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To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group ( n  = 35) and the control group ( n  = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group ( p  < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group ( p  < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group ( p  < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

Background: Cold-inducible RNA-binding protein (CIRP or hnRNP A18) is a multifunctional stress-responsive protein. Our previous study demonstrated that cold stress increased CIRP expression and migrated from the nucleus to the cytoplasm in airway epithelial cells. However, the mechanism through which CIRP migrates from the nucleus to the cytoplasm upon cold stress remains unknown., Methods: The expression of CIRP in the bronchial epithelium was examined using immunofluorescence, real-time polymerase chain reaction (RT-PCR), and Western blotting. The expression of inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) were detected by ELISA and RT-PCR. Transient receptor potential melastatin 8 (TRPM8) receptor function was characterized by Ca 2+ imaging., Results: Cold stress upregulated the expression of CIRP, inflammatory factors and promoted the translocation of CIRP from the nucleus to the cytoplasm in normal human bronchial epithelial (NHBE) cells. Cold stress activated the TRPM8/(Ca 2+ )/PKCα/glycogen synthase kinase 3β (GSK3β) signaling cascade, and that inhibition of this signaling pathway attenuated the migration of CIRP from the nucleus to cytoplasm but did not decrease its overexpression induced by cold stress. Knocked down CIRP expression or blocked CIRP migration between the nucleus and cytoplasm significantly decreased inflammatory factor expression., Conclusions: These results indicate that cold stress leads to the migration of CIRP from the nucleus to the cytoplasm with alteration of expression, which are involved in the expression of inflammatory factors (IL-1β, IL-6, IL-8 and TNF-α) induced by cold air, through TRPM8/Ca 2+ /PKCα/GSK3β signaling cascade., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/atm-21-4447). All authors report a grant from the National Natural Science Foundation of China (No. 81660010 and 81611530713). The authors have no other conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)

The nitrogen-doped carbon nanoparticles (N-CNPs) has a high potential of increasing nitrogen efficiency in farmland. However, little has been known about the effects of N-CNPs on soil microbial communities. In this study, paddy rhizosphere samples were collected from soils being treated with different nitrogen-doped amount of carbon nanoparticles (low, 1.2%, N-CNPs1; medium, 6.7%, N-CNPs2; high, 9.3%, N-CNPs3) for three years. We analyzed the bacterial community structure and diversity using the high-throughput sequencing. PICRUSt gene prediction analysis was used to determine soil community composition and metabolic function. Our results showed that treatment with N-CNPs changed the structure and diversity of soil microbial communities. Soil bacterial community diversity in adding medium amount of nitrogen-doped nanoparticles group (N-CNPs2) was the highest among all the treatments. Crenarchaeota, Acidobacteria and Planctomycetes were the most dominant groups in the soil microbial community. The relative abundances of Crenarchaeota, Acidobacteria and Verrucomicrobia increased, whereas Planctomycetes, Chloroflexi and Nitrospirae decreased with adding N-CNPs. Results of PICRUSt analysis revealed a wide genetic diversity of organisms involved in adding N-CNPs, such as amino acid metabolism, carbohydrate metabolism, lipid metabolism and environmental information processes. Heat map analysis of KEGG demonstrated that adding medium amount of nitrogen-doped nanoparticles (N-CNPs2) group increased the relative abundance of bacterial community associated with soil carbon and nitrogen metabolism.

Aim: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding (OB)., Methods: Consecutive patients between January 1, 2007 and March 1, 2012 were identified retrospectively by reviewing a gastric cancer database at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A follow-up examination was performed on patients who underwent a radical gastrectomy. OB due to gastric cancer included hematemesis, melena or hematochezia, and gastric cancer was confirmed as the source of bleeding by endoscopy. Patients without OB were defined as cases with occult bleeding and those with other initial presentations, including epigastric pain, weakness, weight loss and obstruction. The 3-year overall survival (OS) rate, age, gender, AJCC T stage, AJCC N stage, overall AJCC stage, tumor size, histological type, macroscopic (Borrmann) type, lymphovascular invasion and R status were compared between patients with and without OB. Moreover, we carried out a subgroup analysis based on tumor location (upper, middle and lower)., Results: We identified 939 patients. Of these, 695 (74.0%) were hospitalized for potential radical gastrectomy and another 244 received palliative resection, rerouting of the gastrointestinal tract, chemotherapy, radiotherapy or no treatment due to the presence of unresectable tumors. Notably, there was no significant difference in the percentage of OB patients between resectable cases and unresectable cases (20.3% vs 22.1%, P = 0.541). Follow-up examination was performed on 653 patients (94%) who underwent radical gastrectomy. We found no significant difference in 3-year OS rate (68.2% vs 61.2%, P = 0.143) or clinicopathological characteristics (P > 0.05) between these patients with and without OB. Subgroup analysis based on tumor location showed that the 3-year OS rate of upper gastric cancer was significantly higher in patients with OB (84.6%) than in those without OB (48.1%, P < 0.01) and that AJCC stages I-II (56.4% vs 35.1%, P = 0.017) and T1-T2 category tumors (30.8% vs 13%, P = 0.010) were more frequent in patients with OB than in those without OB. There was no significant difference in 3-year OS rate or clinicopathological characteristics between patients with and without OB (P > 0.05) for middle or lower gastric cancer., Conclusion: Upper gastric cancer patients with OB exhibited tumors at less advanced pathological stages and had a better prognosis than upper gastric cancer patients without OB.

Objective: To analyze the fracture conditions of earthquake casualties, summarize the therapeutic experiences and explore the frontier treatment model., Methods: The clinical data of spot treatment of fracture patients in Wenchun earthquake were collected and analyzed to observe the therapeutic effects of operative patients and to verify the rationality of the cooperated remedy model of unified military and civilian hospitals., Results: Among 236 fracture patients admitted in hospital, there were patients with extremities fractures in 81.3%, multiple fractures in 11.4% and open fractures in 10.6%. In all 55 patients underwent surgical treatment,the functional improvement rate was 65.5% and no infection or amputation happened. Supported by psychological aids, all patients were coordinated with treatment and the short-term outcome was parallel with that of ordinary fracture cases., Conclusion: The general conditions of patients should be paid more attention to during the treatment procedure of fractures because of the great quantity of casualties and severe traumatic conditions in Wenchun earthquake. The cooperated remedy model of unified military and civilian hospitals should be regarded as a new sanitation service practice with certain advantages. Psychological aids can provide strong support for the patients' postoperative rehabilitation.