Objective:To develop the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and test its reliability and validity, so as to provide an effective tool for evaluating the care needs of young and middle-aged terminally ill patients for medical and nursing staff.Methods:This study is a cross-sectional study. Guided by the theory of supportive care needs, an initial scale was formed through literature review, qualitative interviews, Delphi expert consultation, and pre-survey. From July to September 2022, convenience sampling was used to select 570 young and middle-aged terminally ill patients hospitalized in the Oncology Department and Hospice Care Ward of six Class Ⅲ hospitals in Tianjin as the research subject, and a questionnaire survey was conducted on the patients. The items in the scale were selected using item analysis method. The structural validity of the scale was evaluated using exploratory factor analysis and confirmatory factor analysis. The content validity of the scale was evaluated using the scale-level content validity index and the item-level content validity index. The reliability of the scale was evaluated using internal consistency coefficient and half reliability coefficient. A total of 570 questionnaires were distributed, and 565 valid questionnaires were collected, with an effective response rate of 99.12% (565/570) .Results:A total of 18 experts completed two rounds of consultation, with an expert authority coefficient of 0.890, the Kendall's W values of 0.309 and 0.417, respectively ( P<0.05). The Care Needs Scale for Young and Middle-aged Terminally Ill Patients included 6 dimensions and a total of 39 items. Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 71.515%. Confirmatory factor analysis showed that the overall model fitted well. The content validity index at the scale level was 0.942, and the content validity index at the item level was 0.833 to 1.000. The total Cronbach's α coefficient of the scale was 0.975, and the half reliability coefficient was 0.911. Conclusions:The reliability and validity of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients are good, and it can be used as an evaluation tool for the care needs of young and middle-aged terminally ill patients.

The potential medicinal value of Ma bamboo (Dendrocalamus latiflorus), one of the most popular and economically important bamboo species in China, has been underestimated. In the present study, we found that D. latiflorus leaf extract (DLE) reduced fasting blood glucose levels, body weight, and low-density lipoprotein cholesterol with low liver toxicity in db/db mice. In addition, gene expression profiling was performed and pathway enrichment analysis showed that DLE affected metabolic pathways. Importantly, DLE activated the AKT signaling pathway and reduced glucose production by downregulating glucose-6-phosphatase (G6PC) and phosphoenolpyruvate carboxykinase 1 (PCK1) expression. Moreover, network pharmacology analysis identified rutin as an active component in DLE through targeting insulin growth factor 1 receptor (IGF1R), an upstream signaling transducer of AKT. Due to its hypoglycemic effects and low toxicity, DLE may be considered an adjuvant treatment option for type 2 diabetes patients.

Objective To explore the effect of modified meridian breathing training on the lung function of acute stroke patients. Methods Sixty acute stroke patients were randomly divided into an intervention group and a control group, each of 30. In addition to the conventional neurological treatment, the control group received routine breathing training, while the intervention group was given modified meridian breathing training by professional reha-bilitation therapists once a day for 4 weeks. Forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1) , as well as the rate of pulmonary infection were assessed before and after the treatment. Results After 4 weeks of treatment, a significant increase was observed in the average FEV1 and FVC of both groups, but the im-provement in the intervention group was significantly greater than in the control group. There were 3 lung infections ( 10％) in the intervention group, which was significantly lower than the 7 cases ( 23. 3％) in the control group. Conclusion Modified meridian breathing training can improve the lung function of acute stroke patients and reduce the incidence of lung infection.

Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.

Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.

Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus interval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P< 0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R intervals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P< 0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.

Objective To observe the effect of needle warming moxibustion on cognitive dysfunction after stroke. Methods 76 stroke patients with cognitive dysfunction were randomly divided into treatment group (n=38) and control group (n=38). The treatment group received needle warming moxibustion and routine rehabilitation for 4 weeks, while the control group only received routine rehabilitation. They were assessed with Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale before and after treatment. Results The score of MoCA and ADL improved in both groups (P<0.05), and improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Needle warming moxibustion could improve cognitive function in patients after stroke and activities of daily living.

Objective To compare the cost-effectiveness and cost-utility of venlafaxine and mirtazapine in patients with treatment-resistant major depression (TRD).Methods One hundred and five patients with TRD were enrolled in this study and grouped into venlafaxine treatment (n=50) and mirtazapine treatment (n=55) based on the double-blind randomization scheme generated by computer.The treatment costs of antidepressants during 8 weeks were calculated,the rates of clinical response and remission were taken as treatment effectiveness,and the quality-adjusted life years (QALYs) as treatment utility.The descriptive analysis and nonparametric test were used to compare the cost-effectiveness and cost-utility of different groups.Results During 8 weeks,the treatment cost of antidepressant was ￥ 1 396.44 for venlafaxine and ￥ 1 206.90 mirtazapine,and the difference between two groups was ￥ 189.54.The cost-effectiveness ratios between venlafaxine and mirtazapine were very close (differed ￥ 0.06 for remission rate and ￥ 1.08 for response rate respectively).There was no significant difference for cost-utility ratios between two groups (physical functioning Z=-0.15,P＞0.05 ; mental health Z=-0.54,P＞0.05).Conclusion Both cost-effectiveness and cost-utility of venlafaxine in patients with TRD are close between venlafaxine and mirtazapine.

Objective To investigate the inhibitory effects of cationic polymeric liposomes (CPLs) vector-based RNA interference (RNAi) technology on the expression of rat MHCⅡ transactivator ( CⅡTA) and MHCⅡgenes .Methods According to the genetic information of CⅡTA downloaded from GenBank, three short hairpin RNA (shRNA) sequences targeting CⅡTA sequences were designed .CPLs vectors were constructed and coupled to shRNA plasmid vectors to form pCⅡTA-CPLs vectors .Six groups including control group , CPLs control group , pHK-CⅡTA control group and three pCⅡTA-CPLs groups were set up.Rat dendritic cells (DCs) were transfected in vitro.Real time PCR and flow cytometry analysis were used to detect the expression of CⅡTA and MHCⅡat mRNA and protein levels in DCs after transfec-tion.Results The pCⅡTA-CPLs vectors were successfully constructed .Compared with control groups ,the transcription level of CⅡTA and MHCⅡand the expression of MHCⅡat protein level were significantly in-hibited in all pCⅡ TA-CPLs groups ( P<0 .01 ) .The strongest inhibitory effects of pCⅡTA-CPLs on the ex-pression of CⅡTA and MHCⅡgenes were observed in the second pCⅡTA-CPLs group.There was a positive correlation between the expression of CⅡTA and MHCⅡ.Conclusion CPLs vectors were effective gene carriers.The constructed pCⅡTA-CPLs vectors significantly inhibited the in vitro expression of rat CⅡTA and MHCⅡ, which provided evidences for further investigation on pCPLs-CⅡTA vectors in vivo.

Objective To evaluate the clinical efficacy and safety for the CAG regimen combined with thalidomide in elderly patients with acute myelogenous leukemia (AML).Methods 51 untreated elderly cases with AML were randomly divided into treatment group (treated with CAG regimen combined with thalidomide,26 cases) and control group (treated with CAG regimen alone,25 cases),and the clinical efficacy and safety were observed.Results After 2 cycles of treatment,the complete remission (CR) rates of treatment group and control group were 61.5 ％ (16/26) and 48.0 ％ (12/25) respectively,the difference was not significant (P =0.404).With regard to prostecdtive efficacy,the difference was markedly significant,1-year CR rates of treatment group and control group were 53.8 ％(14/26) and 24.0 ％ (6/25) respectively (P =0.045),and 2-year CR rates were 42.3 ％ (11/26) and 12.0 ％ (3/25) respectively (P =0.027).During the follow-up of 2 years,overall 1-and 2-year overall survival rates were 73.1％ and 46.1％ in treatment group versus 52.0 ％ and 24.0 ％ in control group.During the follow-up of 2 years,the estimated mean overall survival time in treatment group was 22 months and it was 13 months in control group (P =0.018).The induction mortality rates and myelosuppression showed no difference between the two groups.Compared with control group,the side effect rate of nausea and vomiting was significantly decreased in treatment group (P =0.025).Conclusion The CAG regimen combined with thalidomide is effective with little side effects for elderly AML,and is worthy of further study and clinic application.