Objective: To evaluate the effect of Tai Chi and Qigong on patients with lumbar disc herniation (LDH). Methods: Relevant data were retrieved from nine English and Chinese databases, including Cochrane Library, PubMed, and Wanfang Data, etc. from inception to June 2024. All published randomized controlled trials assessing the effect of Tai Chi and Qigong on visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, and other health indicators in participants with LDH compared to usual medical care or other treatments were included. Grey literature, trials involving the pushing of hands (Tui Shou) or Tai Chi with weapons, and trials with co-interventions (Tai Chi/Qigong plus another treatment) were excluded. Methodological quality was analyzed using the Cochrane risk of bias tool, and evidence quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool. Results: Fourteen trials (954 patients) were included in this study. Tai Chi and Qigong were associated with lower VAS pain scores (standardized mean difference −0.55, 95% confidence interval [CI] −0.95 to −0.15, P = .01), higher JOA scores (mean difference [MD] 4.40, 95% CI 2.62 to 6.18, P < .001) and straight leg raise test results (MD 9.40°, 95% CI 7.64 to 11.15, P < .001) in patients with LDH. Furthermore, compared with usual care, Tai Chi and Qigong showed enhanced effects on pain and JOA scores. When compared to other exercises or massage, the effect on pain scores was similar but that on JOA scores was significant. Conclusions Tai Chi and Qigong may have favorable effects on VAS pain and JOA scores compared with usual care, and on JOA scores compared with other exercises or massage in patients with LDH. Given the overall poor quality of the evidence, the results of current study should be interpreted cautiously.

Objective To investigate the correlation between serum interleukin-2 receptor(IL-2R),CD4+/CD8+ and disease activity in patients with lupus nephritis(LN).Methods A total of 38 patients with LN who were treated in Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from March 2021 to December 2022 were enrolled in LN group,and 40 healthy persons who underwent physical examination in the hospital during the same period were included in healthy control group.General clinical data,systemic lupus erythematosus disease activity index(SLEDAI)and pathological classification were collected.LN patients were divided into active group and inactive group according to SLEDAI score,and the difference of clinical indicators between two groups was compared.Results The hemoglobin(Hb),platelet count,albumin(ALB),complement C3 and C4 in LN group were significantly lower than those in healthy control group,the positive rates of antinuclear antibody and anti-double strand DNA antibody(anti-ds-DNA antibody),serum creatinine(SCr)and C-reactive protein were significantly higher than those in healthy control group(P<0.05).The ALB of active group was significantly lower than that of inactive group,and IL-2R,erythrocyte sedimentation rate,24h urinary protein quantity and anti-ds-DNA antibody positive rate were significantly higher than those of inactive group(P<0.05).Serum IL-2R levels in LN patients were positively correlated with SLEDAI,SCr,blood urea nitrogen and 24h urinary protein quantity,and negatively correlated with Hb and complement C3(P<0.05).Conclusion Serum IL-2R can be used as an indicator to judge the degree of LN activity and provide a basis for the judgment of clinical disease activity.

Objective To explore the optimal ratio of Baitong decoction based on efficacy,clarify its spectrum-effect relationship,and identify its potential quality markers.Methods An ulcerative colitis(UC)model in mice was established using dextran sulfate sodium.The efficacy of Baitong decoction with varying drug ratios was assessed by evaluating the apparent score,pathological score and inflammatory factor changes of UC in each group of experimental animals.The fingerprints of Baitong decoction with different ratios were established by high performance liquid chromatography(HPLC),and the relationship between the content of each substance and its efficacy was analyzed by partial least squares regression to determine the potential quality markers of Baitong decoction.Results Baitong decoction was most effective in relieving ulcerative colitis when the mass ratio of Fuzi,Ganjiang and Congbai was 1∶2∶2.The fingerprinting identified 14 common peaks across 7 ratios,with 9 peaks were found to be associated with the remission of ulcerative colitis by partial least squares regression analysis.Conclusion The optimal ratio of Fuzi,Ganjiang and Congbai for treating UC is 1∶2∶2.The spectrum-effect relationship analysis suggested that the quality markers of Baitong decoction may be the substances represented by peak 2(benzoylaconine),3,5,6,8(mesaconine),9(aconitine),10(hypaconitine),13(10-gingerol)and 14.

Atherosclerosis is the pathological basis of a variety of cardiovascular diseases,which are still the leading cause of human death worldwide.Ferroptosis is a kind of iron dependent non-apoptotic cell death mode,which is closely related to various physiological mechanisms.Recent studies have found that ferroptosis in macrophages plays an important role in the occurrence and development of atherosclerosis.Based on the imbalance of iron metabolism in macrophages,this paper reviews the correlation between ferroptosis in macrophages and atherosclerosis in terms of the interaction between ferroptosis in macrophages and lipid peroxidation,inflammation,oxidative stress,etc.,in order to provide new ideas for the study of the pathogenesis of atherosclerosis.

Aim To investigate the role of cholesterol in the regulation of lipid raft and the function of platelets.Methods Using in vitro incubation of methyl β-cyclodextrin(MβCD)and in vivo elevation of peripheral blood total cho-lesterol levels to remove and load platelet cholesterol,respectively.Cholera toxin B staining combined with flow cytometry was used to detect platelet lipid raft content,fluorescence antibody staining combined with flow cytometry was used to detect the expression levels of P-selectin and activated integrin α Ⅱ bβ3,annexin Ⅴ labeling combined with flow cytometry was used to detect the level of phospholipid efflux,in vitro experimental system and rat tail bleeding experiment were used to detect platelet aggregation ability.Results The content of lipid raft on B lymphocytes decreased with the removal of cholesterol,while in vitro incubation of MβCD to remove platelet cholesterol significantly increased its lipid raft level(P＜0.05).Consistent with this,in vivo cholesterol loading increased the lipid raft content of B lymphocytes but decreased the lipid raft content of platelets(P＜0.05).The increase in lipid raft after removing cholesterol was not conducive to platelet activation and aggregation function.In vivo cholesterol loading downregulated platelet lipid raft content(P＜0.05),enhanced its ability to respond to low concentration stimulant for activation aggregation and coagulation,and this enhancing effect disappeared after cholesterol removal.Conclusion Platelet cholesterol is a key regulator of platelet lipid raft content and platelet function,which can negatively regulate lipid raft,promote platelet activation,and enhance their coagulation function.

Solitary cervical submental nodule is a relatively rare case in clinical procedure and prone to miss diagnosis.Differential diagnosis with various head and neck diseases is necessary.This article reported a case of solitary cervical submental metastasis of papillary thyroid carcinoma received in the department of surgery,Civil Aviation Shanghai Hospital,Ruijin Gubei Branch,Shanghai Jiao Tong University School of Medicine.The patient came to the outpatient clinic for treatment due to"consciously larger submental tubercle than before".Ultrasound examination revealed suspicious lesions in both the thyroid and submental regions.Ultrasound-guided final needle aspiration biopsy diagnosed as malignant tumor.Surgical resection was performed and the central group lymph nodes dissected Pathological examination confirmed papillary thyroid carcinoma with solitary submental metastasis.This article reported the clinical diagnosis and treatment of this case,in order to improve the disease recognition for clinicians,and make differential diagnosis with other rare neck diseases,and avoid missing diagnoses.

Objective To construct the competency and professional activities of pediatric rehabilitation therapists in China based on World Health Organization rehabilitation competency framework(RCF). Methods Competencies,activities,and tasks in the field of pediatric rehabilitation were collected through literature,offi-cial websites and interviews with key informants using RCF.Competency requirements suitable for pediatric re-habilitation therapists were selected,competency dimensions and activities were adjusted based on the context of pediatric rehabilitation therapy.Similar content was integrated through thematic framework analysis and content analysis.Competencies were matched with typical professional activities.A competency framework and profes-sional activities for Chinese pediatric rehabilitation therapists were developed,and the Delphi method was used to survey 22 experts,ultimately confirming competency dimensions and activity content. Results The enthusiasm coefficient of experts was 88.00%,the authority coefficient was 0.84,and the expert opinions were more focused on importance.The CV values of all competency dimensions and activities were≤0.25,and the W test was statistically significant(P<0.05),indicating a high degree of coordination among experts.A com-petency framework for pediatric rehabilitation therapists in China,included 17 competency dimensions and 17 professional activities. Conclusion To explore the competency of typical professions through RCF may enhance the application of research re-sults in the field of rehabilitation,which provides a reference for clarifying the job content and cultivating the competency of Chinese pediatric rehabilitation therapists.

Objective To investigate the current situation of competency and professional activities of pediatric rehabilitation thera-pists in Jiangsu,Shanghai and Zhejiang. Methods A questionnaire survey was conducted on 168 pediatric rehabilitation therapists in Jiangsu,Shanghai and Zheji-ang,from December,2022 to February,2023,and the general information and the competency were obtained.A total of 35 pediatric rehabilitation therapists were interviewed one-on-one,from October,2022 to January,2023,using thematic framework. Results A total of 162 effective questionnaires were collected.The level of competency of pediatric rehabilitation thera-pists was(3.44±0.87);and it was higher in professional literacy(3.90±0.77)and practice(3.83±0.77),and lower in management and leadership(2.92±1.44),and research(2.14±1.64).Latent class analysis showed that the thera-pists could be divided into four categories,of which the"medium competency"accounted for the most proportion(34.57%),and"low learning and research"was the least(8.64%).The interviews identified problems of compe-tency such as maintaining communication with children's families and managing self-professional development. Conclusion Self-reported rehabilitation competency levels of pediatric rehabilitation therapists in three provinces and cit-ies are above three points in all four dimensions,except for the management and leadership dimension,where the score is below three points.

Although NPM1 mutations are frequently found in acute myeloid leukemia patients, therapeutic strategies are scarce and unsuitable for those who cannot tolerate intensive chemotherapy. Here we demonstrated that heliangin, a natural sesquiterpene lactone, exerts favorable therapeutic responses in NPM1 mutant acute myeloid leukemia cells, with no apparent toxicity to normal hematogenous cells, by inhibiting their proliferation, inducing apoptosis, causing cell cycle arrest, and promoting differentiation. In-depth studies on its mode of action using quantitative thiol reactivity platform screening and subsequent molecular biology validation showed that the ribosomal protein S2 (RPS2) is the main target of heliangin in treating NPM1 mutant AML. Upon covalent binding to the C222 site of RPS2, the electrophilic moieties of heliangin disrupt pre-rRNA metabolic processes, leading to nucleolar stress, which in turn regulates the ribosomal proteins-MDM2-p53 pathway and stabilizes p53. Clinical data shows that the pre-rRNA metabolic pathway is dysregulated in acute myeloid leukemia patients with the NPM1 mutation, leading to a poor prognosis. We found that RPS2 plays a critical role in regulating this pathway and may be a novel treatment target. Our findings suggest a novel treatment strategy and lead compound for acute myeloid leukemia patients, especially those with NPM1 mutations.

OBJECTIVES: The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden. METHODS: A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested. RESULTS: Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P<0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden (P<0.01). Caregiver's caring ability was positively correlated with caregiver's resilience (P<0.01), and both were negatively correlated with caregiver burden (both P<0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively. CONCLUSIONS Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.
Male ; Humans ; Female ; Aged ; Caregiver Burden ; Disabled Persons ; Caregivers ; Surveys and Questionnaires ; Mental Health