Objective To investigate the impact of mitophagy,mediated by the long non-coding RNA SNHG16(LncRNA SNHG16)on diabetes-associated cognitive impairment(DCI).Methods 29 male C57BL/J mice were randomly divided into normal control(NC)group,DCI group and DCI+mitochondrial autophagy inhibitor(DCI+Mdivi-1)group.Morris water maze and new object recognition test were used to detect the cognitive function of mice,qRT-CPR was used to detect the expression of LncRNA SNHG16 and mitochondrial autophagy marker mRNA.Western blot were used to detect the expression of related protein.The mouse hippocampal neurons HT22 were divided into control(Con)group,high glucose(HG)group,HG+SNHG16 silencing(HG+sh-SNHG16)group and HG+no-load control(HG+sh-NC)group.CCK8 method and lactate dehydrogenase(LDH)method were used to detect neuronal damage.JC-1 method was used to detect mitochondrial membrane potential.Results Compared with NC group,the expression of LncRNA SNHG16 and the expression of autophagy-related gene 5,PTEN-induced putative kinase 1(PINK1),Parkin and microtubule associated protein light chain 3(LC3)Ⅱ/Ⅰ increased(P<0.05),while the expression of mitochondrial autophagy-related proteins P62 and mitochondrial outer membrane transposase 20(TOMM20)decreased in T2DM group.Compared with DCI group,the cognitive dysfunction of mice improved,and the expression level of LncRNA SNHG16 decreased in the DCI+Mdivi-1 group(P<0.05).The expressions of LncRNA SNHG16,LC3 Ⅱ/Ⅰ,PINK1 and Parkin were higher in HG group than in Con group(P<0.05),while the cell survival rate and TOMM20 protein expression were lower in HG group than in Con group(P<0.05).Silence of LncRNA SNHG16 can restore the activity of HT22 cells and mitochondrial membrane potential,and reduce the level of mitochondrial autophagy under HG condition.Conclusions The expression level of LncRNA SNHG16 was up-regulated in the hippocampus brain region of mice with diabetic cognitive dysfunction,and mitophagy was overactivated.Silencing of LncRNA SNHG16 inhibits mitophagy in hippocampal neurons and alleviates HG induced hippocampal neuronal damage.

Objective To investigate the impact of mitophagy,mediated by the long non-coding RNA SNHG16(LncRNA SNHG16)on diabetes-associated cognitive impairment(DCI).Methods 29 male C57BL/J mice were randomly divided into normal control(NC)group,DCI group and DCI+mitochondrial autophagy inhibitor(DCI+Mdivi-1)group.Morris water maze and new object recognition test were used to detect the cognitive function of mice,qRT-CPR was used to detect the expression of LncRNA SNHG16 and mitochondrial autophagy marker mRNA.Western blot were used to detect the expression of related protein.The mouse hippocampal neurons HT22 were divided into control(Con)group,high glucose(HG)group,HG+SNHG16 silencing(HG+sh-SNHG16)group and HG+no-load control(HG+sh-NC)group.CCK8 method and lactate dehydrogenase(LDH)method were used to detect neuronal damage.JC-1 method was used to detect mitochondrial membrane potential.Results Compared with NC group,the expression of LncRNA SNHG16 and the expression of autophagy-related gene 5,PTEN-induced putative kinase 1(PINK1),Parkin and microtubule associated protein light chain 3(LC3)Ⅱ/Ⅰ increased(P<0.05),while the expression of mitochondrial autophagy-related proteins P62 and mitochondrial outer membrane transposase 20(TOMM20)decreased in T2DM group.Compared with DCI group,the cognitive dysfunction of mice improved,and the expression level of LncRNA SNHG16 decreased in the DCI+Mdivi-1 group(P<0.05).The expressions of LncRNA SNHG16,LC3 Ⅱ/Ⅰ,PINK1 and Parkin were higher in HG group than in Con group(P<0.05),while the cell survival rate and TOMM20 protein expression were lower in HG group than in Con group(P<0.05).Silence of LncRNA SNHG16 can restore the activity of HT22 cells and mitochondrial membrane potential,and reduce the level of mitochondrial autophagy under HG condition.Conclusions The expression level of LncRNA SNHG16 was up-regulated in the hippocampus brain region of mice with diabetic cognitive dysfunction,and mitophagy was overactivated.Silencing of LncRNA SNHG16 inhibits mitophagy in hippocampal neurons and alleviates HG induced hippocampal neuronal damage.

Objective:This study aims to gain insight into the emotional experiences encountered by healthcare professionals when disclosing cancer diagnoses to patients.Methods:The CNKI,Wanfang Datebase,SinoMed,Weipu Database,PubMed,Web of Science,Scopus,The Cochrane Library,CINAHL,Embase and PsycINFO were searched until May 31,2024.The quality of included studies was evaluated according to 2017 JBI Critical Appraisal Tool for qualitative studies,and Meta-synthesis method was used to integrate the results.Results:A total of 15 studies were included,36 results were extracted,and 13 new categories were summarized.Additionally,three integrated results were synthesized,which were the promoters of disease notification,the internal barriers of disease informing,and the external barriers of disease informing.Conclusion:The current findings reveal a dual experience among medical staff during the notification process,with negative experiences outweighing the positive.Strengthening communication skills,enhancing the support system for disease notification,and advocating for early disclosure of the condition of patients with advanced cancer are imperative.

Objective:To investigate the clinical and imaging characteristics of cervical spine hyperextension injury plus multilevel disco-ligamentous complex (MDLC) injury and the therapeutic effectiveness of their treatment.Methods:A total of 456 patients with cervical hyperextension injury were hospitalized between January 2010 and October 2020 at Department of Orthopaedics, The 909th Hospital, Dongnan Hospital Affiliated to Xiamen University. A retrospective study was conducted to analyze the clinical data of the 43 patients among them who had been diagnosed with MDLC injury and undergone surgical treatment and been fully followed up. They were 37 males and 6 females with an age of (50.6±10.7) years. According to the American Spinal Injury Association (ASIA) grading, there were 1 case of grade A, 8 cases of grade B, 18 cases of grade C, and 16 cases of grade D. The Japanese Orthopaedic Association (JOA) score was (7.9±1.6) points. Anterior cervical decompression, fusion and internal fixation were conducted for 42 patients, and posterior total laminectomy and internal fixation for 1 patient. The clinical and imaging manifestations of the patients, and the consistency between preoperative and intraoperative diagnosis of disco-ligamentous complex (DLC) injury were analyzed. ASIA grading and JOA score were used to assess the outcomes of surgical treatment and comparisons were made between preoperation and postoperation.Results:DLC injury existed at 99 levels (43 cases), with a high incidence at level C 5-6 (30 cases), and high-signal manifestations of cervical cord injury existed at 48 levels, with a high incidence at level C 3-4 (16 cases). Two-segment DLC injury was the most common [74.4% (32/43)], while three-segment DLC injury existed in 9 cases and four-segment DLC injury in 2 cases. There were 21 cases of jumping MDLC injury and 22 cases of continuous MDLC injury. At preoperation, DLC injury was suspected in 10 patients (at 11 levels), of whom 8 (at 9 levels) were diagnosed intraoperatively with DLC injury, and 2 (at 2 levels) were excluded from the DLC injury. All the 43 patients were followed up for (54.7±10.7) months. By the ASIA grading at the last follow-up, 3 cases were grade C, 13 cases grade D, and 27 cases grade E. The JOA score at the last follow-up was (15.1±2.2) points. Both the 2 outcomes showed significant improvements compared with the preoperative values ( P<0.05). Conclusions:The clinical incidence of cervical hyperextension injury combined with MDLC injury is low, but relatively higher in the middle-aged and elderly patients. As the level of DLC injury is often inconsistent with the likely level of cervical spinal cord injury, surgical exploration of the DLC structure with suspected injury can reduce the rate of missed diagnosis and misdiagnosis.

Objective:To construct a communication strategy and implementation method for advanced cancer patients based on two communication models widely used at home and abroad, so as to reduce the difficulty of clinical disease notification.Methods:From January to October 2022, based on the communication model of SPIKES (Setting, Perception, Invitation, Knowledge, Empathy, Summary) and NURSE(Name, Understand, Respect, Support, Explore), combined with literature analysis, qualitative interviews, and expert argumentation, the communication strategy items of advanced cancer patients were constructed.Results:A total of 18 articles were included in the literature analysis. Qualitative interviews were conducted with 20 interviewees (including 4 doctors, 11 nurses, and 5 patients),6 males, 14 females, aged (35.94 ± 8.03) years old. A total of 8 experts participated in the demonstration, 2 males and 6 females, aged (41.88 ± 6.58) years old. Finally, the specific items and words of the disease notification process and communication strategies of advanced cancer patients in line with China ′s clinical practice were constructed. A total of 3 first-level items, 16 second-level items, 53 third-level items, and speech techniques were constructed, including pre-communication preparation, regular communication strategies, and poor communication disposal strategies. The importance score of the item was 4.50 to 5.00, and the coefficient of variation of the item was 0 to 0.12. Conclusions:The communication strategy of advanced cancer patients based on the communication model is scientific and feasible, and can be used as a tool to inform advanced cancer patients.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective:This study aims to gain insight into the emotional experiences encountered by healthcare professionals when disclosing cancer diagnoses to patients.Methods:The CNKI,Wanfang Datebase,SinoMed,Weipu Database,PubMed,Web of Science,Scopus,The Cochrane Library,CINAHL,Embase and PsycINFO were searched until May 31,2024.The quality of included studies was evaluated according to 2017 JBI Critical Appraisal Tool for qualitative studies,and Meta-synthesis method was used to integrate the results.Results:A total of 15 studies were included,36 results were extracted,and 13 new categories were summarized.Additionally,three integrated results were synthesized,which were the promoters of disease notification,the internal barriers of disease informing,and the external barriers of disease informing.Conclusion:The current findings reveal a dual experience among medical staff during the notification process,with negative experiences outweighing the positive.Strengthening communication skills,enhancing the support system for disease notification,and advocating for early disclosure of the condition of patients with advanced cancer are imperative.

Objective To investigate the status of self‐management of blood pressure (BP) among elderly hypertensive patients living in new rural communities of Shanghai. Methods We enrolled a total of 2 241 hypertensive patients over 60 years old who participated in the National Key Research and Development Project "Cohort study on hypertension" of the 13th Five‐Year Plan in Langxia, Shanghai from May to July 2018. Questionnaires, physical examinations, and laboratory tests were conducted. We collected participants' demographic information, cardiovascular history, and self‐management behaviors related to hypertension. The status of self‐management of BP among participants with hypertension was analyzed. Pearson's chi‐squared test was used to explore the differences between males and females. Results Participants'mean age was (70.0±6.8) years, and males accounted for 38.8% of all participants. The systolic and diastolic BP levels of participants were (147.8±15.4) mmHg (1 mmHg=0.133 kPa) and (82.8±9.8) mmHg, respectively. The systolic blood pressure level of women was higher than that of men, and the diastolic blood pressure level of men was higher; the difference was statistically significant (all P<0.05). The awareness, treatment, and control rate of hypertension were 79.0%, 78.0%, and 25.6%, respectively. Males had a significantly higher control rate than females (P<0.05). The status of self‐management of blood pressure was as follows: (1) As to lifestyle, 84.4% of participants lacked exercise, and 69.2% were overweight or obese. The prevalence of smoking and drinking was higher in males (40.7% and 46.2%, respectively), and the proportion of females (12.4%) with anxiety and/or depression was higher than that of males (P all<0.001). (2) Concerning BP‐monitoring, only 10.1% of participants measured BP every week, 22.9% had BP measurement instruments at home, and 4.6% recorded their BP levels. There was no significant difference in self‐blood pressure monitoring behavior between men and women. (3) Regarding adherence to medication treatment, 97.6% took antihypertensive drugs regularly, and 21.6% were on combination therapy. The proportion of men taking combined drugs was higher than that of women, but there was no significant difference. Conclusions The rates of awareness, treatment, and control of hypertension in elderly hypertensive patients in new rural communities of Shanghai were above the national average. However, the status of self‐management of BP was still not satisfactory. More attention should be paid to healthy lifestyle, home BP monitoring, and effective pharmaceutical treatment strategies for hypertension.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.

Objective To explore the perioperative management and surgical outcomes of fracture-dislocation of the upper cervical spine complicated with vertebral artery injury.Methods We retrospectively analyzed the clinical data of 19 patients diagnosed with fracture-dislocation of the upper cervical spine complicated with vertebral artery injury who had been treated at our department from January 2008 through December 2012.They were 14 males and 5 females,aged from 22 to 53 years (mean,35.2 years).All the patients had fractures of the atlas and/or axis,and disordered atlanto-axial relationship as well.According to Frankel grading system,8 cases were Grade D and 11 Grade E.The cervical posterior fixation with pedicle screws was adopted for all and hemostasis was conducted for those with bleeding from the broken vertebral artery.Their Frankel grade,Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) score were compared between preoperation and final follow-up.Results Intraoperative hemorrhage occurred in 2 patients from the injured vertebral artery.Hemostasis was achieved through direct tamponade with bone wax and gelatin sponge in one and through endovascular intervention after bleeding control by direct tamponade in another.Neither of them presented with symptoms of posterior circulation ischemia after operation.The mean operation time was 153.5 min,and the mean blood loss was 542.1 mL.All the patients were followed up for an average time of 28 months.Bony union was obtained in all after an average time of 13.5 weeks.Follow-ups revealed no ischemic stroke in this series.Symptoms of transient ischemic attack,like transient dizziness and blurred vision,appeared in 2 patients.At the final follow-up,all the patients were assessed as Frankel Grade E.Their mean JOA and VAS scores were significantly improved from 8.1 ± 1.2 and 7.0 ± 1.7 preoperatively to 12.7 ± 1.6 and 1.3 ± 1.2,respectively (P ＜ 0.05).Conclusions Angiography examination is routinely indicated for the patients with fracture-dislocation of the upper cervical spine perioperatively.Preoperative evaluation of the vertebral artery and its adjacent structures and effective intraoperative hemostasis can avoid uncontrollable bleeding during operation,reduce postoperative complications,and improve surgical outcomes.