Objective:To systematically integrate the work experience of medical and nursing staff in the remote home palliative care model, so as to provide a reference for improving remote home palliative care services.Methods:Qualitative studies on medical and nursing staff providing remote home palliative care were electronically searched in PubMed, Web of Science, Embase, ProQuest, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 30, 2024. Literature quality evaluation was conducted using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The aggregative integration method was used to synthesize the findings.Results:Researchers repeatedly read, analyzed, and interpreted the 17 included literature, extracting 56 themes and summarizing eight new categories, and further synthesized three integrated results, namely, remote home palliative care provided patients with comprehensive physical, psychological, and mental care, as well as guidance and support for family members; remote home care helped to achieve full coverage of palliative care services; equipment limitations, information security risks, and incomplete processes restricted the development of remote palliative care.Conclusions:Remote home palliative care has improved patient care and family support capabilities, expanded service coverage, and promoted interdisciplinary collaboration. However, there are still issues such as equipment limitations, information security risks, and incomplete processes. Optimizing processes, improving safety mechanisms, and strengthening collaboration platforms will contribute to sustainable development.

Objective:To systematically integrate the work experience of medical and nursing staff in the remote home palliative care model, so as to provide a reference for improving remote home palliative care services.Methods:Qualitative studies on medical and nursing staff providing remote home palliative care were electronically searched in PubMed, Web of Science, Embase, ProQuest, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 30, 2024. Literature quality evaluation was conducted using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The aggregative integration method was used to synthesize the findings.Results:Researchers repeatedly read, analyzed, and interpreted the 17 included literature, extracting 56 themes and summarizing eight new categories, and further synthesized three integrated results, namely, remote home palliative care provided patients with comprehensive physical, psychological, and mental care, as well as guidance and support for family members; remote home care helped to achieve full coverage of palliative care services; equipment limitations, information security risks, and incomplete processes restricted the development of remote palliative care.Conclusions:Remote home palliative care has improved patient care and family support capabilities, expanded service coverage, and promoted interdisciplinary collaboration. However, there are still issues such as equipment limitations, information security risks, and incomplete processes. Optimizing processes, improving safety mechanisms, and strengthening collaboration platforms will contribute to sustainable development.

Objective To analyze the effects of fluid overload(FO)on clinical outcomes of extremely preterm infants with hemody-namically significant patent ductus arteriosus(hsPDA).Methods This retrospective study analyzed data from neonates ≤ 32 weeks ges-tational age(GA)admitted to the Neonatal Intensive Care Unit(NICU)of the Affiliated Hospital of Xuzhou Medical University between November 2021 and July 2024.Infants were categorized into hsPDA and non-hsPDA groups based on the presence or absence of hsPDA.General clinical data and daily FO situation in the first week after birth of the two groups were compared,and the risk factors affecting hsPDA were obtained by Logistic regression analysis.Using the first day of postnatal FO as the test variable and hsPDA as the state varia-ble,receiver operator characteristic(ROC)curve was drawn to calculate the cut-off value of FO,and the cut-off value was divided into groups to analyze the relationship between the first day FO and clinical outcome of very preterm infants.Results A total of 153 extremely preterm infants(GA≤32 weeks)were enrolled,including 110 in the hsPDA group and 43 in the non-HSPDA group.Univariate analysis showed that there were statistically significant differences in birth weight,1-minute Apgar score,postnatal antibiotic use time,parenteral nutrition time,invasive mechanical ventilation time,non-invasive mechanical ventilation time,hospital days,day 1,day 2 and day 4 FO between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that invasive mechanical ventilation time and day 1 FO were risk factors of hsPDA.The ROC curve was drawn with the first day FO as the test variable and hsPDA as the state variable.The area under the curve was 0.903,the sensitivity and specificity were 79.1％and 89.1％,respectively,and the cut-off value of FO on the first day after birth was 8.78％.According to this cut-off value,107 cases were divided into FO≤8.78％group and 46 cases were FO＞8.78％group.Univariate analysis showed that FO＞8.78％group had lower Apgar score at 1 minute,longer invasive mechani-cal ventilation time,and higher incidence of moderate to severe bronchopulmonary dysplasia(BPD)and grade 3 to 4 intraventricular hem-orrhage(IVH).Logistic regression analysis showed that FO＞8.78％on the first day after birth was a risk factor for moderate to severe BPD and grade 3-4 IVH.Conclusion FO＞8.78％on the first day after birth of very preterm infants increased the incidence of moder-ate to severe BPD and grade 3-4 IVH.

Objective To explore the facilitators and barriers of palliative care volunteering,and to provide references for further advancement of palliative care volunteering.Methods Purposeful sampling was used to select 12 volunteers from a palliative care ward in Hangzhou,Zhejiang Province,between April and September 2024.Semi-structured interviews were conducted,and directed content analysis was applied to organize and analyze the data,followed by theme analysis.Results Facilitators and barriers for volunteers' participation in palliative care volunteering were extracted.The 5 sub-themes of facilitators include motivating factors and perceived benefits,support and collaboration among volunteers,professional training and healthcare recognition,increased social awareness and public acceptance,and government support and institutional safeguards.The 5 sub-themes of barriers include limitations in individual capacity,challenges in collaboration with patients,families and healthcare workers,inadequate management and service mechanisms,uneven development of palliative care and insufficient public attention to psychological problems,and inadequate relevant laws and incentives.Conclusion There are more factors affecting the development of palliative care volunteering,and healthcare professionals should adopt targeted strategies to promote the active participation of volunteers in order to promote the sustainable development of palliative care volunteering.

Objective To explore the facilitators and barriers of palliative care volunteering,and to provide references for further advancement of palliative care volunteering.Methods Purposeful sampling was used to select 12 volunteers from a palliative care ward in Hangzhou,Zhejiang Province,between April and September 2024.Semi-structured interviews were conducted,and directed content analysis was applied to organize and analyze the data,followed by theme analysis.Results Facilitators and barriers for volunteers' participation in palliative care volunteering were extracted.The 5 sub-themes of facilitators include motivating factors and perceived benefits,support and collaboration among volunteers,professional training and healthcare recognition,increased social awareness and public acceptance,and government support and institutional safeguards.The 5 sub-themes of barriers include limitations in individual capacity,challenges in collaboration with patients,families and healthcare workers,inadequate management and service mechanisms,uneven development of palliative care and insufficient public attention to psychological problems,and inadequate relevant laws and incentives.Conclusion There are more factors affecting the development of palliative care volunteering,and healthcare professionals should adopt targeted strategies to promote the active participation of volunteers in order to promote the sustainable development of palliative care volunteering.

Objective To analyze the effects of fluid overload(FO)on clinical outcomes of extremely preterm infants with hemody-namically significant patent ductus arteriosus(hsPDA).Methods This retrospective study analyzed data from neonates ≤ 32 weeks ges-tational age(GA)admitted to the Neonatal Intensive Care Unit(NICU)of the Affiliated Hospital of Xuzhou Medical University between November 2021 and July 2024.Infants were categorized into hsPDA and non-hsPDA groups based on the presence or absence of hsPDA.General clinical data and daily FO situation in the first week after birth of the two groups were compared,and the risk factors affecting hsPDA were obtained by Logistic regression analysis.Using the first day of postnatal FO as the test variable and hsPDA as the state varia-ble,receiver operator characteristic(ROC)curve was drawn to calculate the cut-off value of FO,and the cut-off value was divided into groups to analyze the relationship between the first day FO and clinical outcome of very preterm infants.Results A total of 153 extremely preterm infants(GA≤32 weeks)were enrolled,including 110 in the hsPDA group and 43 in the non-HSPDA group.Univariate analysis showed that there were statistically significant differences in birth weight,1-minute Apgar score,postnatal antibiotic use time,parenteral nutrition time,invasive mechanical ventilation time,non-invasive mechanical ventilation time,hospital days,day 1,day 2 and day 4 FO between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that invasive mechanical ventilation time and day 1 FO were risk factors of hsPDA.The ROC curve was drawn with the first day FO as the test variable and hsPDA as the state variable.The area under the curve was 0.903,the sensitivity and specificity were 79.1％and 89.1％,respectively,and the cut-off value of FO on the first day after birth was 8.78％.According to this cut-off value,107 cases were divided into FO≤8.78％group and 46 cases were FO＞8.78％group.Univariate analysis showed that FO＞8.78％group had lower Apgar score at 1 minute,longer invasive mechani-cal ventilation time,and higher incidence of moderate to severe bronchopulmonary dysplasia(BPD)and grade 3 to 4 intraventricular hem-orrhage(IVH).Logistic regression analysis showed that FO＞8.78％on the first day after birth was a risk factor for moderate to severe BPD and grade 3-4 IVH.Conclusion FO＞8.78％on the first day after birth of very preterm infants increased the incidence of moder-ate to severe BPD and grade 3-4 IVH.

Eleven compounds were isolated and purified from the ethyl acetate part of 80% ethanol extract of Ferula feruloides root by a combination of normal-phase silica gel column chromatography, Sephadex LH-20 dextran gel column chromatography and semi-preparative liquid chromatography and then modern wave spectrometry methods (NMR, MS, UV, IR) were used to identify the structures of the compounds, which were identified as baigene D (1), baigene E (2), baigene F (3), β-kirialovin (4), α-kirialovin (5), falcarindiol (6), ammoresinol (7), dshamirone (8), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-3-[4-methyl-5-(4-methy1-2-furyl)-3(E)-pentenyl]-furo[3,2-c]coumarin (9), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadi-enyl]-furo[3,2-c]coumarin (10), and baigene C (11). Compounds 1-3 are new coumarin analogues, and compounds 4-6 are firstly isolated from F. feruloides. The anti-proliferative activity of compounds 5, 7-11 against human gastric cancer (MKN-45) cells was evaluated using MTT assay, which showed that compounds 7-11 exhibited strong inhibitory activity, and compound 5 exhibited weak inhibitory activity.

OBJECTIVE To investigate the effect of Guanxinning tablets(GXN) on early heart failure model rats, and to explore the protective mechanism of GXN on heart failure rats from the perspective of intestinal flora. METHODS Six rats who underwent sham operation were set as sham operation group. Took 80 SD rats to undergo aortic arch stenosis and established a heart failure rat model. The surviving rats were divided into 4 groups, namely the model control group, the positive control group(captopril tablets 12.5 mg·kg–1), high-dose and low-dose of GXN group(600, 1 200 mg·kg–1). The 4 groups were administered continuously for 8 weeks. Cardiac ultrasonography was performed every 4 week. Serum NT-proBNP, hs-CRP, IL-6, TNF-α, SOD and MDA levels were measured. The effects of GXN on the structure and function of intestinal flora were observed based on the high-throughput sequencing technology and bioinformatics analysis of 16S gut microbiome. RESULTS Compared to the model control group, after giving different doses of GXN, the survival rate of rats increased, and the thickness of the ventricular wall decreased to varying degrees. The weight of the heart and coefficient of the heart were all reduced. GXN could also reduce the level of inflammatory factors, inhibit the level increase of NT-proBNP in rats, and increase the activity of serum SOD. In addition, GXN intervention could significantly improve the intestinal flora diversity of rats with heart failure, the possible target genera of GXN were Akkermansia genera, Phascolarctobacterium genera and Oxalobacter genera. The effect of GXN on intestinal function in rats with heart failure might be concentrated in non-homologous end-joining, influenza A, carotenoid synthesis, indole alkaloids biosynthesis, betalain biosynthesis, renin-angiotensin system and other biological pathways. CONCLUSION The protective effect of GXN on early heart failure rats may be related to the regulation of intestinal flora pathway.

Objective:To investigate the treatment outcome of chemotherapy regimens containing azacitidine and mitoxantrone liposome in the treatment of angioimmunoblastic T-cell lymphoma (AITL).Methods:The clinical data of 1 AITL patient with severe clinical symptoms admitted to Weihai Municipal Hospital in July 2021 were retrospectively analyzed, and the relevant literatures were reviewed.Results:The 74-year-old male patient was presented with the manifestations of rash, lymph node enlargement, bloating and fever. He was pathologically diagnosed as AITL by lymph node biopsy. In the early stage of treatment, due to severe clinical symptoms and poor therapeutic effect, the treatment regimens were constantly adjusted. CHOPE, etoposide + chidamide + thalidomide +dexamethasone + cyclosporine, brentuximab vedotin + bendamustine + dexamethasone + cyclosporine + thalidomide +chidamide regimens were used successively, and the disease progressed after short-term complete remission. Finally complete remission was obtained again after a multi-drug combination regimens containing azacitidine and mitoxantrone liposome, following the maintenance treatment of azacitidine combined with chidamide, and the disease condition of the patient remained stable.Conclusions:The chemotherapy regimens containing azacitidine and mitoxantrone liposome can achieve a good therapeutic effect for relapsed/refractory AITL.

BACKGROUND:Bibliometrics and visual analyses based on thematic literature are particularly important for understanding the foundation and frontiers of postmenopausal osteoporosis research. OBJECTIVE:To perform bibliometric,citation,and visualization analyses of highly cited SCI papers in postmenopausal osteoporosis research over the last 20 years. METHODS:The top 100 highly cited papers on postmenopausal osteoporosis published between 2003 and 2022 included in SCI-EXPANDED catalog of the Web of Science database were obtained for bibliometric measure and visual analysis using CiteSpace software. RESULTS AND CONCLUSION:The top 100 highly cited papers have a total of 67 377 citations in the Web of Science Core Collection,with an annual average of 49.17 citations per paper.Postmenopausal osteoporosis research primarily involves medical,engineering,biological,and multidisciplinary fields.The subcategories are dominated by endocrinology and metabolism,and medicine:internal medicine.Stable and close cooperative network relationships have been formed globally.United States,University of California System,Cummings,and Steven R are the country,research institution,and author,respectively,with the most highly-cited publications.The frontiers of postmenopausal osteoporosis research mainly include calcium and vitamin D supplementation and fracture risk,clinical studies of bisphosphonates in the treatment of postmenopausal osteoporosis,atypical femur fracture,clinical studies of new drugs and sequential treatment of postmenopausal osteoporosis,predictors of fracture risk,mid-and long-term follow-up of osteoporotic vertebral compression fractures,genetic polymorphisms and hereditary factors,formulation and updating of clinical practice guidelines for postmenopausal osteoporosis.Large cohort studies,high-quality randomized controlled trials,systematic reviews,meta-analyses,and clinical practice guidelines are the great engines that drive the development of clinical research in postmenopausal osteoporosis.We should make efforts in the above areas to improve China's international influence in the field of osteoporosis.