According to the principle and current domestic and international construction processes of core outcome set(COS) and the characteristics of post-stroke aphasia, this study built COS with evidence-based support for traditional Chinese medicine(TCM) treatment of post-stroke aphasia. Firstly, a comprehensive review was conducted on the articles about the TCM treatment of post-stroke aphasia that were published in the four major Chinese databases, three major English databases, and three clinical registration centers over the past five years. The articles were analyzed and summarized, on the basis of which the main part of the COS for clinical research on the TCM treatment of post-stroke aphasia was formed. Secondly, clinical doctors and related nursing personnel were interviewed, and important outcome indicators in the clinical diagnosis and treatment process were supplemented to form a pool of core outcome indicators. Two rounds of Delphi surveys were carried out to score the importance of the core outcome indicators in the pool. Finally, a consensus meeting of experts was held to establish the COS for clinical research on the TCM treatment of post-stroke aphasia. The final COS included a total of 268 studies [236 randomized controlled trials(RCTs), 21 Meta-analysis, and 11 clinical registration protocols] and 20 open questionnaire survey results. After two rounds of Delphi surveys, a total of 14 outcome indicators and their corresponding measurement tools were included in the expert consensus meeting. The final expert consensus meeting determined the COS for post-stroke aphasia, which included 9 indicator domains and 12 outcome indicators.
Humans ; Aphasia/therapy* ; Stroke/complications* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/therapeutic use* ; Treatment Outcome

Objective:To study the risk factors of thyroid nodules in patients with type 2 diabetes.Methods:Data of patients with type 2 diabetes with normal thyroid function admitted to the Department of Endocrinology of Heze Municipal Hospital from January to June 2024 were collected. Binary logistic regression was used to analyze the influencing factors of thyroid nodules in patients with type 2 diabetes, and the receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of each influencing factor.Results:Among 162 patients with type 2 diabetes, 96 had thyroid nodules, accounting for 59.3%. The incidence of thyroid nodules in women was significantly higher than that in men (χ 2 = 4.56, P = 0.034). Multivariate logistic regression analysis showed that age (≥50 years old), overweight and obesity [body mass index (BMI)≥24.0 kg/m 2], high glycated hemoglobin (≥10%), and high total cholesterol ( > 6.5 mmol/L) were independent risk factors for thyroid nodules in patients with type 2 diabetes ( OR = 1.83, 1.67, 1.08, 3.65, P < 0.05), and men was an independent protective factor ( OR = 0.63, P = 0.039). The ROC curve results showed that total cholesterol and total cholesterol combined with glycated hemoglobin could distinguish patients with thyroid nodules from those without thyroid nodules, with AUC = 0.64 and 0.68, respectively, and the differences were statistically significant ( P < 0.05). Conclusions:The incidence of thyroid nodules in patients with type 2 diabetes is relatively high. Age, overweight and obesity, high glycated hemoglobin, and high total cholesterol are independent risk factors for thyroid nodules in patients with type 2 diabetes, and total cholesterol has the ability to distinguish patients with thyroid nodules.

Radiation-induced heart disease(RIHD)is a severe complication in patients with thoracic cancer undergoing radiotherapy,with important impacts on long-term survival among cancer survivors.There is an urgent need to investigate the pathogenesis of RIHD and to develop effective therapeutic agents,and the establishment of high-quality RIHD animal models is pivotal to addressing these issues.This review summarizes the critical factors to consider in establishing RIHD animal models,including species selection,radiation type,dosage,fractionation,and target fields,and modeling timeline,along with the evaluation method and success criteria.We also consider the potential pathogenic mechanisms underlying RIHD,including DNA damage,oxidative stress,inflammatory responses,mitochondrial dysfunction,renin-angiotensin-aldosterone system activation,and myocardial fibrosis,as well as their interrelationships.These insights provide a comprehensive reference framework for constructing RIHD animal models and advancing mechanistic investigations into this condition.

Objective:To study the risk factors of thyroid nodules in patients with type 2 diabetes.Methods:Data of patients with type 2 diabetes with normal thyroid function admitted to the Department of Endocrinology of Heze Municipal Hospital from January to June 2024 were collected. Binary logistic regression was used to analyze the influencing factors of thyroid nodules in patients with type 2 diabetes, and the receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of each influencing factor.Results:Among 162 patients with type 2 diabetes, 96 had thyroid nodules, accounting for 59.3%. The incidence of thyroid nodules in women was significantly higher than that in men (χ 2 = 4.56, P = 0.034). Multivariate logistic regression analysis showed that age (≥50 years old), overweight and obesity [body mass index (BMI)≥24.0 kg/m 2], high glycated hemoglobin (≥10%), and high total cholesterol ( > 6.5 mmol/L) were independent risk factors for thyroid nodules in patients with type 2 diabetes ( OR = 1.83, 1.67, 1.08, 3.65, P < 0.05), and men was an independent protective factor ( OR = 0.63, P = 0.039). The ROC curve results showed that total cholesterol and total cholesterol combined with glycated hemoglobin could distinguish patients with thyroid nodules from those without thyroid nodules, with AUC = 0.64 and 0.68, respectively, and the differences were statistically significant ( P < 0.05). Conclusions:The incidence of thyroid nodules in patients with type 2 diabetes is relatively high. Age, overweight and obesity, high glycated hemoglobin, and high total cholesterol are independent risk factors for thyroid nodules in patients with type 2 diabetes, and total cholesterol has the ability to distinguish patients with thyroid nodules.

Radiation-induced heart disease(RIHD)is a severe complication in patients with thoracic cancer undergoing radiotherapy,with important impacts on long-term survival among cancer survivors.There is an urgent need to investigate the pathogenesis of RIHD and to develop effective therapeutic agents,and the establishment of high-quality RIHD animal models is pivotal to addressing these issues.This review summarizes the critical factors to consider in establishing RIHD animal models,including species selection,radiation type,dosage,fractionation,and target fields,and modeling timeline,along with the evaluation method and success criteria.We also consider the potential pathogenic mechanisms underlying RIHD,including DNA damage,oxidative stress,inflammatory responses,mitochondrial dysfunction,renin-angiotensin-aldosterone system activation,and myocardial fibrosis,as well as their interrelationships.These insights provide a comprehensive reference framework for constructing RIHD animal models and advancing mechanistic investigations into this condition.

Human brain banks use a standardized protocol to collect,process and store post-mortem human brains and related tissues,along with relevant clinical information,and to provide the tissue samples and data as a resource to foster neuroscience research according to a standardized operating protocols(SOP).Human brain bank serves as the foundation for neuroscience research and the diagnosis of neurological disorders,highlighting the crucial rule of ensuring the consistency of standardized quality for brain tissue samples.The first version of SOP in 2017 was published by the China Human Brain Bank Consortium.As members increases from different regions in China,a revised SOP was drafted by experts from the China Human Brain Bank Consortium to meet the growing demands for neuroscience research.The revised SOP places a strong emphasis on ethical standards,incorporates neuropathological evaluation of brain regions,and provides clarity on spinal cord sampling and pathological assessment.Notable enhancements in this updated version of the SOP include reinforced ethical guidelines,inclusion of matching controls in recruitment,and expansion of brain regions to be sampled for neuropathological evaluation.

Purpose To demonstrate the advantages of non-contrast-enhanced whole-heart coronary magnetic resonance angiography(NCE-CMRA)in evaluating coronary arteries by comparing ultrasonography(US),and to explore the clinical value of NCE-CMRA in the diagnosis of coronary artery lesions of Kawasaki disease(KD)in children.Materials and Methods NCE-CMRA and US imaging data of 41 children with KD from June 2017 to June 2021 who were diagnosed clinically in Lanzhou University Second Hospital were analyzed retrospectively.The display ability of US and NCE-CMRA in coronary arteries were compared.At the same time,the imaging characteristics of NCE-CMRA were analyzed,and the imaging characteristics such as the range and degree of coronary artery lesions displayed by NCE-CMRA were summarized.Results The overall segment display rate of NCE-CMRA in 41 children with KD was 75.6%;the overall segment display rate of US was 46.3%,with statistical difference between the two techniques(χ2=59.04,P<0.001).Regarding the display of the middle and distal segments of coronary arteries,NCE-CMRA had a clear imaging advantage over US(χ2=57.98 and 161.47,P<0.001).In all cases,25 patients(200 segments)had coronary artery lesions,and 94 segments of coronary artery showed different degrees of dilatation,including 8 segments(8.6%)of giant coronary artery aneurysm,35 segments(37.2%)of medium coronary artery aneurysm,and 51 segments(54.2%)of small coronary artery aneurysm or coronary artery dilation.Conclusion NCE-CMRA technology can objectively and accurately display coronary artery in children,and it can specifically evaluate the degree of damage caused by KD.It has important clinical significance in the diagnosis and evaluation of coronary artery lesions in children with KD.

Background The mental health status of prison officers is crucial to the efficiency, security, and stability of a prison, and it is essential to pay attention to the factors that influence their mental health. Objective To understand the mental health status of prison officers, and analyze how nature exposure affects their mental health problems and a potential mediating role of mental fatigue. Methods A cross-sectional survey was carried out from May to June 2022 among 1392 prison officers from eight prisons in a province, and a total of 1284 valid questionnaires were recovered. The Nature Exposure Scale, Mental Fatigue Scale, and Depression-Anxiety-Stress Scale were used to assess nature exposure, mental fatigue, and mental health indicators among prison officers, and to explore the effect of nature exposure on mental health problems and a potential mediating role of mental fatigue. Results The recruited prison officers showed high levels of depression, anxiety, and stress. The prevalence rates of depression, anxiety, and stress were 59.11% (759/1284), 60.67% (779/1284),and 43.93% (564/1284), respectively. The results of correlation analysis revealed that nature exposure was negatively related with mental fatigue and mental health indicators (depression, anxiety, and stress) (r_s=−0.242, −0.308, −0.235, −0.254, P<0.01), while mental fatigue was positively correlated with mental health indicators (depression, anxiety, and stress) (r_s=0.546, 0.533, 0.536, P<0.01). The PROCESS macro results showed that the level of nature exposure among prison officers negatively associated with depression, anxiety, and stress (β=−0.180, −0.104, −0.123), and mental fatigue played a mediating role, with indirect effects of −0.200, −0.192, and −0.199, respectively. Conclusion The levels of depression, anxiety, and stress of prison officers are higher than those of other occupations. Nature exposure negatively associates with depression, anxiety, and stress, that is, it may directly alleviate the mental health problems of prison officers; and it may also alleviate mental health problems by relieving mental fatigue.

Objective: Retrospective analysis of the efficacy and influencing factors of bladder preservation integrated therapy for unresectable invasive bladder cancer confined to the pelvis was done, also including the bladder function preservation and adverse effects analysis. Methods: Sixty-nine patients with unresectable locally invasive bladder cancer who received radiotherapy-based combination therapy from March 1999 to December 2021 at our hospital were selected. Among them, 42 patients received concurrent chemoradiotherapy, 32 underwent neoadjuvant chemotherapyand 43 with transurethral resection of bladder tumors (TURBT) prior to radiotherapy. The late adverse effect of radiotherapy, preservation of bladder function, replase and metastasis and survival were followed-up. Cox proportional hazards models were applied for the multifactorial analysis. Results: The median age was 69 years. There were 63 cases (91.3%) of uroepithelial carcinoma, 64 of stage Ⅲ and 4 of stage Ⅳ. The median duration of follow-up was 76 months. There were 7 grade 2 late genito urinary toxicities, 2 grade 2 gastrointestinal toxicities, no grade 3 or higher adverse events occurred. All patients maintained normal bladder function, except for 8 cases who lost bladder function due to uncontrolled tumor in the bladder. Seventeen cases recurred locally. There were 11 cases in the concurrent chemoradiotherapy group with a local recurrence rate of 26.2% (11/42) and 6 cases in the non-concurrent chemoradiotherapy group with a local recurrence rate of 22.2% (6/27), and the difference in local recurrence rate between the two groups was not statistically significant (P=0.709). There were 23 cases of distant metastasis (including 2 cases of local recurrence with distant metastasis), including 10 cases in the concurrent chemoradiotherapy group with a distant metastasis rate of 23.8% (10/42) and 13 cases in the non-concurrent chemoradiotherapy group with a distant metastasis rate of 48.1% (13/27), and the distant metastasis rate in the non-concurrent chemoradiotherapy group was higher than that in the concurrent chemoradiotherapy group (P=0.036). The median 5-year overall survival (OS) time was 59 months and the OS rate was 47.8%. The 5-year progression-free survival (PFS) time was 20 months and the PFS rate was 34.4%. The 5-year OS rates of concurrent and non-concurrent chemoradiotherapy group were 62.9% and 27.6% (P<0.001), and 5-year PFS rates were 45.4% and 20.0%, respectively (P=0.022). The 5-year OS rates of with or without neoadjuvant chemotherapy were 78.4% and 30.1% (P=0.002), and the 5-year PFS rates were 49.1% and 25.1% (P=0.087), respectively. The 5-year OS rates with or without TURBT before radiotherapy were 45.5% and 51.9% (P=0.233) and the 5-year PFS rates were 30.8% and 39.9% (P=0.198), respectively. Multivariate Cox regression analysis results showed that the clinical stage (HR=0.422, 95% CI: 0.205-0.869) was independent prognostic factor for PFS of invasive bladder cancer. The multivariate analysis showed that clinical stages (HR=0.278, 95% CI: 0.114-0.678), concurrent chemoradiotherapy (HR=0.391, 95% CI: 0.165-0.930), neoadjuvant chemotherapy (HR=0.188, 95% CI: 0.058-0.611), and recurrences (HR=10.855, 95% CI: 3.655-32.638) were independent prognostic factors for OS of invasive bladder cancer. Conclusion: Unresectable localized invasive bladder cancer can achieve satisfactory long-term outcomes with bladder-preserving combination therapy based on radiotherapy, most patients can retain normal bladder function with acceptable late adverse effects and improved survival particularly evident in patients with early, concurrent chemoradiotherapy and neoadjuvant chemotherapy.
Humans ; Aged ; Treatment Outcome ; Retrospective Studies ; Combined Modality Therapy ; Chemoradiotherapy/methods* ; Urinary Bladder Neoplasms/radiotherapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Neoplasm Staging

To develop a caregiver parenting behavior scale for children aged 2 to 6 years, and to verify its reliability and validity. This study recruited 1 350 caregivers of children aged 2 to 6 years. The item discrimination analysis and exploratory factor analysis were used to analyze the structure, dimensions and items of the scale. Homogeneity reliability, split-half reliability and test-retest reliability were used to analyze the reliability of the scale. Content validity and construct validity were used to analyze the validity of the scale. The results showed that the final scale contained 7 dimensions and 45 items. Cronbach's α coefficient of the total scale was 0.945; the coefficient of split half was 0.899; the test-retest reliability analysis showed that the correlation coefficients between the two tests were 0.893 (total score), 0.854 (social), 0.832 (language), 0.871 (gross motor), 0.893 (fine motor), 0.862 (cognitive), 0.832 (self-care), and 0.872 (sensory). The content validity analysis was carried out by two rounds of expert argumentation using Delphi expert consultation method. The Kendall coefficient of the items score in two rounds of Delphi expert consultation was 0.813 (P<0.01). The structure validity analysis showed that there were significant correlations between each dimension and the total scale, also between each dimension of the scale, and the extracted average variance values of each dimension was greater than the correlation coefficients between this dimension and other dimensions. In conclusion, the reliability and validity of the scale are qualified. It can be used as a tool to evaluate and guide the parenting behavior of caregivers of children aged 2 to 6 years.
Humans ; Child ; Caregivers/psychology* ; Reproducibility of Results ; Parenting ; Surveys and Questionnaires ; Factor Analysis, Statistical ; Psychometrics/methods*