Objective:To explore the facilitators and barriers of home-based pulmonary rehabilitation in patients with pulmonary hypertension, in order to provide a basis for medical staff to formulate precise pulmonary rehabilitation interventions.Methods:The maximum variation purposive sampling method was used. From October to December 2023, a total of 12 patients with pulmonary hypertension attending the Department of Cardiology, Tianjin Medical University General Hospital, were selected as study participants and underwent semi-structured interviews. Colaizzi's phenomenological method was applied to analyze the data.Results:The facilitators of home-based pulmonary rehabilitation among patients with pulmonary hypertension included: capability factor (good exercise habits) ; opportunity factors (supervision and support from family members, professional guidance from medical staff) ; motivation factors (rehabilitation enthusiasm, perceived benefits of exercise). The barriers included: capability factors (obvious perception of physical symptoms, lack of knowledge about pulmonary rehabilitation, low level of e-health literacy) ; opportunity factors (unfavorable health environment, limited time) ; motivation factors (fear of exercise, lack of rehabilitation self-discipline) .Conclusions:Home-based pulmonary rehabilitation in patients with pulmonary hypertension is affected by multiple factors. Medical staff should adopt targeted interventions to promote patients' engagement in home-based pulmonary rehabilitation, with the aim of improving cardiopulmonary health, exercise endurance, and quality of life, thereby enhancing clinical prognosis.

Objective:To analyze the research status and emerging hotspots in the field of cardiac telerehabilitation (CTR) and provide references for the development of CTR in China.Methods:A systematic search was conducted for relevant literature on CTR in the databases of China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, Web of Science Core Collection, PubMed, CINAHL, Cochrane Library, and Embase, with a search timeframe from the establishment of the databases to February 28, 2024. EndNote and CiteSpace software were used for visual analysis of the search results.Results:A total of 889 papers were included, of which 269 were in Chinese and 620 were in English, showing an overall increasing trend in publication volume. The Chinese database revealed 12 clustering groups and 9 emerging keywords, while the English database identified 10 clustering groups and 16 emerging keywords.Conclusions:The publication volume of CTR is generally on the rise, but cooperation between countries and institutions still needs strengthening. Current research hotspots and frontiers include the demand for CTR, target populations, exercise program design, and the application of electronic information technology. Researchers in China should fully refer to these hotspots and frontiers and explore CTR models that are suitable for the Chinese patient population.

Objective:To evaluate the impact of roxadustat on thyroid function and to identify the associated factors in patients undergoing maintenance peritoneal dialysis (PD).Methods:This study was a single-center retrospective study. PD patients who received roxadustat or recombinant human erythropoietin (rHuEPO) treatment at Nanjing Drum Tower Hospital between January 2020 and June 2024 were included. The general and clinical information as well as laboratory indexes were collected. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were compared before and after treatment initiation. Hemoglobin (Hb) responses were also observed between the two groups. Logistic regression analysis was performed to explore the factors associated with thyroid function changes.Results:A total of 120 patients were enrolled, with an age of (55.17±16.42) years, including 66 males (55.0%). There were 81 patients received roxadustat (roxadustat group) and 39 patiens received rHuEPO (rHuEPO group). Compared to the rHuEPO group, the roxadustat group had a higher proportion of patients with diabetes ( χ 2= 4.172, P=0.041), a shorter PD vintage ( Z=-3.406, P=0.002), a lower serum level of total cholesterol ( Z=-2.082, P=0.037) and a lower level of fasting blood glucose ( Z=-2.589, P=0.010). Following treatment with roxadustat, the levels of FT4 ( Z=-5.349, P<0.01) and TSH ( Z=-3.720, P<0.01) decreased significantly. In contrast, no significant changes in FT4 or TSH levels were observed in the rHuEPO group (both P>0.05). For both roxadustat and rHuEPO groups, there were no significant changes in FT3 levels after treatment (both P>0.05). Multivariate analysis identified that higher baseline TSH (TSH≥2.27 μIU/ml, OR=1.581, 95% CI 1.196-2.089, P=0.001) and roxadustat exposure ( OR=3.432, 95% CI 1.410-8.355, P=0.007) as independent associated factors of subsequent TSH decline, and identified that higher baseline FT4 (FT4≥14.9 pmol/L, OR=1.390, 95% CI 1.162-1.662, P=0.001) and roxadustat exposure ( OR=5.798, 95% CI 2.225-15.113, P=0.001) as independent associated factors of subsequent FT4 decline. The degrees of hemoglobin changes after roxadustat or rHuEPO treatment did not differ significantly between roxadustat group and rHuEPO group ( t=-1.062, P=0.290). Of the 31 patients who underwent a second thyroid function test during roxadustat treatment, 24 continued with the original regimen, while 7 discontinued roxadustat. Among 24 patients who maintained roxadustat treatment, TSH ( Z=-0.400, P=0.689) and FT4 ( t=0.143, P=0.888) remained stable between the second and third tests. All 7 patients who discontinued roxadustat treatment showed TSH rebound and the changes of TSH levels were more significant than that in continuers ( Z=-2.505, P=0.012). FT4 recovery occurred in only 3 of them, with no significant difference in FT4 change between discontinuers and continuers ( Z=-0.685, P=0.493). Conclusions:Roxadustat commonly suppresses TSH and FT4, but not FT3, in PD patients. Baseline levels of TSH and FT4 are key associated factors of the inhibitory effect of roxadustat on thyroid function. This suppression does not intensify with prolonged exposure and is reversible after discontinuation, with TSH levels normalizing more quickly than FT4. Roxadustat-induced thyroid suppression does not compromise its efficacy in treating renal anemia.

Objective:To investigate the effects of baicalein on the protein kinase B(AKT)/glycogen synthase kinase 3β(GSK3β)pathway and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1 β)in lipopolysaccharide(LPS)-activated BV2 microglial cells.Methods:BV2 microglial cells were cultured and divided into control group,LPS-induced group,and LPS+Baicalein group.Molecular docking was conducted to verify the bind-ing affinity of baicalein to AKT.Western blot and immunofluorescence staining were used to assess the expression and phosphorylation levels of AKT,GSK3β,TNF-α,and IL-1β in activated BV2 cells.Results:Baicalein exhibited a strong binding affinity for AKT.Western blot results showed that LPS stimulation led to increased TNF-α and IL-1 βexpression and decreased phosphorylation of AKT and GSK3β in BV2 cells(P＜0.05).After Baicalein treatment,TNF-α and IL-1 β expression significantly decreased,while AKT and GSK3β phosphorylation levels increased compared to the LPS group(P＜0.05).Immunofluorescence staining results were consistent with those of Western blot.Conclusion:Baicalein inhibits the expression of TNF-α and IL-1 β in activated microglia,potentially through activation of the AKT/GSK3β pathway.

Objective:To investigate the effects of baicalein on the protein kinase B(AKT)/glycogen synthase kinase 3β(GSK3β)pathway and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1 β)in lipopolysaccharide(LPS)-activated BV2 microglial cells.Methods:BV2 microglial cells were cultured and divided into control group,LPS-induced group,and LPS+Baicalein group.Molecular docking was conducted to verify the bind-ing affinity of baicalein to AKT.Western blot and immunofluorescence staining were used to assess the expression and phosphorylation levels of AKT,GSK3β,TNF-α,and IL-1β in activated BV2 cells.Results:Baicalein exhibited a strong binding affinity for AKT.Western blot results showed that LPS stimulation led to increased TNF-α and IL-1 βexpression and decreased phosphorylation of AKT and GSK3β in BV2 cells(P＜0.05).After Baicalein treatment,TNF-α and IL-1 β expression significantly decreased,while AKT and GSK3β phosphorylation levels increased compared to the LPS group(P＜0.05).Immunofluorescence staining results were consistent with those of Western blot.Conclusion:Baicalein inhibits the expression of TNF-α and IL-1 β in activated microglia,potentially through activation of the AKT/GSK3β pathway.

Objective:To explore the facilitators and barriers of home-based pulmonary rehabilitation in patients with pulmonary hypertension, in order to provide a basis for medical staff to formulate precise pulmonary rehabilitation interventions.Methods:The maximum variation purposive sampling method was used. From October to December 2023, a total of 12 patients with pulmonary hypertension attending the Department of Cardiology, Tianjin Medical University General Hospital, were selected as study participants and underwent semi-structured interviews. Colaizzi's phenomenological method was applied to analyze the data.Results:The facilitators of home-based pulmonary rehabilitation among patients with pulmonary hypertension included: capability factor (good exercise habits) ; opportunity factors (supervision and support from family members, professional guidance from medical staff) ; motivation factors (rehabilitation enthusiasm, perceived benefits of exercise). The barriers included: capability factors (obvious perception of physical symptoms, lack of knowledge about pulmonary rehabilitation, low level of e-health literacy) ; opportunity factors (unfavorable health environment, limited time) ; motivation factors (fear of exercise, lack of rehabilitation self-discipline) .Conclusions:Home-based pulmonary rehabilitation in patients with pulmonary hypertension is affected by multiple factors. Medical staff should adopt targeted interventions to promote patients' engagement in home-based pulmonary rehabilitation, with the aim of improving cardiopulmonary health, exercise endurance, and quality of life, thereby enhancing clinical prognosis.

Objective:To analyze the research status and emerging hotspots in the field of cardiac telerehabilitation (CTR) and provide references for the development of CTR in China.Methods:A systematic search was conducted for relevant literature on CTR in the databases of China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, Web of Science Core Collection, PubMed, CINAHL, Cochrane Library, and Embase, with a search timeframe from the establishment of the databases to February 28, 2024. EndNote and CiteSpace software were used for visual analysis of the search results.Results:A total of 889 papers were included, of which 269 were in Chinese and 620 were in English, showing an overall increasing trend in publication volume. The Chinese database revealed 12 clustering groups and 9 emerging keywords, while the English database identified 10 clustering groups and 16 emerging keywords.Conclusions:The publication volume of CTR is generally on the rise, but cooperation between countries and institutions still needs strengthening. Current research hotspots and frontiers include the demand for CTR, target populations, exercise program design, and the application of electronic information technology. Researchers in China should fully refer to these hotspots and frontiers and explore CTR models that are suitable for the Chinese patient population.

Objective:To evaluate the impact of roxadustat on thyroid function and to identify the associated factors in patients undergoing maintenance peritoneal dialysis (PD).Methods:This study was a single-center retrospective study. PD patients who received roxadustat or recombinant human erythropoietin (rHuEPO) treatment at Nanjing Drum Tower Hospital between January 2020 and June 2024 were included. The general and clinical information as well as laboratory indexes were collected. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were compared before and after treatment initiation. Hemoglobin (Hb) responses were also observed between the two groups. Logistic regression analysis was performed to explore the factors associated with thyroid function changes.Results:A total of 120 patients were enrolled, with an age of (55.17±16.42) years, including 66 males (55.0%). There were 81 patients received roxadustat (roxadustat group) and 39 patiens received rHuEPO (rHuEPO group). Compared to the rHuEPO group, the roxadustat group had a higher proportion of patients with diabetes ( χ 2= 4.172, P=0.041), a shorter PD vintage ( Z=-3.406, P=0.002), a lower serum level of total cholesterol ( Z=-2.082, P=0.037) and a lower level of fasting blood glucose ( Z=-2.589, P=0.010). Following treatment with roxadustat, the levels of FT4 ( Z=-5.349, P<0.01) and TSH ( Z=-3.720, P<0.01) decreased significantly. In contrast, no significant changes in FT4 or TSH levels were observed in the rHuEPO group (both P>0.05). For both roxadustat and rHuEPO groups, there were no significant changes in FT3 levels after treatment (both P>0.05). Multivariate analysis identified that higher baseline TSH (TSH≥2.27 μIU/ml, OR=1.581, 95% CI 1.196-2.089, P=0.001) and roxadustat exposure ( OR=3.432, 95% CI 1.410-8.355, P=0.007) as independent associated factors of subsequent TSH decline, and identified that higher baseline FT4 (FT4≥14.9 pmol/L, OR=1.390, 95% CI 1.162-1.662, P=0.001) and roxadustat exposure ( OR=5.798, 95% CI 2.225-15.113, P=0.001) as independent associated factors of subsequent FT4 decline. The degrees of hemoglobin changes after roxadustat or rHuEPO treatment did not differ significantly between roxadustat group and rHuEPO group ( t=-1.062, P=0.290). Of the 31 patients who underwent a second thyroid function test during roxadustat treatment, 24 continued with the original regimen, while 7 discontinued roxadustat. Among 24 patients who maintained roxadustat treatment, TSH ( Z=-0.400, P=0.689) and FT4 ( t=0.143, P=0.888) remained stable between the second and third tests. All 7 patients who discontinued roxadustat treatment showed TSH rebound and the changes of TSH levels were more significant than that in continuers ( Z=-2.505, P=0.012). FT4 recovery occurred in only 3 of them, with no significant difference in FT4 change between discontinuers and continuers ( Z=-0.685, P=0.493). Conclusions:Roxadustat commonly suppresses TSH and FT4, but not FT3, in PD patients. Baseline levels of TSH and FT4 are key associated factors of the inhibitory effect of roxadustat on thyroid function. This suppression does not intensify with prolonged exposure and is reversible after discontinuation, with TSH levels normalizing more quickly than FT4. Roxadustat-induced thyroid suppression does not compromise its efficacy in treating renal anemia.

Objective:To explore the symptom clusters, core symptoms and bridging symptoms in the symptom network of early postoperative patients with laryngeal cancer.Methods:From January 2021 to April 2024, convenience sampling was used to select early postoperative patients with laryngeal cancer admitted to the Department of Otolaryngology at the First Affiliated Hospital of the University of Science and Technology of China as participants. The General Information Questionnaire and M.D. Anderson Symptom Inventory-Head & Neck were used for the survey. R language software was used to analyze symptom clusters, core symptoms, and bridging symptoms in early postoperative patients with laryngeal cancer.Results:A total of 300 questionnaires were distributed and 287 valid questionnaires were collected, with a valid response rate of 95.7%. Network analysis extracted three symptom clusters (oropharyngeal specific symptom cluster, shortness of breath and fatigue symptom cluster, and sleep emotion symptom cluster), among which the oropharyngeal specific symptom cluster was the most severe. Symptom network analysis showed a strong correlation between oropharyngeal pain and swallowing difficulties, distress and fatigue, and restless sleep and sadness. Shortness of breath exhibited the highest intensity centrality ( rs=1.29) and mediation centrality ( rb=96) in the symptom network. It was the core symptom and bridging symptom in the symptom network of early postoperative patients with laryngeal cancer. Conclusions:Early postoperative patients with laryngeal cancer have a severe oropharyngeal-specific symptom cluster, with shortness of breath being the core symptom and bridging symptom in the symptom network. Medical and nursing staff should focus on the mutual influence between early symptoms of patients after laryngectomy and correctly identify core symptoms and bridging symptoms to improve symptom management accuracy.

Purpose/Significance To design a comprehensive data platform to meet the needs of collecting and sharing survey data on meteorological sensitive diseases,so as to enhance monitoring capabilities for meteorological sensitive diseases in China.Method/Process Through various methods such as data extraction,data exchange,data import and customized collection,disease data,meteoro-logical data,environmental data and diagnosis and treatment data are processed and integrated into the platform for unified management.Result/Conclusion This platform realizes the functions of data collection,aggregation,visualization display and data sharing,which can provide support for scientific researchers in various bases across the country to better manage and utilize meteorological sensitive disease survey data.