Objective To explore the communication preferences for advance care planning(ACP)among elderly hospitalized patients and to provide references for improving the ACP implementation rate.Methods Convenience sampling was used to select elderly hospitalized patients from a tertiary hospital in Wenzhou City between April and November 2023.Face-to-face surveys were conducted using a general data collection form and a self-designed questionnaire on ACP communication preferences.Mixed Logit Model,willingness-to-pay analysis,relative importance analysis,and subgroup analysis were employed to explore preferences.Results 204 questionnaires were distributed and 200 valid questionnaires were recovered,with a valid questionnaire response rate of 98.04％.The Mixed Logit Model analysis indicated that key attributes-communication timing,communication form,family participation in ACP communication,legal validity of ACP documents,and out-of-pocket costs-significantly influenced preferences(P＜0.05).Willingness-to-pay analysis showed that changes in communication timing,communication form,and family participation altered patients' willingness to pay.Relative importance analysis ranked the top 3 attributes as commu-nication timing,communication form,and family participation.Subgroup analysis revealed that gender,education level,and residence location affected preferences(P＜0.05).Conclusion Key attributes of ACP communication affect elderly hospitalized patients' preferences and willingness to pay,with variations across subgroups.Healthcare professionals should develop optimal communication programs based on patient preferences and individual characteristics.

Objective To explore the communication preferences for advance care planning(ACP)among elderly hospitalized patients and to provide references for improving the ACP implementation rate.Methods Convenience sampling was used to select elderly hospitalized patients from a tertiary hospital in Wenzhou City between April and November 2023.Face-to-face surveys were conducted using a general data collection form and a self-designed questionnaire on ACP communication preferences.Mixed Logit Model,willingness-to-pay analysis,relative importance analysis,and subgroup analysis were employed to explore preferences.Results 204 questionnaires were distributed and 200 valid questionnaires were recovered,with a valid questionnaire response rate of 98.04％.The Mixed Logit Model analysis indicated that key attributes-communication timing,communication form,family participation in ACP communication,legal validity of ACP documents,and out-of-pocket costs-significantly influenced preferences(P＜0.05).Willingness-to-pay analysis showed that changes in communication timing,communication form,and family participation altered patients' willingness to pay.Relative importance analysis ranked the top 3 attributes as commu-nication timing,communication form,and family participation.Subgroup analysis revealed that gender,education level,and residence location affected preferences(P＜0.05).Conclusion Key attributes of ACP communication affect elderly hospitalized patients' preferences and willingness to pay,with variations across subgroups.Healthcare professionals should develop optimal communication programs based on patient preferences and individual characteristics.

Objective To discuss the application of the"rotating guidewire and correcting the filter recovery hook direction technique"("rotation-correction loop technique"for short),a technique invented by the authors in clinical practice,in the retrieval of complex inferior vena cava filter(IVCF),and to discuss its technical skills and advantages.Methods The clinical data of 417 patients carrying an IVCF,who were admitted to the Department of Vascular Surgery of Second Hospital of Shanxi Medical University of China to retrieve IVCF between January 2022 and December 2022,were retrospectively analyzed.Taking the time spent on the retrieval of IVCF and the intraoperative radiation dose as the evaluation indicators,the advantages and disadvantages of the standard filter retrieval technique,the"rotation-correction loop technique"and the other loop-assisted techniques were compared.Results Both the intraoperative radiation dose and the time spent on the retrieval of IVCF using"rotation-correction loop technique"were remarkably lower than those of other loop-assisted techniques(P＜0.000 1).Conclusion For the retrieval of complex IVCF,especially for the IVCF which is heavily tilted and/or its recovered hook is attached to the vascular wall,the use of"rotation-correction loop technique"can shorten the time spent on the the retrieval of IVCF and reduce the intraoperative radiation dose.This technique carries high safety and practicability,the device is simple and it can be manipulated by single physician,which is conducive to clinical application and promotion.(J Intervent Radiol,2024,33:289-294)

Shoulder pain ranks the third in musculoskeletal pain,with relatively high incidence in the population.Early diagnosis of shoulder diseases is crucial.Deep learning(DL)in shoulder joint imaging was conducive to clinical diagnosis,treatment and prognosis evaluation of shoulder diseases.The research progresses of DL in shoulder joint imaging were reviewed in this article.

OBJECTIVETo evaluate the quality and consistency of recommendations in the clinical practice guidelines (CPGs) for hypertension in Chinese medicine (CM).

METHODSCM CPGs were identified from 5 electronic databases and hand searches through related handbooks published from January 1990 to December 2013. Three reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and compared the CPGs' recommendations on CM syndrome pattern classification and treatment.

RESULTSFive CM CPGs for hypertension were included. The quality score of the evidence-based (EB) guideline was higher than those of the consensus-based with no explicit consideration of evidence-based (CB-EB) and the consensus-based (CB) guidelines. Three out of five patterns in the CPGs were recommended by the EB guideline. Tianma Gouteng Formula () in the EB guideline was recommended mostly for hypertension patients with pattern of ascendant hyperactivity of Gan (Liver)-yang and pattern of yin deficiency with yang hyperactivity in the CPGs. Acupuncture and massage were recommended for Grade I and Grade II hypertension with severe symptoms weakening the quality of life in the EB guideline. For Grade I and Grade II hypertension, CM could be used alone, while for Grade III hypertension, they should be used in combination with Western medicines.

CONCLUSIONThe quality of EB guideline was higher than those of CB and CB-EB CPGs in CM for hypertension and CM should be prescribed alone or combined with Western medicines based on the grade of hypertension.

Humans ; Hypertension ; therapy ; Medicine, Chinese Traditional ; methods ; standards ; Practice Guidelines as Topic ; standards ; Quality Assurance, Health Care ; Quality of Health Care ; standards ; Quality of Life

Objective To study the existence and significance of cholesterol-intestinal hepatic circulation in rabbits by establishing a model of enterohepatic circulation and blocking enterohepatic circulation. Methods In this experiment, the experimental group and the control group were set up to conduct high-cholesterol diets and ordinary diets for differential feeding. By establishing a model of enterohepatic circulation and blocking enterohepatic circulation, cholesterol oxidase method was used to measure serum cholesterol concentration in the experimental group and the control group respectively. Based on the statistical analysis of the data for 6 months, the phenomenon of enterohepatic circulation of cholesterol was studied. Results Based on the data of 6 months, the serum cholesterol concentrations of rabbits in groups Aand Cwere gradually increased. After two months, the hypercholesterolemia was significant in the rabbits in group C. The increase degree of serum cholesterol concentration in the rabbits in group Awas weaker than that in group C. Hypercholesterolemia had no obvious effect. There was statistically significant difference between group Aand group C (P＜0. 05); serum cholesterol concentration in rabbits in group Dwas increased slightly, but the increase was not significant. The increase of serum cholesterol concentration in group Bwas more significant than that of group D. There was a statistically significant difference between group Band group D (P＜0. 05). The serum TC-time line graph was plotted with the serum cholesterol concentration in each group as the ordinate and the time as the abscissa. Compared with group A, the serum cholesterol was increased significantly in group C. Compared with group D, the serum cholesterol in group Bwas increased significantly. Conclusion This experiment shows that the cholesterol enterohepatic circulation phenomenon exists in rabbits. By blocking the enterohepatic circulation in rabbits, it has a certain effect on lowering the content of serum cholesterol in rabbits. This will provide a theoretical basis for further studying the role of blocking enterohepatic circulation in reducing cholesterol levels in the body. It provides new ideas for the clinical treatment of hypercholesterolemia by blocking the cholesterol enterohepatic circulation in clinical practice and points a direction for drug development.

BACKGROUNDDespite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension (RH), its control is still a challenge for conventional medicine. The Chinese herbal formula, Qutan Huayu Fang, has been used effectively to assist antihypertensive agents in blood pressure control, but its effect for RH patients is still unclear. This pilot study aims to explore the effects of taking the formula in addition to antihypertensive medication in the management of RH.

METHODS/DESIGNA prospective cohort study will be conducted in two first-class hospitals of traditional Chinese medicine (TCM). Eligible RH patients will be classified as the experimental group (n = 100) and the control group (n = 100) based on the interventions they receive. Participants taking antihypertensive agents and the Chinese herbal formula will be in the experimental group and those taking antihypertensive agents alone will be in the control group. The whole study will last 24 weeks, including an 8-week observation and follow-up at 24 weeks. The primary outcomes, assessed against patient baseline conditions, will be the reduction of systolic blood pressure and diastolic blood pressure as well as changes in TCM symptoms and signs. These outcomes will be assessed at weeks 2, 4, 6, and 8. The reductions of blood pressure will also be assessed at week 24. Cardiac events and mortality rate will be secondary outcomes and will be assessed at weeks 8 and 24. Any adverse reactions will be recorded during the study. The causal inference method will be used to assess the effectiveness of the inclusion of TCM herbal medicine in the management of patients with RH.

DISCUSSIONThis study will determine whether the Chinese herbal formula is helpful for RH patients treated with antihypertensive agents and the findings will provide a basis for further confirmatory studies.

Antihypertensive Agents ; pharmacology ; Blood Pressure ; drug effects ; Clinical Protocols ; Cohort Studies ; Drug Resistance ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Pilot Projects ; Plants, Medicinal ; Prospective Studies ; Treatment Outcome

OBJECTIVETo systematically review the clinical practice guidelines (CPGs) for ischemic stroke in Chinese medicine (CM) with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

METHODSCM CPGs for ischemic stroke were searched in 5 online databases and hand-searches in CPGrelated handbooks published from January 1990 to December 2012. The CPGs were categorized into evidence based (EB) guideline, consensus based with no explicit consideration of evidence based (CB-EB) guideline and consensus based (CB) guideline according to the development method. Three reviewers independently appraised the CPGs based on AGREE II instrument, and compared the CPGs' recommendations on CM pattern classification and treatment.

RESULTSFive CM CPGs for ischemic stroke were identified and included. Among them, one CPG was EB guideline, two were CB guidelines and two were CB-EB guidelines. The quality score of the EB guideline was higher than those of the CB-EB and CB guidelines. Five CM patterns in the CPGs were recommended in the EB CPG. The comprehensive protocol of integrative Chinese and Western medicine recommended in the EB CPG was mostly recommended for ischemic stroke in the CPGs. The recommendations varied based on the CM patterns.

CONCLUSIONThe quality of EB CPG was higher than those of CB and CB-EB CPGs in CM for ischemic stroke and integrative approaches were included in CPGs as major interventions.

Biomedical Research ; Brain Ischemia ; complications ; therapy ; Health Planning Guidelines ; Humans ; Medicine, Chinese Traditional ; Practice Guidelines as Topic ; Stroke ; complications ; therapy

Acupuncture Therapy ; Humans ; Medicine, Chinese Traditional ; Moxibustion ; Osteoporosis ; diagnosis ; pathology ; therapy ; Practice Guidelines as Topic

OBJECTIVETo investigate the apoptosis of bladder cancer cell 5637 induced by pseudolaric acid B in vitro and its mechanism.

METHODThe cell proliferation was detected by MTT assay;the cell cycle was measured by flow cytometry; the cell apoptosis was observed by flow cytometry with Annexin V-FITC/PI double staining; the expressions of survivin protein and caspase-3 protein were detected by Western blot assay.

RESULTIt showed that pseudolaric acid B remarkably induced apoptosis of 5637 cell line. Moreover, pseudolaric acid B suppressed survivin and up-regulated caspase-3 expression.

CONCLUSIONPseudolaric acid B inhibits the proliferation and induces the apoptosis of 5637 cells. The molecular mechanism of pseudolaric acid B inducing the apoptosis of 5637 cells may be associated with its action of down-regulating the expression of survivin, and up-regulating the expression of caspase-3.

Apoptosis ; drug effects ; Caspase 3 ; analysis ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Diterpenes ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Inhibitor of Apoptosis Proteins ; analysis ; Urinary Bladder Neoplasms ; drug therapy ; pathology