Objective To systematically evaluate and integrate qualitative studies on perception of exercise behaviors in community-dwelling older adults with frailty,and to provide references for clinical development of targeted exercise intervention strategies.Methods A systematic search of PubMed,Medline,Embase,PsycINFO,the Cochrane Library,SinoMed,Wanfang Database,CNKI,and VIP Database for qualitative studies on perception of exercise behaviors in older adults with frailty in the community was conducted from the inception of the databases to June 2024.Literature quality was evaluated using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016 edition),and Meta-synthesis was performed using the theme synthesis method.Results A total of 10 papers were included,grouped into 10 categories and integrated into the 3 domains of the capability,opportunity,and motivation-behavior model(COM-B model),i.e.Preparation for exercise behavior is influenced by capability factors(physical reserve,knowledge reserve,psychological preparation);stage-specific motivational evolution promotes the internalization of exercise behavior(guiding,focusing,stimulating,and maintaining);external conditions provide opportunities for exercise behavior(individual interaction,community environment,and social support).Conclusion Perceptions of exercise behavior among community-dwelling older adults with frailty or are complex and influenced by a variety of factors.Future exercise intervention strategies should consider modifiable factors,enhance knowledge education,stimulate intrinsic motivation,and solidify external conditions,while also accommodating individual differences and preferences,so as to promote exercise participation and health enhancement in this group.

Objective To systematically evaluate and integrate qualitative studies on perception of exercise behaviors in community-dwelling older adults with frailty,and to provide references for clinical development of targeted exercise intervention strategies.Methods A systematic search of PubMed,Medline,Embase,PsycINFO,the Cochrane Library,SinoMed,Wanfang Database,CNKI,and VIP Database for qualitative studies on perception of exercise behaviors in older adults with frailty in the community was conducted from the inception of the databases to June 2024.Literature quality was evaluated using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016 edition),and Meta-synthesis was performed using the theme synthesis method.Results A total of 10 papers were included,grouped into 10 categories and integrated into the 3 domains of the capability,opportunity,and motivation-behavior model(COM-B model),i.e.Preparation for exercise behavior is influenced by capability factors(physical reserve,knowledge reserve,psychological preparation);stage-specific motivational evolution promotes the internalization of exercise behavior(guiding,focusing,stimulating,and maintaining);external conditions provide opportunities for exercise behavior(individual interaction,community environment,and social support).Conclusion Perceptions of exercise behavior among community-dwelling older adults with frailty or are complex and influenced by a variety of factors.Future exercise intervention strategies should consider modifiable factors,enhance knowledge education,stimulate intrinsic motivation,and solidify external conditions,while also accommodating individual differences and preferences,so as to promote exercise participation and health enhancement in this group.

Objective:To construct an evaluation index system for nursing teaching case base, so as to guide the construction of the nursing teaching case base, and provide a basis for evaluating the quality of the case base.Methods:From April to August 2020, the evaluation index system for nursing teaching case base was initially constructed through the integration of literature retrieval and semi-structured interview results, and based on the Donabedian model. A total of 17 experts were selected as the consultation subjects using the Delphi method. After 2 rounds of consultations, expert opinions tended to be unanimous to construct the evaluation index system for nursing teaching case base.Results:In the second round of consultation, the expert authority coefficient was 0.872, and the expert positive coefficient was 94.12% (16/17) , and the kendall's W was 0.115 with a statistical difference ( P<0.05) . Finally, the evaluation index system for nursing teaching case base included 3 first-level indicators, 8 second-level indicators, and 29 third-level indicators. Conclusions:The evaluation index system of nursing teaching case base based on the Donabedian model is scientific and credible, which can provide a basis for the evaluation of nursing teaching case base.

Objective: To investigate the levels of urinary exosomal miR-194-5p in children with idiopathic nephrotic syndrome (INS) and its clinical value as a non-invasive auxiliary diagnostic marker. Methods: Urine samples were collected from 101 INS children and 98 sex- and age-matched healthy children, and the levels of urinary exosomal miR-194-5p were determined by quantitative real-time polymerase chain reaction (qRT-PCR). The clinical value of urinary exosomal miR-194-5p in the diagnosis of children′s INS was evaluated by the ROC curve and correlation analysis. Results: The levels of urinary exosomal miR-194-5p in INS children (2.420 [0.650,9.515] fmol/L) were significantly higher than that in healthy controls (0.360 [0.220,0.653] fmol/L, U=1 552, P＜0.01). Compared with the INS children before treatment, the levels of urinary exosomal miR-194-5p in clinical remission period decreased significantly (0.320 [0.145,0.523] fmol/L vs 0.975 [0.375,4.358] fmol/L, W=708, P＜0.01). Moreover, the levels of miR-194-5p in INS children with heavy urine protein (8.430 [7.225,13.070] fmol/L) were significantly higher than that with light urine protein (2.130 [1.180,3.090] fmol/L, U=0, P＜0.01). The area under the ROC curve (AUC ROC ) of miR-194-5p was 0.843 (95%CI: 0.789-0.897) for the diagnosis of INS children. Spearman correlation analysis showed that the levels of urinary exosomal miR-194-5p in INS children were negatively correlated with serum albumin levels (r=-0.300), and were positively correlated with serum total cholesterol levels (r=0.278) and 24-hour urine protein content (r=0.296, all P＜0.01). Conclusion The levels of urinary exosomal miR-194-5p in INS children increase obviously, and are closely associated with 24-hour urine protein, serum albumin and total cholesterol levels, indicating that urinary exosomal miR-194-5p may be serve as a new non-invasive fluid biopsy molecular marker for the auxiliary diagnosis of INS in children.

Objective To evaluate the safety of pirfenidone in treatment of idiopathic pulmonary fibrosis( IPF). Methods PubMed,the Cochrane library,EMbase,CNKI,and WanFang database were searched using the keywords pirfenidone,idiopathic pulmonary fibrosis,and IPF from January 1999 to January 2015. Randomized controlled trials( RCTs)of pirfenidone in treatment of IPF were selected. The patients in the trial group were given pirfenidone alone while the patients in the control group were given oral placebo. The primary end point event of the outcome was the incidence of pirfenidone′s adverse events. The Meta-analysis was performed using RevMan 5. 2. Results A total of 4 articles including 5 RCTs were enrolled. There were 945 patients in the trial group and 766 patients in the control group. The incidents of many kinds of adverse events in the trial group were markedly higher than those in the control group, including gastrointestinal discomfort[12. 6%(101/804)vs. 5. 2%(40/766),RR = 2. 31,95% CI:63-3. 29,P< 0. 01],nausea[34. 6%(241/695)vs. 15. 0%(99/659),RR = 2. 373,95% CI:1. 92-2. 92,P< 0. 01]and vomiting[13. 3%(83/623)vs. 6. 3%(39/624),RR= 2. 13,95% CI:1. 48-3. 06,P< 0. 01],diarrhea[25. 8%(161/623)vs. 20. 4%(127/624),RR= 1. 27,95% CI:1. 03-1. 56,P=0. 02],anorexia[15. 2%(122/804)vs. 4. 7%(36/766),RR= 3. 10,95% CI:2. 16-4. 46,P<0. 01],abnormal liver function[6. 0%(49/804)vs. 1. 7%(13/766),RR= 2. 48,95% CI:1. 46-4. 23,P<0. 01],rash[30. 4%(189/623)vs. 10. 3%(64/624),RR= 2. 95,95% CI:2. 27-3. 83,P<0. 01],photosensitivity reaction[24. 7%(129/526)vs. 6. 1%(30/489),RR= 5. 54,95%CI:1. 78-17. 30,P<0. 01],insomnia[10. 4%(65/623)vs. 6. 6%(41/624),RR=1. 59,95% CI:1. 09-2. 31,P= 0. 02],dizziness[16. 4%(120/732)vs. 9. 8%(72/731),RR=1. 67,95% CI:1. 27-2. 19,P<0. 01],fatigue[25. 6%(178/695)vs. 16. 3%(108/659),RR = 1. 60,95% CI:1. 29-1. 98,P< 0. 01],and weight loss[10. 1%(63/623)vs. 5. 4%(34/624),RR= 1. 85,95% CI:1. 24-2. 77,P = 0. 03]. However,there was no statistically significant difference in treatment-related serious events[26. 5%(165/623)vs. 26. 4%(165/624),RR = 1. 00,95% CI:0. 83-1. 20,P = 0. 94]. Compared with the control group,there was a statistical significance in the rate of drug withdrawal in the trial group[14. 6%( 117/804 ) vs. 9. 0%( 69/766 ),RR = 1. 62,95% CI:1. 22-2. 15,P <0. 01 ). Conclusion The common adverse events of pirfenidone are gastrointestinal,skin,and neurological system damage and fatigue and loss of weight. The adverse events are mild and mostly recoverable without obvious sequelae. The pirfenidone is safe and well-tolerated.

Objective To evaluate the safety of pirfenidone in treatment of idiopathic pulmonary fibrosis( IPF). Methods PubMed,the Cochrane library,EMbase,CNKI,and WanFang database were searched using the keywords pirfenidone,idiopathic pulmonary fibrosis,and IPF from January 1999 to January 2015. Randomized controlled trials( RCTs)of pirfenidone in treatment of IPF were selected. The patients in the trial group were given pirfenidone alone while the patients in the control group were given oral placebo. The primary end point event of the outcome was the incidence of pirfenidone′s adverse events. The Meta-analysis was performed using RevMan 5. 2. Results A total of 4 articles including 5 RCTs were enrolled. There were 945 patients in the trial group and 766 patients in the control group. The incidents of many kinds of adverse events in the trial group were markedly higher than those in the control group, including gastrointestinal discomfort[12. 6%(101/804)vs. 5. 2%(40/766),RR = 2. 31,95% CI:63-3. 29,P< 0. 01],nausea[34. 6%(241/695)vs. 15. 0%(99/659),RR = 2. 373,95% CI:1. 92-2. 92,P< 0. 01]and vomiting[13. 3%(83/623)vs. 6. 3%(39/624),RR= 2. 13,95% CI:1. 48-3. 06,P< 0. 01],diarrhea[25. 8%(161/623)vs. 20. 4%(127/624),RR= 1. 27,95% CI:1. 03-1. 56,P=0. 02],anorexia[15. 2%(122/804)vs. 4. 7%(36/766),RR= 3. 10,95% CI:2. 16-4. 46,P<0. 01],abnormal liver function[6. 0%(49/804)vs. 1. 7%(13/766),RR= 2. 48,95% CI:1. 46-4. 23,P<0. 01],rash[30. 4%(189/623)vs. 10. 3%(64/624),RR= 2. 95,95% CI:2. 27-3. 83,P<0. 01],photosensitivity reaction[24. 7%(129/526)vs. 6. 1%(30/489),RR= 5. 54,95%CI:1. 78-17. 30,P<0. 01],insomnia[10. 4%(65/623)vs. 6. 6%(41/624),RR=1. 59,95% CI:1. 09-2. 31,P= 0. 02],dizziness[16. 4%(120/732)vs. 9. 8%(72/731),RR=1. 67,95% CI:1. 27-2. 19,P<0. 01],fatigue[25. 6%(178/695)vs. 16. 3%(108/659),RR = 1. 60,95% CI:1. 29-1. 98,P< 0. 01],and weight loss[10. 1%(63/623)vs. 5. 4%(34/624),RR= 1. 85,95% CI:1. 24-2. 77,P = 0. 03]. However,there was no statistically significant difference in treatment-related serious events[26. 5%(165/623)vs. 26. 4%(165/624),RR = 1. 00,95% CI:0. 83-1. 20,P = 0. 94]. Compared with the control group,there was a statistical significance in the rate of drug withdrawal in the trial group[14. 6%( 117/804 ) vs. 9. 0%( 69/766 ),RR = 1. 62,95% CI:1. 22-2. 15,P <0. 01 ). Conclusion The common adverse events of pirfenidone are gastrointestinal,skin,and neurological system damage and fatigue and loss of weight. The adverse events are mild and mostly recoverable without obvious sequelae. The pirfenidone is safe and well-tolerated.

Objective To evaluate the diagnostic and therapeutic significance of serum free light chain (sFLC) in primary systemic(AL) amyloidosis. Methods Twenty-five patients with AL amyloidosis,including 18 men and 7 women with a mean age of 54(47-77) years old, were enrolled from October, 2005to May, 2010. sFLC was measured by immunoturbidimetric assay. The type of monoclonal light chain was judged upon sFLC κ/λ and its sensibility was compared with serum immunofixation and immunohistochemical analysis. Four patients were treated with M (T)D (melphalan/thalidomideand, dexamethasone), one with VD (velcade and dexamethasone) and four with high-dose melphalan followed by autologous stem cell support. The changes of sFLC were serially determined before and after treatment. Results Among the 25 patients with AL amyloidosis, two were κ light chains of precursor protein and 23 were λ light chains. Mean plasma cell in bone marrow was 3.5% (0-15%). Nineteen (76%) patients had abnormal elevated sFLC and abnormal κ/λ ratios, and 17(68% ) patients with immunofixation positive. The sFLC test had similar sensitivity as serum immunofixation (P = 0. 727 ). Twenty-one (84%) patients were shown to have either κor λ immunoreactive amyloid deposits on biopsied tissues. The sFLC test combined with serum immunofixation allowed the M protein to be detected in 22 (88%) patients. The positive rates of immunohistochemical analysis combined with sFLC test and/or serum immunofixation were 96%. Four patients with hematologic response showed obvious improvement in visceral organ involvement, but illness of 5 patients without hematologic response kept stable or progressed. Conclusions sFLC test is a sensitive qualitative and quantitative method to detect M protein. Preliminary data show the patients with obvious sFLC level decrease and/or κ/λ recovery to normal may have a high percentage of improved organs function. sFLC is critical index in diagnosing AL amyloidosis, which might help efficacy assessment.