Leukemia is a critical disease with a high incidence and extremely high fatality rate.Immune escape by leukemia stem cells(LSC)is the main factor for recurrence and progression after remission.Clinical diagnosis and treatment by Traditional Chinese Medicine(TCM)have distinct advantages of syndrome differentiation and treatment.Based on the purpose of diagnosis and treatment,leukemia treatment by TCM emphasizes the harmony of yin and yang to restore human functions,which is conducive to improve autoimmunity and conforms to the mechanism of intervention for tumor cell immune escape.This article discusses the mechanism and research progress of TCM interventions in LSC immune escape based on literature and TCM theory.

Objective To cultivate competent rehabilitation assistive technology workers and systematically develop the undergradu-ate curriculum courses of assistive technology using World Health Organization Rehabilitation Competency Framework(RCF)and International Classification of Functioning,Disability and Health(ICF). Methods The competence of assistive technology workers was discussed based on the ICF,RCF and the service needs of modern assistive devices and technology,and the undergraduate curriculum courses of rehabilitation assistive technology were developed referring to the national vocational competence standards. Results Referring to the national vocational competence standards,the entry-level competence of assistive technology workers was developed based on ICF and RCF.The objectives of undergraduate education were set.Moreover,the undergraduate curriculum courses and core course of assistive technology were developed. Conclusion The undergraduate curriculum courses of assistive technology are developed using ICF and RCF.This will help improve the quantity and competency of rehabilitation assistive technology workers and increase the access for people with disabilities to obtain assistive technology.

The neural circuit is the material carrier for the realization of brain function,consisting of a complex network of different neurons.Neural circuit identification technology tracks the structure and activity of specific neural circuits,to study their adequacy and necessity for brain function,which is crucial for understanding the pathogenesis of brain diseases.As a high-tech tool in the fields of neuroscience and brain science,neural circuit identification technology has been gradually introduced into basic traditional Chinese medicine(TCM)research in recent years.This systematic review considers the principles of neural circuit identification technology and progress in its application in the field of TCM neuroscience.We note that future developments in this field should be based on the overall concept of TCM characteristics and the design of syndrome differentiation and treatment.Further research on the neural circuit mechanisms of diverse method of TCM in diseases will help to promote the deep integration of TCM and modern neuroscience.

Objective:To investigate the clinical manifestations and 18F-FDG PET/CT imaging features of hilar tumor pulmonary infarction. Methods:From July 2016 to June 2021, 49 patients (40 males, 9 females; age 32-81 years) with hilar tumor pulmonary infarction who underwent PET/CT and enhanced CT in the second Hospital of Shandong University and Shandong Cancer Hospital and Institute, Shandong First Medical University were retrospectively enrolled. All patients were diagnosed by imaging follow-up or pathology. Clinical features and 18F-FDG PET/CT imaging features were analyzed. Results:A total of 108 infarcts were found in 49 patients by 18F-FDG PET/CT. Small cell carcinoma was the most common hilar tumor (67.35%, 33/49). The most common clinical manifestations of hilar tumor pulmonary infarction were cough (69.39%, 34/49) and hemoptysis (34.69%, 17/49). Pulmonary infarction was mainly multiple (69.39%, 34/49), and multiple lung lobes might be involved. The CT morphology of infarcts was wedge-shaped (46.30%, 50/108) or patchy (53.70%, 58/108), and the density was mainly bubble consolidation (61.11%, 66/108). There were 91 (84.26%, 91/108) infarcts showing FDG hypermetabolism, with the SUV max of 1.48-6.62, and the hypermetabolism mode was rim sign (36.11%, 39/108) or heterogeneous hypermetabolism (48.15%, 52/108). Nineteen patients (38.78%, 19/49) were complicated with pulmonary vein involvement, and 26 patients (53.06%, 26/49) had ipsilateral pleural effusion. Conclusions:Hilar tumor pulmonary infarction is characterized by cough. It is helpful for the diagnosis of hilar tumor pulmonary infarction in patients with hilar tumor when wedge-shaped, bubble consolidation, rim sign and heterogeneous hypermetabolism lesions are found in 18F-FDG PET/CT images.

Spinocerebellar ataxia (SCA) is a group of highly heterogeneous autosomal dominant genetic disease, including many subtypes. SCA11 is a rare subtype of SCA, and is caused by mutant TTBK2 gene. A case of SCA11 was reported in this article. Whole exome sequencing showed that there was a c.1284dupA frameshift mutation in TTBK2 gene. Literature review found that only 6 pedigrees of SCA11 have been reported, but the mutation site of this case is a novel identified mutation that has not been reported in the Human Gene Mutation Database.

An increased level of reactive oxygen species is a key factor in neuronal apoptosis and epileptic seizures. Irisin reportedly attenuates the apoptosis and injury induced by oxidative stress. Therefore, we evaluated the effects of exogenous irisin in a kainic acid (KA)-induced chronic spontaneous epilepsy rat model. The results indicated that exogenous irisin significantly attenuated the KA-induced neuronal injury, learning and memory defects, and seizures. Irisin treatment also increased the levels of brain-derived neurotrophic factor (BDNF) and uncoupling protein 2 (UCP2), which were initially reduced following KA administration. Furthermore, the specific inhibitor of UCP2 (genipin) was administered to evaluate the possible protective mechanism of irisin. The reduced apoptosis, neurodegeneration, and spontaneous seizures in rats treated with irisin were significantly reversed by genipin administration. Our findings indicated that neuronal injury in KA-induced chronic epilepsy might be related to reduced levels of BDNF and UCP2. Moreover, our results confirmed the inhibition of neuronal injury and epileptic seizures by exogenous irisin. The protective effects of irisin may be mediated through the BDNF-mediated UCP2 level. Our results thus highlight irisin as a valuable therapeutic strategy against neuronal injury and epileptic seizures.
Rats ; Animals ; Kainic Acid/toxicity* ; Brain-Derived Neurotrophic Factor/metabolism* ; Fibronectins/metabolism* ; Hippocampus/metabolism* ; Rats, Sprague-Dawley ; Epilepsy/metabolism* ; Seizures/prevention & control*

Objective:To evaluate the effects of pulmonary rehabilitation on anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) .Methods:The RCTs on application effects of pulmonary rehabilitation in COPD patients were searched in Cochrane Library, Medline, PsycINFO, PubMed, Web of Science, Embase, China Biology Medicine disc, CNKI, Wanfang Database and VIP Database from the establishment of those databases to August 1, 2020. Quality assessment and data extraction were performed for the included articles, and Meta-analysis was performed using Stata 14.0 and RevMan 5.3 software.Results:A total of 14 articles were included, including 1 106 patients. Meta-analysis results showed that pulmonary rehabilitation therapy was helpful to improve the symptoms of depression [ SMD= -0.79, 95% CI (-0.94--0.64) , P<0.01]and anxiety [ SMD=-0.61, 95% CI (-0.82--0.41) , P<0.01]in COPD patients. The results of subgroup analysis showed that the relief degree of depression and anxiety of patients in the intervention group was statistically significantly different from those of the control group ( P<0.01) when the intervention was longer than 3 months or less than or equal to 3 months. Conclusions:Pulmonary rehabilitation can improve the depression and anxiety of COPD patients, and the results of intervention for more than 3 months and less than or equal to 3 months are consistent. Combining the actual clinical situation, the shortest intervention time of 3 months can be used for intervention in order to obtain more ideal intervention effect.

Objective:To investigate the clinical application value of amplitude-integrated electroencephalogram (aEEG) in evaluating the prognosis of brain function in children with disturbance of consciousness.Methods:A total of 100 children with disturbance of consciousness admitted to the pediatric intensive care unit (PICU) in the Third Affiliated Hospital of Zhengzhou University from October 2018 to September 2019 were enrolled.All patients completed aEEG and video electroencephalogram (vEEG) (monitoring hours≥ 6 h), modified Glasgow coma scale (GCS) rating, peripheral blood brain injury marker S100β protein and neuron-specific enolase (NSE) detection within 48 hours of admission.The prognosis was evaluated based on the above results.The actual prognosis of the children was recorded by telephone follow-up based on the pediatric cerebral performance category score (PCPC) until 6 months of onset or clinical death.The receiver operating characteristic curve (ROC) was used to analyze and compare the clinical efficacy of aEEG, vEEG, improved GCS, S100β protein, and NSE in evaluating the prognosis of brain function in children with disturbance of consciousness. Kappa consistency test was made to evaluate the correlation between the estimated prognosis and the actual prognosis. Results:The area under the ROC curve (AUC) of aEEG, vEEG, improved GCS, S100β protein and NSE was 0.847, 0.810, 0.729, 0.685 and 0.784, respectively, indicating the five methods had statistically significant value in evaluating the prognosis of brain function (all P<0.05). Taking the Z value as the gold standard, the clinical efficacy of aEEG in evaluating the prognosis of brain function was significantly different from that of S100β ( Z>1.96, P<0.05), but showed no significant difference with that of other 3 methods.Using the best cut-off value as the gold standard for evaluating the prognosis, aEEG had the highest sensitivity to evaluate a poor prognosis (90.5%). The Kappa consistency test showed that the prognosis predicted by aEEG was consistent with the actual prognosis ( Kappa=0.550, P<0.01). Conclusions:aEEG has a good evaluation value for the brain function prognosis of children with disturbance of consciousness.aEEG has high sensitivity, and the predicated prognosis is consistent with the actual clinical prognosis, so it can be widely used in the diagnosis and treatment of PICU.

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.

Objective? To explore the status quo of nursing masters' core competence and to analyze its influencing factors. Methods? Totally 350 full-time schooling nursing masters from 7 universities from Shandong Province, Guangxi Zhuang Automatous Region, Jilin Province, Yunnan Province, Xinjiang Uygur Automatous Region, Tianjin Municipality and Liaoning Province and 140 nursing teachers from 5 teaching hospitals for nursing masters were selected by convenient sampling between March and October 2018. Nursing masters were investigated with the Core Competence Self-rating Scale for Nursing Masters (CCSRS-NM), while nursing teachers were investigated with the Nurse Master-administered Rating Scale (NMARS). A total of 350 questionnaires were distributed to the master of nursing, 332 valid questionnaires were obtained, 140 questionnaires were distributed to the teachers, and 128 valid questionnaires were obtained. SPSS 17.0 was used for statistical analyses. Multivariate linear regression analysis was employed to explore the influencing factors. Results? The CCSRS-NM score of 332 nursing masters totaled (174.67±23.45); the total NMARS score of 128 nursing teachers was (203.10±26.85). Univariate analysis showed that there were statistical differences in CCSRS-NM scores between nursing masters with different sex, grade, frequent presence at seminars, type of training, time of theoretical learning, published papers or not, attitude to nursing and guidance of supervisors (F/t=2.024, 7.306, 2.375, 2.534, -4.780, 3.792, 11.983, 7.454; P＜0.05); there were statistical differences in NMARS scores between nursing teachers with different age, length of service, professional title, educational background and qualified as supervisors or not (F/t=4.305, 4.696, 6.307, 2.330, -2.226;P＜0.05). According to multivariate analysis, nursing masters' attitude to nursing, time of theoretical learning, guidance of supervisors, sex, published papers or not and grade were the factors influencing nursing masters' core competence (P＜ 0.05); Length of service, professional title and qualified as supervisors or not were the influencing factors to nursing teachers' NMARS scores (P＜ 0.01). Conclusions? The core competence of nursing masters stands at an intermediate level, and nursing teachers' evaluation is higher than nursing masters' self-evaluation. Nursing masters' core competence may be enhanced by strengthening professional attitude education, increasing time of theoretical learning, intensifying supervisors' guidance, encouraging male candidates to study as a nursing major and encouraging nursing masters to publish papers, and reinforcing the communication and exchange between students at different grades. Evaluation of nursing masters' core competence should involve teachers and supervisors with different length of service and professional title.