Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective:To investigate the clinicopathological features,treatment and prognosis of endometrial carcinoma arising in endometrial polyps(EPs).Methods:Thirty-eight cases of endometrial carcinoma arising in EPs were collected in the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2021.The clinical data,pathological characteristics,and follow-up information were retrospectively analyzed from three dimensions:tumor histological type,the menopausal status of the patients and the scope of malignant le-sions.Results:①In terms of tumor histological type,uterine endometrioid carcinoma 33 cases(86.8%)and uter-ine serous carcinoma 50 cases(13.2%),the mean age of patients with endometrioid carcinoma arising from EPs was significantly lower than that of patients with serous carcinoma arising from EPs(53.3±10.0 years vs.63.4±10.3 years,P=0.043).②In terms of menopausal status,endometrioid carcinoma progressed from atypical poly-poid adenomyoma(APA)accounted for 55.6%(10/18)and 5.0%(1/20)in the pre-and post-menopausal group,respectively(P=0.001).The rate of adjuvant therapy was significantly lower in premenopausal patients than in postmenopausal patients(16.7%vs.50.0%,P=0.043).③There were no significant differences in pa-tients age,menopausal status,BMI,comorbidities,abnormal uterine bleeding,maximum diameter of EP,tumor stage,grade,treatment or recurrence rate between cases with tumors confined and unconfined to EPs.Conclu-sions:Endometrioid and serous carcinomas progressed from EPs were more common in perimenopausal and postmenopausal patients,respectively.Malignancies derived from APA contributed to almost half of EP-arising carcinomas in premenopausal women,with a higher degree of differentiation and a low rate of postoperative adju-vant therapy.

Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective:To investigate the clinicopathological features,treatment and prognosis of endometrial carcinoma arising in endometrial polyps(EPs).Methods:Thirty-eight cases of endometrial carcinoma arising in EPs were collected in the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2021.The clinical data,pathological characteristics,and follow-up information were retrospectively analyzed from three dimensions:tumor histological type,the menopausal status of the patients and the scope of malignant le-sions.Results:①In terms of tumor histological type,uterine endometrioid carcinoma 33 cases(86.8%)and uter-ine serous carcinoma 50 cases(13.2%),the mean age of patients with endometrioid carcinoma arising from EPs was significantly lower than that of patients with serous carcinoma arising from EPs(53.3±10.0 years vs.63.4±10.3 years,P=0.043).②In terms of menopausal status,endometrioid carcinoma progressed from atypical poly-poid adenomyoma(APA)accounted for 55.6%(10/18)and 5.0%(1/20)in the pre-and post-menopausal group,respectively(P=0.001).The rate of adjuvant therapy was significantly lower in premenopausal patients than in postmenopausal patients(16.7%vs.50.0%,P=0.043).③There were no significant differences in pa-tients age,menopausal status,BMI,comorbidities,abnormal uterine bleeding,maximum diameter of EP,tumor stage,grade,treatment or recurrence rate between cases with tumors confined and unconfined to EPs.Conclu-sions:Endometrioid and serous carcinomas progressed from EPs were more common in perimenopausal and postmenopausal patients,respectively.Malignancies derived from APA contributed to almost half of EP-arising carcinomas in premenopausal women,with a higher degree of differentiation and a low rate of postoperative adju-vant therapy.

Parkinson disease(PD)and dystonia share a common pathophysiological mechanism.In the later stage of the disease,PD-related dystonia can seriously impact the quality of life of patients and increase the burden of caregivers.This article reviews the common pathophysiological mechanism of PD and dystonia and the manifestations of PD-related dystonia.

Objective:To evaluate the autogenous arteriovenous fistula(AVF) insufficiency by ultrasound monitoring of brachial artery resistance index(RI).Methods:The brachial artery RI and blood flow volume(FV) data of 828 patients who underwent color-Doppler ultrasound detection after AVF in the General Hospital of Western Theater Command from January 2019 to June 2021 were retrospectively analyzed. The patients were grouped according to the adequacy of clinical dialysis, including 668 patients in the group with normal AVF function and 160 patients in the group with insufficient AVF function. The general information and ultrasonic measurement parameters were compared between the two groups. The correlation between brachial artery FV and RI was analyzed. The evaluation of brachial artery flow RI for AVF insufficiency was analyzed by ROC curve.Results:There were statistically significant differences between the two groups in brachial artery RI and FV(both P<0.001). The results of Pearson correlation analysis showed that brachial artery FV was negatively correlated to RI ( r=-0.657, P<0.001). The area under ROC curve for assessing AVF function by brachial artery RI was 0.970, with 95% CI was 0.955-0.986, the optimal cut-off value was 0.665, and the sensitivity and specificity were 0.888 and 0.955, respectively. Conclusions:Brachial artery RI in patients with AVF insufficiency is significantly higher than that in patients with normal AVF function. The optimal cutoff value of brachial artery RI can be used as an evaluation parameter for rapid screening of AVF function.

Objective:To investigate the effect and mechanism of treadmill training on Purkinje cells in the cerebellum of the rats with spinal cord injury(SCI). Method:Total of 108 female SD rats were randomly divided into 3 groups:the sham-operated group,the SCI group,and the SCI+treadmill training(TT)group.The rats in the SCI exercise group started treadmill train-ing after surgery,and BBB scores were used to assess the hindlimb motor function of rats with spinal cord in-jury.The cerebellum tissues were collected on the 3,7 and 14 day after surgery respectively,and the number and morphological changes of Purkinje cells in the cerebellum were detected by HE staining and Nissler stain-ing.The expression of caspase-9 and mGluR1 in Purkinje cells was detected by immunohistochemistry;the ex-pression of caspase-3 and mGluR1 was detected by immunofluorescence;the expression of apoptosis-related proteins Bax,Bcl-2,Cyt-C,caspase-9 and caspase-3 in cerebellar tissue was detected by Western Blot. Result:Compared with the sham-operated group,the BBB scores in SCI and SCI+TT groups were significant-ly decreased(P＜0.05).The number of Purkinje cells in cerebellum was reduced,and the size was reduced and lost the normal morphology.The expression levels of apoptosis-related proteins Bax,Cyt-C,activated caspase-9,and activated caspase-3 proteins in cerebellum were significantly increased(P＜0.05),and Bcl-2 expression was significantly decreased;caspase-9 and caspase-3 expression was increased and mGluR1 expression was decreased in Purkinje cells(P＜0.05).Compared with the SCI group,there was no significant difference in the BBB scores of the SCI+TT group(P＞0.05);the number and normal morphology of Purkinje cells in cerebellum increased;the expression levels of apoptosis-related proteins Bax,Cyt-C,activated caspase-9 and activated caspase-3 de-creased(P＜0.05),and the expression of Bcl-2 increased;the expression levels of caspase-9 and caspase-3 in Pur-kinje cells were decreased,and the expression level of mGluR1 was significantly increased(P＜0.05). Conclusion:Treadmill training can reduce the apoptosis of Purkinje cells in the cerebellum of the rats with spi-nal cord injury through the mitochondrial apoptosis pathway.

Objective:To investigate the clinical characteristics and risk factors of alcoholic liver disease (ALD) combined with type 2 diabetes mellitus (T2DM).Methods:The clinical data of 70 patients with ALD combined with T2DM (ALD + T2DM group) who received treatment from March 2015 to March 2020 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The clinical data of 69 patients with ALD (ALD group) and 69 patients with T2DM (T2DM group) who concurrently received treatment were also analyzed. Sex, age, body mass index, drinking habits and other basic information in the three groups were collected. The risk factors of ALD combined with T2DM were evaluated by logistic regression analysis.Results:The daily alcohol intake and years of drinking in the ALD + T2DM group were (110.97 ± 79.78) g/d and (25.17 ± 10.05) years, respectively, which were significantly higher than (91.48 ± 64.26) g/d and (21.78 ± 8.91) years respectively in the ALD group ( t = 1.699, 2.102, both P < 0.05). The incidence of metabolic syndrome in the ALD + T2DM group was 34.3% (24/70), which was significantly higher than 15.9% (11/69) in the ALD group ( χ2 = 6.210, P < 0.05). The activity ratio of aspartate aminotransferase/alanine aminotransferase, total bilirubin level, gamma glutamyl transpeptidase activity in the ALD + T2DM group were 1.59 ± 0.93, (64.73 ± 39.90) μmol/L, (522.93 ± 353.66) U/L, respectively, which were significantly higher than (1.04 ± 0.53), (10.37 ± 4.51) μmol/L, (35.73 ± 23.99) U/L, respectively in the T2DM group ( t = 4.280, 3.780, 5.045, all P < 0.05). Triacylglycerol level in the ALD + T2DM group was significantly higher than that in the ALD group [(1.69 ± 1.04) mmol/L vs. (1.28 ± 0.87) mmol/L, t = 2.523, P < 0.05). Prothrombin time and lactate dehydrogenase activity in the ALD + T2DM group were (13.13 ± 2.79) s and (226.17 ± 79.93) U/L, respectively, which were significantly higher than (10.41 ± 0.84) s, (172.63 ± 39.34) U/L, respectively in the T2DM group ( t = 7.715, 4.969, both P < 0.05). Multivariate Logistic regression analysis showed that prothrombin time, triacylglycerol level, years of drinking, gamma glutamyl transpeptidase activity, and amount of drinking were the main risk factors for ALD combined with T2DM ( OR = 2.010, 3.270, 1.230, 1.060, 1.006, all P < 0.05). Conclusion:Patients with ALD combined with T2DM are prone to metabolic syndrome and lipid disorders, which may aggravate the disease. Prothrombin time, triacylglycerol level, years of drinking play an important role in the development of ALD combined with T2DM.

Objective:To explore the effects of diary research-based communication pattern on migration stress of first-degree relatives of elderly patients transferred out of ICU.Methods:Totally 86 elderly patients transferred out of ICU postoperatively at the 2nd Affiliated Hospital of Wenzhou Medical University from October 2017 to April 2018 were selected by convenient sampling and divided into the control group ( n=43, admitted between October and December 2017) and the observation group ( n=43, admitted between January and April 2018) according to admission time. Patients in the control group underwent routine communication, while patients in the observation group conducted communication based on diary research. The migration stress levels of the first-degree relatives were compared between the two groups. Results:There was no significant difference in migration stress levels between the first-degree relatives of the two groups before the intervention ( P>0.05) . After the intervention, the level of migration stress of the first-degree relatives in the observation group was lower than that in the control group, and the difference was statistically significant ( t=3.598, P<0.01) . Conclusions:The communication model based on diary research can effectively reduce the level of migration stress among the first-degree relatives of elderly patients who are transferred out of ICU postoperatively.