Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Dental trauma is one of the relatively common emergencies in clinical dental practice, with a high incidence rate, and the maxillary central incisors are the most frequently affected. This article reports a case of a 17-year-old female patient who suffered traumatic complete avulsion of teeth 11 and 21, with tooth 21 lost after avulsion. The prognosis for replantation was poor due to the absence of the buccal alveolar bone wall of tooth 11. Therefore, tooth 11 was treated with extracorporeal root canal therapy and then replanted into the alveolar socket of tooth 21, which had better conditions, followed by elastic splint fixation. After 20 months of follow-up observation, the affected tooth maintained a stable functional position, with no periapical inflammation or ankylosis observed. Subsequently, delayed implant restoration at the site of tooth 11 was performed, ultimately achieving a favorable treatment outcome. This case may provide new insights and references for future clinical practices in tooth replantation.
Humans ; Female ; Tooth Replantation/methods* ; Incisor/injuries* ; Adolescent ; Tooth Avulsion/therapy* ; Maxilla ; Root Canal Therapy

INTRODUCTION: Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are used in the diagnosis and prognostication of rheumatoid arthritis (RA). We wanted to determine the specific contributions of RF and ACPA to the biological nature of RA and whether they act synergistically. METHODS: We identified 731 patients from our prospective multi-ethnic RA cohort and categorised them into four groups: ACPA-positive, RF-positive, doubly positive and doubly negative. We compared the demographics, Disease Activity Score-28, Health Assessment Questionnaire score, quality of life using Short Form 36 and the use of prednisolone and disease-modifying antirheumatic drugs (DMARDs) of these patient groups. RESULTS: Four hundred and ninety-one patients (67.2%) were ACPA+RF+, 54 (7.4%) were ACPA+RF-, 82 (11.2%) were ACPA-RF+ and 104 (14.2%) were ACPA-RF-. Mean disease duration before the study entry was not different in the four groups. Patients with older age of onset were less likely to be positive for RF and ACPA. Fewer ACPA+RF+ patients were in remission compared to those in the other groups ( P < 0.05). Erythrocyte sedimentation rate (ESR) was higher at study entry in the ACPA+RF+ group (40.4 mm/h vs. 30.6-30.9 mm/h, P < 0.05). Prednisolone and number of DMARDs used were higher in the ACPA+RF+ group compared to the doubly negative group. There were no differences in the functional status and quality of life. CONCLUSIONS RA patients who were positive for both ACPA and RF had lower remission rate, higher baseline ESR and required more corticosteroid and DMARD treatment compared to those who were singly positive or doubly negative. Being doubly positive confers a worse outcome to RA patients.
Humans ; Arthritis, Rheumatoid/diagnosis* ; Male ; Female ; Middle Aged ; Rheumatoid Factor/blood* ; Anti-Citrullinated Protein Antibodies/blood* ; Adult ; Quality of Life ; Prospective Studies ; Antirheumatic Agents/therapeutic use* ; Aged ; Peptides, Cyclic/immunology* ; Prednisolone/therapeutic use* ; Surveys and Questionnaires ; Severity of Illness Index ; Prognosis

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

In a healthy human, the airway mucus forms a thin, protective liquid layer covering the surface of the respiratory tract. It comprises a complex blend of mucin, multiple antibacterial proteins, metabolic substances, water, and electrolytes. This mucus plays a pivotal role in the lungs' innate immune system by maintaining airway hydration and capturing airborne particles and pathogens. However, heightened mucus secretion in the airway can compromise ciliary clearance, obstruct the respiratory tract, and increase the risk of pathogen colonization and recurrent infections. Consequently, a thorough exploration of the mechanisms driving excessive airway mucus secretion is crucial for establishing a theoretical foundation for the eventual development of targeted drugs designed to reduce mucus production. Across a range of lung diseases, excessive airway mucus secretion manifests with unique characteristics and regulatory mechanisms, all intricately linked to mucin. This article provides a comprehensive overview of the characteristics and regulatory mechanisms associated with excessive airway mucus secretion in several prevalent lung diseases.
Humans ; Mucus/metabolism* ; Mucins/physiology* ; Lung Diseases/metabolism* ; Respiratory Mucosa/metabolism* ; Pulmonary Disease, Chronic Obstructive/physiopathology* ; Asthma/physiopathology* ; Cystic Fibrosis/physiopathology* ; Mucociliary Clearance/physiology*

Objective To analyze the incidence of cardiovascular events among patients with comorbid chronic obstructive pulmonary disease(COPD)and hypertension(HTN),as well as to identify the associated influ-encing factors.Methods A retrospective analysis was conducted on patients diagnosed with primary hypertension(HTN group,n=64),chronic obstructive pulmonary disease(COPD group,n=64),and concomitant primary hypertension and COPD(combined group,n=64)at our hospital between December 2021 and January 2025.Cardiovascular event incidence,pulmonary function parameters-including forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and percent predicted FEV1(FEV1%pred)-and blood pressure levels(systolic blood pressure[SBP],diastolic blood pressure[DBP])were compared across the three groups.Kaplan-Meier curves were constructed to illustrate and compare the cumulative incidence of cardiovas-cular events.Covariance analysis was performed to assess the impact of hypertension on pulmonary function,and Cox proportional hazards regression was employed to identify factors associated with cardiovascular outcomes.Results The total incidence rate of cardiovascular events in the HTN group was 14.06%,which was significantly lower than that in the COPD group(29.69%)and the combined HTN-COPD group(48.44%)(P<0.05).A highly significant difference was observed in the cumulative incidence rates across the three groups(P<0.05).Specifically,the COPD group exhibited a higher cumulative incidence than the HTN group(P<0.05),while the combined group showed the highest incidence,exceeding both the COPD and HTN groups(P<0.05).Pulmonary function parameters-including FVC,FEV1,PEF,and FEV1%pred-were significantly higher in the HTN group compared to both the COPD and combined groups(P<0.05).Moreover,these indices were also higher in the COPD group than in the combined group(P<0.05).Systolic and diastolic blood pressure(SBP and DBP)levels in the combined group were significantly elevated compared to both the HTN and COPD groups(P<0.05),and SBP and DBP in the HTN group were higher than those in the COPD group(P<0.05).After adjusting for potential confounders,the intergroup dif-ference in FVC remained statistically significant(P<0.05),and the effect of group on FEV1%pred was particularly robust(partial η2=0.754,P<0.05).Compared with patients without cardiovascular events,those who experienced events differed significantly by disease type(P<0.05).The proportions of patients with HTN alone and HTN com-bined with COPD were higher in the event group than in the non-event group(P<0.05).Additionally,FVC and FEV1%pred were lower in the event group,whereas SBP and DBP were higher(all P<0.05).Multivariate analysis identified disease type,FEV1%pred,and SBP as independent predictors of cardiovascular events(P<0.05).Deci-sion tree analysis further highlighted that the coexistence of HTN and COPD constitutes a critical determinant in cardiovascular risk stratification.Conclusions The incidence of cardiovascular events in patients with COPD com-bined with HTN was significantly higher than in those with either condition alone.Furthermore,the coexistence of these diseases,along with impaired lung function(as indicated by reduced FEV1%predicted)and increased SBP,were independent risk factors for cardiovascular events.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Aim To study whether intravenous injec-tion of miR-129-3p mimetic(agomir)can resist bone loss caused by hind limb disuse,and to provide new i-deas for preventing bone loss in microgravity environ-ment.Methods Forty-eight C57BL/6J male mice were randomly divided into the control group(CON),tail suspension model group(TS),tail suspension+miR-129-3p agomir administration group(miRNA)and tail suspension+miR-129-3p negative sequence agomir control group(NC).The miRNA group was given 4 mg·kg-1 miR-129-3p agomir by intravenous injection into the medial canthus twice a week.The NC agomir group were consistent with those in the miR-129-3p agomir group,and the CON and TS groups were given only equal volumes of normal saline.After four weeks,all mice were sacrificed and samples were collected.Micro-CT scan of femur,three-point femur bending test,serum bone metabolism index detection,oxidative stress index detection and osteogenesis-related protein expression analysis in bone tissue were per-formed.Results After four weeks,the number of tra-becular bone in the TS group was significantly re-duced,and Tb.BMD,Tb.Th,Tb.N,Tb.BS/TV and Tb.BV/TV were significantly lower than those in the CON group(P＜0.01).While Tb.Sp TS group was significantly higher than the CON group(P＜0.05),the maximum load and flexural strength of the femur significantly decreased(P＜0.01),the content of ser-um bone formation index PINP was significantly lower than that of the CON group(P＜0.01),and the con-tent of bone resorption index CTX-I was significantly higher than that of the CON group(P＜0.01),the content of serum oxidative damage indexes 8-iso-PGF2α and 8-OHdG significantly increased(P＜0.01),and the expression of osteogenesis-related pro-teins in bone tissue markedly decreased(P＜0.01).However,the increase or decrease of all indexes in miRNA group was significantly lower than that in TS group.Conclusions miR-129-3p mimetic can signifi-cantly reduce bone loss caused by hind limb disuse.This experiment provides a new idea and method for preventing bone loss in microgravity environment.

Objective To analyze the incidence of cardiovascular events among patients with comorbid chronic obstructive pulmonary disease(COPD)and hypertension(HTN),as well as to identify the associated influ-encing factors.Methods A retrospective analysis was conducted on patients diagnosed with primary hypertension(HTN group,n=64),chronic obstructive pulmonary disease(COPD group,n=64),and concomitant primary hypertension and COPD(combined group,n=64)at our hospital between December 2021 and January 2025.Cardiovascular event incidence,pulmonary function parameters-including forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and percent predicted FEV1(FEV1%pred)-and blood pressure levels(systolic blood pressure[SBP],diastolic blood pressure[DBP])were compared across the three groups.Kaplan-Meier curves were constructed to illustrate and compare the cumulative incidence of cardiovas-cular events.Covariance analysis was performed to assess the impact of hypertension on pulmonary function,and Cox proportional hazards regression was employed to identify factors associated with cardiovascular outcomes.Results The total incidence rate of cardiovascular events in the HTN group was 14.06%,which was significantly lower than that in the COPD group(29.69%)and the combined HTN-COPD group(48.44%)(P<0.05).A highly significant difference was observed in the cumulative incidence rates across the three groups(P<0.05).Specifically,the COPD group exhibited a higher cumulative incidence than the HTN group(P<0.05),while the combined group showed the highest incidence,exceeding both the COPD and HTN groups(P<0.05).Pulmonary function parameters-including FVC,FEV1,PEF,and FEV1%pred-were significantly higher in the HTN group compared to both the COPD and combined groups(P<0.05).Moreover,these indices were also higher in the COPD group than in the combined group(P<0.05).Systolic and diastolic blood pressure(SBP and DBP)levels in the combined group were significantly elevated compared to both the HTN and COPD groups(P<0.05),and SBP and DBP in the HTN group were higher than those in the COPD group(P<0.05).After adjusting for potential confounders,the intergroup dif-ference in FVC remained statistically significant(P<0.05),and the effect of group on FEV1%pred was particularly robust(partial η2=0.754,P<0.05).Compared with patients without cardiovascular events,those who experienced events differed significantly by disease type(P<0.05).The proportions of patients with HTN alone and HTN com-bined with COPD were higher in the event group than in the non-event group(P<0.05).Additionally,FVC and FEV1%pred were lower in the event group,whereas SBP and DBP were higher(all P<0.05).Multivariate analysis identified disease type,FEV1%pred,and SBP as independent predictors of cardiovascular events(P<0.05).Deci-sion tree analysis further highlighted that the coexistence of HTN and COPD constitutes a critical determinant in cardiovascular risk stratification.Conclusions The incidence of cardiovascular events in patients with COPD com-bined with HTN was significantly higher than in those with either condition alone.Furthermore,the coexistence of these diseases,along with impaired lung function(as indicated by reduced FEV1%predicted)and increased SBP,were independent risk factors for cardiovascular events.

Aim To study whether intravenous injec-tion of miR-129-3p mimetic(agomir)can resist bone loss caused by hind limb disuse,and to provide new i-deas for preventing bone loss in microgravity environ-ment.Methods Forty-eight C57BL/6J male mice were randomly divided into the control group(CON),tail suspension model group(TS),tail suspension+miR-129-3p agomir administration group(miRNA)and tail suspension+miR-129-3p negative sequence agomir control group(NC).The miRNA group was given 4 mg·kg-1 miR-129-3p agomir by intravenous injection into the medial canthus twice a week.The NC agomir group were consistent with those in the miR-129-3p agomir group,and the CON and TS groups were given only equal volumes of normal saline.After four weeks,all mice were sacrificed and samples were collected.Micro-CT scan of femur,three-point femur bending test,serum bone metabolism index detection,oxidative stress index detection and osteogenesis-related protein expression analysis in bone tissue were per-formed.Results After four weeks,the number of tra-becular bone in the TS group was significantly re-duced,and Tb.BMD,Tb.Th,Tb.N,Tb.BS/TV and Tb.BV/TV were significantly lower than those in the CON group(P＜0.01).While Tb.Sp TS group was significantly higher than the CON group(P＜0.05),the maximum load and flexural strength of the femur significantly decreased(P＜0.01),the content of ser-um bone formation index PINP was significantly lower than that of the CON group(P＜0.01),and the con-tent of bone resorption index CTX-I was significantly higher than that of the CON group(P＜0.01),the content of serum oxidative damage indexes 8-iso-PGF2α and 8-OHdG significantly increased(P＜0.01),and the expression of osteogenesis-related pro-teins in bone tissue markedly decreased(P＜0.01).However,the increase or decrease of all indexes in miRNA group was significantly lower than that in TS group.Conclusions miR-129-3p mimetic can signifi-cantly reduce bone loss caused by hind limb disuse.This experiment provides a new idea and method for preventing bone loss in microgravity environment.