Objective To systematically evaluate the real-life experience of stroke patients in the hospital-home transition period,and to provide a reference for better clinical development of transitional nursing practice.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang Data,VIP database,and China Biomedical Literature Database for qualitative studies on the real experience of stroke patients in the hospital-to-home transition period from the establishment of the database to October 2023.The quality of the literature was evaluated using the Joanna Brigg Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 14 studies were included,and 48 research results were extracted and 9 categories were summarized.The final synthesis included 3 integrated results:the discharge preparation period was in contradiction;after being discharged from the hospital,life changed dramatically and there was a variety of transition barriers;active response to illness and the experience of self-growth.Conclusion The hospital-home transition period for stroke patients is a critical period for patients'rehabilitation,and medical staff should strengthen the implementation of the transitional discharge plan,strengthen the connection between hospitals and families and communities,pay attention to the psychological experience of patients,so as to help stroke patients achieve a smooth transition from hospital to home.

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans ; Brain Neoplasms/pathology* ; Neoplasm Recurrence, Local/metabolism* ; Glioma/pathology* ; Neural Stem Cells/pathology* ; Oligodendrocyte Precursor Cells/pathology* ; Tumor Microenvironment

Epilepsy is a common chronic neurological disease, and its comorbidity has attracted more attention.The proportion of epileptic children with mental disorders is also increasing year by year.Among them, children with epilepsy have more depression and anxiety disorders.Repeated seizures can easily cause depression and anxiety, and depression and anxiety can also induce epilepsy, thus the two affect each other.The assessment, screening, diagnosis and intervention of comorbid depression and anxiety in children with epilepsy have become an important part of clinical practice.This review summarized the relationship between epilepsy and depression and anxiety disorders in children, and its research progress on pathogenesis, clinical diagnosis, evaluation and treatment.

This study compared the effects on bone metabolism and morphology of pathological obesity induced by excessive fat intake in a non-hibernator (mice) versus healthy obesity due to pre-hibernation fattening in a hibernator (ground squirrels). Kunming mice were fed a high-fat diet to provide a model of pathological obesity (OB group). Daurian ground squirrels fattened naturally in their pre-hibernation season (PRE group) were used as a healthy obesity model. Micro-computed tomography (micro-CT) and three-point bending tests were used to determine the microstructure and mechanical properties of bone. Western blots were used to analyze protein expression levels related to bone metabolism (Runt-related transcription factor 2 (RunX2), osteocalcin (OCN), alkaline phosphatase (ALP), osteoprotegerin (OPG), receptor activator of nuclear factor-‍κB ligand (RANKL), cathepsin K, matrix metallopeptidase 9 (MMP9), patched protein homolog 1 (Ptch1), phosphorylated β‍-‍catenin (P‍-‍β‍-‍catenin), and glycogen synthase kinase-3β (GSK-3β)). Compared with controls, there was no obvious bone loss in the OB mice, and the stiffness of the femur was increased significantly. Compared with summer active squirrels, bone formation was enhanced but the mechanical properties did not change in the PRE group squirrels. In OB mice, western blots showed significantly increased expression levels of all proteins except RunX2, OPG, and Ptch1. PRE ground squirrels showed significantly increased expression of most proteins except OCN and Ptch1, which decreased significantly, and P‍-‍β‍-‍catenin and OPG, which did not change. In conclusion, for non-hibernating mice, moderate obesity had a certain protective effect on bones, demonstrating two-way regulation, increasing both bone loss and bone formation. For pre-hibernating ground squirrels, the healthy obesity acquired before hibernation had a positive effect on the microstructure of bones, and also enhanced the expression levels of proteins related to bone formation, bone resorption, and Wnt signaling.
Mice ; Animals ; Hibernation ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Glycogen Synthase Kinase 3 beta/metabolism* ; Diet, High-Fat ; X-Ray Microtomography ; Sciuridae/metabolism* ; Obesity

OBJECTIVETo identify potential mutations in a family affected with inherited factor Ⅶ (FⅦ) deficiency.

METHODSProthrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, FⅦ activity (FⅦ:C) and other coagulant parameters of the proband and 15 family members were measured. Potential mutations were screened in the pedigree by polymerase chain reaction and direct DNA sequencing.

RESULTSThe PT of the proband and his younger brother was significantly prolonged to 39.0 s and 30.1 s, respectively. FⅦ:C of the proband and his younger brother was obviously reduced to 2% and 3%, respectively. FⅦ:C of his grandmother, maternal grandmother, aunt, father, mother, maternal uncle and maternal aunt was all below the normal range (80%-108%), which measured 68%, 54%, 71%, 73%, 62%, 72% and 59%, respectively. The other coagulant parameters were in the normal range. Two heterozygous mutations, g.11349G>A and g.11482T>G, both reside in exon 8 of the F7 gene, have resulted in p.Arg304Gln and p.His348Gln substitutions, were identified in the proband. The same mutations were also found in the proband's younger brother. Four maternal members in this family (grandmother, mother, maternal uncle and maternal aunt of the proband) were heterozygous for the p.Arg304Gln mutation, while three paternal members (grandmother, aunt and father of the proband) were heterozygous for the p.His348Gln mutation.

CONCLUSIONThe proband had inherited two independent mutations of the F7 gene including g.11349G>A and g.11482T>G from his mother and father, respectively. The compound heterozygous mutation probably explains the low FⅦ concentrations in this pedigree.

Adult ; Base Sequence ; Blood Coagulation Tests ; Factor VII ; genetics ; metabolism ; Factor VII Deficiency ; blood ; genetics ; Female ; Genetic Testing ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Pedigree ; Young Adult

Objective To test plasma insulin‐like growth factor 1(IGF‐1) level in type 2 diabetic patients with malignant tumor , and make comparison with diabetic patients and normal patients .To discuss the significance of detection of plasma IGF‐1 level in type 2 diabetes in screening early malignant tumor .Methods Plasma IGF‐1 level were determined in type 2 diabetes among malig‐nant tumor group ,type 2 diabetes ,and normal control group ,and statistical comparison was made between the three groups .Results the plasma levels of IGF‐1 of type 2 diabetes mellitus ,type 2 diabetes mellitus with malignant tumor were significantly lower than normal group(P<0 .05) .And the plasma level of IGF‐1 in type 2 diabetes mellitus with malignant tumor group was obviously high‐er than that of type 2 diabetic group(P<0 .05) .Plasma IGF‐1 ,FBG ,HbA1c and 2 HBG level are risk factors for tumor .The level of FIns is a protective factor for tumor .Conclusion Type 2 diabetes is closely related to the malignant tumor ,and the plasma levels of IGF‐1 is a risk factor for tumor .

To analyze the mutations of F12 genein one pedigree with congenital factor FXII (FXII) deficiency , and investigatethe molecular mechanisms of FXII deficiency . Methods Activated partial thromboplastin time(APTT),Prothrombin time(PT), FXII activity(FXII:C), FXII antigen(FXII:Ag) and other coagulant parameters were tested in the proband and his family members .5'and 3'UTR,all exons and their exon-intron boundaries of F12 gene were analyzed by direct sequencing .The detected mutations were confirmed by reverse sequencing .100 healthy persons were as normal controls .Results The proband showed a markedly prolonged APTT (106.4s), the FXII:C and FXII:Ag were 2.0% and 1.0%, respectively .Hissecond daughter and granddaughter had slightly prolonged APTT , and other family members are normal.The FXII:C and FXII:Ag of family members were also decreased ( his son, 23.0% and 21. 0%;his elder daughter , 23.0%and 23.0%;his second daughter ,24.0%and 23.0%;hisgranddaughter , 23.0%and 23.0%).The phenotype of all members is consistent with cross -reactive material negative . Nucleotide sequencing analysis showed that the proband had missense mutations in the F 12 gene, including one homozygous mutationc.1556T >G ( p.Leu519Arg) and a commonly reported single nucleotide polymorphism site within the promoter region of the F 12 gene (46T/T) .Sequencing results from the proband 'children demonstrate them as carriers of a heterozygous missense mutation .The proband 's wife is normal and with 46C/C in the promoter region .Conclusion The c.1556T>G in exon 13 is a novel mutation .This mutation affects FXIIcatalytic function , associated with a reduced level of FXII .

Objective To investigate the relationship between positive peritoneal exfoliated cancer cells and the clinicopathological features of patients with hepatocellular carcinoma before any invasive treatment.Methods Of the 92 patients with hepatocellular carcinoma who underwent laparotomy,ascites fluid was collected in the patients with peritoneal ascites; and peritoneal lavage fluid was collected in those patients without peritoneal ascites.Then,shedded cancer cells in these fluid samples were detected.Results The positive rates of peritoneal cancer cells were associated with the TNM stage,tumor location and tumor size.The positive detection rate of cancer cells in TNM stage Ⅲ and Ⅳ was significantly higher than stage Ⅰ and Ⅱ (38.1％ vs 8.0％ ; P =0.0005).The positive detection rate was higher in tumors located closer to the surface (P =0.0 002),and with larger diameter (P =0.00 007).Conclusion Peritoneal cancer cells were significantly correlated with tumor stage,tumor location and size in hepatocellular carcinoma.

OBJECTIVETo identify potential mutations and explore the molecular mechanism underlying combined inherited coagulation factors VII(FVII) and X(FX) deficiency for a family featuring consanguineous marriage between maternal cousins.

METHODSProthrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, FVII activity (FVII:C), FX activity (FX:C), FVII antigen (FVII:Ag), FX antigen (FX:Ag) and other coagulant parameters of the proband and 5 family members were measured. Potential mutations in exons, exon-intron boundaries and 5', 3' untranslated sequences of F7 and F10 genes were screened by polymerase chain reaction and direct sequencing. Suspected mutations were confirmed by sequencing the opposite strand.

RESULTSPT and APTT of the proband were obviously prolonged to become 76.4 s and 60.2 s, respectively. FVII:C, FVII:Ag,FX:C and FX:Ag of the proband were obviously reduced to become 4%, 6%, 6% and 33%, respectively. Both PT and APTT of her grandmother, father, mother and daughter were slightly prolonged, which have measured 16.4 s, 15.8 s,16.9 s, 16.5 s, and 44.0 s, 42.1 s, 41.1 s, 43.5 s, respectively. And their FVII:C (34%, 39%, 31%, 40%, respectively), FX:C (50%, 58%, 47%, 42%, respectively) and FX:Ag (51%, 54%, 58%, 47%, respectively) were slightly reduced, while FVII:Ag was in the normal range. The coagulant parameters of her younger brother were within normal range. Two homozygous mutations, g.11267C to T in exon 8 of F7 gene, which resulted in an Arg277Cys substitution, and g.28139G to T in exon 8 of F10 gene which led to a Val384Phe substitution, were identified in the proband. The proband's grandmother, parents and daughter were heterozygous for both Arg277Cys and Val384Phe mutationss. Wild-type alleles of both F7 and F10 genes were also found in the younger brother.

CONCLUSIONA homozygous Arg277Cys mutation and a Val384Phe mutation have been respectively identified in the F7 and F10 genes, which can explain the low levels of FVII and FX in this family. The former has been inherited from the consanguineous parents.

Adult ; Aged ; Consanguinity ; Factor VII Deficiency ; genetics ; Factor X Deficiency ; genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Mutation ; Pedigree ; Phenotype

Objective To compare and analyze the surgical efficacy of different ways of left and right transthoracic ap-proaches on patients with middle thoracic esophageal cancer. Methods The 120 patients with middle esophageal carci-noma were divided into observation group (60 cases) and the control group (60 cases) randomly. The patients in obser-vation group were treated with right chest-belly-neck three-incision. The control group accepted left breast single in-cision. The operation duration, postoperative hospitalization time and indwelling chest tube time, the number of lymph node dissection, the rate of proximal spread of tumor, incidence of postoperative complications and 2-year survival rate were recorded and analyzed. Results Compared with control group, the operation duration, postoperative hospitalization time, the number of lymph node dissection and 2-year survival rate in observation group were higher. The rate of proximal spread of tumor in observation group were lower than in control group (P<0.05). The incidence of pulmonary infection and anastomotic leak were higher (P<0.05). Conclusion Compared with left breast single incision, right chest-belly-neck three-incision can provide a wider extent of lymphadenectomy, especially for mediastinal and abdominal, which may improve the survival in two years of patients with middle esophageal carcinoma. But the operation time may be longer and the incidence of pulmonary infection and anastomotic leak may be higher. Surgery should be selected according to the specific circumstances of patients.