Objective To study the relationship between blood microRNA-133b(miR-133b)and solu-ble fms-like tyrosine kinase 1(sFLT1)levels with the prognosis in the patients with endometrial cancer.Methods A total of 122 patients with endometrial cancer visited in the gynecology department of this hospital from January 2015 to January 2016 were prospectively selected as the study subjects,and divided into the sur-vival group(n=58)and death group(n=64)according to the 5-year prognosis of the patients with endome-trial cancer.The miR-133b and sFLT1 levels were compared between the two groups.The COX regression was used to analyze the relationship between miR-133b and sFLT1 with the prognosis of the patients with en-dometrial cancer.Results The levels of miR-133b and sFLT1 in the survival group were higher than those in the death group,and the differences were statistically significant(P＜0.05).The median survival time in the miR-133b low-level group was shorter than that in the miR-133b high level group,and the difference was sta-tistically significant(P＜0.05).The median survival time of the sFLT1 low level group was shoeter than that in the sFLT1 high level group,and the difference was statistically significant(P＜0.05).The FIGO stageⅢ-Ⅳ and lymph node metastasis were the independent risk factors for the prognosis of endometrial cancer(P＜0.05),and the pathological G1-G2,high level of miR-133b and sFLT1 were the independent protective factors for the prognosis of endometrial cancer(P＜0.05).Conclusion The miR-133b and sFLTl low levels in the patients with endometrial cancer are associated with the disease progression,and both are the independ-ent risk factors of prognosis.

Objective:To optimize the strategy of Nuss procedure with open approach via median sternotomy for pectus excavatum(PE) with congenital heart disease(CHD).Methods:25 PE patients with CHD treated in our center from January 2017 to November 2021 were reviewed and divided into two groups. The CHD surgery and open Nuss procedure with median sternotomy were performed concomitantly in 9 cases(group A), whose height of(121.7±28.0)cm, weight of(22.2±14.0)kg, age of(7.65±4.08) years old, and Haller index of 3.99±1.37. 16 cases underwent open Nuss procedure via median re-sternotomy after congenital heart surgery(group B), whose height of(130.9±27.2)cm, weight of(26.5±14.3)kg, age of(8.82±4.09) years old, and Haller index of 4.18 ± 0.97. The cardiac anatomy, cardiac function and the severity of PE of all patients were evaluated by echocardiography and computed tomography preoperatively. The preoperative gender, appearance of PE, types of associated CHD, retrosternal adhesion and the interval between open Nuss procedure and CHD surgery were collected. The details of operation, hospital stay, intraoperative adverse events, postoperative complications and follow-up were collected.Results:All the operations were accomplished successfully in 25 children. No intraoperative complications occurred. One had a postoperative wound infection in group A. The operation time of group A was significantly longer than that of group B[(3.78±1.54) h vs.(2.19±0.94) h, P<0.05]. There was no significant difference in the mechanical ventilation time between the two groups[(22.50±45.64) h vs.(4.18±1.41) h, P=0.263]. The ICU stay of group A was significantly longer than that of group B[(4.00±6.42) days vs.(1.13±0.34) days, P<0.05]. There was no significant difference in the length of hospital stay between the two groups[(16.00±15.18) days vs.(9.19±2.31) days, P=0.419]. The Nuss bar was removed in 14 cases of the two groups, with a interval of(27.9±11.25) months after open Nuss procedure, the postoperative Haller Index was 2.48±0.49. There was no difference of LVEF in postoperative and preoperative echocardiography(0.663±0.028 vs. 0.659±0.038, P=0.533). The FVC and FEV1 were significantly improved compared with before operation[(87.2±3.9)% vs.(84.1±8.2)%]. The outcome was good. Conclusion:For PE patients with CHD, one-stage or staged individualized Nuss procedure with open approach via median sternotomy can be performed after careful preoperative evaluation. A skillful median re-sternotomy and widely dissecting retrosternal adhesion between sternum and anterior wall of heart are necessary to avoid serious intraoperative complications such as massive heart bleeding and ensure good sternal elevation.

Purpose: Anxiety, depression, and poor quality of life (QOL) were considered important concerns that hindered the rehabilitation of breast cancer survivors. A number of studies have investigated the effects of physical activity, but they have not reached the same conclusions. This review aimed to identify the effects of physical activity on QOL, anxiety, and depression in breast cancer survivors. Methods: PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SinoMed, CNKI, Vip, and WanFang databases were searched for the time period between January 1, 2012, and April 30, 2022. Studies were included if they were randomized controlled trials of the effects of physical activity on QOL, anxiety, or depression in breast cancer survivors. The tools of the Joanna Briggs Institute were used to assess the quality of the included studies. R software version 4.3.1 was used for meta-analysis. Results: A total of 26 studies, involving 2105 participants, were included in the systematic review. Among these, 20 studies involving 1228 participants were included in the meta-analysis. Compared with the control group, the results indicated that physical activity can significantly improve QOL(Hedges' g = 0.67; 95% CI 0.41–0.92) and reduce anxiety (Hedges' g = −0.28; 95% CI −0.46 to −0.10) in breast cancer survivors. However, the effect of physical activity on depression (Hedges' g = −0.46; 95% CI −0.99 to 0.06) was not statistically significant. Conclusions Physical activity was an effective intervention to improve QOL and reduce anxiety in breast cancer survivors, as well as showed positive trends in depression, although without statistical significance. More well-designed studies are required to clarify the effects of different types of physical activities on the QOL, anxiety, and depression among breast cancer survivors.

Objective    To explore the early results of Ozaki operation in children with aortic regurgitation. Methods    We retrospectively analyzed the clinical data of 15 patients with aortic regurgitation who received the Ozaki operation in our hospital from April 2017 to July 2019. There were 11 males and 4 females with an average operation age of 10.7±3.7 years. Besides preoperative evaluation, aortic regurgitation and cardiac function were evaluated on 1 day, 1 week, 1 month, 3 months, and 6-12 months after surgery. Results    In 14 (93.3%) patients , the aortic valve leaflets functioned well on 1 day, 1 month, 3 months, and 6-12 months, and the regurgitation grade was Ⅰ-Ⅱ, which was improved than before (P=0.001). The cardiac function of children recovered quickly after operation. There was no statistical difference in ejection fraction on 1 day, 1 month, 3 months, and 6-12 months after operation (P>0.05). No children died, and no other clinical event was found. Conclusion    The Ozaki technique of reconstructing a tricuspid aortic valve leaflet for the treatment of severe aortic regurgitation in children is effective in short term, and the persistence of its valve function remains to be determined in the long-term follow-up.

The "vicious cycle" established between tumor growth and osteolysis aggravates the process of breast cancer bone metastasis, leading to life-threatening skeletal-related events that severely reduce survival and quality of life. To effectively interrupt the "vicious cycle", innovative therapeutic strategies that not only reduce osteolysis but also relieve tumor burden are urgently needed. Herein, a bone-seeking moiety, alendronate (ALN), functionalized coordination polymer nanoparticles (DZ@ALN) co-delivering cisplatin prodrug (DSP) and antiresorptive agent zoledronate (ZOL)

Objective:To observe the clinical characteristics of pressure regulation frequency of shunt pump in patients with hydrocephalus after ventriculoperitoneal shunt, and explore the correlation between frequencies of shunt pump and prognoses of these patients.Methods:One hundred and one patients underwent ventriculoperitoneal shunt in our hospital from January 2018 to December 2018 were selected. According to the frequencies of postoperative pressure regulation of these patients, they were divided into non-pressure regulation group, low-frequency pressure regulation group (1-2 times) and high-frequency pressure regulation group (2 times or more). The relations of high-pressure hydrocephalus/normal pressure hydrocephalus with pressure regulation frequency, and relation between causes of pressure regulation and pressure regulation frequency were compared, and the prognoses of patients with different pressure regulation frequencies were analyzed.Results:Among the 101 patients with implanted adjustable pressure shunt, 34 had no pressure regulation after surgery, 52 had low-frequency pressure regulation, and 15 had high-frequency pressure regulation. The percentages of patients accepted low-frequency pressure regulation and high-frequency pressure regulation in patients with high-pressure hydrocephalus were significantly higher than those with normal pressure hydrocephalus ( P<0.05). The proportions of patients with insufficient shunt, excessive shunt or magnetic field interference in the low-frequency pressure regulation group were significantly higher than those in the high-frequency pressure regulation group ( P<0.05), while the proportions of patients with abnormal shunt (stagger of insufficient shunt, excessive shunt) in the low-frequency pressure regulation group were significantly lower than those in the high-frequency pressure regulation group ( P<0.05). There were 7 patients with poor curative effect, including 4 patients from the low-frequency pressure regulation group and 3 from the high-frequency pressure regulation group. The prognoses of patients with different pressure regulation frequencies were statistically different( P<0.05), the good prognosis rate of patients in the non-pressure regulation group, low-frequency pressure regulation group and high-frequency pressure regulation group decreased successively. Conclusion:About 66.3% patients need pressure regulation treatment again after hydrocephalus-ventriculoperitoneal shunt; the rate of poor efficacy in patients accepted high-frequency pressure regulation is obviously higher than that in patients accepted low-frequency pressure regulation, which needs clinical attention.

Objective Mitral valve regurgitation often leads to cardiac insufficiency or even heart failure .Methods We tried a mitral valve annuloplasty with a ring to improve the effect of mitral valvuloplasty , 5 males and 6 females; aged(8.0 ± 4.5)years;weight(26.1 ±13.9)kg.From February 2015 to December 2017, 11 children underwent mitral valve annuloplasty with an mitral valve ring in our hospital.Immediately after surgery, the degree of mitral valve regurgitation was significant im-proved from moderate-severe to mild-moderate(P<0.05).Results 1 case of early death, 1 case had a mitral valve replace-ment because of early hemolysis.The rest of the children were discharged smoothly.The follow-up of 3 months of mitral valve regurgitation was not aggravated comparing with that immediately after surgery(P>0.05).There was no worsening of cardiac function at follow-up(P>0.05), and no other adverse events.Therefore, artificial mitral annuloplasty with a ring is effective in treating mitral regurgitation in children .The annulus had potential growth characteristics and did not require lifelong oral an-ticoagulant.Conclusion For some patients with difficulty, this method of mitral valvuloplasty can enlarge the surgical indica-tion and improve the quality of life of children.The treatment effect is good.

Objective To analyze the clinical features and prognosis of acute myeloid leukemia (AML) patients with incomplete blood recovery [platelet count (Plt) < 100 ×109/L or absolute neutrophil count (ANC)<1.0×109/L] at the first time of achieving morphologic complete remission(CR). Methods The clinical data of 302 AML patients (non-M3) who were treated at the First Affiliated Hospital of Zhengzhou University from January 2010 to September 2015 were retrospectively reviewed. They were divided into CR group (Plt≥100×109/L and ANC≥1.0×109/L) and CR with incomplete blood recovery group (Plt<100×109/L or ANC<1.0 ×109/L) according to the condition of blood count at the first time of achieving morphologic CR. The clinical features and prognostic differences between the two groups were compared, and univariate analysis and mutivariate analysis were performed to compare the recurrence and survival of AML with incomplete blood recovery. Results Two hundred and sixteen (71.5%) patients were in CR group and 86 (28.5%) were in CR with incomplete blood recovery group. There was no statistically difference between the two groups in terms of age, high white blood cell, peripheral blasts ratio, France-American-Britain (FAB) type, cytogenetic risk classification and FLT3-ITD/NPM1 gene mutation (all P>0.05). Bone marrow blasts before therapy and the proportion of bone marrow CR in the first course of chemotherapy in CR group were higher than those in CR with incomplete blood recovery group (both P< 0.05), and the proportion of minimal residual disease (MRD) positive patients was lower in CR group (P=0.004). Bone marrow proliferation at the time of achieving morphologic CR was more active in CR group (P=0.001). The 3-year relapse rate in CR group was lower than that in CR with incomplete blood recovery group (P= 0.003), and overall survival (OS) rate and disease-free survival (DFS) rate were higher than those in CR with incomplete blood recovery group (both P< 0.05). Multivariate prognostic analysis for relapse, OS rate and DFS rate showed that high risk karyotype,≥2 courses of induction therapy and neutrophils not recovery were independent risk factors for AML patients with incomplete blood recovery (all P>0.05). In addition, FLT3-ITD positive was an independent risk factor for OS rate(P< 0.001), and peripheral blood blasts ≥0.60 was an independent risk factor for DFS rate (P= 0.047). Conclusions AML patients with incomplete blood recovery at the first time of achieving morphologic CR have a poor prognosis. AML patients with high-risk karyotype, ≥2 courses of induction therapy, incomplete neutrophils recovery may have a worse prognosis, and they should be regarded as high-risk groups and given more aggressive treatment.

Objective To systematically evaluate and analyze the evidence level of randomized controlled trials (RCT) of preoperative skin preparation for emergency percutaneous coronary intervention (PCI), and to understand the current research status and evidence level of preoperative skin preparation randomized controlled trials for emergency PCI, and provide reference for skin preparation for emergency PCI. Methods PubMed, EMbase, The Cochrane Library, CINAHL, JBI, CBM, CNKI, Wanfang DATA were searched by computer from inception to March, 2018 for emergency PCI preoperative skin preparation randomized controlled trials. Two evidence panel members searched and selected articles independently and the quality was assessed in accordance with Cochrane Manual. The articles were analyzed with Review Manager 5.3, and the evidence quality was assessed with GRADE profiler 3.6.1 software. Results A total of 5 RCTs were included, of which the number of RCTs with grade A quality was 1 and the number of RCTs with grade B was 4. The results of the Meta analysis showed that there was no significant difference in the incidence of skin infections at the postoperative puncture site by conventional methods for routine removal of surgical wild hair and no removal of hair prior to emergency PCI (P＜0.05). In addition, regular removal of hair before surgery may result in prolonged preoperative preparation and may cause psychological discomfort to the patient. After the GRADE system rating, the quality of the evidence body was of a lower level. Conclusions It is more beneficial to shorten the treatment time without routine removal of all the hair at the puncture site and the surrounding patients. The evidence included is not yet certain whether the incomplete removal of hair can reduce the infection rate. In the future, more large-scale, multi-center, high-quality research should be carried out to provide more credible evidence for this study.

Objective? To explore the effects of strengthening out-of-hospital health beliefs on perceived well-being and behavioral change in elderly patients with colon cancer. Methods? Totally 112 elderly patients with colon cancer admitted in Nanyang City Center Hospital from August 2015 to August 2017 were selected by convenient sampling and divided into two groups (n=56) based on the time of admission. Patients in the control group received conventional nursing care, while patients in the observation group received out-of-hospital health beliefs. Both interventions lasted for 6 months. The knowledge needs scale for cancer patients and the Health Promoting Lifestyle Profile-Ⅱ (HPLPⅡ) were used to evaluate the perceived well-being and healthy behaviors in the two groups before and after intervention. Results? The scores of psychological needs, technical needs, medication needs and rehabilitation needs and the total score of the knowledge needs scale for cancer patients in the observation group were higher than those before intervention and those of the control group after intervention. The scores of self-fulfillments, exercise, health responsibility, nutrition, pressure handling and interpersonal support and the total score of HPLP Ⅱ of the observation group were higher than those before intervention and those of the control group after intervention (P＜ 0.05). Conclusions? Strengthening out-of-hospital health beliefs can effectively improve the perceived well-being of elderly patients with colon cancer and enable them to develop healthy behaviors.