Objective To review the application of shared decision making in acute coronary syndrome,so as to provide references for future research and application.Methods Based on the scoping review methodology,a systematic search was conducted in SinoMed,CNKI,Wanfang,PubMed,Embase,Cochrane Library,Web of Science,and CINAHL.The search time limit was from the establishment of the database to January 8,2023,and the included literature was summarized and analyzed.Results A total of 17 articles were included.The application of shared decision making in acute coronary syndromes includes diagnosis,treatment,primary and secondary prevention.5 patient decision aids were retrieved.The influencing factors include patient factors,medical staff factors and implementation process factors.The clinical application has good effectiveness and feasibility.Conclusion Shared decision making can help patients with acute coronary syndrome to increase their decision making knowledge,improve their decision-making experience and improve the quality of decision making.In the future,we should broaden the application scope of shared decision making in acute coronary syndromes,develop scientific and practical decision aids,take targeted measures,and explore the application of shared decision making in clinical diagnosis and treatment in China.

Objective To analyze the diagnostic value and misdiagnosis reasons of MRI in benign and malignant prostatic transitional zone lesions.Methods A total of 147 patients with prostatic transitional zone lesions were selected.The diagnostic value and misdiagnosis reasons of MRI in benign and malignant prostatic transitional zone lesions were analyzed.Results The accuracy rate of MRI diagnosis was 78.23％,and the misdiagnosis rate was 21.77％.MRI had high consistency with the pathological diagnosis results(Kappa=0.816,P＜0.001).MRI had high diagnostic value in benign and malignant prostatic transitional zone lesions,and the area under the curve(AUC)was 0.767.The shape,signal uniformity,boundary condition,capsule condition,diffusion weighted imaging(DWI)signal intensity,apparent diffusion coefficient(ADC)value,and time-signal intensity curve type of the lesion were all independent risk factors for misdiagnosis of benign and malignant prostatic transitional zone lesions using MRI(P＜0.05).Conclusion MRI has high diagnostic value in benign and malignant prostatic transitional zone lesions.The causes of misdiagnosis are lesion shape,signal uniformity,boundary condition,capsule condition,DWI signal intensity,ADC value,and time-signal intensity curve type.

OBJECTIVE To investigate the impacts of isorhynchophylline （IRN） on airway inflammation in asthmatic mice by regulating the monocyte chemotactic protein-1 （MCP-1）/CC chemokine receptor 2 （CCR2） signaling pathway. METHODS The asthmatic mice model was established by injecting and inhaling ovalbumin. The successfully modeled mice were randomly grouped into asthma group， IRN low-dose group （IRN-L， intragastric administration of 10 mg/kg IRN）， IRN high-dose group （IRN-H， intragastric administration of 20 mg/kg IRN）， IRN-H+CCL2 group [intragastric administration of 20 mg/kg IRN+intraperitoneal injection of 7.5 ng CC chemokine ligand 2 （CCL2）] and positive control group （intraperitoneal injection of 2 mg/kg dexamethasone）. The mice injected and inhaled with sterile phosphate-buffered solution were included in the blank control group， with 10 mice in each group. The mice in administration groups were given relevant medicine once a day， for consecutive 2 weeks. The levels of airway hyperreactivity indexes such as enhanced （Penh） value， tumor necrosis factor-α （TNF-α），interleukin-13 （IL-13） and IL-4 in serum， the number of eosinophil （EOS）， lymphocyte （LYM） and neutrophils （NEU） in alveolar lavage fluid and the protein expressions of MCP-1 and CCR2 in lung tissue were observed in each group； the pulmonary histopathological changes were observed， and inflammatory cell infiltration score was evaluated. RESULTS Compared with the blank control group， the infiltration of inflammatory cells in the lung tissue of mice was more significant in the asthma group， and there was swelling and shedding of cells； inflammatory infiltration score， Penh value， the levels of IL-4， IL-13 and TNF-α， the number of EOS， NEU and LYM， the protein expressions of MCP-1 and CCR2 were increased significantly （P＜0.05）. Compared with the asthma group， the pathological injuries of the IRN-L group， IRN-H group and positive control group were improved， and the above quantitative indexes were decreased significantly （P＜0.05）. Compared with the IRN-L group， the above quantitative indexes of the IRN-H group and positive control group were decreased significantly （P＜0.05）. There was no statistical significance in the above quantitative indexes between the IRN-H group and the positive control group （P＞0.05）. Compared with the IRN-H group， the above quantitative indexes of the IRN-H+CCL2 group were increased significantly （P＜0.05）. CCL2 reversed the protective effect of high-dose IRN on asthmatic mice. CONCLUSIONS IRN may reduce the release of airway inflammatory factors in asthmatic mice by inhibiting the activation of the MCP-1/CCR2 signaling pathway， so as to achieve the purpose of improving asthma.

OBJECTIVE To study the tocolysis effects of Angelica sinensis polysaccharides on threatened abortion model rats and their impacts on Th1/Th2 balance by regulating the phosphoinositide 3-kinase （PI3K）/protein kinase B （AKT） signaling pathway. METHODS Pregnant rats were randomly grouped into the control group， model group， A. sinensis polysaccharide group （200 mg/kg）， PI3K/AKT signaling pathway inhibitor LY294002 group （5 mg/kg）， and A. sinensis polysaccharide+LY294002 group （200 mg/kg A. sinensis polysaccharide+5 mg/kg LY294002）， with 10 rats in each group. Except for the control group， rats in all other groups were given mifepristone （8.3 mg/kg） and misoprostol （100 μg/kg） intragastrically to establish a threatened abortion model， and intragastric or intraperitoneal injection of corresponding drugs. The serum levels of estrogen， progesterone， interferon-γ （IFN-γ）， tumor necrosis factor-α （TNF-α）， and interleukin-4 （IL-4） in each group of rats were detected， and the uterine ovarian index and embryonic mortality rate of rats in each group were measured； the morphology of uterine tissue in rats was observed in each group； Th1/Th2 balance in peripheral blood of rats as well as the expression of PI3K/AKT signaling pathway-related proteins in the uterine tissues of rats in each group were detected. RESULTS Compared with the control group， the uterine tissue of rats in the model group showed pathological damage； the serum levels of estrogen， progesterone and IL-4， uterine ovarian index， peripheral blood Th2 cell ratio， and the ratios of phosphorylated PI3K （p-PI3K）/PI3K and phosphorylated AKT （p-AKT）/AKT in uterine tissue were all decreased （P＜0.05）； the embryo mortality rate， Th1 cell ratio， Th1/Th2 ratio， and serum levels of IFN-γ and TNF-α were increased （P＜0.05）. Compared with the model group， the pathological damage of uterine tissue in the A. sinensis polysaccharide group was reduced， and the above indexes were all improved significantly （P＜0.05）； LY294002 could weaken the effect of A. sinensis polysaccharide on model rats （P＜0.05）. CONCLUSIONS A. sinensis polysaccharides can improve Th1/Th2 imbalance in threatened abortion model rats by activating the PI3K/AKT signaling pathway， thereby inhibiting immune inflammation， and promoting embryo survival.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

【Objective】 To explore the effects of perceived risk of COVID-19 of college students on their anxiety and depression, as well as the roles of attention to negative information and perceived social support, so as to provide theoretical basis for colleges and universities to formulate corresponding intervention measures. 【Methods】 By the convenience sampling method, totally 1 404 college students from Shaanxi and Henan provinces were investigated online by using General Information Questionnaire, Perceived Risk of COVID-19 Pandemic Scale, Attention to Negative Information Scale, Patient Health Questionnaire, Generalized Anxiety Disorder and Perceived Social Support Scale. SPSS 20.0 was used for data analysis, Pearson correlation method was used to explore the correlation between variables. The mediating effect of attention to negative information and the moderating effect of perceived social support were analyzed by PROCESS. 【Results】 The scores of anxiety and depression of the 1 404 college students included in the study were 4.03±4.48 and 6.21±5.41, respectively. The detection rate of anxiety symptom was 29.9%, and that of depression symptom was 44.4%. The risk perception of COVID-19 epidemic of the college students was positively correlated with attention to negative information (r=0.373, P<0.001), anxiety (r=0.227, P<0.001), and depression (r=0.226, P<0.001). Anxiety (r=0.553, P<0.001) and depression (r=0.497, P<0.001) were positively correlated with attention to negative information, while perceived social support was negatively correlated with the risk perception of the COVID-19 (r=-0.154, P<0.001), attention to negative information (r=-0.259, P<0.001), anxiety (r=-0.321, P<0.001) and depression (r=-0.278, P<0.001). The risk perception of COVID-19 affected the anxiety and depression of the students mainly through the mediating effect of attention to negative information. The total effect of risk perception of COVID-19 and anxiety was 0.227, and the mediating effect accounted for 80.18% of the total effect. The total effect of risk perception of COVID-19 and depression was 0.228, and the mediating effect accounted for 90.35% of the total effect. Perceived social support played a moderating role in the last half of this mediating model. 【Conclusion】 Risk perception of COVID-19 indirectly affects the occurrence of anxiety and depression in college students through attention to negative information, and perceived social support plays a moderating role in this mediating model. The findings suggest that when a risk event occurs, colleges and universities should pay attention to guiding students to adjust their attentional bias to external information, and give students enough care and support to improve their mental health.

【Objective】 To understand the status of COVID-19 vaccination among elderly adults in long-term care facilities and analyze the influencing factors so as to provide scientific basis for improving the policy of COVID-19 vaccination. 【Methods】 The socio-demographic characteristics, disease-related data, disability, and COVID-19 vaccination status of 575 elderly adults who resided in long-term care facilities in Shaanxi Province were collected via Sojumpin in January 2022. Factors that affected non-vaccinated elderly adults were analyzed by using the SPSS 25.0 software. 【Results】 Of the included 575 participants, 199 (34.6%) were not vaccinated against COVID-19. Univariate analysis showed that COVID-19 vaccination was associated with age, room type, length of stay, marital status, number of children, chronic diseases (i.e., diabetes, stroke, dementia), disability degree, and long-term medication use. Logistic regression analysis demonstrated that age of 90 years or above (OR=4.25), triple room (OR=6.17), moderate disability (OR=2.94), severe disability (OR=6.67), long-term medication use (OR=1.81), and stroke (OR=1.74) were independent risk factors for not injecting COVID-19 vaccine. 【Conclusion】 The COVID-19 vaccination coverage rate of elderly adults in long-term care facilities needs to be improved, and more attention should be paid to the high-risk groups (e.g., who are older, and have disability, long-term medication use, or stroke).

【Objective】 To explore the relationship between chronic comorbidity and the physical and mental health of relatives of elderly people during the nursing home confinement, and to analyze the mediating effects of perceived stress and intolerance of uncertainty in this context. 【Methods】 A total of 568 family members of elderly people in nine elderly institutions in Shaanxi Province were selected. The survey included the short version of the Perceived Stress Scale, Intolerance of Uncertainty Scale, and The World Health Organization-5 Well-being Index. The data were analyzed with Stata for correlation and mediation effects. 【Results】 ① The comorbidities of chronic diseases was positively correlated with the perceived stress (r=0.16, P<0.001) and intolerance of uncertainty (r=0.11, P=0.006) of the family members, but negatively correlated with the physical and mental health of the family members (r=-0.13, P=0.002). ② The mediating effect of perceived stress between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.023, accounting for 18.8% of the total effect; the mediating effect of intolerance of uncertainty between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.041, accounting for 33.5% of the total effect. 【Conclusion】 During closed management in a nursing facility, the physical and mental health of family members of older adults with chronic co-morbidities is poorer than that of family members of non-chronic co-morbidities. And it can lead to a decline in physical and mental health of family members through increased perceived stress and intolerance of uncertainty.

【Objective】 To investigate the intrinsic relationship of social support and psychological capital with college students’ volunteer motivation in the post-epidemic era so as to provide theoretical basis for formulating policies and measures to increase college students’ participation in volunteer activities. 【Methods】 In March 2022, 1 120 college students from 15 universities in Henan Province were selected by convenient sampling method. Their general information, social support, psychological capital, and volunteer motivation were investigated, and univariate analysis, correlation analysis and intermediary effect analysis were performed. 【Results】 The differences of scores in six dimensions of volunteer motivation (i.e., values, understanding, enhancement, career, social interaction, and self-protection) were statistically significant (F=124.90, P<0.001). There were significant differences in social support level of college students of different genders (t=-2.40, P<0.05), and the difference in volunteer motivation level among different grades of college students was statistically significant (F=6.72, P<0.001). Social support, psychological capital, and volunteer motivation were positively correlated with one another (r=0.41, r=0.35, r=0.50, P<0.001). Part of the intermediary effect of psychological capital between social support and volunteer motivation was significant (intermediary effect value=0.49, 95% CI: 0.39-0.59). 【Conclusion】 Colleges and universities can take corresponding measures to improve college students’ volunteer motivation level by improving social support and psychological capital level.

Humans ; Computed Tomography Angiography ; Deep Learning ; Coronary Angiography ; Coronary Artery Disease ; Tomography, X-Ray Computed ; Coronary Stenosis/diagnosis* ; Retrospective Studies ; Fractional Flow Reserve, Myocardial ; Predictive Value of Tests