Objective To understand the factors that affect the pulmonary rehabilitation behavior of elderly patients with lung cancer during the post-operative transitional period,and provide reference bases for formulating the pulmonary rehabilitation plan of elderly patients with lung cancer during the transitional period and improving the compliance of pulmonary rehabilitation.Methods Based on the capability,opportunity,and motivation-behavior model(COM-B model),12 elderly lung cancer patients who underwent surgery at a tertiary A tumor hospital in Tianjin from March to July 2022 were selected for semi-structured interviews using descriptive research methods and purposive sampling method.The data were analyzed using directed content analysis.Results The ability factors(physical strength and postoperative discomfort symptoms of the elderly limit lung rehabilitation exercise,lack of pulmonary rehabilitation knowledge and awareness of the importance of exercise in lung rehabilitation knowledge),opportunity factors(lack of grassroots medical and health services,limiting lung rehabilitation exercise;family and friends are important resources for promoting lung rehabilitation exercise;medical support is a guarantee for promoting lung rehabilitation exercise),motivational factors(high self-efficacy in exercise is the foundation for lung rehabilitation exercise,perception of lung rehabilitation effects increases motivation for lung rehabilitation exercise)and 7 sub themes were extracted.Conclusion There are certain obstacles and promoting factors in the transitional lung rehabilitation process for elderly lung cancer patients after surgery.It is necessary to improve their postoperative discomfort symptoms,increase their knowledge of lung rehabilitation,enhance their awareness of lung rehabilitation,face the social support role of family,friends,and medical staff,improve the infrastructure and lung rehabilitation system,increase community lung rehabilitation support,provide multi-channel high-quality lung rehabilitation resources,and promote the development of smart medical services,constructing a transitional lung rehabilitation strategy for elderly patients with lung cancer.

Currently, there is still no effective curative treatment for the development of late-stage liver fibrosis. Here, we have illustrated that TB001, a dual glucagon-like peptide-1 receptor/glucagon receptor (GLP-1R/GCGR) agonist with higher affinity towards GCGR, could retard the progression of liver fibrosis in various rodent models, with remarkable potency, selectivity, extended half-life and low toxicity. Four types of liver fibrosis animal models which were induced by CCl₄, α-naphthyl-isothiocyanate (ANIT), bile duct ligation (BDL) and Schistosoma japonicum were used in our study. We found that TB001 treatment dose-dependently significantly attenuated liver injury and collagen accumulation in these animal models. In addition to decreased levels of extracellular matrix (ECM) accumulation during hepatic injury, activation of hepatic stellate cells was also inhibited via suppression of TGF-β expression as well as downstream Smad signaling pathways particularly in CCl₄-and S. japonicum-induced liver fibrosis. Moreover, TB001 attenuated liver fibrosis through blocking downstream activation of pro-inflammatory nuclear factor kappa B/NF-kappa-B inhibitor alpha (NFκB/IKBα) pathways as well as c-Jun N-terminal kinase (JNK)-dependent induction of hepatocyte apoptosis. Furthermore, GLP-1R and/or GCGR knock-down results represented GCGR played an important role in ameliorating CCl₄-induced hepatic fibrosis. Therefore, TB001 can be used as a promising therapeutic candidate for the treatment of multiple causes of hepatic fibrosis demonstrated by our extensive pre-clinical evaluation of TB001.

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

OBJECTIVE: To explore the clinical characteristics and genetic basis for a pair of twins affected with hyaline fibromatosis syndrome (HFS). METHODS: Clinical data of the twins were retrospectively analyzed. High-throughput sequencing was carried out to detect potential pathogenic variants. CLUSTALX was employed to analyze cross-species conservation of the mutant amino acids. Impact of the mutations was predicted by using software including PolyPhen-2 and Mutation taster. RESULTS: The pair of twins have featured growth and intelligence retardation, and were found to carry compound heterozygous variants of the ANTXR2 gene including c.1214G>A and c.1074delT, among which c.1214G>A was unreported previously. Both variants were predicted to be pathogenic. In addition to growth and mental delay, the pair of twins also featured hyperplasia of the gum and soft tissue-like masses of the auricle. The younger brother had rupture of the auricle mass during follow-up. CONCLUSION The patients' condition can probably be attributed to the compound heterozygous variants of the ANTXR2 gene. Above finding has facilitated molecular diagnosis of the patients.
Asian Continental Ancestry Group/genetics* ; China ; Humans ; Hyalinosis, Systemic/genetics* ; Male ; Mutation ; Pedigree ; Receptors, Peptide/genetics* ; Retrospective Studies

Objective: To evaluate the efficacy of fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation (manipulation of balance and muscle tendon relaxing) in the treatment of chirospasm after stroke. Methods: A total of 104 patients with chirospasm after stroke who metthe inclusion criteria from July 2016 to June 2018 were selectedand divided into tow groups with the digital table methodwith 52 cases in each group. The control group was given routine rehabilitation training while the observation group was given fumigation with Shujin-Jieluan decoction combined with Pingheng-Shujin manipulation based oncontrol group, and the two groups both were treated for 8 weeks. The Modified Ashworth Scale (MAS) was used for chirospasm classification, and Key Point tabletop electromyography device was used to record the frequency, average amplitude and the shortest latency of F wave of median nerve. Fugl-Meyer motor function rating scale was used to evaluate hand motor function, and modified Barthel Index (BI) was used to evaluate life functionand clinical efficacy. Results: The effective rate was 88.5% (46/52) in observation group and was 65.4% (34/52) in control group (χ²=7.800, P=0.005). After treatment, the frequency (15.11 ± 2.06 vs. 16.72 ± 1.95, t=4.093), average amplitude (0.52 ± 0.04 mV vs. 0.59 ± 0.05 mV, t=7.883) and the shortest latency (24.37 ± 2.85 ms vs. 25.88 ± 2.43 ms, t=2.907) of F wave in observation group were significantly lower than the control group (P<0.01). Fugl-Meyer hand function score (6.51 ± 1.45 vs. 5.09 ± 1.22, t=5.404) and BI index score (60.87 ± 5.16 vs. 56.54 ± 4.25, t=4.671) were significantly higher than the control group (P<0.01). The distribution of MAS classification in observation group was significantly lower than that of control group (Z=8.410, P=0.004). Conclusions Fumigation with Shujin-Jieluan Decoction combined with Pingheng-Shujin Manipulation can improve the neuromuscular transmission of patients with chirospasm after stroke, and facilitate the recovery of hand function and viability.

Objective: To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs. Methods: The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom. Results: A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6%, 499/852), after negotiation, 441 FSWs (88.4%, 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4%, 99/687), after negotiation, 54 FSWs (54.5%, 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3%, 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4%, 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1%,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2%, 21/499) reported that they used other strategies. 22 (4.4%, 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation (OR=4.00, 95%CI: 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use (OR=30.17, 95%CI: 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation (OR=4.44, 95%CI: 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use (OR=5.52, 95%CI: 1.55-19.73). Conclusions Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

Objective To study the characteristics of Chinese ischemic stroke subclassification (CISS) in relation with migration to different climatic zones in autumn and winter.Methods Ninety-six subjects who travelled from northeast China,northwest China and north China to Hainan Province from September 2012 to February 2017 and were admitted to our hospital due to cerebral infarction occurred within 3 weeks after they arrived at Hainan were included in this study.Their demographic data,risk factors for cerebrovascular disease,laboratory blood test and imaging parameters were recorded.The patients were classified according to their medical history,auxiliary examination findings and CISS.The recorded data were statistically analyzed.Results CISS showed that penetrating artery disease,large artery atherosclerosis,cardiogenic stroke,and undetermined etiology accounted for 50.0％,38.5％,4.2％,7.3％ respectively.Hypertension (70.8 ％) and abnormal glucose metabolism (61.5％) were the major risk factors for cerebral in farction.Conclusion The incidence of penetrating artery disease is the highest,followed by that of large artery atherosclerosis in cerebral infarction patients.Alert to cerebral infarction should thus be stressed for those with hypertension and abnormal glucose metabolism who are going to travel in autumn and winter.

Objective To systematically assess whether cilostazol can delay the progression or decrease the carotid intima-media thickness (clMT).Methods Papers on the effect of cilostazol on cIMT in randomized controlled trials and cohort studies were retrieved from a number of foreign and domestic databases.The data were analyzed by Review Manager 5.3.Results Six randomized controlled trials and two cohort studies were included in this study.A total of 1107 patients were divided into cilostazol therapy group (n=533) and control group (n=574).Meta-analysis showed that cilostazol therapy for 6 months,12 months,≥24 months could reduce the maximum cIMT with a mean difference of-0.04 mm (95％CI:-0.05--0.03,P=0.000),a mean difference of -0.04 mm (95％CI:-0.05--0.03,P=0.000) and a mean difference of-0.08 mm (95％CI:-0.11-0.05,P =0.000) respectively.Conclusion Cilostazol therapy for 6 months,12 months,24 months or more than 24 months can reduce the maximum cIMT,which is needed to be confirmed by studies with a large sample of clinical data.

OBJECTIVETo explore the regulation of acupuncture for transforming growth factor β1 (TGF-β1) expression in the lung tissues of bronchial asthmatic rats.

METHODSForty SPF male SD rats were randomly divided into a blank group, a model group, an acupuncture group and a shallow fast acupuncture group, 10 rats in each group. Asthma model was established in the model, acupuncture, and shallow fast acupuncture groups, and no intervention was applied in the blank and model groups. Before atomization excitation, 20 min acupuncture was applied at "Dazhui" (GV 14) "Feishu" (BL 13) "Fengmen" (BL 12) in the acupuncture group. Acupuncture only into skin without needle retained at the above acupoints was used in the shallow fast acupuncture group before atomization excitation from the day of model established. All the treatment was given 7 times, once the other day. The pathological lunge tissues of rats were observed by HE staining; the protein expression of TGF-β1 in the lung tissues was examined by immunohistochemical staining and immunofluorescence staining. The TGF-β1 expressions in bronchoalveolar lavage fluid (BALF) and serum were showed by ELISA.

RESULTSThere were changes in the lung tissues in the model group, including mucus plug in the bronchial lumen, irregular bronchial epithelium, thick airway smooth muscle, local break, narrow lumen, a large number of inflammatory cell infiltration. The phenomena in the acupuncture group were improved and those in the shallow fast acupuncture group were not apparently changed compared with those in the model group. The IOD value of TGF-β1 expression in the model group increased compared with that in the blank group (<0.05); the positive expression in the acupuncture group was lower than those in the model and shallow fast acupuncture groups (both<0.05). The contents of TGF-β1 in BALF and serum of the acupuncture group were lower than those in the model and shallow fast acupuncture groups (all<0.05).

CONCLUSIONSAcupuncture may improve airway inflammatory response and remolding of asthma by inhibiting TGF-β1 expression.

Objective·To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (△BW) of twin pregnancy. Methods·The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (△EFW) and ?BW. Results·About 15.9 percent of twins (totally 277 cases) had severe △BW (△BW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with △EFW in other gestational weeks,△EFW last time before parturition was most consistent of △BW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22-24 gestational weeks. Conclusion·Twin △BW was relatively better predicted by △EFW last time before parturition. Twin pregnancy without severe △EFW (△EFW<20%), especially MCDA with △EFW<20% at 22-24 weeks, had low probability of selective intrauterine growth restriction in the future.