Objective To conduct a scoping review of studies related to gamified physical activity interventions for pediatric cancer patients,and to extract the gamification elements and application effects within physical activity intervention programs.Methods A computer-assisted search was conducted in CNKI,Wanfang Data,VIP Database,China Biology Medicine disc,Cochrane Library,PubMed,Embase,and Web of Science for studies on gamified physical activity interventions in pediatric cancer patients,with a search period from database inception to December 31,2023.The included literature was screened,summarized,and analyzed.Results A total of 18 articles were included,including 9 randomized controlled trials,4 quasi-experimental studies,and 5 mixed-method studies.The gamified intervention programs for physical activity in children with cancer integrated 7 gamification elements,including goal setting,capacity to overcome challenges,providing feedback on performance,reinforcement,progress monitoring,social connectivity,and fun and playfulness.The types of physical activity in the intervention programs included aerobic exercise,balance training,strength training,endurance training,etc.The intensity of the activities was mainly low to moderate;the duration was mostly 30～60 minutes per session;the intervention duration ranged from 5 weeks to 1 year.Numerous research findings indicate that gamified physical activity interventions for children with cancer can help improve physical function,quality of life,and fatigue levels.However,there is signi-ficant controversy regarding their impact on improving physical activity levels.Conclusion The gamified inter-vention for physical activity in children with cancer was safe and feasible.It is recommended that in the future,personalized and phased gamified intervention programs should be developed to evaluate the intervention effects.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder and its symptoms are subject to the composition of the gut microbiota. However, it is not yet clear how probiotics relieve IBS, and there is no well-acknowledged standards concerning the clinical application of probiotics. This systematic review was conducted on the literature published from January 2020 to December 2023 and included 12 randomized controlled trials on probiotics in the treatment of IBS. Compared with placebo, the probiotic preparations improved the overall efficacy in IBS patients and was also well tolerated, suggesting the potential of probiotics in IBS management. Nevertheless, different probiotic strains, dosages, combinations, and dosing schedules may affect the outcomes. In the future, large-scale, multi-center, long-term follow-up studies are still needed to clarify the effective strains and methods of use and to promote the use of probiotics in the treatment of IBS.

Objective To conduct a scoping review of studies related to gamified physical activity interventions for pediatric cancer patients,and to extract the gamification elements and application effects within physical activity intervention programs.Methods A computer-assisted search was conducted in CNKI,Wanfang Data,VIP Database,China Biology Medicine disc,Cochrane Library,PubMed,Embase,and Web of Science for studies on gamified physical activity interventions in pediatric cancer patients,with a search period from database inception to December 31,2023.The included literature was screened,summarized,and analyzed.Results A total of 18 articles were included,including 9 randomized controlled trials,4 quasi-experimental studies,and 5 mixed-method studies.The gamified intervention programs for physical activity in children with cancer integrated 7 gamification elements,including goal setting,capacity to overcome challenges,providing feedback on performance,reinforcement,progress monitoring,social connectivity,and fun and playfulness.The types of physical activity in the intervention programs included aerobic exercise,balance training,strength training,endurance training,etc.The intensity of the activities was mainly low to moderate;the duration was mostly 30～60 minutes per session;the intervention duration ranged from 5 weeks to 1 year.Numerous research findings indicate that gamified physical activity interventions for children with cancer can help improve physical function,quality of life,and fatigue levels.However,there is signi-ficant controversy regarding their impact on improving physical activity levels.Conclusion The gamified inter-vention for physical activity in children with cancer was safe and feasible.It is recommended that in the future,personalized and phased gamified intervention programs should be developed to evaluate the intervention effects.

Objective To compare the application value of coronary computed tomography angiography(CCTA)based plaque characteristics and computed tomography(CT)derived parameters in predicting future major adverse cardiovascular events(MACE)between patients with and without diabetes mellitus.Methods A total of 425 patients who underwent CCTA in Shunde Hospital Affiliated to Southern Medical University from June 2016 to November 2016 were retrospectively analyzed.Patients were divided into DM group(n=120)and non-DM group(n=305)for follow-up.According to the occurrence of MACE during follow-up,patients were divided into DM group(n=81),DM+MACE group(n=39),non-DM group(n=39),non-DM group(n=244)and non-DM+MACE group(n=61).The differences in general characteristics,biochemical index and parameters in imaging were compared among the four groups.Cox proportional hazards regression analysis was used to analyze the influencing factors for MACE in the two populations.The receiver operating characteristic(ROC)curve was used to analyze the difference in the predictive value of different plaque characteristics and CT-derived parameters for MACE.Results The levels of coronary artery calcification score(CACS),and the proportion of low-attenuation plaque(LAP)were higher in the DM+MACE group than in the DM group(P<0.05).The levels of positive reconstruction(PR),the proportion of antihypertensive drugs,CAD-RADS,CACS,residual cholesterol and apolipoprotein B were higher in the non-DM+MACE group than in the non-DM group(P<0.05).Cox proportional hazards regression analysis showed that CACS≥100(HR 2.151,95%CI 1.128～4.102,P=0.020)and LAP(HR 2.337,95%CI 1.032～5.290,P=0.042)were the influencing factors for MACE in patients with DM.PR(HR 124.305,95%CI 42.883～360.326,P<0.001)was the influencing factor for MACE in patients without DM.ROC curve analysis showed that the AUC of CACS combined with LAP were 0.606,0.609 and 0.660 for predicting MACE in DM patients within 1,3 and 5 years respectively.The AUC of PR for predicting MACE were 0.862,0.927,and 0.806 in the non-DM population within 1,3,and 5 years respectively.The predictive value of CACS and LAP for MACE in the DM patients was stable during the 5 years,while the predictive value of PR for MACE in the non-DM population decreased significantly after 4 years.Conclusions The predictive values of different plaque characteristics and CT derived parameters for future MACE are different between population with and without diabetes.The combination of CACS and low-attenuation plaques can effectively evaluate the risk of MACE in diabetic patients,while PR has a higher predictive value for MACE in non-diabetic patients.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder and its symptoms are subject to the composition of the gut microbiota. However, it is not yet clear how probiotics relieve IBS, and there is no well-acknowledged standards concerning the clinical application of probiotics. This systematic review was conducted on the literature published from January 2020 to December 2023 and included 12 randomized controlled trials on probiotics in the treatment of IBS. Compared with placebo, the probiotic preparations improved the overall efficacy in IBS patients and was also well tolerated, suggesting the potential of probiotics in IBS management. Nevertheless, different probiotic strains, dosages, combinations, and dosing schedules may affect the outcomes. In the future, large-scale, multi-center, long-term follow-up studies are still needed to clarify the effective strains and methods of use and to promote the use of probiotics in the treatment of IBS.

Objective To compare the application value of coronary computed tomography angiography(CCTA)based plaque characteristics and computed tomography(CT)derived parameters in predicting future major adverse cardiovascular events(MACE)between patients with and without diabetes mellitus.Methods A total of 425 patients who underwent CCTA in Shunde Hospital Affiliated to Southern Medical University from June 2016 to November 2016 were retrospectively analyzed.Patients were divided into DM group(n=120)and non-DM group(n=305)for follow-up.According to the occurrence of MACE during follow-up,patients were divided into DM group(n=81),DM+MACE group(n=39),non-DM group(n=39),non-DM group(n=244)and non-DM+MACE group(n=61).The differences in general characteristics,biochemical index and parameters in imaging were compared among the four groups.Cox proportional hazards regression analysis was used to analyze the influencing factors for MACE in the two populations.The receiver operating characteristic(ROC)curve was used to analyze the difference in the predictive value of different plaque characteristics and CT-derived parameters for MACE.Results The levels of coronary artery calcification score(CACS),and the proportion of low-attenuation plaque(LAP)were higher in the DM+MACE group than in the DM group(P<0.05).The levels of positive reconstruction(PR),the proportion of antihypertensive drugs,CAD-RADS,CACS,residual cholesterol and apolipoprotein B were higher in the non-DM+MACE group than in the non-DM group(P<0.05).Cox proportional hazards regression analysis showed that CACS≥100(HR 2.151,95%CI 1.128～4.102,P=0.020)and LAP(HR 2.337,95%CI 1.032～5.290,P=0.042)were the influencing factors for MACE in patients with DM.PR(HR 124.305,95%CI 42.883～360.326,P<0.001)was the influencing factor for MACE in patients without DM.ROC curve analysis showed that the AUC of CACS combined with LAP were 0.606,0.609 and 0.660 for predicting MACE in DM patients within 1,3 and 5 years respectively.The AUC of PR for predicting MACE were 0.862,0.927,and 0.806 in the non-DM population within 1,3,and 5 years respectively.The predictive value of CACS and LAP for MACE in the DM patients was stable during the 5 years,while the predictive value of PR for MACE in the non-DM population decreased significantly after 4 years.Conclusions The predictive values of different plaque characteristics and CT derived parameters for future MACE are different between population with and without diabetes.The combination of CACS and low-attenuation plaques can effectively evaluate the risk of MACE in diabetic patients,while PR has a higher predictive value for MACE in non-diabetic patients.

Objective:To explore the mediating role of psychosocial adaptation level in the relationship between menopausal symptoms and community integration in young breast cancer patients after chemotherapy.Methods:A total of 538 young breast cancer patients who underwent day chemotherapy in the outpatient Department of Breast Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine from September 2022 to May 2023 were selected by convenience sampling method.The general data survey scale,menopause rating scale(MRS),psychosocial adaptation questionnaire for breast cancer patients,and community integration questionnaire(CIQ)were used to investigate the patients.Results:The scores of menopausal symptoms,psychosocial adaptation level,and community integration in young breast cancer patients after chemotherapy were 6.88±3.14,134.12±21.53 and 16.27±6.24,respectively.Menopausal symptoms in young patients were negatively correlated with the total score and each dimension score of psychosocial adaptation level,and the psychosocial adaptation level was positively correlated with the total score and each dimension score of community integration.Community integration was negatively correlated with the total score and each dimension score of menopausal symptoms(all P＜0.001).The mediation effect test showed that the level of psychosocial adaptation played a mediating role between menopausal symptoms and community integration in young breast cancer patients,with a mediating effect of-0.799 and a mediating effect accounting for 63.21%.Conclusion:Improving the level of psychosocial adaptation of young breast cancer patients can alleviate menopausal symptoms and thus improve the community integration of young patients.

Objective To investigate the application value of extracellular volume fraction(ECV)obtained from enhanced CT in diagnosis and classification of acute pancreatitis.Methods The clinical data from patients with acute pancreatitis(acute pancreatitis group)and normal controls(control group)underwent enhanced CT were analyzed retrospectively.The CT values of pancreas and abdominal aorta in the same sclice on precontrast and equilibrium-phase images were measured,and then pancreatic ECV was calcu-lated.The measured parameters were compared between the groups of control and acute pancreatitis,and subgroups of non-severe and severe pancreatitis.The logistic regression analysis was used to identify the risk factors for acute pancreatitis and severe pancrea-titis,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency in diagnosis and classifica-tion of acute pancreatitis.Results The pancreatic CT value and ECV were independent risk factors for acute pancreatitis(P＜0.05),and the ECV was an independent risk factor for severe pancreatitis(P＜0.05).The area under the curve(AUC)of ECV was higher in acute pancreatitis group(0.81)and severe pancreatitis subgroup(0.68).Conclusion As a quantitative parameter,the ECV obtained from enhanced CT has higher clinical application value and higher popularity in the diagnosis and classification of acute pancreatitis.

Objective:To explore the mediating role of psychosocial adaptation level in the relationship between menopausal symptoms and community integration in young breast cancer patients after chemotherapy.Methods:A total of 538 young breast cancer patients who underwent day chemotherapy in the outpatient Department of Breast Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine from September 2022 to May 2023 were selected by convenience sampling method.The general data survey scale,menopause rating scale(MRS),psychosocial adaptation questionnaire for breast cancer patients,and community integration questionnaire(CIQ)were used to investigate the patients.Results:The scores of menopausal symptoms,psychosocial adaptation level,and community integration in young breast cancer patients after chemotherapy were 6.88±3.14,134.12±21.53 and 16.27±6.24,respectively.Menopausal symptoms in young patients were negatively correlated with the total score and each dimension score of psychosocial adaptation level,and the psychosocial adaptation level was positively correlated with the total score and each dimension score of community integration.Community integration was negatively correlated with the total score and each dimension score of menopausal symptoms(all P＜0.001).The mediation effect test showed that the level of psychosocial adaptation played a mediating role between menopausal symptoms and community integration in young breast cancer patients,with a mediating effect of-0.799 and a mediating effect accounting for 63.21%.Conclusion:Improving the level of psychosocial adaptation of young breast cancer patients can alleviate menopausal symptoms and thus improve the community integration of young patients.

Objective To investigate the protective effect and mechanism of curcumin on acute lung injury in septic mice.Methods Totally 120 clean BALB/c male mice were randomly (random number) divided into 8 groups:sham group,sepsis group,curcumin control group,curcumin intervention group,negative virus-sepsis group,negative virus-curcumin intervention group,Mfn2 interference-sepsis group,and Mfn2 interference-curcumin intervention group,15 rats in each group.Mice in the sepsis and the curcumin groups were given the cecal ligation and puncture (CLP) mice in the curcumin intervention and curcumin control groups were given curcumin 200 mg/(kg·d) for 1 week,and mice in the negative virus-sepsis group and negative virus-curcumin intervention groups were established by injection of a negative adeno-associated virus in the tail vein.The Mfn2 interference-sepsis and Mfn2 interference-curcumin intervention groups were established by injecting an adeno-associated virus carrying the Mfn2 interference sequence through the tail vein.Mice were sacrificed after 24 h in each group.The degree of lung injury was examined by lung wet-to-dry weight ratio and pathological examination.The inflammatory factors of alveolar lavage fluid including TNF-α and IL-6 were detected by ELISA,the activation of caspase-3,a key molecule for apoptosis,was detected by Western blot,and apoptosis was detected by TUNEL.The data were analyzed by SPSS 22.0 software,the count data was analyzed by x2 test,and the comparison of measurement data between groups was analyzed by one-way ANOVA.Results Compared with the sham group,the wet-to-dry weight ratio of lung tissue in the sepsis group was significantly increased (71.11 ± 3.78 vs 31.11 ± 5.61,P=0.002),the histopathological score was significantly higher (P=0.006),the inflammatory factors TNF-α (P=0.001) and IL-6 (P=0.012) were dramatically increased,and the apoptosis of lung tissue and the expression of caspase-3 cleaved were also significantly increased (P=0.001).Compared with the sepsis group,the wet-to-dry weight ratio and the histopathological score of lung tissue in the curcumin-treated group was significantly lower (32.84 ± 6.15 vs 71.11 ± 3.78,P=0.004),and the inflammatory factors TNF-α(P=0.013) and IL-6 (P=0.003) were obviously decreased,and apoptosis and apoptosis-related protein caspase-3 cleaved expression were also dramatically decreased (P=0.012).After Mfn2 was down-regulated,Mfn2 interference-curcumin intervention group interfered with Mfn2.Compared with the sepsis group,the dry-to-wet weight ratio and the histopathological score of the lung tissue of the mice was not significantly decreased.Further studies found that after down-regulating Mfn2,compared with the Mfn2 interfere-sepsis group,Mfn2 interfere-curcumin intervention group had no such performance.The inflammatory factors TNF-α and IL-6 were not significantly decreased,and the apoptosis of lung tissue and the expression of apoptosis-related protein caspase-3 cleaved were not significantly reduced.Conclusion Curcumin may attenuate acute lung injury in sepsis by up-regulating the expression of Mfn2.