Objective To explore the application effect of advanced lung rehabilitation programs in patients un-dergoing high flow nasal cannula oxygen therapy(HFNC).Methods Convenience sampling method was used to se-lect 40 HFNC patients admitted to the respiratory department,ICU,coronary heart disease monitoring unit,and other departments of a tertiary A comprehensive hospital in Tianjin from January to June 2023 as the experimental group,and 40 HFNC patients admitted from June to December 2022 as the control group.Both groups of patients received HFNC treatment during hospitalization and continued at home,while the experimental group adopts the information-motivation-behavioral skills(IMB)model as the theoretical basis,implements advanced pulmonary rehabili-tation during the stable condition period,discharge preparation period,and home rehabilitation period,and imple-ments compliance management of home pulmonary rehabilitation through cloud follow-up,and the control group re-ceived routine lung rehabilitation and home follow-up.The degree of respiratory distress,6-minute walking distance,exercise self-efficacy,quality of life were compared between the 2 groups before intervention,2 months and 6 months after intervention,and compliance with home pulmonary rehabilitation was compared between the 2 groups 6 months after intervention.Results The repeated measures analysis of variance showed that there was an interaction effect between time and the 2 groups in terms of difficulty in breathing,6-minute walking distance,exercise self-ef-ficacy,and quality of life(P＜0.05).Simple effect analysis showed that after 2 and 6 months of intervention,the ex-perimental group performed better than the control group in the respiratory distress,6-minute walking distance,exer-cise self-efficacy,and quality of life(P＜0.05).Within 6 months of intervention,the compliance of home pulmonary rehabilitation in the experimental group was better than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion The application of advanced pulmonary rehabilitation programme based on IMB can improve respiratory symptoms and improve exercise self-efficacy and adherence to pulmonary rehabilitation,en-hance activity endurance and improve quality of life.

Objective To observe the effect of preoperative muscle strength training combined with postoperative BIODEX balance function training in improving the motor function of patients with total hip arthroplasty (THA). Methods A total of 110 patients with THA from January 2021 to December 2022 were selected as research objects, and were divided into observation group and control group by the simple randomization method, with 55 cases in each group. The control group received conventional postoperative rehabilitation training, while the observation group was treated with muscle strength training and BIODEX balance function training. Imaging indicators (acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone, and centering rate of femoral prosthesis) at 5 days after surgery were compared between two groups; the joint motor function (Harris score for hip joint), balance ability [Berg Balance Scale (BBS)] and daily activity ability [Activities of Daily Life Scale (ADL)] before treatment and one month after treatment were compared between the two groups. Results There were no significant differences in acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone and centering rate of femoral prosthesis between the two groups at 5 days after surgery (P>0.05); after one month of treatment, the Harris score for hip joint, the BBS score and ADL score in both group increased significantly, and the scores in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion Preoperative muscle strength training combined with postoperative BIODEX balance function training shows a significant therapeutic effect, which can effectively improve the hip motor function and enhance the balance control ability in patients with THA.

OBJECTIVE To establish characteristic HPLC chromatograms for Jubei mixture, and to simultaneous determine its six components by HPLC-ELSD. METHODS An HPLC specific chromatogram of the Jubei mixture was established. The chromatographic column was Agilent ZORBAX-C18(250 mm×4.6 mm, 5 μm), gradient elution was conducted with acetonitrile(A)-0.1% phosphoric acid aqueous solution(B) as the mobile phase, the flow rate was 1.0 mL·min-1, and the column temperature was 30℃, the detection wavelength was 250 nm. An HPLC-ELSD method was established and the chromatography was accomplished on a Waters T3 C18(250 mm×4.6 mm, 5 μm) column, the mobile phase consisted of acetonitrile(A)-1% acetic acid aqueous solution(B) in a gradient mode, the flow rate was 1.0 mL·min-1, the column temperature was set at 30℃. RESULTS The characteristic chromatograms of the HPLC with baicalin as the reference peak was established, and eight common peaks were defined. The linear ranges of amygdalin, liquiritin, peimine, peiminine, platycodin D and ophiopogonin D were good within their own ranges(r ≥ 0.999). The average recovery were 99.1%, 98.6%, 100.9%, 97.7%, 98.9% and 98.0%, RSD were 0.4%, 1.0%, 1.1%, 1.2%, 0.7% and 1.3%, respectively. CONCLUSION The established methods can be used to qualitative identification and quantitative determination of Jubei mixture, can effectively used for evaluation and quality control of Jubei mixture.

Objective:To optimize the Manchester needs tool for injured children (MANTIC) scale , and evaluate its reliability and validity among injured children. Methods:The MANTIC scale was optimized through Delphi expert consultation and pre-tests. From March 2023 to June 2023 , a total of 317 injured children admitted in 7 level A tertiary hospitals in Zhejiang and Shandong provinces and their families were surveyed with general data, optimized MANTIC scale, and EuroQol 5-dimension health questionnaire for youth (EQ-5D-Y). Item analysis was conducted on the data of the 317 patients collected with optimized MANTIC scale through the test for homogeneity and value-based decision-making method and the content validity test of the scale was evaluated with item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). It was evaluated with KMO test values and Bartlett′s test of sphericity to determine whether the scale was suitable for exploratory factors. The number of common factors was determined based on the K1 criterion and scree plot to further obtain the structural validity of the scale of the item load value. The correlation validity of the scale was evaluated with the correlation coefficient of the optimized MANTIC scale and EQ-5D-Y. The reliability of the scale was tested with Cronbach alpha coefficient and Guttman split-half reliability coefficient. Results:A total of 332 questionnaires were distributed, among which 317 valid ones were collected, with a response rate of 95.6%. The test of homogeneity in the item analysis showed that the correlation coefficient between each item and the total score of the scale was 0.40-0.80. The results of the value-based decision-making method showed that the critical ratio of high-and low-scored groups was 6.08-28.01. The quality of all the items met the retention requirements so that the reliability and validity tests could be continued. Validity test found that I-CVI was 0.83-1.00, consistent S-CVI was 0.83, and mean S-CVI was 0.95. In structural validity analysis, the KMO value was 0.96, and the Chi-square value of Bartlett′s test of sphericity was 10755.76 ( P<0.01). A total of 9 common factors were extracted with the K1 criterion (eigen value>1), and the scree plot indicated 9 common factors with a cumulative variance contribution rate of 73.46%. Factor extraction and rotation showed that the load value of each item of the scale ranged from 0.589 to 0.874. The correlation coefficient of the optimized MANTIC scale and EQ-5D-Y was r= 0.55 ( P<0.01).Reliability test showed that the Cronbach alpha coefficient of the total scale and all dimensions was 0.96 and 0.77-0.98, and the Guttman split-half reliability coefficient was 0.76 and 0.73-0.98. Conclusion:The optimized MANTIC scale can attain good reliability, validity, consistency and stability, and can reflect the concept to be expressed and the content to be evaluated, indicating that it can be used to evaluate the injury rehabilitation needs of injured children and their families throughout the entire treatment process.

Objective:To investigate the effect of treatment of spinal meningioma with microsurgical procedures.Methods:From January 2003 to March 2022, there were 120 patients who had spinal meningioma and treated in the Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University. Their clinical data were retrospectively analysed. Of the 120 patients, there were 90 females and 30 males, aged from 14 to 85 (average, 54) years old. According to McCormick Classification, 29 cases were in grade I, 59 cases were in grade II, 25 cases were in grade III, and 7 cases were in grade IV. They were all underwent microsurgery. Patients were followed up by outpatient service within 3 months after surgery, then reviewed by outpatient visits and telephone interviews. McCormick's classification method and MRI examination were used to analyse the neurological and imaging changes of the patients before and after the surgery.Results:A total of 113 patients had complete resection and 7 had the resection of most part of the spinal meningioma. No infection, cerebrospinal fluid leakage, other complications and death occurred. Three months after surgery, 95 patients achieved the improvement or even completely disappearance of symptoms (such as numbness, pain, limited movement, etc.). There were 23 patients who had the symptoms unchanged as what before the surgery. Two patients had the symptoms worsened after the surgery. At 3 months after surgery, 95 cases (79.2%) improved, 23 cases (19.2%) were stable, and 2 cases (1.6%) aggravated. According to McCormick classification method, 92 cases were in grade Ⅰ, 15 cases were in gradeⅡ, 10 cases were in grade Ⅲ, and 3 cases were in grade Ⅳ. MRI scans showed that the dural sac were well refluxed, and no recurrence was found.Conclusion:Microsurgery is safe and effective for removal of spinal meningioma, with significant improvement in symptoms with fewer complications.

Colonoscopy with polypectomy significantly reduces the incidence of colorectal cancer and cancer - related mortality. However, a pooled miss rate of 22% for polyps was documented. Aims: To explore the clinical application value of an artificial intelligence (AI)-based colorectal polyp diagnostic system for polyp detection. Methods: A total of 400 patients who underwent colonoscopy in the First Affiliated Hospital of Soochow University from September to November 2021 were selected according to the inclusion and exclusion criteria and were randomly divided into two groups: one group received routine colonoscopy, and the other group received AI system assisted colonoscopy. There were 200 cases in each group. The Boston Bowel Preparation Scale (BBPS) was used to evaluate bowel preparation quality. The primary outcome was polyp detection rate (PDR), and the secondary outcome was polyps per colonoscopy (PPC). Results: AI system significantly increased PDR and PPC (37.0% vs. 23.0%, 0.775 vs. 0.495, all P<0.05), especially for diminutive and small polyps (diminutive polyps: 23.0% vs. 13.0%, 0.410 vs. 0.295; small polyps: 16.0% vs. 8.0%, 0.255 vs. 0.095; all P<0.05). No significant difference in large polyp detection was observed between the two groups (all P>0.05). The bowel preparation quality was classified as“poor”(BBPS 0-5 points),“qualified”(BBPS 6-7 points) and“excellent”(BBPS 8-9 points). There were no significant differences in polyp detection between the two groups when the bowel preparation quality was“poor”or “excellent”(all P>0.05). PDR and PPC were significantly increased in AI group when the bowel preparation quality was “qualified”(33.0% vs. 20.0%, 0.670 vs. 0.450, all P<0.05). Conclusions: AI-based colorectal polyp diagnostic system can significantly improve PDR and PPC because of the significant increase in the number of diminutive and small polyps detected. In addition, when the bowel preparation is qualified, the AI system can play better for polyp detection.

Objective:To explore the related factors influencing the length of hospital stay(LOS) of pregnant women with heart disease (PWHD) after cesarean section.Methods:A total of 306 patients with PWHD who underwent cesarean section from January 2012 to March 2019 were collected. Among them, 203 patients had not undergone heart surgery (uncorrected group) and 103 patients who had undergone heart surgery (corrected group) during the same period. Demographic, perioperative and postoperative data were recorded. Predictors associated with postoperative LOS were determined using univariate and multivariate linear regression analysis models.Results:(1) The median LOS after cesarean section in the uncorrected group was 6 days (5-8 days). The results of univariate linear regression analysis showed that 38 parameters had significant impact on LOS ( P<0.05). The results of multivariate linear regression analysis showed that 5 parameters were independent risk factors for prolonged LOS in the uncorrected group; among them, the median LOS in uncorrected group with hypertensive disorders of pregnancy was 3 days longer than that in patients with PWHD alone [7 days (5-8 days) vs 4 days (4-5 days), β=0.195, P=0.001]; the median LOS in uncorrected group with high serum creatinine was 3 days longer than normal patients [7 days (5-13 days) vs 4 days (4-5 days), β=0.145, P=0.015]; the LOS of patients who chose general anesthesia was 2 days longer than that of patients who chose spinal anesthesia [6 days (4-8 days) vs 4 days (4-5 days), β=0.154, P=0.007]; the LOS of patients with postoperative pulmonary infection was 4 days longer than that of patients without pulmonary infection [8 days (5-15 days) vs 4 days (4-5 days), β=0.269, P<0.01]; the LOS of patients who admitted to ICU after surgery was 2 days longer than that not admitted patients [6 days (5-8 days) vs 4 days (4-5 days), β=0.268, P<0.01]. (2) The median LOS after cesarean section in corrected group was 4 days (4-5 days). The results of univariate linear regression analysis showed that 8 parameters had significant impact on the LOS (all P<0.05). The results of multivariate linear regression analysis showed that 2 parameters, which were American Society of Anesthesiologists (ASA) grade ( β=0.198, P=0.028) and intraoperative blood loss ( β=0.285, P=0.003), were the independent risk factors for prolonged LOS in corrected group. Conclusion:Preoperative with hypertensive disorders of pregnancy, preoperative creatinine increase, intraoperative general anesthesia, postoperative pulmonary infection, and postoperative admission to ICU are independent predictors of prolonged LOS in uncorrected patients with PWHD; ASA classification and intraoperative bleeding are independent predictor of prolonged postoperative LOS in patients with corrected PWHD.

Objective To investigate the expression of elongation of very long-chain fatty acids family member 6 (ELOVL6) in high-grade serous ovarian carcinoma (HSOC), and explore the correlation between its expression and clinical prognosis in these patients. Methods The expression of ELOVL6 at mRNA and protein levels were respectively detected by reverse transcription (RT)-PCR and immune histochemistry method in 12 cases with normal ovarian tissues and 172 cases with HSOC from primary tumor site, forty of which had paired peritoneal metastatic tissues. Results (1) The results tested by RT-PCR showed that ELOVL6 expression in normal ovarian tissue was 4.8±1.1, while 1.2±0.7 in primary tumors and 1.8 ± 0.9 peritoneal metastatic sites in HSOC. Compared with normal ovarian tissue, the level of ELOVL6 mRNA was significantly lower in HSOC (P<0.05). There was no significant difference between primary and peritoneal metastatic sites in HSOC (P=0.610). It was shown that ELOVL6 protein localized in cytoplasm of ovarian cancer cell by immunostaining assay. (2) ELOVL6 expression was observed in all normal ovarian tissue, 70.2%of G1-G2 and 48.8%of G3 HSOC (P<0.05). ELOVL6 expression in drug-resistant group were significantly lower than that in non-resistant group (39.1% vs 65.0%, P<0.01). The median disease-free survival was 41 months in the ELOVL6-positive group and 39 months in ELOVL6-negative group (P>0.05). The total median survival was 52 months in ELOVL6-positive group and 44 months in ELOVL6-negative group (P>0.05). Conclusion Low expression of ELOVL6 may correlate with the poor differentiation and drug resistance in HSOC.

BACKGROUNDAberrant epithelial repair has been observed in chronic rhinosinusitis (CRS) patients; however, the mechanism of epithelial cell repair regulation is unclear. Epidermal growth factor (EGF) plays an important role in regulating epithelial cell repair in lower airway and may be a critical factor in the remodeling processes of CRS. The objective of our research is to evaluate the differences between CRS and normal subjects and between chronic rhinosinusitis without nasal polys (CRSsNP) and chronic rhinosinusitis with nasal polys (CRSwNP) in the regulation of EGF pathways and the regulating proliferative position of classic Ras/Raf/MEK/ERK pathways.

METHODSWe evaluated the proliferation rates of ethmoidal mucosal cells before and after stimulation with EGF, epidermal growth factor receptor (EGFR) kinase inhibitor AG1478, and extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 using MTT assays. We also analyzed the sinonasal epithelial cells collected from control subjects and patients with CRS subtypes CRSsNP and CRSwNP for the expression of ERK1/2, phosphorylated ERK1/2, P21, P15, and P27 using western blotting analyses.

RESULTSThe proliferation rates of sinonasal epithelial cells before and after EGF stimulation were lower in CRS patients than in the controls. AG1478 or PD98059 inhibitor treatment of control epithelial cells did not result in a significant difference in proliferation. Although, AG1478 and PD98059 inhibited the proliferation of CRS cells, the degree of proliferation inhibition was markedly different in CRSsNP. AG1478 suppressed the proliferation of CRSwNP epithelial cells, whereas PD98059 had no effect. The ratio of ERK1/2 phosphorylation in CRS cells was lower than that of the control cells. Cyclin-dependent kinase inhibitors were highly expressed in CRS cells compared with that of control cells. ERK1/2 and P27 showed differential expression in CRSsNP and CRSwNP.

CONCLUSIONSDifferences existed in EGF pathways in CRS patients and normal subjects as well as in CRSsNP and CRSwNP. Classical Ras/Raf/MEK/ERK pathway may assume absolute superiority in control cells. Ras/Raf/MEK/ERK classical pathway and other pathways might be active at the same time to stimulate epithelial cell proliferation in CRSsNP. The function of Ras/Raf/MEK/ERK classical pathway was weaker in CRSwNP than in CRSsNP and when the classical pathway was blocked in CRSwNP, some other pathway could have completely compensated the proliferation induced by the Ras/Raf/MEK/ERK pathway.

Adult ; Aged ; Cell Proliferation ; drug effects ; Cells, Cultured ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; cytology ; Sinusitis ; metabolism

Objective To explore the influence of integrated traditional Chinese medicine and western medicine on neurological function in patients with ischemic stroke.Methods One hundred patients with ischemic stroke were randomly divided into a treatment group and a control group.Both groups were given basic treatment.At this basis,sixty patients in the treatment group were given Chinese decoction,Kudiezi injection,traditional Chinese medicine soaking,and comprehensive rehabilitation; forty patients in the control group were given citicoline,modem rehabilitation techniques.Both groups were treated for 21 days.The scores of NIHSS,ADL,and MMSE were assessed at 7th day,14th day,and 21st day after admission of the trial,respectively.Results After 14 days,the scores of NIHSS (22.33± 1.06)in treatment group were decreased significantly (P＜0.05).After 21 days,the scores of NIHSS,ADL,MMSE in treatment group were(18.73±1.23),(20.19±2.17),(38.68±2.85),and(21.65±l.41),(25.37±2.34),(32.12±3.11)in control group,the improvement of scores in treatment group were superior to the control group (P＜0.05).The total effective rate was 91.67％ in treatment group,and 70％ in control group,it was significantly higher in treatment group than that in the control group (x2=7.98,P＜0.05).Conclusion The therapy of integrated traditional Chinese medicine and western medicine can significantly improve ischemic stroke,enhance the therapeutic efficiency of patients with ischemic stroke.