OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.

BACKGROUND:It has been found that internal factors such as anatomical structure,hormone level and neuromuscular function of athletes are closely related to the risk of anterior cruciate ligament injuries,and external factors such as the material of the playing field also become one of the risk factors affecting the occurrence of non-contact anterior cruciate ligament injuries,but they are relatively under-attended in the current studies. OBJECTIVE:To explore effects of artificial turf versus natural grass on the biomechanical performance of the lower limbs in young females during jump-landing. METHODS:According to the test needs,artificial turf and natural grass in accordance with the standards of GB/T 20033.3-2006 and GB/T 19995.1-2005 were leveled and fixed on two three-dimensional force measuring platforms.Twenty-one young females were voluntarily recruited and completed the jump-landing task on the artificial turf and natural grass.Subjects stood on the steps and then jumped forward,jumped down to the force measuring platform and immediately jumped with full force to the force measuring platform again.The two landings were required to fall to the two force measuring platforms,and the whole jumping action was considered successful without any pause.The kinematic,kinetic and electromyographic data of the lower limbs during the landing process were collected synchronously to compare and analyze the differences between the two. RESULTS AND CONCLUSION:In terms of kinetics,posterior and vertical ground reaction force at the initial landing moment during jump-landing on the natural grass were significantly lower than those on the artificial turf(P＜0.05,P＜0.01),as well as at the peak ground reaction force moment(P＜0.05,P＜0.05).Additionally,the knee flexion moment when jump-landing on the natural grass was higher than that on the artificial turf(P＜0.01).In terms of electromyography,within 100 ms after the initial landing moment,the electromyography activity levels of medial femoris muscle,lateral femoris muscle and anterior tibialis muscle when jump-landing on the natural grass were significantly lower than those on the artificial turf(P＜0.05,P＜0.01,P＜0.05).To conclude,compared with the natural grass,jump-landing on the artificial turf leads to an change in biomechanical performance that will cause an increase in anterior cruciate ligament tension.

Building a scientific and reasonable performance-based salary distribution system is a key measure for public hospitals to adapt to new policies and environments,enhance operational management capabilities,and improve medical service levels.Based on the high-quality development of public hospitals,combined with medical reform policies and hospital development needs,it analyzes the current situation and problems of performance-based salary distribution in public hospitals,and proposes reform and optimization suggestions to promote high-quality development of public hospitals.

Objective:To explore potential categories of disease progression fear and self-management ability in patients with maintenance hemodialysis (MHD) and their influencing factors.Methods:Convenience sampling was used to select MHD patients in the Blood Purification Center of the Affiliated Nantong Hospital of Nanjing University of Chinese Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, and the Affiliated Huaian First People's Hospital of Nanjing Medical University from November 2022 to May 2023 as study subjects. General Information Questionnaire, Fear of Progression Questionnaire-short form (FoP-Q-SF), Hemodialysis Self-management Instrument (HDSMI), and Perceived Social Support Scale (PSSS) were used to conduct the survey. Mplus 8.7 software was applied to conduct latent profile analysis, and multiple Logistic regression was used to explore the factors influencing the disease progression fear and self-management ability of different MHD patients.Results:A total of 380 questionnaires were distributed, and 364 valid questionnaires were recovered, with an effective recovery rate of 95.79%. The mean scores of FoP-Q-SF and HDSMI in 364 MHD patients were (2.53±0.84) and (2.81±0.54), respectively. MHD patients' fear of disease progression and self-management ability were manifested in three different potential categories, named high fear-general self-management (59.34%, 216/364), moderate fear-low self-management (24.45%, 89/364), and low fear-good self-management (16.21%, 59/364). Multiple Logistic regression showed that age, education level, marital status, comorbidities, duration on dialysis, and social support were influencing factors in the potential categories of fear of disease progression and self-management ability in MHD patients, and the difference was statistically significant ( P<0.05) . Conclusions:Healthcare professionals should give appropriate interventions to MHD patients with different types of fear of progression and self-management ability in order to reduce patients' fear of disease progression and improve their self-management ability.

Objective:To explore the trajectories of kinesiophobia in initial hemodialysis patients and their influencing factors.Methods:A convenience sampling method was used to recruit patients undergoing their first hemodialysis treatment at Hemodialysis Center, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June to December 2023. Baseline data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Dialysis Patient Symptom Burden Index (DFSSBI), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Fatigue Inventory (MFI-20), and the Pittsburgh Sleep Quality Index (PSQI). The TSK was used to measure kinesiophobia levels at 1, 3, and 6 months post-dialysis. Data were analyzed using a latent class growth mixture model, univariate analysis, and multinomial Logistic regression.Results:A total of 251 patients were surveyed, and 239 completed follow-ups. Three latent classes of kinesiophobia trajectories were identified: persistently high kinesiophobia group (32.22%, 77/239), moderate kinesiophobia-declining group (28.45%, 68/239), and persistently low kinesiophobia group (39.33%, 94/239). Multinomial Logistic regression analysis indicated that age, marital status, presence of sleep disorders, history of falls in the past year, symptom burden, fear of disease progression, and fatigue significantly influenced kinesiophobia trajectory classes ( P<0.05) . Conclusions:Kinesiophobia in initial hemodialysis patients exhibits distinct trajectories. Healthcare professionals should implement targeted interventions based on the influencing factors of kinesiophobia trajectory development.

Building a scientific and reasonable performance-based salary distribution system is a key measure for public hospitals to adapt to new policies and environments,enhance operational management capabilities,and improve medical service levels.Based on the high-quality development of public hospitals,combined with medical reform policies and hospital development needs,it analyzes the current situation and problems of performance-based salary distribution in public hospitals,and proposes reform and optimization suggestions to promote high-quality development of public hospitals.

Objective:To explore potential categories of disease progression fear and self-management ability in patients with maintenance hemodialysis (MHD) and their influencing factors.Methods:Convenience sampling was used to select MHD patients in the Blood Purification Center of the Affiliated Nantong Hospital of Nanjing University of Chinese Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, and the Affiliated Huaian First People's Hospital of Nanjing Medical University from November 2022 to May 2023 as study subjects. General Information Questionnaire, Fear of Progression Questionnaire-short form (FoP-Q-SF), Hemodialysis Self-management Instrument (HDSMI), and Perceived Social Support Scale (PSSS) were used to conduct the survey. Mplus 8.7 software was applied to conduct latent profile analysis, and multiple Logistic regression was used to explore the factors influencing the disease progression fear and self-management ability of different MHD patients.Results:A total of 380 questionnaires were distributed, and 364 valid questionnaires were recovered, with an effective recovery rate of 95.79%. The mean scores of FoP-Q-SF and HDSMI in 364 MHD patients were (2.53±0.84) and (2.81±0.54), respectively. MHD patients' fear of disease progression and self-management ability were manifested in three different potential categories, named high fear-general self-management (59.34%, 216/364), moderate fear-low self-management (24.45%, 89/364), and low fear-good self-management (16.21%, 59/364). Multiple Logistic regression showed that age, education level, marital status, comorbidities, duration on dialysis, and social support were influencing factors in the potential categories of fear of disease progression and self-management ability in MHD patients, and the difference was statistically significant ( P<0.05) . Conclusions:Healthcare professionals should give appropriate interventions to MHD patients with different types of fear of progression and self-management ability in order to reduce patients' fear of disease progression and improve their self-management ability.

Objective:To explore the trajectories of kinesiophobia in initial hemodialysis patients and their influencing factors.Methods:A convenience sampling method was used to recruit patients undergoing their first hemodialysis treatment at Hemodialysis Center, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June to December 2023. Baseline data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Dialysis Patient Symptom Burden Index (DFSSBI), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Fatigue Inventory (MFI-20), and the Pittsburgh Sleep Quality Index (PSQI). The TSK was used to measure kinesiophobia levels at 1, 3, and 6 months post-dialysis. Data were analyzed using a latent class growth mixture model, univariate analysis, and multinomial Logistic regression.Results:A total of 251 patients were surveyed, and 239 completed follow-ups. Three latent classes of kinesiophobia trajectories were identified: persistently high kinesiophobia group (32.22%, 77/239), moderate kinesiophobia-declining group (28.45%, 68/239), and persistently low kinesiophobia group (39.33%, 94/239). Multinomial Logistic regression analysis indicated that age, marital status, presence of sleep disorders, history of falls in the past year, symptom burden, fear of disease progression, and fatigue significantly influenced kinesiophobia trajectory classes ( P<0.05) . Conclusions:Kinesiophobia in initial hemodialysis patients exhibits distinct trajectories. Healthcare professionals should implement targeted interventions based on the influencing factors of kinesiophobia trajectory development.

Objective:To analyze the clinical efficacy and prognostic factors of comprehensive treatment for atypical teratoid / rhabdomyoma tumor (AT/RT).Methods:Clinical data of children diagnosed with AT/RT who underwent radiotherapy in Department of Oncology of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from November 2012 to September 2022 were retrospectively analyzed. Pearson Chi-square test or continuous-corrected Chi-square test or Fisher's exact probability method were used for inter-group comparison of categorical variables. Independent sample t-test or Wilcoxon rank-sum test were used for inter-group comparison of continuous variables. Kaplan-Meier method was used to calculate the 1-year and 2-year overall survival (OS) rate and progression free survival (PFS) rate. Univariate and multivariate Cox regression analyses were employed to determine relevant prognostic factors. Results:A total of 45 patients were included, with a male/female ratio of 1.65:1, including 27 children aged ≥3 years old. All patients received surgery and radiotherapy in which 39 patients received chemotherapy, 41 craniospinal irradiation (CSI), and 4 whole brain or focal radiation therapy. The median follow-up was 28 (13.5, 49) months. A total of 14 patients died after comprehensive treatment. The 1-year OS rate was 80.0% and the PFS rate was 71.1%. The 2-year OS rate was 75.5% and the PFS rate was 65.7%. Survival prognostic analysis showed negative imaging assessment after radiotherapy ( HR=0.087, 95% CI: 0.011-0.697, P=0.022) was a favorable factor for PFS. The primary tumor<4.8 cm ( HR=0.221, 95% CI: 0.052-0.935, P=0.040) and CSI ( HR=0.085, 95% CI: 0.011-0.651, P=0.018) were favorable factors for OS. In subgroup analysis, CSI also improved OS in children aged ≥3 years ( HR=0.014, 95% CI: 0-0.470, P=0.017), but there was no significant difference in PFS. In children without cerebrospinal fluid dissemination, negative radiographic results after radiotherapy ( HR=0.066, 95% CI: 0.009-0.481, P=0.007; HR=0.076, 95% CI: 0.008-0.695, P=0.024, respectively) and CSI (HR=0.105, 95% CI: 0.012-0.937, P=0.044; HR=0.054, 95% CI: 0.005-0.629, P=0.020, respectively) were favorable factors for PFS and OS in children, and the primary tumor<4.8 cm also suggested a longer OS ( HR=0.094, 95% CI: 0.013-0.690, P=0.020). Conclusions:Comprehensive treatment including radiotherapy improves clinical prognosis of children with AT/RT. Our study shows that negative imaging results after radiotherapy are associated with PFS improvement. The primary tumor<4.8 cm and CSI are favorable factors for OS. CSI is also a significantly positive prognostic factor in children aged ≥3 years and those without cerebrospinal fluid dissemination.

The operating room was the core department of a hospital,and its operational efficiency had a significant impact on the high-quality development of a hospital.An analysis has revealed that low efficiency and irrational allocation in the operating room were mainly due to the lack of operational regulations and norms,the unreasonable arrangement of surgical specialties,and the unbalanced allocation of supporting resources.To address these issues,the First Affiliated Hospital of Zhengzhou University has taken into account the overall allocation of resources for the central operating room and the central operating room,and formulated strategies to improve operational efficiency,including adjusting the operational mechanism,optimizing the structure of surgical specialties,and providing corresponding supporting resources.Based on the adjustment of surgical structure,the implementation effect of the program was measured and evaluated,which provided practical strategies for optimizing operating room efficiency in hospitals.