Objective The existing evidence of exercise rehabilitation in patients undergoing surgery for valvular heart disease was analyzed,described and evaluated by using evidence mapping methods.Methods Systematic reviews and randomized controlled trials on exercise rehabilitation of patients undergoing valvular heart disease surgery were searched from CNKI,Wanfang Data,VIP,CBM,Embase,PubMed,Cochrane Library,Web of Science,Ovid,CINAHL and other databases,and the search period was established until April 23,2024.The quality of the included literature was evaluated,and the feature information of the included literature was visualized in the form of bubble map and table.Results Fifty-one literatures(including 44 randomized controlled trials and 7 systematic evaluations)were finally included.Among the 44 randomized controlled trials,the types of exercise were mainly related to anaerobic exercise(3 literatures),aerobic exercise(11 literatures),flexibility training(8 literatures),and multisport exercise(22 literatures);postoperative inpatient rehabilitation accounted for a relatively high proportion(16 literatures),followed by overall postoperative rehabilitation(13 literatures)and pre-operative prehabilitation(7 literatures).Twenty-seven conclusions were categorized as"beneficial",15 as"possibly beneficial,"and one ach as"unclear"and"no effect".Seven systematic evaluations were subjected to Meta-analysis,and in terms of the design of the included studies,there were only 3 systematic reviews that included randomized controlled trials.Of the study conclusions,three were"beneficial",three were"possibly beneficial"and one was"unclear".Conclusion The evidence mapping shows that exercise rehabilitation is generally beneficial or potentially beneficial in the rehabilitation of valvular heart disease surgery,mainly in the postoperative inpatient rehabilitation phase.High-quality studies are needed to further investigate the effectiveness of exercise programs with different intensities,frequencies,and durations,as well as different valve types,adverse effects of exercise,and other outcome indicators.

Objective To systematically review the efficacy of enhanced recovery after surgery(ERAS)nursing on patients with dissection of aorta.Methods Nine databases,including PubMed,CNKI,etc were searched to identify randomized controlled trials involving dissection of aorta patients undergoing ERAS nursing.The retrieval time was from setting up of the databases until March 2024.Literature quality assessment followed by"Cochrane handbook for systematic reviews of interventions.Version 5.1.0",and Meta-analysis was conducted utilizing software of RevMan 5.4.Results Nine literatures with a total of 723 patients were included.The results of Meta-analysis showed that compared with the conventional nursing model,the application of ERAS nursing model could effectively promote the process of patients'postoperative recovery,and there were significant differences in indicators such as the time of postoperative mechanical ventilation,the time of the first postoperative out-of-bed activity,the time of tubing removal,the incidence of complications,the length of hospital stay,and the degree of perceived pain(P＜0.05).Conclusion Implementing nursing model based on ERAS on dissection of aorta patients can effectively enhance patients'postoperative recovery outcomes,thus worth clinical promotion and application.

Objective To evaluate the effect of mindfulness-based intervention in patients after percutaneous coronary intervention(PCI)through Meta-analysis.Methods Nine databases,including CNKI and PubMed,were searched for randomized controlled trials on the effect of mindfulness intervention in patients after PCI,and the search period was from the establishment of the database to May 31,2024.Two researchers independently screened the literature,extracted data and evaluated the quality,and used Revman 5.4 software for Meta-analysis.Results A total of 11 randomized controlled trials involving 998 patients were included.The results of Meta-analysis showed that compared with conventional care,the use of mindfulness-based intervention therapy could positively improve patients'postoperative anxiety,perceived stress level,mindfulness awareness and other indicators.In terms of safety measures,the incidence of cardiac adverse events was not statistically significant compared with usual care(P＞0.05).Conclusion Mindfulness intervention has a significant effect in patients after PCI.

Objective:To investigate the molecular features of hand, foot and mouth disease (HFMD) caused by coxsackievirus A10 (CVA10) in Qingdao and analyze the clinical features of mild and severe cases.Methods:A total of 6 677 cases of HFMD routinely monitored by Qingdao Women and Children Hospital from 2014 to 2021 were enrolled. Throat swab samples were collected. Clinical data of these cases were retrospectively analyzed. Virus nucleic acid was extracted from the samples and the serotypes of enteroviruses were identified. The VP1 genes of CVA10 strains were amplified and sequenced. A phylogenetic tree based on the VP1 gene sequences was constructed using MEGA7. 0 software. SPSS23.0 software was used for statistical analysis.Results:There were 285 cases positive for CVA10, including 183 males and 102 females, and children under five years old accounted for 89.8%. Most of CVA10 infection occurred between the months of April to September. The count of white blood cells, the percentage of neutrophils, the concentration of hemoglobin, and the levels of aspartate aminotransferase and alanine transaminase were significantly higher in severe patients than in mild patients. Besides, chest radiography and brain CT revealed more abnormalities in severe patients, and the duration of ECG monitoring was longer in them. Compared with mild cases, severe cases developed rash early than fever with rash mostly on buttocks ( P<0.05). Phylogenetic analysis showed that most of the CVA10 strains circulating in Qingdao between 2014 and 2021 belonged to clade Ⅰ, and there were two variations A23V and I283V in the amino acid sequence of clade Ⅰ. Conclusions:This study showed that children of all ages were susceptible to CVA10, especially those under five years old. CVA10 showed complex and diverse epidemic trends in different regions and years.

Objective:To learn about the arsenic status of drinking water in Urumqi City and evaluate its health risk, so as to provide scientific basis for the construction of water improvement projects in Urumqi City.Methods:From 2018 to 2020, 687 water samples were collected at monitoring sites in 7 districts and 1 county of Urumqi City for three consecutive years, and arsenic in drinking water was detected according to "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006), and the arsenic in drinking water was evaluated according to "Standards for Drinking Water" (GB/T 5749-2006). The health risk of arsenic in drinking water in Urumqi City was evaluated by using the health risk assessment model recommended by United States Environmental Protection Agency (USEPA).Results:All of 687 water samples were centralized water supply, the arsenic compliance rates in dry season ( n = 342) and wet season ( n = 345), surface water ( n = 414) and underground water ( n = 273) were 100.0%. In dry season, the carcinogenic risk of arsenic via drinking water was 8.24 × 10 -6/a. In wet season, the carcinogenic risk of arsenic via drinking water was 3.30 × 10 -6/a. Conclusions:Remarkable achievements have been made in the construction of water improvement projects in Urumqi City, and the drinking water arsenic condition is good, the health risk of arsenic via drinking water is small. In the future, we should continue to strengthen the monitoring of drinking water quality, promote the construction of water improvement projects, further improve the drinking water sanitation, and put forward targeted prevention and control measures to ensure drinking water safety.

Objective To explore the differentially expressed micro RNAs (miRNAs) in serum-derived extracellular vesicles (EVs) of patients with Parkinson's disease (PD) and healthy individuals.Methods Thirty-six patients with late-onset Parkinson's disease (LOPD,age of onset being more than 50 years),20 patients with early-onset Parkinson's disease (EOPD,age of onset being no more than 50 years),and 10 healthy individuals were collected in our hospital from January 2015 to December 2017.Serum of all subjects was collected and EVs were extracted.The miRNA chip and real-time quantitative (qRT)-PCR were used to analyze and verify the differentially expressed exosomal miRNAs between PD patients and healthy individuals;Cytoscape software was used to analyze the common target genes regulated by differentially expressed miRNAs,and String database was used to analyze the interaction and function of target genes.And qRT-PCR was further used to analyze the expression level and correlation of differentially expressed miRNAs and their target genes in patients with EOPD and LOPD,respectively.Results As compared with healthy individuals,LOPD patients had significantly up-regulated expression levels ofmiR-143-3p and miR-1180 in the serum derived EVs,and statistically down-regulated miR-451 and miR-500 levels (P＜0.05).The miR-143-3p expression level in EOPD patients was significantly higher than that in LOPD patients (t=3.888,P=0.018).The target genes B-cell lymphoma-2 (BCL2) and AKT1 were involved in regulating the cholinergic synapses and neurotrophin signaling pathways,and the BCL2 relative expression level in EOPD patients was significantly higher than that in LOPD patients and healthy controls (P＜0.05);and the relative expression levels of BCL2 and miR-143-3p were negatively correlated in the serum derived EVs of EOPD patients (r=-0.556,P=0.025).Conclusion The miR-143-3p and BCL2 expression levels are negatively correlated in the serum derived EVs of EOPD patients;changes of expression level may be related to plasticity of synaptic structure and apoptosis of nerve cells.

Objective: To illuminate the gene characteristics and clinical characterization of Coxsackievirus B5 (CV-B5) strains isolated from patients with sevre hand, foot and mouth disease (HFMD) in Qingdao city. Methods: A total of 1 844 patients of HFMD were consecutively admitted to Qingdao Women and Children's Hospital from 2013 to 2014. Information of the study population described above was collected retrospectively. The samples were collected from at least 1 site (throat swab, cerebrospinal fluid), which viral nucleic acid extracted and the entire VP1 gene sequences of CV-B5 isolates were amplified and sequenced, then the homology and phylogeny analysis were conducted by MEGA7.0. The prototype Faulkner strain and other VP1 amino acid sequences were derived from the GenBank database. Results: A total of 8 CV-B5 positive cases were obtained, including 4 males and 4 females; 6 severe hospitalized cases and 2 outpatients. The age of 6 hospitalized patients ranged from 3 to 48 months, with a median of 26 months. For the six inpatients, fever, convulsions vomiting, diarrhea and rash were the main clinical manifestation, and all combined with viral encephalitis. Compared with the prototype strain Faulkner, in the VP1 region,the nucleotide and the amino acid homologies was 77.3%-78.8% and 95.5%-97.0% respectively. Five out of the six severe cases with substitution of serine (S) to asparagine (N) at amino acid site 95 in the VP1 region. The sequences of 8 CV-B5 strains were classified into genogroup D. Conclusion Hand, foot and mouth disease associated with CV-B5 virus infection can result in nervous system involvement and the main complication was viral encephalitis. The CV-B5 strains associated with severe hand, foot and mouth disease had high nucleotide homology and present a certain regional aggregation.

Objective To investigate the therapeutic effect of eperisone on patients with subacute spinal cord neuropathy with incomplete spasm.Methods Forty-eight patients with Subacute spinal cord neurosis combined degeneration of both lower extremity incomplete spasm in Department of Neurology,Zhejiang Quhua Hospital were selected and randomly divided into control group and study group.The control group were treated with folic acid and mecobalamin,the study group received more with eperisone,and 14days for one course,two groups were treated for two course.Ashworth spasm Scale,simple Fugl-Meyer score scale,improved Barthel index,bilateral H tibial nerve reflex status,clinical efficacy and complications were compared before and after the treatment.Results After treatment,levels of the flexion and extension of knee joint in 2 groups increased,and the scores of Ashworth spasticity scale decreased,scores of FMA and MBI increased,the latency of H reflex latency increased,levels of Hmax/Mmax decreased(P<0.05),compared with the control group,levels of the flexion and extension of knee joint in the study group were higher,and the scores of Ashworth spasticity scale were lower,scores of FMA and MBI were higher,the latency of H reflex latency were higher,levels of Hmax/Mmax were lower(P<0.05),the effective rate of the control group(66.67％)was lower than the study group(91.67％)(P<0.05),the non-performing rate in 2 groups had no difference(25.00％Vs 20.83％).Conclusion Eperisone has definite effect on patients with subacute spinal cord neuropathy with incomplete spasms.it can decrease muscle tension and spasticity and improve neurological function.

Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy with XELOX (oxaliplatin+capecitabine) regimen combined with postoperative adjuvant concurrent radiotherapy and chemotherapy for stage III advanced gastric cancer. Methods:A total of 55 patients with stage III advanced gastric cancer from Shouguang People's Hospital, Zibo Central Hospital, and Shandong Qian-foshan Hospital of Shandong University were enrolled in this study. The patients were randomly divided into the treatment group and the control group. In the treatment group, 28 patients were treated with neoadjuvant chemotherapy with XELOX regimen, underwent surgery, and then received postoperative adjuvant three-dimensional conformal radiotherapy synchronous XELOX regimen. In the con-trol group, 27 cases underwent surgery in advance, and received radiotherapy synchronous XELOX regimen. Results:The objective re-sponse rate of the treatment group was 75%. The tumor resection rate was 92.9%, which was significantly higher than that of the con-trol group at 81.5%(P=0.049). The tumor radical resection rates in the treatment and control groups were 71.4%and 44.4%, respec-tively, which are significantly different (P=0.043). The lymph node metastasis in the treatment group was 48.2%, which was significant-ly lower than that of the control group at 60.2%(P=0.006). In the treatment group, one case achieved pathologic complete tumor re-gression, 9 cases were of good tumor regression, and 7 cases were of moderate tumor regression. The 1-year, 2-year, and 3-year surviv-al rates of the treatment and control groups were 88.9%vs. 69.2%, 66.7%vs. 46.2%, and 59.3%vs. 38.5%, respectively, which are sig-nificantly different (P=0.037, P=0.045, and P=0.049). The results showed no significant difference of incidence of toxicity in the two groups (P>0.05). Conclusion: Neoadjuvant chemotherapy with XELOX regimen combined with postoperative adjuvant concurrent chemoradiotherapy for stage III advanced gastric cancer can improve the radical resection rate and long-term postoperative survival rate of patients, as well as reduce the rate of lymph node metastasis.

Objective To assess the feasibility,safety and efficacy of endoscopic papillectomy (EP) for tumors at the ampulla of Vater (AV).Methods A total of 15 patients with tumor at AV that were indicated for EP were included in this prospective study.Their clinical profiles,procedural parameters and outcome were evaluated.Results All patients underwent EP procedure successfully.Four patients who were diagnosed as having chronic inflammation in the reference endoscopy were confirmed as having adenoma after EP.Out of the 11 patients who were previously diagnosed as andenoma on biopsy,2 of low differentiated adenocarcinoma,1 of well differentiated adenocarcinoma and 1 malignant transformation were pathologically confirmed after EP.Stents were implanted in 8 patients with dilated pancreatic and/or common bile duct.Except for 2 cases of melena and 2 transient elevated level of blood amylase after EP,no other major complications occurred.Three patients,including 1 case of low-differentiated adenocarcinoma,1 case of malignant transformation and 1 case of lesion residual,were referred to surgery,another patient with low-differentiated adenocarcinoma declined any additional intervention because of old age.In the remaining 11 cases ( 11/15,73.3％ ) including one well differentiated adenocarcinoma,no recurrence was observed during a follow-up period of 23.4 (5 to 47) months.Conclusion EP is a minimal invasive,safe and effective treatment for tumors at AV,which also can provide an accurate staging of the lesion.