There are many treatment options for cancer,and patients need to repeatedly weigh the pros and cons when choosing,consider various health risks and the impact on their families,and are prone to decision-making fatigue,which not only affects their decision-making judgment,but also may affect their physical and mental health.This paper summarizes the concept,theoretical model,and evaluation tools of decision fatigue,and summarizes the influencing factors and coping strategies of decision fatigue in cancer patients,which can provide a reference for domestic medical staff to further develop personalized decision support tools and carry out relevant clinical practice and scientific research.

Objective:This study aims to investigate the inner experiences of cancer patients when confronting financial toxicity through a Meta-analytical approach. The goal is to provide evidence-based insights and theoretical references for clinical healthcare professionals to fully understand the feelings and experiences associated with financial toxicity in cancer patients, thereby laying a foundation for targeted interventional measures.Methods:A computerized search was conducted across databases including CINAHL, PubMed, PsycINFO, Embase, Scopus, Web of Science, CNKI, WanFang, VIP, Sinomed and other databases, collecting qualitative studies related to the inner experience of financial toxicity among cancer patients, up until April 12, 2023. Quality appraisal of the included literature was carried out according to JBI′s standards for qualitative research, and results were synthesized using Meta-aggregation methods.Results:Twenty-three studies were included, from which 82 specific outcomes were extracted. These were categorized into 11 new thematic groups and ultimately synthesized into four integrated findings: the impact of objective costs, subjective burden, and unreasonable expectations; diverse cognitive attitudes and management coping strategies; multiple pressures and challenges on patients and their families; and the articulation of needs and perceptions of beneficial growth.Conclusions:Healthcare professionals should pay attention to the financial toxicity issues that patients face at the initial stage of cancer diagnosis. Timely communication about economic issues between patients and healthcare providers is essential to help patients have a preliminary understanding of the impending financial toxicity at the onset of the disease. A comprehensive intervention that emphasizes different aspects of objective and subjective financial toxicity, coupled with multi-dimensional mitigation strategies, can promote active coping in patients, enhance familial emotional and financial support to overcome challenges together, and prioritize patients′ needs and expectations to guide them towards reinforcing positive experiences and minimizing the impact of financial toxicity.

BACKGROUND:Previous studies have shown that silent mating-type information regulator 2 homolog 1(SIRT1)-mechanistic target of rapamycin(mTOR)signaling plays an important role in the progression of osteoarthritis.Emodin has a protective effect on osteoarthritic chondrocytes. OBJECTIVE:To investigate the effects of emodin on the proliferation,apoptosis and oxidative stress of osteoarthritic chondrocytes based on the SIRT1-mTOR signaling. METHODS:Rat chondrocytes were isolated and cultured in vitro.Osteoarthritic chondrocyte model in vitro was induced by 10 ng/mL interleukin-1β.Cell counting kit-8 method was used to determine the viability of rat chondrocytes treated with 0,20,40,80,120,160 μmol/L emodin,and the appropriate concentration of emodin was selected.Rat chondrocytes isolated and cultured in vitro were randomly divided into control group,model group,low-dose emodin group,high-dose emodin group,EX527 group,and high-dose emodin+EX527 group.In vitro osteoarthritis model was constructed by induction of 10 ng/mL interleukin 1β in all groups except the control group.The cells in the latter four groups were correspondingly treated with emodin or/and EX527.The proliferation and apoptosis of chondrocytes in each group were detected by cell counting kit-8,Edu staining and flow cytometry respectively.The relative content of reactive oxygen species and the levels of malondialdehyde,superoxide dismutase,catalase,and glutathione peroxidase in chondrocytes of rats in each group were measured with the kit.The expression of proteins related to cell matrix degradation,apoptosis and the SIRT1-mTOR pathway-related proteins in each group were detected by western blot. RESULTS AND CONCLUSION:Compared with the control group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the model group were decreased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were increased(P<0.05).Compared with the model group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the low-and high-dose emodin groups were increased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were decreased(P<0.05).Compared with the low-and high-dose emodin groups,the indexes of EX527 group showed the opposite trend(P<0.05).Compared with the high-dose emodin group,the survival rate of chondrocytes,the positive rate of Edu,the levels of superoxide dismutase,catalase,and glutathione peroxidase,and the expression of Bcl-2 and SIRT1 proteins in the high-dose emodin+EX527 group were decreased,while the apoptosis rate,the relative content of reactive oxygen species,the level of malondialdehyde,the expression of Bax,matrix metalloproteinase 3,matrix metalloproteinase 9 proteins,and p-mTOR/mTOR were increased(P<0.05).To conclude,emodin can inhibit oxidative stress of osteoarthritic chondrocytes by activating the SIRT1-mTOR signaling,thereby promoting chondrocyte proliferation and reducing apoptosis.

The continuous advancement of medical technology promotes the prolongation of the survival period of patients with gynecological malignant tumors while also bringing a considerable financial burden to the patients. This subjective and objective economic burden faced by cancer patients is referred to as financial toxicity. This article aims to review the concept, assessment tools, influencing factors, and intervention measures of financial toxicity in patients with gynecological malignant tumors, in order to provide a theoretical basis for related research and practice in clinical settings.

The presence of parenting concerns in female breast cancer patients who have to raise minor children can have multifaceted impacts on the patients. This research reviews the concept of parenting concerns in female breast cancer patients, assessment tools, current research status, reasons for its occurrence, multidimensional influences, influencing factors, and intervention measures to provide a theoretical basis for Chinese clinical medical staff to adopt targeted nursing measures for female breast cancer patients raising minor children.

Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.

Objective To investigate the status of the plague natural focus and assess the risk of plague in regions with large scale engineering construction project,in order to provide a basis for plague prevention and control.Methods The survey was carried out in 14 regions with large scale engineering construction project of 40 counties in Guizhou Province in 2000-2011,2-3 towns were selected in each county and 2-3 villages in each town,the plague hosts and flea vectors in the residential houses and outdoors were investigated,the sera of 5 animals were collected in each village.The capture rate of hosts and flea index were calculated.Then the samples were cultured and serological tested for plague.Results The density of rodents was 1.14％-3.87％ in the reservoir region' residential building of hydro power station (Tianshengqiao,Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo) and Xingyi airport,and Rattus flavipestus was the dominant species.The density of rodents was 0.00％-0.84％ in the reservoir region of hydro power station (Hongjiadu,Yingzidu,Goupitan,Longtan) and Jinyang district; the total flea index in Yinzidu,Pingban,Longtan reservoir regions of hydro power stations were 3.16,2.00,1.06,3.47 and 1.99,respectively.A total of 21 rodent and flea samples from Tianshengqiao hydro power station were tested positive for F1 antigen of the plague.Three strains of Yersiniapestis were isolated.Nine rat filter paper blood samples and 7 sera of indicative animals were tested plague F1 antibody positive.Other regions with large scale engineering construction project were tested negative.Conclusions The reservoir region of Tianshengqiao hydro power station is endemic areas of the plague,where belong to high risk areas.The density of Rattus flavipestus is higher than the controlling standard of the country in the reservoir region of hydro power station (Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo),where belong to potential risk areas.The plague prevention and monitoring should be continually strengthened to reduce the risk of plague.

OBJECTIVETo identify and characterize the Brucella strains from Guizhou province in 2010-2013.

METHODSA total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE).

RESULTSBoth of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I.

CONCLUSIONThe epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

Animals ; Bacterial Typing Techniques ; Brucella ; classification ; Brucellosis ; epidemiology ; China ; epidemiology ; DNA, Bacterial ; Goats ; Humans ; Molecular Typing ; Polymerase Chain Reaction

Objective To survey the major host animal and media fleas of plague in Beipanjiang Basin,to gain insights into plague foci and to provide a basis for prevention and control of plague.Methods According to the epidemiological site survey methods,from 2008 to 2010 five villages in five townships (towns) in coastal watershed of Beipanjiang were selected.The methods of cage trapping and 5 meters thread clamp were used to capture rodents indoor and outdoor,respectively.After rats were anesthetized with ether anesthesia,rat body flea were combed and stored in sterile tubes.The liver and spleen of rodents were collected and stored in the test tube with preservation solution,and free body fleas on rats were collected with flea sticky paper and stored in sterile tubes.Blood specimens (5 ml) of indicating animal and normal people were collected,serum was separated and sent for laboratory test.The four-step method was utilized to isolate Yersinia pestis from rodents and fleas,the indirect hemagglutination (IHA) was used to test F1 antibodies on the blood of rodents filter,blood serum of humans and rodents.Results Totally 243 rodents were captured,202 indoor and 41 outdoor,the capture rate was 4.90％ and 1.15％,respectively.Rodents captured belong to 9 species,4 genera,1 family and 1 order,Rattus flavipectus and Mus pahari were dominant species.Five rodents had body flea,the dyed flea rate was 2.06％;53 fleas were captured,total flea index was 0.218 1.Rat fleas were classified in 2 families,2 genera and 2 species,and Cheopis was the dominant species.Yersinia pestis and plague F1 were not detected.Conclusion The epidemic indication has not been found in Beipanjiang Basin,but the nurturing conditions for Rattus flavipectus plague foci along the coast are exist.

Objective To identify and characterize the Brucella strains from Guizhou province in 2010-2013. Methods A total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE). Results Both of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I. Conclusion The epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.