Objective: To explore the mediating effects of psychological flexibility and exercise self-efficacy between frailty and social isolation among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide the basis for alleviating social isolation in this population. Methods: From July to November 2024, elderly patients with T2DM aged ≥65 years were selected by using the convenience sampling method from the endocrinology and geriatrics departments of a tertiary hospital in Shanxi Province. Demographic and clinical data were collected using structured questionnaires. Frailty was assessed using the FRAIL Scale, psychological flexibility was measured with the Acceptance and Action Questionnaire-II (AAQ-II), exercise self-efficacy was evaluated via the Chinese version of the Exercise Self-Efficacy Scale, and social isolation was quantified employing the General Alienation Scale. The mediating effects of psychological flexibility and exercise self-efficacy between frailty and social isolation were analyzed using the Process macro program. Results: A total of 300 elderly patients with T2DM were included, with a mean age of (71.16±4.88) years. There are 167 males (55.67%) and 133 females (44.33%). The mean scores for frailty, psychological flexibility, exercise self-efficacy, and social isolation were (2.82±1.59), (28.32±6.95), (5.69±1.20), and (39.27±9.24). Mediation analysis revealed that frailty positively affected social isolation (β=0.227, 95%CI: 0.132-0.323). It also indirectly positively influenced social isolation through psychological flexibility (β=0.165, 95%CI: 0.105-0.234) and exercise self-efficacy (β=0.150, 95%CI: 0.093-0.217), and the chained mediating effect of psychological flexibility and exercise self-efficacy (β=0.066, 95%CI: 0.038-0.100). Conclusion Frailty exacerbates social isolation by diminishing psychological flexibility and exercise self-efficacy among elderly patients with T2DM.

Objective:To investigate the clinicopathological and genetic features of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion.Methods:The clinical, morphological and immunohistochemical features of 14 cases of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion diagnosed from January 2019 to December 2022 in the Department of Pathology, Foshan Traditional Chinese Medicine Hospital, Foshan, China were retrospectively analyzed. The cases were all subject to FISH or next generation sequencing for analysis of molecular genetic features. The literature was reviewed.Results:There were 5 males and 9 females, with the age at presentation ranging from 6 to 36 years (mean, 22 years). Tumors occurred in the head and neck (9 cases), pelvic region (2 cases), bladder (one case), right humerus (one case), and the abdominal wall, humerus and pubic at the same time (one case). Presenting symptoms varied by location but often included pain or discomfort. Most of the patients showed aggressive radiographic features with soft tissue extension. The tumors had a median size of 6.6 cm (range, 2-23 cm). The tumors were poorly defined and irregularly shaped. Microscopic examination showed diffuse proliferation of spindle or epithelioid cells. While morphologically high-grade tumors displayed obvious cytological atypia, a high mitotic count and tumor necrosis, low-grade tumors grew in sheets and fascicles composed of spindle, epithelioid cells with moderate or abundant amounts of eosinophilic cytoplasm, without pronounced cytological atypia. The tumor cells expressed Desmin, MyoD1, and Myogenin, as well as ALK, EMA, and CKpan. EWSR1/FUS-TFCP2 gene fusion was detected in 14 cases with next generation sequencing and confirmed by FISH. Six cases had EWSR1-TFCP2 fusions and 8 cases showed FUS-TFCP2 fusions. Follow-up information was available in 13 patients, ranged from 5 to 37 months. At the end of follow-up period, 7 patients died of the disease. Six patients were alive:two cases had local recurrences and metastases, two cases of recurrences, one case of metastasis and one case without recurrences and metastasis.Conclusions:Epithelioid and spindle cell rhabdomysarcomas with EWSR1-TFCP2 or FUS-TFCP2 fusion show a very aggressive clinical course, and more commonly occur in the head and neck. Their genetic hallmark is the presence of EWSR1/FUS-TFCP2 fusions. Familiarity with its clinicopathological characteristics is helpful in avoiding misdiagnoses.

Transcatheter aortic valve replacement (TAVR) has seen a surge in clinical research, basic research, and innovative device development both domestically and internationally in the previous 2023. This article aims to review the progress of TAVR in the past year from the perspectives of international, and domestic research development of application. It highlights new clinical and basic research findings both domestically and internationally, the emergence of new devices and technologies, and the development and use of TAVR in China. Finally, it provides an outlook on the trajectory of TAVR development in 2024.

Objective To retrieve,evaluate and summarize the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis and to provide references for clinical practice.Methods We systematically searched computer decision support systems,guideline websites,association official websites and databases for evidence on prevention and nursing care of pregnancy-induced diastasis recti abdominis,including guidelines,expert consensuses,clinical decision-making,systematic reviews and randomized controlled trials.The retrieval period was from the inception of databases to January 2024.There were 4 researchers who evaluated the quality of the included literature independently,extracted and summarized the evidence according to the subject.Results A total of 18 articles were included,including 2 clinical decisions,4 guidelines,5 expert consensuses,3 systematic reviews,and 4 randomized controlled trials.24 pieces of best evidence were summarized from 5 aspects,including the antenatal prevention,team building,nursing assessment,intervention strategies,and effecti-veness evaluation.Conclusion This study summarizes the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis,which can provide a reference basis for nurses to manage diastasis recti abdominis and improve the life quality of maternal woman.

Objective To observe the consistency of 5.0T and 1.5T MR spectroscopy(MRS)for quantitating proton density fat fraction(PDFF)of liver.Methods Lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％were prepared.1H-MRS were collected using 5.0T and 1.5T MR scanners,respectively,and PDFF were obtained with jMRUI software.Totally 23 people,including 11 cases of fatty liver and 12 healthy adults were prospectively collected,and volume of interest(VOI)in the liver were selected to acquire 1H-MRS,and PDFF were obtained with jMRUI software and corresponding workstation,respectively.The consistencies of PDFF measured with different methods were analyzed.Results PDFF of lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS all had good consistencies and being positively correlated,so were PDFF of liver tissue measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS.Conclusion 5.0T and 1.5T 1H-MRS had good consistency for quantitating liver PDFF.Measuring liver PDFF with workstation in clinical practice was helpful to simplifying workflow.

Objective To establish the reference interval of serum non-high-density lipoprotein cholesterol(n-HDL-C)in adults in Yan'an city of Shaanxi Province and analyze the influencing factors.Methods A total of 16 921 adults from 10 towns in Yan'an City of Shaanxi Province from January to September 2023 were selected by random sampling.Age,sex,smoking,drinking,exercise,hypertension,diabetes,dyslipidemia,chronic disease,residence,eating habits,marital status,education and monthly income were investigated.Height,weight,waist circumference and blood pressure were measured.Serum triglyceride(TG),total cholesterol(TCHO),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),Apolipoprotein A1(ApoA1),Apolipoprotein B(ApoB)and lipoprotein a[Lp(a)]levels were detected,and n-HDL-C levels were calculated:n-HDL-C(mmol/L)=TCHO(mmol/L)-HDL-C(mmol/L).The 95％reference interval(P25～P97 5)was calculated according to the percentile method recommended in WS/T402-2012 Health Industry Standard of the People's Republic of China.Multivariate logistic regression was used to analyze the influencing factors of serum n-HDL-C level.Results The serum n-HDL-C levels in both males and females were not normally distributed(S=2.119,2.091,all P＜0.001).There were significant differences in serum levels of n-HDL-C among males aged＞60 years old[2.98(2.50,3.37)mmol/L],18～30 years old[2.84(2.49,3.26)mmol/L],31～40 years old[2.98(2.62,3.42)mmol/L],41～50 years old[3.10(2.62,3.47)mmol/L]and 51～60 years old[3.05(2.64,3.46)mmol/L]contrast,and the differences were significant(H=3.618～5.680,all P＜0.05).There were significant differences in serum levels of n-HDL-C among women aged 51～60 years[3.08(2.71,3.44)mmol/L],18～30 years[2.64(2.29,3.07)mmol/L],31～40 years[2.67(2.31,3.08)mmol/L]and 41～50 years old[2.94(2.58,3.29)mmol/L]contrast(H=8.161～13.445,all P＜0.001).There were significant differences in serum n-HDL-C levels among patients aged＞60 years old[2.98(2.57,3.34)mmol/L],18～30 years old,31～40 years old and 41～50 years old contrast,and the differences were significant(H=7.985～14.018,all P＜0.001).The reference interval of serum n-HDL-C level in adult population was obtained by combining the age groups with no statistical significance:males aged 18～60 years old(1.97～3.97mmol/L),＞60 years old(1.86～3.91mmol/L);females aged 18～50 years(1.82～3.74 mmol/L),＞50 years old(1.94～3.88 mmol/L).A total of 16 921 adults were divided into normal n-HDL-C group and abnormal group,and the differences of serum TG(1.02±0.31 mmol/L vs 1.24±0.37mmol/L),TCHO(3.97±1.02 mmol/L vs 4.66±1.25 mmol/L),LDL-C(2.37±0.58mmol/L vs 2.59±0.67 mmol/L)levels and age(43.55±11.52 years vs 46.27±8.13 years)between the two groups were significant(t=2.041～3.151,all P＜0.05),in which the abnormal rate of serum n-HDL-C level was 42.50％.Multivariate Logistic regression analysis showed that males,lack of exercise,overweight or obesity,dyslipidemia,urban residents,and high school education or above were the influential factors for serum n-HDL-C levels in adults in this region(all P＜0.05).Conclusion The reference interval of serum n-HDL-C level in adults in this area was preliminarily established.Males,lack of exercise,overweight or obesity,dyslipidemia,urban residents,and high school education or above were the influential factors of abnormal serum n-HDL-C levels in adults in this area.

Zika virus (ZIKV) is an emerging pathogen associated with neurological complications, such as Guillain-Barré syndrome in adults and microcephaly in fetuses and newborns. This mosquito-borne flavivirus causes important social and sanitary problems owing to its rapid dissemination. However, the development of antivirals against ZIKV is lagging. Although various strategies have been used to study anti-ZIKV agents, approved drugs or vaccines for the treatment (or prevention) of ZIKV infections are currently unavailable. Repurposing clinically approved drugs could be an effective approach to quickly respond to an emergency outbreak of ZIKV infections. The well-established safety profiles and optimal dosage of these clinically approved drugs could provide an economical, safe, and efficacious approach to address ZIKV infections. This review focuses on the recent research and development of agents against ZIKV infection by repurposing clinical drugs. Their characteristics, targets, and potential use in anti-ZIKV therapy are presented. This review provides an update and some successful strategies in the search for anti-ZIKV agents are given.
Adult ; Animals ; Drug Repositioning ; Humans ; Infant, Newborn ; Microcephaly ; Pharmaceutical Preparations ; Zika Virus ; Zika Virus Infection/prevention & control*

Objective To evaluate the relationship between the degree of brain injury during the perioperative period of liver transplantation and postoperative cognitive dysfunction (POCD).Methods Thirtythree patients,undergoing elective liver transplantation,were enrolled in this study.Before induction of anesthesia (T0),at 5 min before blocking the portal vein (T1),5 min after opening the portal vein (T2),5 min after opening the hepatic artery (T3),and at 24 h after surgery (T4),blood samples were collected from the central vein for determination of the serum concentrations of S1O0β protein and neuron-specific enolase (NSE) by enzyme-linked immunosorbent assay.Patients were divided into POCD group and control group (group C) according to whether POCD happened within 7 days after surgery.Results Compared with the baseline value at T0,the serum concentrations of S100β protein were significantly increased at T2 and T3,and the serum concentrations of NSE was increased at T3 (P＜0.05).There was no significant difference in serum concentrations of S100β and NSE at each time point between group POCD and group C (P＞0.05).Conclusion The degree of brain injury during the perioperative period of liver transplantation is not the dominant factor for the development of POCD in the patients.

Objective To evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy( IMRT)for postoperative mediastinal lymph node metastasis in esophageal cancer. Methods A total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group(A group,31 cases)and the capecitabine combined with IMRT group( B group,31 cases). Both of two groups received IMRT radiotherapy with a total dose of 60-66 Gy, 30-33 times in 6-6. 5 weeks. The patients in B group were treated with capecitabine(1 250mg/ m2 ,2 f/ d, d1-d14,21 d × 2 cycle). Results Group A:there were 7 cases of complete response(CR),12 of partial response(PR),10 of stable disease(SD),and 2 of progressive disease(PD);the effective rate was 61. 3%(19 / 31). Group B:there were 10 cases of CR,16 of PR,4 of SD,and 1of PD;the effective rate was 83. 9%(26 / 31). There was a statistical significance between the effective rates of A group and B group(χ2 = 3. 971, P < 0. 05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29. 0% and 38. 7%(χ2 = 0. 648,P = 0. 421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19. 4% and 25. 8%(χ2 = 0. 369,P = 0. 544). The different incidence of the two adverse reactions between group A and B had no statistical significance. Conclusion Compared with IMRT alone,IM-RT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis.

Objective To analyze and study the connections between hypovolemia and lower extremity deep venous thrombosis (LDVT)in patients with cerebral infarction. Methods A total of 504 hospitalized patients with cerebral in-farction were selected. According to the comparison between infarction group and non-infarction group, ROC curves of urea nitrogen/creatinine ratio, plasma osmotic pressure, combined index of the two indices above and D-dimer were created, cut-off value of the indices above was calculated, and sensitivity and specificity were compared. Results Analysis on the results of ROC curves showed ROC area under the curve of urea nitrogen/creatinine ratio in the diag-nosis of LDVT in 10-14 days after admission was 0.788(95%CI 0.727-0.848),the optimal diagnostic cut-off point was 101.705, the sensitivity was 58%, and the specificity was 88.7%; ROC area under the curve of plasma osmotic pres-sure was 0.892 (95%CI 0.836-0.949), the optimal diagnostic cut-off point was 305.77 mmol/L, the sensitivity was 85.5%, and the specificity was 90.8%; ROC area under the curve of the combined index was 0.895 (95%CI 0.837-0.952); ROC area under the curve of D-dimer was 0.883(95%CI0.832-0.935), the optimal diagnostic cut-off point was 3.055 ug/L,the sensitivity was 85.5%, and the specificity was 82.1%. Conclusion Combined index of urea nitro-gen/creatinine ratio and plasma osmotic pressure in the diagnosis of LVDT is better than D-dimer, which is beneficial for early diagnosis.