1 to 16 months, no recurrence or complication were observed. 【Conclusion】 Transvaginal HDMA is an ideal surgical method in the treatment of complex vesicovaginal fistula, which has advantages of small trauma, fast recovery and high success rate.