Objective:To systematically evaluate and synthesize qualitative studies on the journey experiences and needs of patients with cancer-associated venous thromboembolism (CAT) , providing reference for developing full-course intervention strategies oriented to CAT prevention and management needs.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and VIP regarding qualitative studies on CAT patients' prevention and management journey experiences and needs, from database inception to June 30, 2024. The quality of included literature was assessed using the 2024 version of the Joanna Briggs Institute (JBI) Qualitative Research Quality Appraisal Criteria. Findings were synthesized using a Meta-synthesis approach.Results:A total of 13 studies were included, from which 104 themes were extracted and categorized into 12 new categories, ultimately integrated into three synthesized findings: tasks change as the journey progresses; emotions gradually shift from negative to positive; pain points are key areas to improve the journey experience.Conclusions:CAT patients experience varying journey-related experiences and needs. Healthcare providers should identify key management content at each stage to meet patients' multidimensional and diverse prevention and management needs, constructing individualized management plans oriented to CAT journey requirements.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To systematically evaluate and synthesize qualitative studies on the journey experiences and needs of patients with cancer-associated venous thromboembolism (CAT) , providing reference for developing full-course intervention strategies oriented to CAT prevention and management needs.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and VIP regarding qualitative studies on CAT patients' prevention and management journey experiences and needs, from database inception to June 30, 2024. The quality of included literature was assessed using the 2024 version of the Joanna Briggs Institute (JBI) Qualitative Research Quality Appraisal Criteria. Findings were synthesized using a Meta-synthesis approach.Results:A total of 13 studies were included, from which 104 themes were extracted and categorized into 12 new categories, ultimately integrated into three synthesized findings: tasks change as the journey progresses; emotions gradually shift from negative to positive; pain points are key areas to improve the journey experience.Conclusions:CAT patients experience varying journey-related experiences and needs. Healthcare providers should identify key management content at each stage to meet patients' multidimensional and diverse prevention and management needs, constructing individualized management plans oriented to CAT journey requirements.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To help flying personnel prevent flight fatigue risk and ensure flight safety by investigating the fatigue and countermeasures of flying personnel during long-haul flight.Methods:Air Force flying personnel were randomly selected from a cluster. They were divided into 21-30, 31-40 and 41-50 years group according to age. According to the post, they were divided into fighter pilots, bomber pilots, air navigation commander/air communication controller/aerial machinist and other groups. The self-made "questionnaire of aeromedical support to long-haul flight safety" was used to collect the fatigue condition and countermeasures of flying personnel in long-haul flight for the comparison among age and post groups.Results:Out of 156 questionnaires, 150 were valid, with a response rate of 96.2%. For the comparisons among age groups, the significant differences were observed in 3 fatigue symptoms such as drowsiness/sleepiness, discomfort on neck, waist, and shoulders, and degraded reaction ( χ2=12.62, 11.77, 12.23, P=0.002, 0.003, 0.002), 2 fatigue countermeasures such as talking with teammates and engaging in physical activity ( χ2=6.37, 16.70, P=0.041,<0.001), and 4 measures of maintaining flight ability such as sleep management, comprehensive physical training, functional food intake and simulation training ( χ2=8.81, 11.48, 9.59, 7.32, P=0.012, 0.003, 0.008, 0.026). For the comparisons among post groups, the significant differences were observed in 3 fatigue symptoms as visual fatigue, drowsiness/sleepiness, and discomfort on neck, waist, and shoulders ( χ2=10.39, 17.89, 8.42, P=0.016, 0.001, 0.038), as well as in fatigue countermeasures chosen like taking in water or food ( χ2=19.06, P<0.001) and in improving flight ability chosen like relieving eye fatigue ( χ2=12.09, P=0.007). Conclusions:The age and post factors influence the fatigue conditions and countermeasures chosen in the flying personnel during long-haul flight. The targeted and comprehensive interventions are suggested.

Objective To study the safety and effectiveness of chloral hydrate in children undergoing ABR tests.Methods From December 2015 to March 2022,5 513 children under the age of 12 were selected for ABR ex-amination in West China Hospital of Sichuan University,who received chloral hydrate sedation(dose of 30 mg/kg).Data on administration method(mixed or direct),sleep deprivation(yes or no),failure performance(such asfailure to sleep,insufficient sedation,superficial sleep),adverse events(vomiting,irritability,etc.)were retrospectively analyzed.Total sedation failure rate,sedation failure rates in different age groups(≤0.5 years,0.5～3 years,3～12 years)and adverse event rate were calculated.Results Among the 5 513 ABR tests,199(3.61％)failed seda-tion.The sedation failure rates in different age groups(≤0.5 years,0.5～3 years,3～12 years)were 3.03％,4.31％and 3.11％,respectively.In the sedation failure tests,insufficient sedation was found in 81.91％of the tests.The incidence of adverse events was 10.55％,with most commonly vomiting.Conclusion The sedation fail-ure rate and the incidence of adverse events of chloral hydrate at 30 mg/kg were relatively low,thus chloral hydrate can be considered safe and effective at this dose.

Objective To explore the short-term efficacy of endovascular isolation treatment for type A aortic intramural hematoma(AIH)with pericardial effusion,and to discuss the endovascular isolation treatment strategy for type A AIH with pericardial effusion.Methods A total of 12 patients with type A AIH complicated by pericardial effusion,who were admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China between February 2018 and November 2021,were enrolled in this study.Before surgery,the intima of the ascending aorta was intact in all patients,but a rupture at the proximal intima of the aortic arch or the thoracic descending aorta was detected.All patients received endovascular isolation treatment.Among them,4 patients received endovascular isolation treatment within one week after the onset of disease,and 8 patients received selective operation after receiving conservative treatment for one week.The patients were followed up for one year.Results Among the patients who received endovascular isolation treatment within one week after the onset of disease,one patient recovered smoothly,two patients developed type A dissection within 3 months after surgery,and one died early after surgery.All the 8 patients,who received selective operation after receiving conservative treatment for one week,recovered smoothly.Conclusion For patients with type A AIH complicated by mild to moderate pericardial effusion,selective endovascular isolation treatment after receiving the conservative treatment to alleviate the ascending aortic hematoma can achieve ideal therapeutic effect.

Rheumatoid arthritis(RA)is a prevalent autoimmune disease characterized by chronic inflammation and excessive proliferation of the synovium.Currently,treatment options focus on either reducing inflam-mation or inhibiting synovial hyperplasia.However,these modalities are unsatisfactory in achieving the desired therapeutic outcomes.Halofuginone hydrobromide(HF),an herbal active ingredient,has demonstrated pharmacological effects of both anti-inflammation and inhibition of synovial hyperplasia proliferation.However,HF's medical efficacy is limited due to its poor water solubility,short half-life(ti/2),and non-target toxicity.In the current study,by using the advantages of nanotechnology,we presented a novel dual-targeted nanocomplex,termed HA-M@P@HF NPs,which consisted of a hyaluronic acid(HA)-modified hybrid membrane(M)-camouflaged poly lactic-co-glycolic acid(PLGA)nanosystem for HF delivery.These nanocomplexes not only overcame the limitations of HF but also achieved simultaneous targeting of inflammatory macrophages and human fibroblast-like synoviocytes-RA(HFLS-RA).In vivo experiments demonstrated that these nanocomplexes effectively suppressed immune-mediated inflam-mation and synovial hyperplasia,safeguarding against bone destruction in rats with adjuvant-induced arthritis(AIA).Remarkable anti-arthritic effects of these nanocomplexes were accomplished through promoting repolarization of M1-to-M2 macrophages and apoptosis of HFLS-RA,thereby offering a promising therapeutic strategy for RA.

Objective:To understand residents' health status and disease characteristics by analyzing the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020, thus providing scientific evidence for disease prevention and treatment.Methods:Information on the first page of inpatient medical records from 77 secondary or higher-level hospitals was provided by the Tianjin Health and Medical Big Data Platform.The codes of the International Classification of Diseases 10th revision(ICD-10)were used by the system for standardized diagnoses at hospital discharge.The disease spectrum of inpatients was analyzed based on the systems implicated by diseases.Age stratification was performed in examining changes in the orders of diseases across the spectrum.Results:Between 2018 and 2020, a total of 3 568 034 patients were discharged, with 1 204 733 in 2018, 1 372 747 in 2019, and 990 554 in 2020.Male patients accounted for 49.2%(1 756 867/3 568 034), elderly patients(65 years or older)accounted for 33.5%(1 194 189/3 568 034), and patients from tertiary hospitals accounted for 86.5%(3 085 482/3 568 034).According to the ICD-10, there were 19 categories of diseases when diagnoses at discharge were considered.Over the three-years period, the top ten diseases made up 81.1%(2 893 430/3 568 034)of all cases at discharge, with high consistency in their rankings(harmonic index value Wa=0.986, χ2=70.989, P<0.001).The circulatory system and the nervous system always occupied the top two positions, while the respiratory system decreased from third to seventh place in 2020.The rankings of factors affecting health and healthcare access increased.The circulatory system, nervous system, respiratory system, digestive system, and tumors consistently ranked among the top six categories in the disease spectrum of the elderly and the rankings of diseases related to the eye, ear, endocrine system, musculoskeletal system, and connective tissue system were also up compared to those of the entire population. Conclusions:Hospitalized patients are concentrated in tertiary hospitals, with a relatively high proportion of elderly patients.In the disease spectrum, circulatory system diseases, neurological system diseases, digestive system diseases, tumors, and respiratory system diseases have always been at the top of the list for medical treatment, both for the entire population and for elderly patients, with a significant decrease in the ranking of respiratory system diseases in 2020.The rankings of eye, ear, endocrine, musculoskeletal, and connective tissue diseases in elderly patients have increased compared to the entire population, indicating a need to step up the development of geriatric medicine and related specialties and the importance to promote the healthy China initiative and healthy aging.

Rheumatoid arthritis (RA) is a prevalent autoimmune disease characterized by chronic inflammation and excessive proliferation of the synovium. Currently, treatment options focus on either reducing inflammation or inhibiting synovial hyperplasia. However, these modalities are unsatisfactory in achieving the desired therapeutic outcomes. Halofuginone hydrobromide (HF), an herbal active ingredient, has demonstrated pharmacological effects of both anti-inflammation and inhibition of synovial hyperplasia proliferation. However, HF's medical efficacy is limited due to its poor water solubility, short half-life (t _1/2), and non-target toxicity. In the current study, by using the advantages of nanotechnology, we presented a novel dual-targeted nanocomplex, termed HA-M@P@HF NPs, which consisted of a hyaluronic acid (HA)-modified hybrid membrane (M)-camouflaged poly lactic-co-glycolic acid (PLGA) nanosystem for HF delivery. These nanocomplexes not only overcame the limitations of HF but also achieved simultaneous targeting of inflammatory macrophages and human fibroblast-like synoviocytes-RA (HFLS-RA). In vivo experiments demonstrated that these nanocomplexes effectively suppressed immune-mediated inflammation and synovial hyperplasia, safeguarding against bone destruction in rats with adjuvant-induced arthritis (AIA). Remarkable anti-arthritic effects of these nanocomplexes were accomplished through promoting repolarization of M1-to-M2 macrophages and apoptosis of HFLS-RA, thereby offering a promising therapeutic strategy for RA.