Objective:To summarize the content and effects of exercise interventions for stroke survivors, providing references for medical and nursing personnel in formulating exercise intervention plans for these patients.Methods:Literature on exercise interventions for stroke survivors was searched in databases such as China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, Cochrane Library, PubMed, Embase, and Web of Science up to May 1, 2023. Data extraction and summarization were conducted on the included literature.Results:Twenty-two articles were included in the review. The exercise types for stroke survivors primarily involved aerobic and resistance training; the intensity was mainly moderate to high; the frequency was mostly 3-5 times per week, with each session lasting 30-60 minutes; and the duration of interventions ranged from as short as two weeks to as long as one year. Exercise interventions improved stroke survivors' functional mobility, quality of life, cardiopulmonary function, mental state, cognitive function, fatigue, sleep, and compliance to varying degrees.Conclusions:Exercise interventions have achieved positive outcomes in stroke survivors. In the future, medical and nursing personnel can incorporate patient preferences into exercise intervention plans while ensuring patient safety to promote rehabilitation.

Objective:To conduct an overview of systematic reviews on the safety and effectiveness of early mobilization in stroke patients.Methods:Systematic reviews of early mobilization in stroke were electronically searched on China National Knowledge Infrastructure, WanFang Data, VIP, Chinese Biology Medicine, Cochrane Library, PubMed, Web of Science, CINAHL, Embase, and the Joanna Briggs Institute Evidence-Based Health Care Center Database. The search period was from database establishment to May 2023. Two researchers independently conducted literature screening, data extraction, and methodological quality evaluation of the included literature, as well as evidence summary and grading.Results:A total of 10 systematic reviews were included. The methodological quality evaluation showed that one article was of medium quality, two articles were of low quality, and seven articles were of extremely low quality. The evidence quality evaluation indicated that there were three pieces of high-quality evidence, 17 pieces of medium-quality evidence, 21 pieces of low-quality evidence, and 17 pieces of extremely low-quality evidence.Conclusions:Early mobilization is beneficial for improving the daily living ability and limb motor function of stroke patients, reducing the incidence of complications, shortening hospital stay, and enhancing their walking ability in the short term. However, the quality of evidence in the systematic review is relatively low, and further improvement is needed in the research design of early mobilization intervention measures to provide strong support for clinical practice.

Objective To investigate the protective effect of herba artemisiae scopariae extract on multidrug resistance protein 3(MDR3)gene mutation-induced neonatal parenteral nutrition-associated cholestasis(PNAC)and its possible mechanism.Methods ①Human primary hepatocytes were treated with cell culture in vitro,CRISPR/Cas9 lentivirus infection and MDR3 mutant gene lead-in.The levels of hepatic and biliary biochemical indexes[alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(TBil),direct bilirubin(DBil),indirect bilirubin(IBil),total bile acid(TBA)]in the supernatant of hepatocytes before and after 16,32,48 hours were compared to determine the time required for fatty acid induction of PNAC hepatocyte model with MDR3 gene mutation.② Human primary hepatocytes were divided into blank control group,MDR3 gene wild type group,MDR3 gene mutation group,and herba artemisiae scopariae extract intervention group according to random number table method.The blank control group was treated with culture medium only,the MDR3 gene wild type group was infected with lentivirus and mixed with wild type MDR3 gene and culture medium,the MDR3 gene mutation group was infected with lentivirus and cultured in culture medium with the mutant genes lead-in of LV-MDR3KI(c.485T>A,c.2793insA,c.1031G>A,c.3347G>A)mutation,while the MDR3 mutant gene was lead-in by lentivirus infection and cultured in culture medium,and then pretreated with 100 g/L herba artemisiae scopariae extract in the herba artemisiae scopariae extract intervention group,then the four groups of hepatocytes were induced with 1%fat emulsion,and the treatment time was the time needed to construct the PNAC hepatocytes model with MDR3 gene mutation.The levels of ALT,AST,TBil,DBil,IBil and TBA in the supernatant of hepatocytes were measured by enzyme-linked immunosorbent assay(ELISA).The mRNA expression abundance of adenosine triphosphate binding cassette proteins(ABCB4,ABCB11,ABCC2,ABCC3,ABCC4)encoding MDR3,bile salt export pump(BSEP),multidrug resistance associated protein(MRP)2-4,and tumor necrosis factor-α(TNF-α)genes were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).Results Compared to the blank control group and MDR3 gene wild type group,there was no significant difference in the levels of ALT,AST,TBil,DBil,IBil,TBA in the supernatant of MDR3 gene mutant group before and 16 hours after induction with 1%fat emulsion,however after treated with 1%fat emulsion for 32 hours and 48 hours,the levels of ALT,AST,TBil,DBil,IBil,TBA in the supernatant of MDR3 mutant hepatocytes were significantly increased(P<0.05),consequently the time required for fatty acid induction of PNAC hepatocyte model was 32 hours.At 32 hours after treatment with fat emulsion,the levels of ALT,AST,TBil,DBil,TBA in the supernatant of hepatocytes in the herba artemisiae scopariae extract intervention group were significantly decreased[ALT(ng/L):148.3±2.3 vs.164.9±7.0,AST(ng/L):2767.4±78.8 vs.3239.4±107.1,TBil(μmol/L):7.6±0.2 vs.13.6±0.3,DBil(μmol/L):1.8±0.1 vs.5.7±0.2,TBA(μmol/L):3.4±0.2 vs.6.7±0.1,all P<0.05].The ABCB4,ABCC2,ABCC3,ABCC4 mRNA expression of MDR3,MRP2,MRP3,MRP4 in the blank control group,MDR3 wild type group,MDR3 gene mutation group and the herba artemisiae scopariae extract intervention group had no significant difference.The expression of TNF gene mRNA was highly expressed in MDR3 gene mutation group(2-??Ct:1.258±0.200 vs.1.001±0.052),and was low expressed in the herba artemisiae scopariae extract intervention group(2-??Ct:0.387±0.247 vs.1.258±0.200),and there was a significant difference between the two groups(both P<0.05).Compared to the MDR3 gene mutation group,the ABCB11 gene encoding BSEP mRNA expression in the herba artemisiae scopariae extract intervention group was significantly increased(2-??Ct:2.955±0.479 vs.1.333±0.529,P<0.05).Conclusion The herba artemisiae scopariae extract has a protective effect on PNAC induced by MDR3 gene mutation,which may be related to antagonizing inflammatory reaction,decreasing the expression of TNF mRNA and improving the expression of ABCB11 gene encoding BSEP.

Objective To investigate the current status and influencing factors of physical activity (PA) among stroke survivors. Methods A total of 203 stroke survivors were selected as the research subjects using convenient sampling method. General information questionnaire, Stroke Self-efficacy Scale, Perceived Social Support Scale, Modified Rankin Scale, International Physical Activity Questionnaire-Long Form, Fatigue Severity Scale, and European Five-Dimension Health Scale were used for questionnaire survey. Based on the health ecological model, hierarchical multiple linear regression analysis was used to explore the influencing factors of PA among stroke survivors. Results Using metabolic equivalents (MET) to quantify energy expenditure, the weekly PA energy expenditure of 203 stroke survivors was 693.0 (0, 1 386.0) MET. The results of hierarchical multiple linear regression analysis showed that personal traits (stroke staging), behavioral characteristics and psychology (Modified Rankin Scale score, fatigue severity, stroke recovery self-efficacy), and interpersonal networks (perceived social support-friend support dimension) were the main influencing factors of PA among stroke survivors (P < 0.05), which could explain 55.5% of the variation in PA. Conclusion The level of PA among stroke survivors is influenced by multi-dimensional and multi-level complex factors in their health ecosystem, and it is currently at a low level. Healthcare professionals can formulate comprehensive strategies to improve PA among stroke survivors based on the health ecological model, aiming to further enhance the PA level of stroke survivors and promote physical function recovery.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective:To investigate the effect of Yinertong antibacterial fluid combined with Yintshu antibacterial gel on puncture wound infection in pleural catheter drainage.Methods:A total of 80 patients who underwent pleural catheter drainage in Gulou Hospital Affiliated to Medical College of Nanjing University from January 2018 to December 2019 were enrolled. They were divided into the control group and the experimental group by random digits table method, with 40 cases each. The control group was given alcohol disinfection and traditional iodophor. The experimental group was given Yinerong antibacterial fluid combined with Yintshu antibacterial gel. The infection of puncture wound, degree of edema, incidence of catheter displacement, colonization rate of catheter pathogens, pain, and nursing satisfaction were observed and compared between the two groups.Results:The wound infection rate was 15% (6/40) in the control group, and 0(0/40) in the experimental group, the difference was statistically significant ( χ2=4.50, P<0.05). There was no significant difference in colonization rate of catheter pathogens between the two groups ( P>0.05). There were 28, 6, 4 and 2 cases of no edema, mild, moderate and severe edema in the control group and 38, 1, 1 and 0 cases in the experimental group, the difference was statistically significant ( Z=8.19, P<0.05). There was no significant difference in the scores of Visual Analogue Scale (VAS) of immediate pain of puncture between the two groups ( P>0.05). The score of VAS after 24 hours of puncture and at the time of extubation was (3.10 ± 1.34), (1.50 ± 1.36) points in the experimental group, and (3.83 ± 1.28), (2.38 ± 1.28) points in the control group, the differences were statistically significant ( t=2.48, 2.97, both P<0.05). The satisfaction rate after discharge was 97.5% (39/40) in the experimental group, and 80.0% (32/40) in the control group, the difference was statistically significant ( χ2=8.31, P<0.05). Conclusions:The combined application of Yinertong antibacterial fluid and Yintshu antibacterial gel can significantly reduce the wound infection rate of pleural catheter drainage, reduce wound edema and pain, and improve patients′ satisfaction with nursing work, which is worthy of popularization and application.

Objective: To analyze the method and effect of reconstruction of the orbital floor defect with preserved orbital contents after advanced maxillary sinus cancer resection. Methods: Thirty-three patients of T3/T4 stage maxillary sinus cancer with orbital invasion who were treated in Shandong Provincial Hospital from January 2010 to October 2016 were retrospectively analyzed, including 20 males and 13 females, aged from 12 to 80 years old. Patients were treated with appropriate surgical methods according to their clinical manifestation, imaging finding, invasion range, preoperative and intraoperative pathology. Surgical approaches such as maxillectomy, expanded maxillectomy and superstructure maxillectomy were used for patients with Medpor orbit floor repairment. Patients were followed up regularly after surgery, and the surgical efficacy was discussed by descriptive statistical method. Results: Of those 33 cases, 19 were squamous cell carcinoma, 8 were adenoid cystic carcinoma, 5 were inverted papilloma malignant transformation, and 1 was myoepithelial carcinoma in our study. After tumor resection and orbital floor repair, the orbital contents and eyeball function of all patients remained intact. During follow-up time ranged from 3 to 8 years, a total of 6 patients relapsed at 3 years and died of ineffective treatment. The survival rate was 81.8% (27/33). Conclusion Tumor resection and Medpor orbital floor repair in maxillary sinus cancer patients with orbital invasion can preserve the function of the eyeball well, greatly improve the quality of patient′s life.

OBJECTIVE: To detect potential variation in glutaryl-CoA dehydrogenase (GCDH) gene among three Chinese families affected with glutaric acidemia type Ⅰ(GA-1) and correlate the genotypes with phenotypes. METHODS: Genomic DNA was extracted from peripheral blood samples derived from three patients with GA-1 and their family members. The coding regions of the GCDH gene were amplified with PCR and subjected to Sanger sequencing. RESULTS: The clinical manifestation of the patients varied from macrocephaly to severe encephalopathy, with notable phenotypic difference between siblings carrying the same variation. In pedigrees 1 and 2, the probands have carried compound heterozygous variations c.1133C>T(p.Ala378Val) and c.1244-2A>C, which were derived their fathers and mothers, respectively. In pedigree 3, the proband has carried compound heterozygous variation c.339delT (p.Tyr113) and c.406G>T (p.Gly136Cys). Among these, variations c.339delT and c.1133C>T were verified as novel by retrieval of dsSNP, HGMD and 1000 genome database. Bioinformatic analysis suggested that above variations can affect protein function and are probably pathogenic. CONCLUSION Above discovery has expanded the mutation spectrum of the GCDH gene. No correlation was found between the clinical phenotype and genotype of GA-1 patients.
Amino Acid Metabolism, Inborn Errors ; diagnosis ; genetics ; Brain Diseases, Metabolic ; diagnosis ; genetics ; China ; DNA Mutational Analysis ; Glutaryl-CoA Dehydrogenase ; deficiency ; genetics ; Humans ; Mutation

OBJECTIVETo delineate the clinical features and potential mutation of the ATP7A gene in a family affected with Menkes disease.

METHODSClinical data of a patient and his family members were analyzed. Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) assays were performed to detect the mutation of the ATP7A gene.

RESULTSThe patient was admitted at the age of 5 months due to severe epilepsy and marked delayed psychomotor development. Significantly light complexion, pudgy cheeks and sparse fuzzy wooly hair were noted. Cranial magnetic resonance imaging and angiography revealed cortical atrophy, leukoencephalopathy and circuitous of intracranial vessels. The plasma ceruloplasmin was decreased. MLPA has identified a deletion spanning exons 8 to 12 of the ATP7A gene. His mother was found to be a heterozygous carrier of the same mutation.

CONCLUSIONThe clinical features and a novel mutation of the ATP7A gene of the family have been delineated.

Adenosine Triphosphatases ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Cation Transport Proteins ; genetics ; China ; Copper-transporting ATPases ; DNA Mutational Analysis ; Exons ; Female ; Heterozygote ; Humans ; Infant ; Male ; Menkes Kinky Hair Syndrome ; genetics ; Mutation ; Pedigree

Objective To provide reference for clinical pharmacists participating in pharmacotherapy of low molecular weight heparin calium-induced thrombocytopenia.Methods Clinical pharmacists carried out pharmaceutical care for a patient with chronic cor pulmonale with acute exacerbation of chronic asthmatic bronchitis in the use of low molecular weight heparin calium,who developed progressive thrombocytopenia,and helped clinicians to manage adverse reaction and select subsequent treatment drug.Results The suggestions were adopted by clinicians.The platelets of patients gradually recovercd without thrombosis events.Condusion Participation of clinical pharmacists in the treatment of low molecular weight heparin calium induced-thrombocytopenia can effectively improve the prognosis of patients and ensure the safety in drug use.