Objective To retrieve,evaluate and summarise the best evidences for early exercise rehabilitation in patients with acute heart failure,hence to provide references for clinically early exercise rehabilitation.Methods Websites of BMJ best clinical practice,the International Guidelines Collaborative Network(GIN),the UK National Institute of Clinical Medicine Guidance Library(NICE),the Ontario Registered Nurses Association(RNAO),the Australian JBI evidence-based health care centre database(JBI),Cochrane Library,PubMed,Web of Science,CINAHL,Medlive,CBM,CNKI,Wanfang Data and VIP published between April 1st,2018 and April 13th,2023 were searched to collect literatures that were relevant to clinical practice,guidelines,expert consensus,evidence summary,systematic evaluation and meta-analysis in early exercise rehabilitation in patients with acute heart failure.Two trained researchers independently evaluated the included literatures,and then extracted and summarised the evidences that met the inclusion criteria.Results A total of 16 articles were retrieved,including 2 articles in clinical decisions,6 guidelines,3 expert consensus,2 evidence summaries,1 recommended practice and 2 systematic reviews.Twenty pieces of the best evidence across 9 dimensions were summarised,including indications of exercise rehabilitation,timing for exercise rehabilitation intervention,flexibility movement,low intensity resistance exercise and inspiratory muscle training.Conclusions The summarised best evidence for early exercise rehabilitation in patients with acute heart failure can provide the healthcare professionals with evidence-based references in clinical practice.Healthcare professionals are encouraged to apply the evidence to propose the plans for individualised early exercise rehabilitation,after fully consideration of the physical condition and willingness of the patients.

Objective:To investigate the effect of long non-coding RNA (lncRNA) H19 regulating miRNA-675 (miR-675) and phosphatase and tensin homologue-deleted chromosome ten gene (PTEN) on the cell proliferation of glioma.Methods:Glioma cell lines U87-MG and U251 were chosen. The siRNA online design tool wad used to design small interfering RNA (siRNA) targeting H19. U87-MG and U251 cell lines with the stable knockdown of H19 were constructed (the stable knockdown of H19 group), and the cells randomly transfected with siRNA plasmid were taken as the control group, and normal cultured cells were treated as the blank group. Additionally, miR-675 and control microRNA were transfected into U87-MG and U251 with the stable knockdown of H19 (the overexpressing miR-675 group and the corresponding control group). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of miR-675 and H19 in each group; the methyl thiazolyl tetrazolium (MTT) assay was used to detect the cell proliferation ability; the dual luciferase reporter gene assay was used to verify the targeting relationship between miR-675 and PTEN; Western blot was used to detect the relative expression level of PTEN protein.Results:The MTT assay results showed that the proliferation ability of U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group; and the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). qRT-PCR detection results showed that the relative expression level of miR-675 in U251 cells in the stable knockdown of H19 group and the corresponding control group was 0.329±0.009 and 1.043±0.087, respectively, and the difference was statistically significant ( t = 14.15, P < 0.001); the relative expression level of miR-675 in U87-MG cells in the stable knockdown of H19 group and the corresponding control group was 0.299±0.009 and 1.027±0.106, respectively, and the difference was statistically significant ( t = 11.85, P < 0.001); the relative expression level of miR-675 in U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group. The dual luciferase reporter gene assay verified that miR-675 could bind to the 3'-UTR of PTEN. Western blot detection results showed that the relative expression level of PTEN protein in U87-MG and U251 cells in the stable knockdown of H19 group was higher than that of the corresponding control group and the blank group; in the U87-MG and U251 cells in the stable knockdown of H19 group, the relative expression level of PTEN in the overexpressing miR-675 group was lower than that of the corresponding blank group and the control group. In the U87-MG and U251 cells in the stable knockdown of H19 group, the cell proliferation ability of the overexpressing miR-675 group was higher than that of the corresponding blank group and the control group; the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). Conclusions:lncRNA H19 may regulate the cell proliferation of glioma cells through the miR-675-PTEN signaling pathway.

Objective To analyze the influencing factors of unstable ventilation pressure during nasal continuous positive airway pressure(NCPAP)treatment in neonates with hyaline membrane dis-ease(HMD)and construct a nomogram model.Methods A retrospective analysis was conducted in 157 HMD neonates who underwent NCPAP treatment.The patients were divided into unstable group(n=49)and stable group(n=108)based on the occurrence of unstable ventilation pressure during treatment.Logistic regression analysis was used to identify influencing factors of unstable ventilation pressure during NCPAP treatment in HMD neonates.A nomogram model was constructed using R software,and its predictive performance was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and the Hosmer-Lemeshow goodness-of-fit test.Results Unstable venti-lation pressure occurred in 49 HMD neonates during NCPAP treatment,with an incidence rate of 31.21％(49/157).Univariate analysis showed that unstable ventilation pressure during NCPAP treatment had no relation to gestational age,gender,birth weight,delivery mode,neonatal Apgar score,catheter distortion,or excessive condensation in the tube(P＞0.05).However,NCPAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness were identified as influencing factors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).Multivariate Logistic regression analysis revealed that NCPAP treatment duration ≥72 h,nasal mucosa damage,secretion blockage in the airway,and restlessness were independent risk fac-tors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).A no-mogram model was constructed based on these four independent risk factors.The ROC curve demon-strated good discrimination for the nomogram model,with an area under the curve of 0.801(95％CI,0.730 to 0.861).The Hosmer-Lemeshow goodness-of-fit test showed a chi-square value of 3.550 with a P-value of 0.470,and the calibration curve had a slope close to 1,indicating good fit validity for the nomogram prediction model.Conclusion The nomogram model constructed based on NC-PAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness has good predictive value for the occurrence of unstable ventilation pressure during NCPAP treatment in HMD neonates.

Objective To analyze the influencing factors of unstable ventilation pressure during nasal continuous positive airway pressure(NCPAP)treatment in neonates with hyaline membrane dis-ease(HMD)and construct a nomogram model.Methods A retrospective analysis was conducted in 157 HMD neonates who underwent NCPAP treatment.The patients were divided into unstable group(n=49)and stable group(n=108)based on the occurrence of unstable ventilation pressure during treatment.Logistic regression analysis was used to identify influencing factors of unstable ventilation pressure during NCPAP treatment in HMD neonates.A nomogram model was constructed using R software,and its predictive performance was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and the Hosmer-Lemeshow goodness-of-fit test.Results Unstable venti-lation pressure occurred in 49 HMD neonates during NCPAP treatment,with an incidence rate of 31.21％(49/157).Univariate analysis showed that unstable ventilation pressure during NCPAP treatment had no relation to gestational age,gender,birth weight,delivery mode,neonatal Apgar score,catheter distortion,or excessive condensation in the tube(P＞0.05).However,NCPAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness were identified as influencing factors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).Multivariate Logistic regression analysis revealed that NCPAP treatment duration ≥72 h,nasal mucosa damage,secretion blockage in the airway,and restlessness were independent risk fac-tors for unstable ventilation pressure during NCPAP treatment in HMD neonates(P＜0.05).A no-mogram model was constructed based on these four independent risk factors.The ROC curve demon-strated good discrimination for the nomogram model,with an area under the curve of 0.801(95％CI,0.730 to 0.861).The Hosmer-Lemeshow goodness-of-fit test showed a chi-square value of 3.550 with a P-value of 0.470,and the calibration curve had a slope close to 1,indicating good fit validity for the nomogram prediction model.Conclusion The nomogram model constructed based on NC-PAP treatment duration,nasal mucosa damage,secretion blockage in the airway,and restlessness has good predictive value for the occurrence of unstable ventilation pressure during NCPAP treatment in HMD neonates.

Objective:To compare the difference between breast bracket combined with polyurethane foam and single polyurethane foam in the accuracy of immobilization, providing a better immobilization for breast cancer radiotherapy.Methods:Fifty breast cancer patients who received radiotherapy in Sun Yat-sen University Cancer Center from March 2021 to July 2021 were selected. Among them, 25 patients were immobilized with polyurethane foam (foam group), and the other 25 patients were immobilized with polyurethane foam combined with breast bracket (combination group). All patients were scanned by CBCT once a week to obtain setup errors in the SI, LR and AP directions for t-test. The formula M PTV=2.5 Σ+0.7 σ was used to calculate the margin of the planning target volume(M PTV). Results:The setup errors in the foam group were SI (2.0±3.26) mm, LR (0.88±2.76) mm, AP (1.22±3.55) mm, Rtn -0.24°±0.85°, Pitch 0.16°±1.11°, Roll -0.32°±1.05°, and the M PTV were 6.75 mm, 8.46 mm and 8.73 mm, respectively. The setup errors in the combination group were SI (1.0±3.01) mm, LR (0.62±2.74) mm, AP (1.82±3.21) mm, Rtn 0.64°±0.59°, Pitch 0.71°±1.22°, Roll 0.29°±0.73°, and the M PTV were 6.35 mm, 7.47 mm, and 7.61 mm, respectively. After comparing the setup errors in the three-dimensional directions between two groups, the t value of LR, SI, AP and Rtn, Pitch, Roll was -4.304, -2.681, 1.384, and -9.457, -3.683, -5.323, respectively. And the differences in the LR, SI, Rtn, Pitch and Roll directions were statistically significant (all P<0.05). Conclusions:The immobilization effect of polyurethane foam combined with breast bracket is better and the M PTV is also smaller than those of polyurethane foam alone. Therefore, it is recommended to use polyurethane foam combined with breast bracket for immobilization in breast cancer radiotherapy.

Objective: To investigate correlations between motor skills with focused and shifting attention among preschool children, and to provide basis for the overall development of preschool children aged 4-6 years. Methods: During March to June 2020, a total of 165 preschool children aged 4-6 years were selected and investigated with subscales of the Bruininks Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2) for agility and limb bilateral coordination assessment, and subscales of the Movement Assessment Battery for Children test 2nd Edition (MABC-2) for throwing and catching skill assessment, as well as balance subscale for the assessment of limb movement coordination, hand eye coordination, agility, and balance. The Kansas Reflection Impulsivity Scale for Preschoolers for Pre schoolers (KRISP) and Dimensional Change Card Sort (DCCS) were used to assess focused and shifting attention levels. Correlation and linear regression analyses were performed for statistical analysis. Results: Except for one handed throwing skills and shifting attention, there were statistically significant gender differences between boys and girls in total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, total score of agility of movement, total score of movement balance, static support, walking on tiptoe, foot to foot jump and focused attention( t =-6.86, -2.00 ,-3.15,-3.75,-3.00,-2.95,-2.18,-2.11,-3.21, P ＜0.05), and girls were better than boys; children s total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, agility of movement, walking on tiptoe and focused attention improves with age( r =0.47,0.41,0.47,0.51,0.16,0.31, P ＜0.05); After excluding the interference of gender and age, total score of body movement coordination was significantly correlated with preschool children s focused attention( β=0.31,95%CI =0.08-0.39, P ＜0.01). Conclusion Limb movement coordination and focused attention are significantly and positively correlated among preschool children aged 4-6 years. Therefore, preschool education and family activities should focus on designing and developing limb movement coordination related games and courses to enhance the focused attention of and form favorable attention quality in preschool children aged 4-6 years.

Objective:To investigate the clinicopathological features and prognosis of skeletal-muscle cytotoxic T-cell lymphoma (CTL).Methods:The clinical data of 14 cases of skeletal muscle CTL and 47 cases of non-skeletal muscle extranodal CTL patients in Beijing Friendship Hospital Affiliated to Capital Medical University and the 989 Hospital of the joint logistics support force of the people′s Liberation Army (the former 152 hospital) from 2008 to 2019 were collected retrospectively. Immunophenotype, EBV infection status and T-cell receptor (TCR) clonality of tumor cells were evaluated. The clinicopathological features and prognosis of the two groups were compared.Results:Skeletal-muscle CTL accounted for 23.0% (14/61) of extranodal CTL in the same period. The median age of the patients was 42.3 years (range 11-76 years), including six males and eight females. The main clinical manifestations were painless masses. Two patients (2/14) had B symptoms. The tumors occurred in the cheek (7 cases), the tongue (4 cases), the lower lip (3 cases) and the left upper arm (2 cases), and in two cases had two sites. Ten cases were of stage ⅠE and four cases stage ⅡE. Compared with non-skeletal-muscle extranodal CTL, many patients of skeletal-muscle CTL did not have B symptoms, the clinical stage was lower, and the tumor mainly involved the oral cavity (cheek, tongue and lip, P<0.05). Morphologically, the tumor showed diffuse infiltration of heterotypic lymphocytes in skeletal muscle. Immunohistochemistry showed that in 11/14 cases, there were reduced or loss of expression of some the T cell antigens (CD2, CD3, CD5, CD7). TIA-1, Gr B and CD8 (CD8 +>CD4 +) were expressed in all cases, and CD56 was negative. The median Ki-67 proliferation index was 35.0% (range 5%-60%). EBER in situ hybridization was negative in all cases. The results of TCR clonality analysis showed clonal TCR gene rearrangement were detected in eight cases. The median follow-up time was 40 months (range 10-67 months). Ten patients were tumor free; the 5-year survival rate of skeletal-muscle CTL was 100%. Compared with non-skeletal-muscle extranodal CTL (5-year overall survival rate was 35.9%), the difference was statistically significant (χ2=8.277, P=0.004). Conclusions:Skeletal-muscle CTL mostly occurs in the skeletal muscle of cheek and mouth. Tumor cells show morphologic characteristics of muscle invasion and myositis-like feature. It also shows CD8 +>CD4 +immunophenotype, cytotoxic molecular pattern and is associated with low clinical stage and good prognosis.

Exosomes, as nano-vesicular substances secreted by stem cells, is rich in cells signals, which participate in cells communications. It has a good prospect in application without the risk of stem cells. In this review, the biological characteristics of exosomes were introduced, so as the advances of their effects on the fibroblasts function, extracellular matrix formation and anti-oxidation, which demonstrated a prosperous way in skin anti-aging.

Exosomes, as nano-vesicular substances secreted by stem cells, is rich in cells signals, which participate in cells communications. It has a good prospect in application without the risk of stem cells. In this review, the biological characteristics of exosomes were introduced, so as the advances of their effects on the fibroblasts function, extracellular matrix formation and anti-oxidation, which demonstrated a prosperous way in skin anti-aging.

OBJECTIVETo assess the value ofF-fluorodeoxyglucose (F-FDG) positron emission tomography-CT (PET-CT) in detection of primary tumor and pelvic lymph node metastasis in International Federation of Gynecology and Obstetrics (FIGO) stages ⅠA2-ⅡA cervical cancer.

METHODSThe clinical data of 91 patients with FIGO stagesⅠA2-ⅡA cervical cancer were retrospectively analyzed. The sensitivity ofF-FDG PET-CT in detection of cervical cancer was calculated. The long diameter, short diameter and SUVmax were compared between metastatic lymph nodes (MLN) and non-metastatic lymph nodes (NMLN). The optimal cut-off values of different indexes were determined by receiver operating characteristic (ROC) curve and area under curve (AUC), and the sensitivity, specificity and accuracy were calculated.

RESULTS F-FDG PET-CT examinations were positive in 89 patients (89/91, 96.7%). The short diameters of NMLN and MLN were (6.50±2.31)mm and (4.21±1.49)mm(=4.855,<0.05); the SUVmax of NMLN and MLN were 4.56±3.34 and 1.92±1.41(=31.685,<0.05). ROC AUCs of the short diameter and SUVmax in diagnosis of metastatic lymph nodes were 0.802 and 0.861. Taken short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as cut-off values, the corresponding sensitivity, specificity and accuracy in diagnosis of metastatic lymph nodes were 85.0%, 93.0% and 86.8%, respectively.

CONCLUSIONS F-FDG PET-CT is sensitive to detect primary lesion and pelvic lymph node metastases in FIGO stages ⅠA2-Ⅱ A cervical cancer, and the highest diagnostic accuracy may be obtained by taking short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as the standard.