Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease(COPD)in disease self-control and to inform clinical nursing practice.Methods From March to May 2024,a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City,China,and the data were analyzed using the Colaizzi 7-step analysis method.Results Totally 3 themes and 9 sub-themes were extracted,namely self-control challenges due to cognitive deficits(lack of knowledge leads to ambiguous control direction;cognitive bias hinders control strategy formulation;negative perception leads to control avoidance),weakening trend of self-control behaviors(decision-making conflicts between immediate indulgence and delayed gratification;lack of reinforcement mechanisms leads to psycho-emotional depletion;external temptations lead the self to imitate bad behavior),urgent need for multiple supports to help with self-control(the desire for continuity and stability of family support,the need for professionalism and accuracy of healthcare guidance,and the expectation for rationality and matching of resource allocation).Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control,help them effectively deal with the challenges of disease self-control,strengthen self-control behaviors,and satisfy their diversified needs by strengthening the support of families,professionals,and the community to improve poor outcomes and reduce the cost of healthcare services.

Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease(COPD)in disease self-control and to inform clinical nursing practice.Methods From March to May 2024,a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City,China,and the data were analyzed using the Colaizzi 7-step analysis method.Results Totally 3 themes and 9 sub-themes were extracted,namely self-control challenges due to cognitive deficits(lack of knowledge leads to ambiguous control direction;cognitive bias hinders control strategy formulation;negative perception leads to control avoidance),weakening trend of self-control behaviors(decision-making conflicts between immediate indulgence and delayed gratification;lack of reinforcement mechanisms leads to psycho-emotional depletion;external temptations lead the self to imitate bad behavior),urgent need for multiple supports to help with self-control(the desire for continuity and stability of family support,the need for professionalism and accuracy of healthcare guidance,and the expectation for rationality and matching of resource allocation).Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control,help them effectively deal with the challenges of disease self-control,strengthen self-control behaviors,and satisfy their diversified needs by strengthening the support of families,professionals,and the community to improve poor outcomes and reduce the cost of healthcare services.

Metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) is a well-established oncogenic long non-coding RNA, the higher expression of which is strongly correlated with cancer events such as tumorigenesis, progression, metastasis, drug resistance, and treatment outcome in solid cancers. Recently, a series of studies has highlighted its potential role in hematological malignancies in terms of these events. Similar to solid cancers, MALAT1 can regulate various target genes via sponging and epigenetic mechanisms, but the miRNAs sponged by MALAT1 differ from those identified in solid cancers. In this review, we systematically describe the role and underlying mechanisms of MALAT1 in multiple types of hematological malignancies, including regulation of cell proliferation, metastasis, stress response, and glycolysis. Clinically, MALAT1 expression is related to poor treatment outcome and drug resistance, therefore exhibiting potential prognostic value in multiple myeloma, lymphoma, and leukemia. Finally, we discuss the evaluation of MALAT1 as a novel therapeutic target against cancer in preclinical studies.

Objective:To summarize evidence for physical activity management in cancer patients based on the Joanna Briggs Institute (JBI) approach for evidence synthesis in health care, providing a scientific basis for the clinical standardization of physical activity management in cancer patients.Methods:Literature was searched according to the "6S" pyramid model of evidence, using BMJ Best Practice, UpToDate, JBI Evidence-Based Practice Database, Cochrane Library, global guideline websites, professional cancer association websites, and relevant Chinese and English databases for all evidence regarding physical activity in cancer patients. The search covered the period from February 13, 2018, to February 13, 2023. Guided by the JBI approach for evidence synthesis, two researchers independently evaluated the quality of the literature and extracted relevant evidence in accordance with clinical scenarios.Results:Thirty articles were included, comprising two guidelines, three expert consensuses, one evidence summary, 21 systematic reviews, and three randomized controlled trials. A total of 29 best evidence points were summarized in six aspects: benefits of physical activity, physically active people, pre-activity assessment, implementation of physical activity programs, safety monitoring of physical activity, and ongoing support strategies.Conclusions:This study supplements and updates 15 pieces of evidence based on existing evidence, ultimately forming a best evidence summary for the management of physical activity in cancer patients, providing evidence-based support for clinical management. Most evidence comes from international studies. It is recommended that Chinese researchers consider the activity ability and willingness of cancer patients when applying these findings in future research, and consider the specific clinical context, or conduct foundational research to further validate the evidence, to comprehensively improve the quality of life of cancer patients.

Objective:To identify the value of ultrasound radiomic features extracted from the bladder wall at tumor base in predicting myometrial invasion of bladder cancer.Methods:A total of 175 cases with bladder cancer confirmed by pathology from January 2017 to February 2022 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. They were divided into training set and testing set in a ratio of 7∶3. The MaZda texture analysis software was used to draw the region of interest (ROI) of the bladder wall and the tumor region for extracting texture features. The minimum absolute reduction and variable selection operator (LASSO) regression and 10-fold cross-validation were used to screen the features of training set for establishing the models. And the ROC curve was used to evaluate the efficiency of the models.Results:A total of 279 texture features were extracted from the ROI of the bladder wall and the tumor region, and 5 texture features were screened out for constructing omics scoring models by LASSO regression and 10-fold cross-test. The area under ROC curve (AUC)s used in training set and testing set of the bladder wall were 0.921 and 0.856, while the AUCs applied in training set and testing set of the tumor region were 0.849 and 0.704. Both in the training set and test set, the AUCs of the model of the bladder wall were higher than those of the model of the tumor region (all P<0.05). Conclusions:The omics scoring model based on the texture features of the bladder wall at tumor base can effectively identify muscle-invasive bladder cancer(MIBC) and non-muscle-invasive bladder cancer(NMIBC), and has better performance than the model based on the texture feature of the tumor region.

Objective:To explore the effect of probiotics Lactiplantibacillus plantarum(LP) WCFS1 by gavage on acute necrotizing pancreatitis (ANP) and associated ileum injury in mice. Methods:Twenty-four healthy male mice were gavaged with broad-spectrum antibiotics for 3 weeks to establish microbiota-depleted mice, and then randomly divided into control group (CON), ANP model group (ANP), LP gavage group (LP) and LP gavage and ANP induced group (LP+ ANP) , with 6 mice in each group. Mice in LP and LP+ ANP group were treated by gavage of LP (1×10 9 CFU/ml, 0.2 ml/day per mouse) for 1 week, while CON and ANP were gavaged with sterile phosphate buffered saline for 1 week instead. The ANP model was induced by intraperitoneal injection with caerulein (100 μg/kg) for 10 times with 1-hour interval between two injections and the 10th injection with lipopolysaccharide(LPS) 5 mg/kg intraperitoneally, and the mice were sacrificed 2 h later. Levels of LP in stool and ileal mucosa were detected by real-time PCR; the pancreas and ileum were collected for pathological examination to observe the extent of tissue inflammation and to score the pathology. Serum amylase activities were determined by enzymatic kinetic chemistry; serum inflammators levels and intestinal permeability were detected by ELISA; levels of inflammators in pancreatic and ileal tissues were detected by real-time PCR; ileal tight-junction proteins (occludin, claudin-1 and ZO-1) were measured by immunofluorescence staining. Results:LP levels in the stool and ileal mucosa of mice were significantly increased after LP gavage, and the differences were statistically significant (913.30±39.12 vs 2.39±1.39, 23.11±0.50 vs 1.38±0.28, all P value <0.05). The pathological scores of pancreatic tissue of CON, LP, ANP and LP+ ANP group were (0.26±0.41), (0.17±0.26), (8.55±0.46) and (6.30±0.45); the serum amylase activities were (219.70±19.73), (217.60±11.30), (2896.24±98.32) and (1837.13±131.60)U/L, IL-1β were (0.87±0.28), (1.4±0.85), (67.41±6.45) and (36.33±5.65)pg/ml, IL-6 were (0.74±0.27), (0.16±0.16), (280586.12±39163.92) and (107912.75±31283.47)pg/ml, IL-10 were (35.52±5.27), (50.99±15.34), (2008.45±184.83) and (3070.35±403.71)pg/ml; the expression level of pancreatic IL-1β mRNA was 1.42±0.39, 0.95±25, 20.53±0.50 and 10.69±1.01, IL-6 mRNA was 1.31±0.44, 0.93±0.023, 21.97±1.71 and 11.54±1.75, IL-10 mRNA was 0.93±0.14, 0.75±0.15, 0.99±0.21 and 1.76±0.19; there was no significant difference between LP and CON group, and pancreatic pathological scores, serum amylase、IL-1β and IL-6 levels, and the expression level of pancreatic IL-1β and IL-6 mRNA were significantly decreased in LP+ ANP group compared with those in ANP group, while serum IL-10 levels and the expression level of pancreatic IL-10 mRNA were significantly increased compared with ANP group, and all the differences were statistically significant (all P values <0.05). The pathological scores of ileal tissue of CON, LP, ANP and LP+ ANP group were 0, 0, (3.17±0.41) and (1.67±0.52); the levels of serum DAO of CON, LP, ANP and LP+ ANP group were (0.03±0.03), (0.02±0.02), (0.50±0.05) and (0.49±0.06)ng/ml; LPS levels were (2.75±0.35), (3.74±0.28), (7.19±0.92) and (5.88±0.38)ng/ml; the expression level of ileal IL-1β mRNA was 1.21±0.20, 1.17±0.09, 1.81±0.25 and 1.63±0.21; IL-6 mRNA was 1.01±0.29, 2.83±0.42, 54.45±8.50 and 16.87±4.42; IL-10 mRNA was 1.12±0.41, 6.09±2.51, 11.65±1.47 and 29.86±2.93. There was no significant difference between LP and CON group, except that the ileal IL-10 mRNA expression was significantly higher than that of CON group. Ileal pathological scores, serum LPS levels and the expression level of ileal IL-6 mRNA were significantly lower in LP+ ANP group than those in ANP group, while the expression level of ileal IL-10 mRNA was significantly higher than that of ANP group; the expression of ileal tight junction proteins (ocludin, claudin-1, ZO-1) was significantly higher than those in ANP group, and all the differences were statistically significant (all P values <0.05). Conclusions:LP WCFS1 gavage could ameliorate the injury of pancreatic and ileal barrier in caerulein-induced ANP mice.

Objective:To explore the early prognosis on patient of idiopathic pulmonary fibrosis (IPF) combined with different degrees of pulmonary arterial hypertension (PAH) undertake lung transplantation (LTx).Methods:From January 2017 to December 2020, the clinical data of 134 patients with IPF who underwent LTx in Wuxi People's Hospital were analyzed retrospectively. According to the average pulmonary artery pressure detected by right cardiac catheter before operation, the patients were divided into mild PAH group (63 cases), moderate PAH group (47 cases) and severe PAH group (24 cases). The donor data and the recipient's preoperative, intraoperative and postoperative data were collected; the postoperative survival curve to analyze early survival among the three patient groups.Results:With the increase of pulmonary artery pressure, the rate of abnormal right ventricular function increased, the end diastolic diameter of left ventricle decreased before operation, and the rate of using veno-arterial extracorporeal membrane oxygenation (V-A ECMO) increased during the surgery ( P<0.05). Multivariate analysis found that combined severe PAH had significant effects on primary graft dysfunction (Primary graft dysfunction, PGD), retracheal intubation or tracheotomy, hypovolemic shock within 72 h, and 6-month survival after LTx. The survival surve showed that 30-day survival rates of patients with IPF complicated with mild, moderate and severe PAH were 85.7%, 80.8% and 66.7% respectively, and the 6-month survival rates were 80.9%, 74.0% and 62.2%, respectively. Conclusion:Patient of IPF combined with different degrees of PAH had a significant impact on cardiac function and intraoperative ECMO selection of LTx, and severe PAH could significantly reduce the early survival rate after LTx.

Objective: To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients. Methods: A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge). Results: The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01). Conclusion The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.

Objective To investigate the design,incisional method and clinical experiences of using the mi cro-dissected polyfoliate anterolateral thigh perforator flap to repair of complex soft tissue defect in extremities.Methods From June,2017 to September,2018,12 cases of different kinds of complex soft tissue defect in extremities were repaired by micro-dissected free polyfoliate anterolateral thigh perforator flap.Each flap was divided into two cutaneous perforators to give two separate flap with a common vascular supply.The flaps were cut from the superficial layer of the deep cervical fesciae and without fascia lata.The donor sites were treated by subcutaneous cosmetic suture.Patients were followed-up by outpatient service,telephone and WeChat video to observe and record the flap's appearance,sensory recovery,extremities function and the scars of the donor site to evaluate its clinical efficacy.Results All flaps survived without vascular crisis happened except one-leaf necrosis occurred,which healed with local flap transferring.The donor sites remained linear scars.The mean flap thickness of this group after micro-dissection was (4.5±0.5) mm.All the patients were followed-up for 5-15 months.The 2 point discrimination ranged between 0.5-2.0 cm.Sensory restoration ranking was S3-S3+.The range of montion of wrist joint was 65°-90°,and that of ankle joint was 40°-60°.Conclusion The micro-dissected polyfoliate anterolateral thigh perforator flap is an ideal method for complex and irregular multiple sites soft tissue defect in extremities as it can keep good economic benefit and minimal damage to the donor site.

Objective To study the clinical characteristics of outpatients with hand,foot and mouth disease (HFMD) caused by different serotypes of enteroviruses.Methods This was a prospective study.From February 2017 to March 2018,563 outpatients with HFMD were enrolled by systematic sampling in the Department of Infectious Diseases,Henan Children's Hospital.Throat swabs were collected to determine the serotypes via PCR.Demographic,clinical,and laboratory data were collected by standard questionnaire.All cases were followed up twice at 2 and 9 weeks after the initial outpatient visit through telephone interview.A total of 563 cases were enrolled and 555 (98.6％) cases were positive for human enteroviruses,including 338 (60.9％) males.Analyses were stratified by enterovirus serotypes,Chi square test or Fisher's exact test,Rank sum test was used for comparison among different groups.Results The age of 555 cases was 24.2 (16.4,41.3) months.Among them 44.0％ (224 cases) were identified as coxsackievirus (CV)-A6,while 189 cases,35 cases,14 cases and 73 cases were identified as CV-A16,enterovirus (EV)-A71,CV-A10 and other serotypes,respectively.Fever (≥37.5 ℃C) was present in 51.4％(285/555) of laboratory confirmed cases.The proportions of fever in cases of CV-A6 (68.9％(168/244)) and CV-A10 (12/14) were significantly higher than those in cases of CV-A16 (31.7％(60/189),x2=57.344,14.313,both P=0.000),other serotypes (43.8％(32/73),x2=15.101 and 8.242,P=0.000 and 0.004) and EV-A71 (37.1％(13/35),x2=13.506 and 9.441,P=0.000 and 0.002) respectively.There was no significant difference between CV-A6 and CV-A10 in presentation of fever (x2=1.785,P=0.182).There were 359 cases (64.7％) with eruptions in mouth,hands,feet and buttocks.Cases infected with EV-A71 had the highest proportions (74.3％(26/35)) of rash emerging simultaneously in mouth,hands,feet,and buttocks.The proportion in cases of CV-A 16,CV-A6,CVA 10 and other serotype were 73.5％ (139/189),61.9％ (151/244),7/14 and 49.3％ (36/73),respectively.The proportion of rash on other parts of body,such as face,limbs or torso in cases infected with CV-A6 (16.8％ (41/244)) was the higherest and the proportion in cases of CV-A16,EV-A71,CV-A10 or other serotypes were 8.5％(16/189),5.7％(2/35),1/14,6.8％(5/73),respectively.None of these cases developed serious complications.Desquamation occurred in 45.5％ (179/393) cases 7.5 (5.0,9.0) days after disease onset and 13.5％ (53/393) cases showed onychomadesis 31.0 (18.0,33.5) days after disease onset.The proportion of desquamation and onychomadesis associated with CV-A6 (64.2％ (95/148) and 31.8％ (47/148)) was significantly higher than CV-A16 (31.8％ (49/154) and 1.3％ (2/154),x2=33.601 and 52.482,both P=0.000) and other serotypes (38.0％(19/50) and 6.0％(3/50),x2=10.236 and 12.988,P=0.001 and 0.000).Desquamation appeared more in cases of CV-A6 than in cases of CV-A10 (2/11,x2=9.386,P=0.002),with the proportion of onychomadesis higher in CV-A6 than in EV-A71 (3.3％ (1/30),x2=11.088,P=0.001).Conclusion Clinical manifestation such as fever,rash emerging parts,desquamation and onychomadesis are different among outpatient HFMD cases infected with CV-A16,CV-A6,EV-A71,CV-A10 and other enteroviruses.