BackgroundRehabilitation for schizophrenia typically relies on pharmacological interventions， yet their efficacy in improving social function and quality of life remains limited. In recent years， non-pharmacological approaches have shown promise in enhancing rehabilitation outcomes. However， research on the effectiveness of psychomotor therapy specifically for young and middle-aged schizophrenic inpatients is limited. ObjectiveTo explore the effects of psychomotor therapy on the rehabilitation of young and middle-aged schizophrenic inpatients， and to provide a reference for treatment strategies. MethodsA total of 104 young and middle-aged schizophrenic inpatients who met the International Classification of Diseases，tenth edition （ICD-10） diagnostic criteria and hospitalized in the Fourth People's Hospital of Wuhu from June 2021 to June 2022 were selected. Patients were randomly divided into two groups of 52 each using random number table method. Both groups received treatment with risperidone tablets （2~4 mg/d） ， along with routine nursing care. Additionally， the research group received an extra 45~55 minutes of psychomotor therapy 2~3 times per week for 12 weeks. The control group received the same psychomotor therapy after the study. Positive and Negative Symptom Scale （PANSS）， Scales of Social-skills for Psychiatric Inpatient （SSPI） and Insight and Treatment Attitude Questionnaire （ITAQ） were used to assess the patients before the intervention and at 4^th， 8^th and 12^th week after the intervention. ResultsThe main effects of intervention at different time points for PANSS positive symptoms， negative symptoms and general psychopathology subscale scores， PANSS total score， SSPI score and ITAQ score were all statistically significant （F=33.989， 204.245， 82.817， 279.596， 26.144， 7.463， P<0.01）. Furthermore， statistically significant between-group differences were observed in PANSS negative symptoms and general psychopathology subscale scores， PANSS total score， SSPI score and ITAQ score （F=30.053， 5.306， 33.417， 33.013， 18.608， P<0.05 or 0.01）. Moreover， the interaction effect of time and group were statistically significant for PANSS positive symptoms， negative symptoms and general psychopathology subscale score， PANSS total score and SSPI score （F=3.472， 9.798， 3.843， 14.390， 20.661， P<0.05 or 0.01）. After 12 weeks of intervention， the research group exhibited statistically significantly lower PANSS total score and subscale scores compared with baseline （P<0.01）， while their SSPI total score was significantly higher than that of control group（P<0.01）. Additionally， compared with the control group， the research group had statistically significantly lower PANSS total score and subscale scores ， while their SSPI score was statistically significantly higher than those of control group（P<0.01）. ConclusionPsychomotor therapy may contribute to the improvement of the psychiatric symptoms and social function in young and middle-aged inpatients with schizophrenia， enhancing their rehabilitation outcomes. ［Funded by Health Commission Scientific Research Project of Wuhu （number， WHWJ2021y073）］

Objective:To discuss the effect of adipose-derived stem cell-derived exosomes(ADSC-Exos)on the migration ability of the macrophages RAW264.7,and to clarify its role in promoting function of the macrophages.Methods:The adipose tissue adjacent to epididymis of the SD rats was isolated to perform primary culture of the adipose-derived stem cells(ADSCs).The adipogenic and osteogenic differentiation induction was conducted,and the multidirectional differentiation potential of the ADSCs was detected by oil Red O and Alizarin red staining.Western blotting and immunofluorescence methods were used to detect the positive expressions of the ADSCs markers CD29 and CD44;the ADSC-Exos were extracted by Exos isolation kit,and the morphology,size,and distribution of particle size of the ADSC-Exos were examined by transmission electron microscope and nanoparticle tracking analyzer;the expression levels of exosome-specific markers CD9 and TSG101 proteins in the ADSC-Exos were detected by Western blotting method;the uptake of ADSC-Exos by the macrophages was observed by tracing method.The macrophages RAW264.7 were divided into control group,10 mg·L-1 ADSC-Exos group,20 mg·L-1 ADSC-Exos group,and 40 mg·L-1 ADSC-Exos group.The activities of the macrophages in various groups were detected by 5-ethynyl-2'-deoxyuridine(EdU)staining;the number of migration macrophages in various groups was detected by Transwell chamber assay;the adhesion of macrophages in various groups was observed by fluorescence microscope.Results:After 24 h of primary culture,the ADSCs adhered to the wall and exhibited scattered,elongated shapes;after 7 d of culture,the adherent cells showed a comb-like,vortex-like orderly arrangement,resembling fibroblasts;after 10 passages,the irregular morphology of the ADSCs and decreased proliferation rate were found.The isolated ADSCs showed potential for the osteogenic and adipogenic differentiation,and the expressions of CD29 and CD44 proteins were positive.The transmission electron microscope observation resuls showed that the ADSC-Exos appeared disc-shaped,and the main peak of particle size distribution was around 132 nm.The CD9 and TSG101 proteins were positively expressed in the ADSC-Exos,indicating successful extraction.The fluorescence microscope results showed red fluorescence signals around the nuclei of the RAW264.7 cells,indicating the uptake of ADSC-Exos by the macrophages.Compared with control group,the rates of EdU positive cells in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the rate of EdU positive cells in 20 mg·L-1 ADSC-Exos group was significantly increased(P<0.05).Compared with control group,the numbers of migration cells in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the numbers of migration cells in 20 and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05).Compared with control group,the numbers of the adherent macrophages in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the number of adherent macrophages in 20 mg·L-1 ADSC-Exos group was significantly increased(P<0.05).Conclusion:The ADSC-Exos can be internalized by the macrophages and they can enhance the migration ability of the macrophages by affecting the cell adhesion.

AIM: To explore the role of clinical pharmacist in the treatment of patients with transjugular intrahepatic portosystemic shunt. METHODS: Clinical pharmacist participated in the treatment of a patient with repeated oral bleeding after transjugular intrahepatic portal shunt followed treatment with multiple antithrombotic drugs, which assisted the physician to diagnose and adjust the antithrombotic treatment plan as well as provided the patient with whole-process pharmaceutical care and online management. RESULTS: Based on the inquiry about the patient's past and current medical history and medication consumption, the pharmacist considered that there was weak correlation between oral hemorrhage and antithrombotic drugs and advised for dentist inspection. Thereafter, the patient was diagnosed with chronic gingivitis. The dosage of warfarin was adjusted, and the pharmacists managed it online after discharge to achieve stable INR of the patient. In the later online follow-up, an abnormal increase of INR was encountered, By asking about the history of medication, it was considered that the increase in INR was related to taking amoxicillin capsules. Therefore, the pharmacist suggested to stop amoxicillin capsule and to gradually adjust the dose of warfarin to the original level to improve the treatment. CONCLUSION: The involvement of clinical pharmacists in clinical treatment facilitates comprehensive pharmaceutical care of patients, which plays a positive role in the efficacy and safety of medication therapy.

Transcatheter aortic valve replacement is the effective treatment for severe aortic stenosis. PhaseⅠ cardiac rehabilitation is the key period for the recovery of cardiac function, the establishment of rehabilitation consciousness and rehabilitation education, which has important clinical significance. This article reviews the content and research status of Phase I cardiac rehabilitation after transcatheter aortic valve replacement and the nursing mode led by specialist nurses of Phase I cardiac rehabilitation after transcatheter aortic valve replacement, so as to provide reference for improving nursing effect of Phase I cardiac rehabilitation after transcatheter aortic valve replacement.

Gastric cancer (GC) is associated with high morbidity and mortality rates. Thus, early diagnosis is important to improve disease prognosis. Endoscopic assessment represents the most reliable imaging method for GC diagnosis; however, it is semi-invasive and costly and heavily depends on the skills of the endoscopist, which limit its clinical applicability.Therefore, the search for new sensitive biomarkers for the early detection of GC using noninvasive sampling collection methods has attracted much attention among scientists.Urine is considered an ideal biofluid, as it is readily accessible, less complex, and relatively stable than plasma and serum. Over the years, substantial progress has been made in screening for potential urinary biomarkers for GC. This review explores the possible applications and limitations of urinary biomarkers in GC detection and diagnosis.

Humans ; Fractures, Compression/surgery* ; Spinal Fractures/surgery* ; Multiple Myeloma/drug therapy* ; Vertebroplasty ; Osteoporotic Fractures/therapy* ; Treatment Outcome ; Bone Cements

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

OBJECTIVE：To preliminarily optimize the preparation technology of Ligustrazine pellicle ，and to study its in vitro percutaneous permeation characteristics. METHODS ：With the amounts of PVA- 124，ethyl alcohol ，glycerin，tween-80 and azone as factors ，single factor experiment was used to optimize the Ligustrazine pellicle matrix formulation ；modified scoring standard was used to evaluate the film formation time ，film formation ability ，ductility，uniformity and the presence of bubble. On the basis of the optimal matrix formulation ，the pellicle with different loading amount of ligustrazine （300，250，200，150，100，50 mg/mL） was prepared and its maximum loading amount was investigated. HPLC method was adopted to determine the content of ligustrazine，and methodology investigation was conducted. Isolated back skin of rats were collected ，the percutaneous permeation test was conducted for high ，medium and low loading amount （100，75，50 mg/mL）of Ligustrazine pellicle. At 15，30，45，60， 75，90，120，150，180 min，the sample was taken and the permeation rate of ligustrazine was calculated. RESULTS ：When the amounts of PVA- 124，ethyl alcohol，glycerin，tween-80 and azone were 2.5 g，7.0 mL，1.97 mL，0.07 mL，0.28 mL（in terms of 50 mL formulation amount ），the optimal matrix formulation of Ligustrazine pellicle was obtained. The maximum drug loading amount of ligustrazine was 100 mg/mL. The linear ranges of ligustrazine was 3.125-100 μg/mL. The specificity，precision， reproducibility，recovery and stability investigation of content determination method of ligustrazine were all in line with the requirements（RSD＜2％）. The permeation rate of high ，medium and low loading amount of Ligustrazine pellicle were 608.42， 384.19，158.20 μg（/ cm2·h）. CONCLUSIONS ：According to the optimized formulation ，the prepared Ligustrazine pellicle had a short film forming time ，stable and re liable quality ； the drug-loading amount was up to 100 mg/mL. The pellicle with drug-loading amount of 75 mg/mL had reached the penetration rate range of effective plasma concentration of ligustrazine treatment.

Objective:To explore the application effect of nursing measures based on comprehensive geriatric assessment in the prevention of nursing adverse events in elderly patients undergoing cardiac surgery.Methods:56 elderly patients who underwent cardiac surgery in Beijing Anzhen Hospital Affiliated to Capital Medical University from June 2018 to May 2019 were selected as the observation group. According to the principle of reciprocity, 51 elderly patients who underwent cardiac surgery from June 2017 to May 2018 were selected as the control group. The control group was given routine nursing while the observation group carried out comprehensive geriatric assessment based on routine nursing and formulated nursing plans and measures based on assessment results. The incidence of adverse nursing events during hospitalization and length of hospital stay were compared between the two groups.Results:The unplanned extubation rate, aspiration rate and fall rate in the observation group were respectively 1.79% (1/56) , 1.79% (1/56) and 0 (0/56) , which were lower than 13.73% (7/51) , 15.69% (8/51) and 9.80% (5/51) in the control group, and the differences were statistically significant ( P<0.05) . The incidence of stress injury was 0 (0/56) in the observation group and 1.96% (1/51) in the control group, and the difference was not statistically significant ( P>0.05) . The infection rate of tube incision in the observation group was 0 (0/56) , which was lower than 9.80% (5/51) in the control group, and the difference was statistically significant ( P<0.05) . The length of hospital stay in the observation group was shorter than that in the control group, and the difference was statistically significant ( Z=8.068, P<0.01) . Conclusions:Application of comprehensive geriatric assessment in elderly patients undergoing cardiac surgery can reduce the incidence of unplanned extubation, aspiration, falls and other nursing adverse events, reduce the infection rate of incision and shorten the length of hospital stay.

Objective:To explore the influence of obstructive sleep apnea hypopnea syndrome (OSAHS) on nocturnal blood pressure and angina pectoris in patients undergoing cardiac artery bypass graft (CABG) .Methods:From January to December 2018, we selected 76 patients with simple CABG at Beijing Anzhen Hospital affiliated to Capital Medical University by purposive sampling. Before surgery, patients were treated with the portable sleep respiratory monitoring and bedside blood pressure monitoring. Patients were divided into group of mild or no OSAHS ( n=35) and group of moderate or severe OSAHS ( n=41) based on apnea hypopnea index (AHI) . We compared the differences in the baseline data, sleep respiratory examination indexes, nocturnal angina pectoris, blood pressure at 21∶00, 3∶00 and 6∶00 among patients between two groups. Results:Among CABG patients with moderate or severe OSAHS, the systolic pressure at 3∶00 and 6∶00 was (115.8±12.5) mmHg and (156.8±17.5) mmHg respectively all higher than those among CABG patients with mild or no OSAHS with statistical differences ( P<0.05) ; the incidence of nocturnal angina pectoris was 29.27% (12/41) higher than that [2.86% (1/35) ]among CABG patients with mild or no OSAHS with a statistical difference ( P<0.05) . Logistic regression analysis showed that the systolic pressure at 3∶00 could affect the occurrence of nocturnal angina pectoris among CABG patients with OSAHS ( OR=1.050, 95% CI 1.003-1.100, P=0.039) ; the decrease of average oxygen saturation could also affect the occurrence of nocturnal angina pectoris among those patients ( OR=0.628, 95% CI 0.397-0.993, P=0.046) ; the differences were all statistical. Conclusions:Early morning systolic pressure of CABG patients with OSAHS raises, and OSAHS may increase the incidence of nocturnal angina pectoris among CABG patients.