With the increasing incidence of cardiovascular diseases,Professor WANG Yongyan has adhered to the traditional principles while embracing innovation,proposing to apply the theory of"the heart governing the spirit"to the prevention and treatment of cardiovascular diseases.He emphasized that it is crucial to preserve the spirit before the onset of disease,which includes maintaining a balanced diet,regular lifestyle,avoiding excessive labor,maintaining a serene and unfettered mind,and nurturing the spirit within.For those already suffering from disease,preventing progression and deterioration requires adjusting the spirit,and skilled practitioners should first inspect the patient's spirit by examining the eyes,tongue,facial complexion,and overall physical condition.In treatment,adjusting the spirit involves distinguishing between different imbalances of qi,blood,yin,yang,cold,heat,deficiency,and excess,and employing appropriate method to calm and nourish the spirit accordingly.After the illness,nurturing the spirit is essential,including spiritual nourishment through exercise,dietary therapy,emotional therapy,and external treatments.By applying the theory of"the heart governing the spirit"throughout the prevention,treatment,and rehabilitation of cardiovascular diseases,Professor WANG Yongyan's approach effectively prevents the occurrence of cardiovascular diseases,controls their progression,inhibits deterioration,and improves the prognosis of patients.

Objective To establish sensitive indicators for the evaluation of emergency nursing quality in patients with acute aortic dissection. Methods Based on the three-dimensional quality theory model of "structure-process-outcome", evidence-based nursing methods were used to synthesize evidence and conduct two rounds of expert consultation to determine sensitive indicators for the quality of emergency nursing in patients with acute aortic dissection. Results The effective recovery rates of the two rounds of expert consultation questionnaires were 100.00% and 94.12%, respectively. The judgment basis coefficients (Ca) of the experts who participated in the two rounds of consultation were 0.893 and 0.914, respectively, and the familiarity coefficients (Cs) were 0.902 and 0.921, respectively, and the authority coefficients (Cr) were 0.898 and 0.918, respectively. The Kendall coefficients of the first round of consultation experts for the first, second, and third-level indicators were 0.212, 0.247, and 0.327, respectively, and were 0.225, 0.349, and 0.257, respectively in the second round of consultation experts. Finally, the sensitive indicators for the quality of emergency nursing of AAD patients were constructed, including 3 first-level indicators, 8 second-level indicators, and 29 third-level indicators. Conclusion The sensitive indicators for the quality of emergency nursing of AAD patients constructed in this study can be used as a basis for evaluating the quality of emergency nursing in patients with acute aortic dissection.

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

Objective:To observe the rehabilitation effect of Baduanjin combined with elastic band training on elderly patients with sarcopenia. Methods:From January 2019 to January 2021, 120 elderly sarcopenia patients in our hospital who met the inclusion criteria were divided into two groups according to the random number table method, with 60 in each group. The control group was given conventional treatment intervention for sarcopenia, and the observation group was Baduanjin exercises combined with elastic band training on the basis of the control group. Both groups were intervened for 12 weeks. The skeletal muscle index (SMI), muscle grip strength, short physical performance battery (SPPB) and Modified Barthel Index (MBI) were used to compare between two groups before and after the intervention. Results:After treatment, the SMI index [(6.77 ± 1.03) kg/m 2vs. (6.35 ± 1.12) kg/m 2, t=2.14], muscle grip strength [(23.06 ± 3.48) kg vs. (19.41 ± 3.79) kg, t=5.50], SPPB score [(9.12 ± 2.24) vs. (7.85 ± 2.13), t=3.18] and MBI score [(82.43 ± 20.75) vs. (64.36 ± 19.42), t=4.93] of the observation group were significantly higher than those in the control group ( P<0.05). After treatment, the distribution of muscle activity function in the observation group was significantly better than that of the control group ( Z=-2.28, P=0.023). Conclusion:Baduanjin combined with elastic band training can improve the muscle function and quality of daily activities in elderly patients with sarcopenia.

Objective:To explore the detection and segmentation of ischemic core infarct volume of the acute stroke in diffusion weighted imaging (DWI) images using cascaded VB-Net.Methods:MRI data of 1 500 patients (2 456 lesions) with acute ischemic stroke in Henan Provincial People′s Hospital from December 2016 to December 2018 were retrospectively analyzed. Firstly, manual segmentation of ischemic core was performed on DWI images (b=1 000 s/mm 2), and then all data were divided into training set, validation set and independent test set by 8∶1∶1. Then, the cascaded VB-Net was constructed, and the core infarct was automatically detected and segmented in the test set. Interclass correlation coefficient (ICC) was used to evaluate the consistency of volume size measured by manual segmentation and cascaded VB-Net. The patients were divided into large ischemic core lesion group (ischemic core volume ≥10 ml) and small ischemic core lesion group (ischemic core volume<10 ml), and the Dice coefficient difference between the two groups was compared using Mann-Whitney U test. Results:In independent test set, cascaded model had the detection rate of 94.6% (243/257) with Dice coefficient of 0.76 (0.68, 0.84). The agreement of cacade VB-Net segmented [4.19(1.21,14.13)ml] and manual segmented ischemic core infarct volume [4.08(1.19,17.92)ml] was high (ICC=0.97, P<0.001). There was no significant difference in Dice coefficient between large and small lesion groups [0.76 (0.69, 0.85), 0.76 (0.67, 0.84), Z=-0.44, P=0.657]. Conclusions:The cascaded VB-Net model provided a tool to realize automatic detection, segmentation, and calculation of ischemic core infarct volume. It has good segmentation accuracy and high consistency with manual segmentation, which can provide an auxiliary decision-making tool for the selection of treatment plans.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To explore the mediating effect of social support between self-management ability and health-promoting lifestyle in elderly cancer patients with peripherally inserted central catheter (PICC) .Methods:This study was a cross-sectional study. From October 2018 to October 2019, convenience sampling was used to select 472 elderly cancer patients with PICC from two Class Ⅲ Grade A general hospitals in Henan Province as the research subject. The General Information Questionnaire, Cancer Patients PICC Self-management Scale (CPPSM) , Social Support Rating Scale (SSRS) and Health Promotion Lifestyle ProfileⅡ (HPLP-Ⅱ) were used for investigation. The mediating effect of social support between self-management ability and health-promoting lifestyle in elderly cancer patients with PICC was analyzed. A total of 472 questionnaires were distributed, and 467 valid questionnaires were recovered, with a valid recovery rate of 98.9%.Results:Among 467 elderly cancer patients with PICC, the scores of social support, self-management ability, and health-promoting lifestyle were (42.87±7.94) , (147.32±22.17) , and (114.93±25.20) , respectively. There was a positive correlation between social support and self-management ability ( r=0.244, P<0.01) , a positive correlation between social support and health-promoting lifestyle ( r=0.377, P<0.01) , and a positive correlation between self-management ability and health-promoting lifestyle ( r=0.471, P<0.01) . The results of the mediating effect analysis showed that social support played a partial mediating effect between the self-management ability and the health-promoting lifestyle of elderly cancer patients with PICC, accounting for 17.6% of the total effect. Conclusions:Social support is a mediating variable between self-management ability and health-promoting lifestyle in elderly cancer patients with PICC. Medical and nursing staff should pay attention to and improve the social support of elderly cancer patients with PICC, and take corresponding intervention measures to improve the health-promoting behavior and health level of elderly cancer patients.

Objective: To determine the effects of ginsenoside rg3 on the body weight of C57BL/6J obese mice and to investigate its underlying weight loss mechanisms with a focus on white fat browning-related factors. Methods: Eight-week-old C57BL/6J male mice were fed a high-fat diet for 12 successive weeks to construct the obese model. C57BL/6J male mice were fed a standard chow diet to construct normal control group. After 8 weeks of intervention with ginsenoside rg3, the food intake, body weight, body fat mass, blood sugar, and lipid profiles of the mice in each group were detected. Hematoxylin and eosin (HE) staining was used to observe the histological morphology of the adipose tissues. Real-time poly-merase chain reaction (RT-PCR) and Western blotting (WB) were applied to detect the gene and protein expression levels of peroxisome proliferators-activated receptor gama (PPARγ), Peroxisome proliferator-activated receptor-gamma coactivator -1alpha (PGC-1α), PR domain containing 16 (PRDM16), and uncoupling protein 1 (UCP-1).Results: Compared to normal control group mice, the body weight, food intake, body fat composition, and blood lipid levels of model group mice increased significantly. After 8 weeks of intervention with ginsenoside rg3, body weight, body fat composition, food intake, and blood lipid profiles decreased. HE staining showed that ginsenoside rg3 can improve white adipocyte hypertrophy to a certain extent. RT-PCR and WB demonstrated that ginsenoside rg3 can increase the mRNA and protein expression levels of PPARγ, PGC-1α, PRDM16, and UCP-1 in the adipose tissues of obese mice. Conclusion: The weight reduction effect of ginsenoside rg3 may be related to the promotion of white fat browning.

Objective:To explore the value of radiomics features extracted from multi-parameter MRI (mp-MRI) in preoperative prediction of triple negative breast cancer (TNBC) and non triple negative breast cancer (NTNBC).Methods:The clinical and preoperative-MRI data of 371 patients with breast cancer confirmed by surgical pathology from January 2017 to July 2019 in Henan Provincial People′s Hospital were retrospectively analyzed. Based on the results of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) from postoperative pathological specimens, the cancer was classified as TNBC and NTNBC. Patients were randomly assigned to a training set ( n=250) and a validation set ( n=121). Quantitative radiomics features were extracted from three-dimensional lesions based on dynamic contrast enhanced-T 1WI (DCE-T 1WI) and fat-suppressed T 2WI sequences, and 32 quantitative radiomics features were selected by Mann-Whitney U test, elastic network, and support vector machine recursive feature elimination. Three radiomics signatures were constructed by using the algorithm of support vector machine based on the quantitative radiomics features extracted from fat-suppressed T 2WI, DCE-T 1WI and the mp-MRI of their combination. The prediction performances were evaluated by receiver operating characteristic (ROC) curve and the area under the ROC curve, accuracy, sensitivity, and specificity were calculated. Results:There were 61 patients with TNBC and 310 patients with NTNBC. The clinicopathological characteristics between NTNBC and TNBC were statistically different in the pathological grade (χ2=24.544, P<0.001). Other clinicopathological characteristics (age, maximum diameter of mass, vascular tumor thrombus, axillary lymph nodes) were not statistically differences between NTNBC and TNBC ( P>0.05). The radiomics signature presenting the best performance for predictive TNBC and NTNBC were based on mp-MRI radiomics features. The area under the ROC curve, accuracy, sensitivity, and specificity were 0.91[95% confidence interval (CI) 0.881-0.932], 86.0%, 84.4% and 86.3% in training set, and 0.84 (95%CI 0.807-0.868), 75.2%, 68.7% and 76.1%, in validation set, respectively. Conclusion:Radiomics based on mp-MRI features can be a effectively potential tool for predictive TNBC and NTNBC breast cancer and provide scientific basis for clinicians to make treatment decisions.

Psoriasis is characterized by abnormal proliferation of keratinocytes, as well as infiltration of immune cells into the dermis and epidermis, causing itchy, scaly and erythematous plaques of skin. The understanding of this chronic inflammatory skin disease remains unclear and all available treatments have their limitations currently. Here, we showed that IMMH002, a novel orally active S1P modulator, desensitized peripheral pathogenic lymphocytes to egress signal from secondary lymphoid organs and thymus. Using different psoriasis animal models, we demonstrated that IMMH002 could significantly relieve skin damage as revealed by PASI score and pathological injure evaluation. Mechanistically, IMMH002 regulated CD3 T lymphocytes re-distribution by inducing lymphocytes' homing, thus decreased T lymphocytes allocation in the peripheral blood and skin but increased in the thymus. Our results suggest that the novel S1P agonist, IMMH002, exert extraordinary capacity to rapidly modulate T lymphocytes distribution, representing a promising drug candidate for psoriasis treatment.