Objective To systematically evaluate and analyze qualitative studies of parental engagement in kangaroo mother care experiences for preterm infants in the NICU,aiming to provide references for promoting the early recovery of preterm infants in NICU and improving the quality of nursing services.Methods Relevant were searched for qualitative studies of parental engagement in kangaroo mother care for preterm infants in NICU.The search time limit was from the construction of the database to July 19,2024.The quality of the included literature was assessed using the Joanna Brigg Institute's(JBI)Australian Centre for Evidence-Based Health Care's Quality Assessment Criteria for Qualitative Research,and the results were integrated using the meta-integration methods.Results A total of 17 papers were included in the literature,and 61 findings were extracted,grouped into 10 new categories.These were further synthesized into 4 integrated findings:physical and psychological perceptions of participation in kangaroo mother care;challenges to participation in kangaroo mother care;facilitators of participation in kangaroo mother care;expectations and suggestions for kangaroo mother care.Conclusion Hospital administrators should further improve the management specifications of kangaroo mother care for preterm infants in NICU,optimize resource allocation and strengthen publicity.At the same time,healthcare professionals should actively promote the establishment of peer and family support systems and increase participation in kangaroo mother care to facilitate early recovery of preterm infants in NICU and to continuously promote the improvement of nursing service quality.

Objective To explore the protective effect and possible mechanism of modified Shenqi Dihuang Decoction on podocytes in db/db mice based on ROS/NLRP3/GSDMD signaling pathway.Methods Fifty 8-week-old male db/db mice(SPF grade)were randomly divided into the model group,losartan group and TCM low-,medium-and high-dosage groups,with 10 mice in each group.Ten heterozygous db/m mice served as the blank group.Interventions were administered respectively for 12 weeks.The body mass,random blood glucose,serum creatinine,blood urea nitrogen and 24 h urinary protein content were detected,HE,PAS,PASM,Masson and Sirius red staining was used to observe the morphology of renal tissue,transmission electron microscopy was used to observe the ultrastructure of renal tissue,fluorescent probes were used to observe the release of ROS in renal tissue,immunofluorescence staining was used to detect the expression of Nephrin,NLRP3,Cleaved Caspase-1 and GSDMD-N in renal tissue,and Western blot was used to detect the expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18,Nephrin,Podocin,PODXL,WT-1 and Desmin proteins.Results Compared with the blank group,the body mass and random blood glucose of the model group mice significantly increased(P<0.05),and the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein were significantly increased(P<0.05);glomerular hypertrophy,dilation of renal glomeruli and tubules,thickening of basement membrane,matrix proliferation in mesangial area,abnormal deposition of collagen fibers in renal interstitium,accompanied by damage to renal tubular epithelial structure and focal glomerulosclerosis,significant increase in type Ⅰ collagen deposition,extensive fusion of podocyte processes,and scattered electron dense material in the basement membrane or subepithelial layer;the ROS content in renal tissue significantly increased(P<0.05),and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin significantly increased(P<0.05),the protein expression of Nephrin,Podocin,PODXL and WT1 significantly decreased(P<0.05).Compared with the model group,the body mass and random blood glucose of mice in each dosage of TCM group were relatively stable,the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein decreased;the pathological damage to renal tissue was reduced,the ultrastructure of podocytes was improved,and the density of podocytes increased;the ROS content decreased,and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin decreased,while the protein expression of Nephrin,Podocin,WT1 and PODXL increased.With the dosage of modified Shenqi Dihuang Decoction increased,the improvement effect gradually strengthened,and the differences in TCM high-dose group was statistically significant(P<0.05).Conclusion Modified Shenqi Dihuang Decoction can protects podocytes in db/db mice,potentially by modulating the ROS/NLRP3/GSDMD signaling pathway.

Objective To systematically evaluate and analyze qualitative studies of parental engagement in kangaroo mother care experiences for preterm infants in the NICU,aiming to provide references for promoting the early recovery of preterm infants in NICU and improving the quality of nursing services.Methods Relevant were searched for qualitative studies of parental engagement in kangaroo mother care for preterm infants in NICU.The search time limit was from the construction of the database to July 19,2024.The quality of the included literature was assessed using the Joanna Brigg Institute's(JBI)Australian Centre for Evidence-Based Health Care's Quality Assessment Criteria for Qualitative Research,and the results were integrated using the meta-integration methods.Results A total of 17 papers were included in the literature,and 61 findings were extracted,grouped into 10 new categories.These were further synthesized into 4 integrated findings:physical and psychological perceptions of participation in kangaroo mother care;challenges to participation in kangaroo mother care;facilitators of participation in kangaroo mother care;expectations and suggestions for kangaroo mother care.Conclusion Hospital administrators should further improve the management specifications of kangaroo mother care for preterm infants in NICU,optimize resource allocation and strengthen publicity.At the same time,healthcare professionals should actively promote the establishment of peer and family support systems and increase participation in kangaroo mother care to facilitate early recovery of preterm infants in NICU and to continuously promote the improvement of nursing service quality.

Objective To explore the protective effect and possible mechanism of modified Shenqi Dihuang Decoction on podocytes in db/db mice based on ROS/NLRP3/GSDMD signaling pathway.Methods Fifty 8-week-old male db/db mice(SPF grade)were randomly divided into the model group,losartan group and TCM low-,medium-and high-dosage groups,with 10 mice in each group.Ten heterozygous db/m mice served as the blank group.Interventions were administered respectively for 12 weeks.The body mass,random blood glucose,serum creatinine,blood urea nitrogen and 24 h urinary protein content were detected,HE,PAS,PASM,Masson and Sirius red staining was used to observe the morphology of renal tissue,transmission electron microscopy was used to observe the ultrastructure of renal tissue,fluorescent probes were used to observe the release of ROS in renal tissue,immunofluorescence staining was used to detect the expression of Nephrin,NLRP3,Cleaved Caspase-1 and GSDMD-N in renal tissue,and Western blot was used to detect the expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18,Nephrin,Podocin,PODXL,WT-1 and Desmin proteins.Results Compared with the blank group,the body mass and random blood glucose of the model group mice significantly increased(P<0.05),and the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein were significantly increased(P<0.05);glomerular hypertrophy,dilation of renal glomeruli and tubules,thickening of basement membrane,matrix proliferation in mesangial area,abnormal deposition of collagen fibers in renal interstitium,accompanied by damage to renal tubular epithelial structure and focal glomerulosclerosis,significant increase in type Ⅰ collagen deposition,extensive fusion of podocyte processes,and scattered electron dense material in the basement membrane or subepithelial layer;the ROS content in renal tissue significantly increased(P<0.05),and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin significantly increased(P<0.05),the protein expression of Nephrin,Podocin,PODXL and WT1 significantly decreased(P<0.05).Compared with the model group,the body mass and random blood glucose of mice in each dosage of TCM group were relatively stable,the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein decreased;the pathological damage to renal tissue was reduced,the ultrastructure of podocytes was improved,and the density of podocytes increased;the ROS content decreased,and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin decreased,while the protein expression of Nephrin,Podocin,WT1 and PODXL increased.With the dosage of modified Shenqi Dihuang Decoction increased,the improvement effect gradually strengthened,and the differences in TCM high-dose group was statistically significant(P<0.05).Conclusion Modified Shenqi Dihuang Decoction can protects podocytes in db/db mice,potentially by modulating the ROS/NLRP3/GSDMD signaling pathway.

Objective:To explore the effectiveness of the Exowalk gait training robot in improving the walking ability of stroke survivors.Methods:Forty stroke survivors were randomly divided into a control group and an experimental group, each of 20. In their rehabilitation, the control group was given routine walking training, while the experimental group′s training was assisted with the Exowalk robot. Both groups trained for 60 minutes a day, five days a week for four weeks. Before as well as after 2 and 4 weeks of training functional ambulatory categories (FACs), the Berg balance scale (BBS), the 6-minute walking test (6MWT), the 10-minute walking test (10MWT), the Rivermead mobility index and an exercise index were used to evaluate those in both groups.Results:After 2 weeks significant improvement was observed in the average FAC, BBS, 6MWT and 10MWT results of both groups, without significant differences between them. After 4 weeks there was still no significant difference in the groups′ average BBS scores. However, the average FAC rating in the experimental group had improved significantly while there was no significant increase in the control group′s average score.Conclusions:The Exowalk robot can help to improve the balance and walking ability of hemiplegic stroke survivors.

Objective:To investigate the effect of the neoadjuvant chemotherapy course adjustment on the patients with esophageal cancer underwent delayed operation.Methods:The clinical data of patients with esophageal cancer treated in Cancer Hospital, Chinese Academy of Medical Sciences from 2019—2020, who underwent neoadjuvant chemotherapy strategy adjustment (multiple course chemotherapy group) or not (control group), were retrospectively studied. The clinical pathological characteristics and postoperative complication of these two group were compared and analyzed.Results:The cases who underwent the interval between chemotherapy and operation more than 4 weeks in multiple course chemotherapy group and control group were 17 and 6, with significant difference ( P<0.05). The average operative blood loss of these two groups were 88.6 ml and 46.1 ml, the average postoperative hospital stays were 14.7 days and 10.0 days, with significant difference ( P<0.05). The incidence rate of postoperative complication in the multiple course chemotherapy group was 40.9% (9/22), not significantly different from 31.8% (7/22) of control group ( P>0.05). There were no death within postoperative 7 days and 30 days in both groups. Cases with apparent tumor regression [tumor regression grade (TRG) 1 to 3] in multiple course chemotherapy group were 14, with marginal tumor regression (TRG 4 to 5) were 8, while there were 7 and 15 in the control group, respectively, with significant difference ( P<0.05). After multiple neoadjuvant chemotherapy, the imaging examination of patients indicated an almost total tumor degradation and the postoperative pathology showed no residual malignant tumor tissue was observed. Conclusions:Increased neoadjuvant chemotherapy course for patients with locally advanced esophageal cancer can obtain more obvious tumor degradation response. Neoadjuvant chemotherapy adjustment according to the operation schedule is recommended.

Objective:To investigate the effect of the neoadjuvant chemotherapy course adjustment on the patients with esophageal cancer underwent delayed operation.Methods:The clinical data of patients with esophageal cancer treated in Cancer Hospital, Chinese Academy of Medical Sciences from 2019—2020, who underwent neoadjuvant chemotherapy strategy adjustment (multiple course chemotherapy group) or not (control group), were retrospectively studied. The clinical pathological characteristics and postoperative complication of these two group were compared and analyzed.Results:The cases who underwent the interval between chemotherapy and operation more than 4 weeks in multiple course chemotherapy group and control group were 17 and 6, with significant difference ( P<0.05). The average operative blood loss of these two groups were 88.6 ml and 46.1 ml, the average postoperative hospital stays were 14.7 days and 10.0 days, with significant difference ( P<0.05). The incidence rate of postoperative complication in the multiple course chemotherapy group was 40.9% (9/22), not significantly different from 31.8% (7/22) of control group ( P>0.05). There were no death within postoperative 7 days and 30 days in both groups. Cases with apparent tumor regression [tumor regression grade (TRG) 1 to 3] in multiple course chemotherapy group were 14, with marginal tumor regression (TRG 4 to 5) were 8, while there were 7 and 15 in the control group, respectively, with significant difference ( P<0.05). After multiple neoadjuvant chemotherapy, the imaging examination of patients indicated an almost total tumor degradation and the postoperative pathology showed no residual malignant tumor tissue was observed. Conclusions:Increased neoadjuvant chemotherapy course for patients with locally advanced esophageal cancer can obtain more obvious tumor degradation response. Neoadjuvant chemotherapy adjustment according to the operation schedule is recommended.

Objective:To investigate the clinical characteristics and surgical management based on the clinical manifestation, pathological feature and the medical imaging finding of ciliated muconodular papillary tumor (CMPT).Methods:The data of clinical manifestation, pathological feature and the medical imaging finding of 15 patients with CMPT who received surgical treatment from January 2017 to April 2019 were collected and retrospectively analyzed.Results:CMPT generally occurred in the elderly people. Most of the diameter of the tumor was less than 1 cm, while the diameters of other 3 patient were 1~2 cm. The computed tomography (CT) scan of 9 patients displayed solid nodule, while 4 displayed ground glass opacity (GGO), and other 2 showed no significant abnormal. Thirteen patients received minimally invasive video-assisted thoracoscopic surgery (VATS), the other 2 received open surgery. Eight patients received lobectomy, 3 received thoracoscopic anatomical partial-lobectomy, 4 received wedge resection. The frozen section diagnostic results of 8 patients were adenocarcinoma, including 3 mucinous adenocarcinoma. Other 5 patients were diagnosed as CMPT and 2 were reported as infection nodule. During the perioperative period, 2 patients occurred cardiac arrhythmia, 1 occurred pulmonary infection. None of the patients had local recurrence or distant metastasis during the follow-up.Conclusions:CMPT usually presents as solitary peripheral lung nodules without obvious symptoms. Most CMPTs are incidentally detected by routine CT scan. Some of the cases are accompanied by primary lung cancer probably. Surgical treatment is the major therapy for CMPT. The imaging feature of CT scam usually shows a solid nodule or a GGO locates in peripheral pulmonary. Frozen section diagnosis for CMPTs can be easily confused with adenocarcinoma or mucinous adenocarcinoma.

Objective:To investigate the clinical characteristics and surgical management based on the clinical manifestation, pathological feature and the medical imaging finding of ciliated muconodular papillary tumor (CMPT).Methods:The data of clinical manifestation, pathological feature and the medical imaging finding of 15 patients with CMPT who received surgical treatment from January 2017 to April 2019 were collected and retrospectively analyzed.Results:CMPT generally occurred in the elderly people. Most of the diameter of the tumor was less than 1 cm, while the diameters of other 3 patient were 1~2 cm. The computed tomography (CT) scan of 9 patients displayed solid nodule, while 4 displayed ground glass opacity (GGO), and other 2 showed no significant abnormal. Thirteen patients received minimally invasive video-assisted thoracoscopic surgery (VATS), the other 2 received open surgery. Eight patients received lobectomy, 3 received thoracoscopic anatomical partial-lobectomy, 4 received wedge resection. The frozen section diagnostic results of 8 patients were adenocarcinoma, including 3 mucinous adenocarcinoma. Other 5 patients were diagnosed as CMPT and 2 were reported as infection nodule. During the perioperative period, 2 patients occurred cardiac arrhythmia, 1 occurred pulmonary infection. None of the patients had local recurrence or distant metastasis during the follow-up.Conclusions:CMPT usually presents as solitary peripheral lung nodules without obvious symptoms. Most CMPTs are incidentally detected by routine CT scan. Some of the cases are accompanied by primary lung cancer probably. Surgical treatment is the major therapy for CMPT. The imaging feature of CT scam usually shows a solid nodule or a GGO locates in peripheral pulmonary. Frozen section diagnosis for CMPTs can be easily confused with adenocarcinoma or mucinous adenocarcinoma.

Objective To investigate the effects of Tim-3 on the renal ischemia-reperfusion injury (IRI),and explore the role of monocyte-macrophage cell system.Methods Totally 72 C57BL/ 6 mice were randomly divided into four groups (n =18 each).(1) IR + Tim-3 rnAb group (experimental group):Each mouse was intraperitoneally injected with 200μg of anti-Tim-3 mAb and the IR model of mouse kidney was established after 1 day;(2) IR + IgG monoclonal antibody group (negative control group):each mouse was intraperitoneally injected with anti-IgG mAb (200 μg) and the IR model of mouse kidney was established after 1 day;(3) IR group:mouse kidney IR model was established only;(4) Control group:mouse kidney IR model was not established.At 6,24 and 48 h after IR respectively,venous blood of 6 mice in each group was taken from the infrarenal vein.Scr and CystinC were detected and PAS staining was used to observe the pathological change of renal tissues.Cell apoptosis was detected by TUNEL staining.Pax,bcl-2 and caspase-3 expression in renal tissue was detected by Western blotting.Immunohistochemistry was used to detect the distribution of Tim-3 and activated macrophage cells.Flow cytometry and ELISA were used to evaluate the level of Tim-3 and inflammatory cytokines secretion respectively.Results Compared with control group,the Tim-3 expression was dramatically increased in IR group and I/R + Tim-3 mAb group.The serum Scr and CystinC levels were increased in IR group,and Tim-3 blocking decreased the levels of serum Scr and CystinC (P＜0.05).PAS and TUNEL staining showed that renal injury score and apoptotic index were higher in IR group than those in control group.Tim-3mAb significantly decreased those markers,and ameliorated the renal tubulointerstitial injury induced by IRk The expression levels of Caspase-3 and Bax/bcl-2 was increased in IR group,but deceased by Tim-3mAb.IR induced F4/80 + distribution and inflammatory cytokines secretion in renal tubular interstitial tissues,while Tim-3mAb down-regulated F4/80 + activation and the levels of inflammatory cytokines.Conclusion The findings demonstrated Tim-3 may promoted renal IRI through regulating mononuclear phagocyte system function.