Objective To evaluate the clinical efficacy of modified Lishui Qiangxin Decoction(composed of Astragali Radix,Arecae Pericarpium,Descurainiae Semen Lepidii Semen,Poria,Polyporus,Cinnamomi Ramulus,Salviae Miltiorrhizae Radix et Rhizoma,Asini Corii Colla,Aucklandiae Radix,etc.)for elderly patients with chronic heart failure(CHF),and to investigate its effects on ventricular remodeling and serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK),high-sensitivity C-reactive protein(hs-CRP),and interleukin 6(IL-6).Methods A total of 150 elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome treated at Tangshan Central Hospital from December 2021 to December 2024 were enrolled.The patients were divided into trial(n=76)group and control(n=74)group.The control group received standard western treatment(vasodilation,diuresis,and cardiotonic therapy),while the trial group received additional modified Lishui Qiangxin Decoction,both groups were treated for 8 weeks.The changes in traditional Chinese medicine(TCM)syndrome scores,Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,ventricular remodeling parameters[left ventricular mass(LVM),early to late diastolic mitral inflow velocity ratio(E/A),left ventricular ejection fraction(LVEF)],serum sTWEAK,hs-CRP,and IL-6 levels were observed,and clinical efficacy was evaluated.Results(1)After 8 weeks of treatment,the overall response rate in the trial group was 97.37％(74/76),while that in the control group was 86.49％(64/74).The intergroup comparison(by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores for dyspnea,edema,cold intolerance and cold limbs,and palpitations and shortness of breath were significantly lower in both groups compared to before treatment(P＜0.05).Additionally,the reduction in scores was significantly greater in the trial group than in the control group(P＜0.01).(3)After treatment,the LVM of both groups decreased compared to before treatment(P＜0.05),and the E/A and LVEF increased compared to before treatment(P＜0.05).The reduction in LVM and the increase in E/A and LVEF in the trial group were significantly greater than those in the control group(P＜0.01).(4)After treatment,the serum levels of sTWEAK,hs-CRP,and IL-6 in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).(5)After treatment,the MLHFQ scores of emotional,physical,symptom dimensions and total score of the MLHFQ scale in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).Conclusion Modified Lishui Qiangxin Decoction effectively alleviates symptoms,improves left ventricular function,reduces inflammatory markers of sTWEAK,hs-CRP and IL-6,and enhances quality of life in elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome.

Background::Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs.Methods::We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians’ recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs.Results::A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility ( n = 3304, 43.1%) and a lack of trust in primary healthcare institutions ( n = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half ( n = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo PFTs. Conclusions::Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies such as providing financial incentives, promoting education, and establishing community-based programs to enhance the utilization of PFTs.

Rectal cancer is a common malignant tumor in China, with a high mortality rate ranking fifth. Neoadjuvant therapy for rectal cancer can improve patient prognosis and even achieve pathological complete remission (pCR) in some patients, thereby avoiding complications and functional damage caused by radical surgery. Therefore, how to accurately evaluate pCR before surgery is currently a research hotspot. In recent years, new imaging technologies such as endorectal ultrasound, magnetic resonance imaging (MRI), and positron emission computed tomography (PET-CT) have developed rapidly, and imaging evaluation of pCR after neoadjuvant therapy for rectal cancer has achieved good results. This article provides a review of this field, aiming to provide a basis for personalized treatment of rectal cancer patients.

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:We try to screen out predictive indicators with higher value by analyzing the differences in clinical and laboratory indicators between severe fever with thrombocytopenia syndrome (SFTS) patients in the intensive care unit (ICU) group and non-ICU group.Methods:The clinical and laboratory index data of 69 SFTS patients diagnosed in the laboratory in a hospital from June to December 2019 were retrospectively collected. According to the clinical outcome of the patients, they were divided into ICU and non-ICU groups. The differences in clinical manifestations and laboratory indicators between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to screen the more valuable predictive indicators.Results:Compared with the non-ICU group, ICU group SFTS patients had significantly higher procalcitonin (PCT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), leucine aminopeptidase (LAP), glutamate dehydrogenase (GDH), adenosine deaminase (ADA), cystatin C (Cys C), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), lactate dehydrogenase (LDH) levels ( W=530.0, P=0.003; W=496.5, P=0.015; W=496.0, P=0.015; W=535.5, P=0.002; W=545.5, P=0.001; W=498.5, P=0.013; W=537.0, P=0.002; W=523.0, P=0.004; W=512.0, P=0.007; W=502.0, P=0.012; W=486.0, P=0.023; W=509.0, P=0.008; W=541.0, P=0.002) and significantly lower platelet count (PLT), indirect bilirubin (IBIL), albumin/globulin ratio(A/G) and superoxide dismutase (SOD) levels ( W=199.0, P=0.024; W=175.5.5, P=0.009; t=-2.9, P=0.004; W=209.5, P=0.036; t=-3.0, P=0.004). ROC result showed that ALP [area under the curve (AUC)=0.804, 95% confidence interval ( CI) (0.679~0.929)] and LDH [AUC=0.805, 95% CI (0.680~ 0.930)] have a higher value for predicting the risk of severe illness. Conclusions:Abnormal liver function, heart function, and renal function indicators in SFTS patients indicate that patients are at risk of exacerbation. Among them, ALP and LDH levels have higher predictive value for risk of severe disease, suggesting that the monitoring of patients with the above symptoms should be strengthened in the clinical nursing process.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.

Objective To observe the effect of new vomit-receiving device in department of neurosurgery. Methods A total of 44 patients with vomiting symptoms in our department in May 2015 were randomly divided into the observation group (n=23) and the control group (n=21). The observation group used a new type of vomit-receiving device to carry out vomiting nursing, while the control group was treated with conventional vomiting nursing. The number of cases of vomiting and the number of occurrence times were observed. Results Observation group of 23 cases with no vomit leaks occur, and the control group 21 patients vomit leaked out in 16 cases, the incidence of vomit were leaked by 72.73% (χ2=27.53, P < 0.01), vomiting leaked rate was 40.74% (22/54) (χ2 = 32.49, P < 0.01), including who prepared to receive tools but not timely for 16 times, receive tools leakage for 5 times, no enough capacity of receive tool for 1 times. The total score of patients′ satisfaction in the observation group was 78, while the total score of patients in the control group was 57. The difference was statistically significant (t=2.80, P＜0.01). The total nursing time of the observation group was 68 min, and that of the control group was 347 min,the difference was statistically significant (t=-5.73, P＜0.01). Conclusions The new vomit-receiving device can effectively reduce the incidence of vomit substance leakage, and the installation is easy to install, easy to operate and conducive to the management of vomit. It greatly improves the efficiency of nursing, and effectively improves the satisfaction of patients and their families to nursing.

Objective To investigate the status of body weight,total body fat and skeletal muscle in elderly patients with diabetes.Methods A total of 71 elderly diabetic patients (study group) who met entry criteria and signed informed consent were consecutively enrolled,and 70 healthy subjects (control group) matched for age and gender were selected into the study.Body weight,body mass index (BMI),waist-to-hip ratio (WHR),total body fat (TBF),abdominal fat (AF),visceral fat (VF),visceral fat area (VFA),fatfree mass (FFM),total body muscle (TBM),skeletal muscle (SM),skeletal muscle height index (SMHI) and grip strength (GS) were measured by anthropometry and multi-frequency bioelectric impedance analysis.The rate of low weight,overweight and obesity was judged by BMI;the rate of abdominal obesity by WHR;and the status of muscle by TBM,SM,MHI and GS.Results The two groups were comparable at baseline.Compared to the control group,the rate of low weight [36.6％ (26/71) vs.20.0％ (14/70),x2 =4.791,P=0.039],weight loss [(1.37± 1.57) kg vs.(0.82± 1.12) kg,t=2.402,P =0.018],ratio of people whoexperienced weight loss＞5％ in 3 months [22.5％ (16/71) vs.8.6％ (6/70),x2 =5.219,P=0.035],TBF％ [(32.3±5.0)％ vs.(30.3±5.2)％,t=2.294,P=0.023],WHR (0.91±0.55vs.0.87±0.51,t =2.661,P =0.009),the rate of abdominal obesity [49.3％ (35/71) vs.25.7％ (18/70),x2 =8.355,P=0.005],AF [(12.1±3.4) kg vs.(10.3±3.6) kg,t=2.981,P=0.003],VF [(2.9±0.8) kg vs.(2.5±0.9) kg,t=2.853,P=0.005] andVFA [(99.8±26.3) cm2 vs.(84.9±31.1) cm2,t=3.045,P=0.003] were increased significantly in study group,while the FFM [(34.9±7.5) kg vs.(37.9±5.6) kg,t=-2.691,P=0.008],SM [(25.8±4.5) kgvs.(27.3±3.5) kg,t=-2.140,P=0.034],SMHI [(9.4±1.8) kg/m2 vs.(10.2±1.5) kg/m2,t=-3.081,P=0.002] andGS [(29.3±6.6) kg vs.(31.8±5.7) kg,t=-2.406,P=0.017] were decreased significantly in study group.Conclusion Abnormal weight,abdominal obesity and loss of skeletal muscle were more likely to be observed in elderly patients with diabetes.

Objective To systematically evaluate the clinical effect of prone position mechanical ventilation on the improvement of oxygenation in patients with severe pneumonia. Methods Pubmed, Embase, Cochrane Library, CNKI, Wanfang Data and VIP database were searched from the time of database built up until December 10th, 2017. All the published randomized controlled trials (RCTs) about the effects of prone position ventilation on the oxygenation of severe pneumonia patients were screened, and were confirmed by the literature reference citation retrieval. Inclusion and exclusion criteria had been used to review and rank the literature. After evaluating the quality of included studies, the data was extracted from RCTs and given a Meta-analysis using RevMen 5.1. Results Twelve RCTs with 650 cases were included. Eleven of them were Chinese literature while 1 was in English. Ten studies showed that the prone position ventilation had a significant influence on improving partial pressure of oxygen [weighted mean difference (WMD) =9.93, 95% confidence interval (95%CI) = 2.92-16.95, P = 0.006], publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on partial pressure of carbon dioxide (WMD =9.99, 95%CI = 1.81-18.18, P = 0.02), publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on oxygenation index (WMD = 31.22, 95%CI = 26.06-36.39, P < 0.000 01), publication bias was found in these studies. Two studies showed that the prone position ventilation had a significant influence on oxygen saturation of blood (WMD = 2.12, 95%CI = 1.24-3.00, P < 0.000 01), no publication bias was found in these studies. Conclusion Prone position ventilation can effectively improve the patients' oxygenation index, partial pressure of oxygen, and oxygen saturation of blood, and reduce the partial pressure of carbon dioxide.