Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning.Methods PubMed,Web of Science,Cochrane Library,Embase,CINAHL,Yimaitong,Wanfang Database,China National Know-ledge Network,VIP Database,and China Biomedical Literature Database were systematically searched.The search time limit is from database establishment to April 30,2024.Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened,and the"consensus based standards for the selection of health measurement instruments"was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools.The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion.Results A total of 14 articles were included,including 10 advance care planning readiness assessment tools suitable for the elderly.None of the articles reported cross-cultural validity,measurement error,and responsiveness.The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both"adequate",with A-level recommendations,and the remaining assessment tools were all B-level recommendations.Conclusion There are various types of advance care planning readiness assessment tools for the elderly,but the methodological quality needs to be improved and the measurement properties need to be further evaluated.It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.

Objective:To evaluate the safety and clinical efficacy of enteral nutrition (EN) initiated within 24 h after heart transplantation in pediatric patients.Methods:A retrospective cohort study was conducted. Clinical data from 16 pediatric heart transplant recipients at the Seventh Medical Center of the Chinese People′s Liberation Army General Hospital between October 2022 and October 2024 were collected, including demographics, anthropometric measurements, biochemical markers, cytokine levels, and clinical outcomes. Based on the timing of EN initiation, the patients were divided into EN-initiated within 24 h and EN-initiated after 24 h 2 groups. Demographic data, preoperative extracorporeal membrane oxygenation (ECMO) support, physical examination indicators, laboratory parameters, and cytokine levels were compared between groups using independent samples t-test, Mann-Whitney U test, Fisher′s exact probability test. Results:The cohort comprised 16 patients (10 males and 6 females) with an age of (12.5±1.9) years. The EN-initiated within 24 h group comprised 6 cases, and the EN-initiated after 24 h group comprised 10 cases. No significant difference was observed between the two groups in age, preoperative body mass index Z-score, preoperative ECMO support, physical examination indicators, laboratory parameters (total protein, albumin, hemoglobin), or cytokine levels (all P>0.05). Compared to the EN-initiated after 24 h group, the EN-initiated within 24 h group exhibited a shorter intensive care unit stay ( t=2.65, P<0.05) and shorter mechanical ventilation duration ( t=2.23, P<0.05) than EN-initiated after 24 h group. Total hospitalization length had no significant difference ( P>0.05). At 72 h post-transplant, the EN-initiated within 24 h group had a lower interleukin-12 P70 ( t=2.46, P<0.05) and interferon-γ levels ( t=2.55, P<0.05) than EN-initiated after 24 h group. Prior to discharge, the EN-initiated within 24 h group has a lower mean skinfold thickness ( t=2.49, P<0.05) and lower mid-upper arm circumference ( t=2.36, P<0.05) compared with the EN-initiated after 24 h group. Conclusions:Initiating EN within 24 h postoperatively is safe and feasible in pediatric heart transplant recipients. Early EN may shorten the length of intensive care unit stay and mechanical ventilation while attenuating postoperative release of inflammatory cytokine.

Objective To systematically evaluate the advance care planning readiness assessment tools applicable to the elderly and to provide a reliable assessment tool for the development of advance care planning.Methods PubMed,Web of Science,Cochrane Library,Embase,CINAHL,Yimaitong,Wanfang Database,China National Know-ledge Network,VIP Database,and China Biomedical Literature Database were systematically searched.The search time limit is from database establishment to April 30,2024.Pre-established medical care plan readiness assessment tools that meet the inclusion criteria were screened,and the"consensus based standards for the selection of health measurement instruments"was used to evaluate the methodological quality and measurement attributes of the inclusion assessment tools.The improved version of the evidence quality evaluation and recommendation strength grading method is used to grade the evidence of the assessment tool and form the final recommendation opinion.Results A total of 14 articles were included,including 10 advance care planning readiness assessment tools suitable for the elderly.None of the articles reported cross-cultural validity,measurement error,and responsiveness.The content validity and internal consistency of the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients were both"adequate",with A-level recommendations,and the remaining assessment tools were all B-level recommendations.Conclusion There are various types of advance care planning readiness assessment tools for the elderly,but the methodological quality needs to be improved and the measurement properties need to be further evaluated.It is temporarily recommended to use the Chinese Advance Care Planning Readiness Scale and the Advance Care Planning Readiness Scale for Chronic Disease Patients.

Objective:To evaluate the safety and clinical efficacy of enteral nutrition (EN) initiated within 24 h after heart transplantation in pediatric patients.Methods:A retrospective cohort study was conducted. Clinical data from 16 pediatric heart transplant recipients at the Seventh Medical Center of the Chinese People′s Liberation Army General Hospital between October 2022 and October 2024 were collected, including demographics, anthropometric measurements, biochemical markers, cytokine levels, and clinical outcomes. Based on the timing of EN initiation, the patients were divided into EN-initiated within 24 h and EN-initiated after 24 h 2 groups. Demographic data, preoperative extracorporeal membrane oxygenation (ECMO) support, physical examination indicators, laboratory parameters, and cytokine levels were compared between groups using independent samples t-test, Mann-Whitney U test, Fisher′s exact probability test. Results:The cohort comprised 16 patients (10 males and 6 females) with an age of (12.5±1.9) years. The EN-initiated within 24 h group comprised 6 cases, and the EN-initiated after 24 h group comprised 10 cases. No significant difference was observed between the two groups in age, preoperative body mass index Z-score, preoperative ECMO support, physical examination indicators, laboratory parameters (total protein, albumin, hemoglobin), or cytokine levels (all P>0.05). Compared to the EN-initiated after 24 h group, the EN-initiated within 24 h group exhibited a shorter intensive care unit stay ( t=2.65, P<0.05) and shorter mechanical ventilation duration ( t=2.23, P<0.05) than EN-initiated after 24 h group. Total hospitalization length had no significant difference ( P>0.05). At 72 h post-transplant, the EN-initiated within 24 h group had a lower interleukin-12 P70 ( t=2.46, P<0.05) and interferon-γ levels ( t=2.55, P<0.05) than EN-initiated after 24 h group. Prior to discharge, the EN-initiated within 24 h group has a lower mean skinfold thickness ( t=2.49, P<0.05) and lower mid-upper arm circumference ( t=2.36, P<0.05) compared with the EN-initiated after 24 h group. Conclusions:Initiating EN within 24 h postoperatively is safe and feasible in pediatric heart transplant recipients. Early EN may shorten the length of intensive care unit stay and mechanical ventilation while attenuating postoperative release of inflammatory cytokine.

Objective:To investigate the clinical value of spherical lens with 0.05 D intervals in optometry for small incision lenticule extraction (SMILE) in myopic eyes.Methods:A randomized controlled clinical study was conducted.Sixty patients (120 eyes) with low to moderate myopia and myopic astigmatism who underwent SMILE in the 989th Hospital of the PLA from June 2021 to February 2022 were enrolled.The patients were randomly divided into 0.05 D interval group (optometry with spherical lens at 0.05 D interval) and 0.25 D interval group (optometry with spherical lens at 0.25 D interval), with 30 cases (60 eyes) in each group.There was no significant difference in matched age, sphericity, cylindricity, and best corrected visual acuity (BCVA) (all at P>0.05). The preoperative monocular red-green balance, 1- and 3-month postoperative monocular red-green balance, uncorrected visual acuity and spherical equivalent of both groups were compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the 989th Hospital of the PLA (No.WZLL-2021-034). Written informed consent was obtained from each subject before any medical examination. Results:The preoperative red-green balance rate in 0.05 D interval group was 95.00%(57/60), which was higher than 35.00%(21/60) in 0.25 D interval group, showing a statistically significant difference ( Wald χ2=17.642, P<0.001). The 1- and 3-month postoperative red-green balance rates in 0.05 D interval group were 63.33%(38/60) and 56.67%(34/60), which were higher than 23.33%(14/60) and 21.67%(13/60) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=9.137, P=0.003; Wald χ2=7.483, P=0.006). The 1- and 3-month postoperative visual acuity in 0.05 D interval group were -0.1(-0.1, -0.1) and -0.1(-0.1, -0.1), which were higher than 0.0(-0.1, 0.0) and -0.1(-0.1, 0.0) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=11.624, P=0.001; Wald χ2=12.841, P<0.001). The 1- and 3-month postoperative spherical equivalent were -0.07(-0.25, 0.13)D and -0.13(-0.25, 0.13)D in 0.05 D interval group, which were higher than -0.13(-0.38, 0.25)D and -0.13(-0.38, 0.25)D in 0.25 D interval group respectively, showing no statistically significant difference between the two groups ( Wald χ2=0.029, P=0.866; Wald χ2=0.189, P=0.664). Conclusions:Compared with spherical lens at 0.25 D interval, 0.05 D interval can improve the accuracy of preoperative and postoperative red-green balance rate and postoperative visual acuity in patients with low to moderate myopia who undergo SMILE.

This study aims to develop a method to detect bovine multi-cytokines based on flow cytometry. Previously we have prepared and screened monoclonal antibodies against bovine cytokines IFN-γ, IL-2, TNF-α, IP-10 and MCP-1. These bovine cytokine monoclonal antibodies were fluorescently labeled, and the combination of antibody and cell surface molecules were used to develop the method for detecting bovine multi-cytokines. Subsequently, the developed method was used to determine the cytokine expression profile of Mycobacterium bovis BCG infected bovine peripheral blood mononuclear cells in vitro, and evaluate the cytokine expression level of peripheral blood CD4⁺ T cells of tuberculosis-positive cattle. The bovine multi-cytokine flow cytometry detection method can effectively determine the cytokine expression of BCG-infected bovine peripheral blood T lymphocytes. Among them, the expression levels of IFN-γ, IL-2, and TNF-α continue to increase after 40 hours of infection, while the expression levels of IP-10 and MCP-1 decreased. The combined detection of IFN-γ, IL-2, and TNF-α on CD4⁺ T lymphocytes in peripheral blood of cattle can effectively distinguish tuberculosis-positive and tuberculosis-negative samples. This method may facilitate evaluating the level of cellular immune response after bovine pathogen infection and vaccine injection.
Cattle ; Animals ; Cytokines ; BCG Vaccine/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Interleukin-2 ; Flow Cytometry/methods* ; Chemokine CXCL10/metabolism* ; Leukocytes, Mononuclear ; CD4-Positive T-Lymphocytes/metabolism* ; Tuberculosis ; Antibodies, Monoclonal/metabolism*

Objective:To explore the influence of social support and depression on the infirmity of the elderly in the community.Methods:From September to October 2020, convenience sampling was used to select 489 community elderly people from 4 communities in Junshan Street, Wuhan Economic and Technological Development Zone as the research object. The self-designed General Information Questionnaire, Fried Frailty Phenotype, 30-Item Geriatric Depression Scale (GDS-30) and Social Support Rating Scale (SSRS) were used to investigate the elderly. Logistic regression was used to analyze the relationship among depression, social support, and frailty.Results:A total of 489 questionnaires were distributed, 470 valid questionnaires were recovered, and the valid recovery rate was 96.1%. The incidences of pre-frailty and frailty among the elderly in the community were 35.3% (166/470) and 6.6% (31/470) , respectively. The incidence of depression was 14.0% (66/470) . Logistic regression analysis showed that social support and depression were the influencing factors of frailty in the elderly ( P<0.05) . Conclusions:Social support and depression are the influencing factors of the elderly in the community.

Angiosarcoma is a rare malignant tumor of soft tissue in adults. However, tumor ulcers caused by foot angiosarcoma are rarely reported in the literature. This paper outlines a case of foot angiosarcoma misdiagnosed as diabetic foot ulcer. It was treated as diabetic foot ulcer in other hospitals without notable improvement. In consideration of its special clinical characteristics and treatment process, pathological biopsy was performed after admission, and angiosarcoma was confirmed. The purpose of this article is to emphasize that foot angiosarcoma or other tumor ulcers in diabetes patients are easily misdiagnosed as diabetic foot ulcers. If there is no obvious improvement in treatment, pathological tissue biopsy should be performed as early as possible.

Biomimetic nanoengineering presents great potential in biomedical research by integrating cell membrane (CM) with functional nanoparticles. However, preparation of CM biomimetic nanomaterials for custom applications that can avoid the aggregation of nanocarriers while maintaining the biological activity of CM remains a challenge. Herein, a high-performance CM biomimetic graphene nanodecoy was fabricated via purposeful surface engineering, where polyethylene glycol (PEG) was used to modifying magnetic graphene oxide (MGO) to improve its stability in physiological solution, so as to improve the screening efficiency to active components of traditional Chinese medicine (TCM). With this strategy, the constructed PEGylated MGO (PMGO) could keep stable at least 10 days, thus improving the CM coating efficiency. Meanwhile, by taking advantage of the inherent ability of HeLa cell membrane (HM) to interact with specific ligands, HM-camouflaged PMGO showed satisfied adsorption capacity (116.2 mg/g) and selectivity. Finally, three potential active components, byakangelicol, imperatorin, and isoimperatorin, were screened from Angelica dahurica, whose potential antiproliferative activity were further validated by pharmacological studies. These results demonstrated that the purposeful surface engineering is a promising strategy for the design of efficient CM biomimetic nanomaterials, which will promote the development of active components screening in TCM.

Objective:To explore the effect of rhythm activation exercise on loneliness and physical activity ability of empty nest elderly.Methods:Using the convenient sampling method, a total of 90 empty nest elderly who were admitted to the elderly unaccompanied ward of the First People's Hospital of Hefei from January to June 2019 were selected as the research objects. They were randomly divided into the control group, the observation group 1 and the observation group 2, with 30 cases in every group. The patients in the control group took conventional nursing methods, the observation group 1 performed rehabilitation exercises, while the observation group 2 performed rhythm activation exercises under the guidance of nurses. After the intervention for 12 weeks, the differences in Barthel Index Scale, the short form of UCLA Lone lines scale (ULS-8) and the range of motion of each joint of limb movement were compared among the three groups.Results:After the intervention, the total score of Barthel index of the observation group 2 was (68.66±6.00) , which was higher than (58.00±8.16) of the control group and (60.00±6.64) of the observation group 1, and the differences were statistically significant ( P<0.05) . The total score of loneliness of the observation group 2 was (20.06±1.93) , which was lower than (27.11±1.77) of the control group and (26.32±1.74) of the observation group 1, and the differences were statistically significant ( P<0.05) . The scores of all dimensions of limb motor activity in observation group 2 were higher than those in the control group and the observation group 1, and the differences were statistically significant ( P<0.01) . Conclusions:Rhythm activation exercise can well improve the loneliness of empty-nest elderly, improve their self-care ability and improve physical mobility of the elderly to a certain extent.