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This meta-analysis aimed to systematically evaluate the effects of positive psychological interventions on anxiety, depression, stress, mindfulness, hope, quality of life, and disease activity, as well as inflammation biomarkers, in patients with inflammatory bowel disease. Databases such as Cochrane Library, PubMed, EBSCO, Embase, Web of Science, China Biomedical Literature Database, China Knowledge Network, and WANFANG DATA were searched by two researchers from the time of each database's creation to November 2022. A total of 14 randomized controlled trials (RCTs) with 1,191 patients were included. The results showed that positive psychological interventions were effective in reducing anxiety (standardized mean difference [SMD] = -0.81, 95% confidence interval [CI] [-1.33, -0.30], p = .002), depression (SMD = -0.86, 95% CI [-1.32, -0.41], p = .0002), and stress (SMD = -0.68, 95% CI [-1.05, -0.31], p = .0003), and significantly increased the level of hope (weighted mean difference [WMD] = 3.26, 95% CI [0.84, 5.68], p = .008), mindfulness (SMD = 0.59, 95% CI [0.30, 0.88], p < .0001), and quality of life (SMD = 0.61, 95% CI [0.09, 1.14], p = .02) of patients with inflammatory bowel disease. This suggests that positive psychological interventions can significantly improve positive psychology and reduce negative emotions in patients with inflammatory bowel disease.

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Soil heavy metal pollution poses a serious threat to food security, human health, and soil ecosystems. Based on 644 soil samples collected from a typical oasis located at the eastern margin of the Tarim Basin, a series of models, namely, multiple linear regression （LR）, neural network （BP）, random forest （RF）, support vector machine （SVM）, and radial basis function （RBF）, were built to predict the soil heavy metal content. The optimal prediction result was obtained and utilized to analyze the spatial distribution features of heavy metal contamination and relevant health risks. The outcomes demonstrated that： ① The average Cd content in the study area was 0.14 mg·kg-1, which was 1.17 times the soil background value of Xinjiang, making it the primary factor of soil heavy metal contamination in the area. Additionally, the carcinogenicity risk coefficients of Cd for both adults and children were less than 10-4, indicating that there were no significant long-term health risks for humans in the area. ② The estimation accuracies of the five inversion models were compared, and the validation set of the RF model had an R2 value of 0.763 7, which was the highest among the five models. Additionally, the RMSE, MAE, and MBE of the RF model were the smallest among the five models. Therefore, the predicted values of the RF model were most consistent with the measured values of the soil Cd content. The predicted map of soil Cd distribution derived from the RF model coincided best with the interpolation map. ③ The RF model outperformed the other four models in predicting health risks associated with the soil Cd element for both adults and children, resulting in better prediction results. Comparatively, the predicted values of the LR model in the validation set varied greatly, leading to unreliable results. It was demonstrated that the RF was the best model for predicting soil Cd content and evaluating health risks in the study area, considering its superior generalization capability and anti-overfitting ability.

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Background: Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined. Methods: The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model. Results: The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=-0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=-0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients. Conclusions: The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

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BACKGROUND: Health-related quality of life (HRQOL) has increasingly been accepted as a supplementary outcome measure for patients before and after lung transplantation (LT). This longitudinal study was conducted to recognize the tracks of HRQOL during the first year after transplantation and the main factors associated with HRQOL of LT recipients. The research was conducted in accordance with the 2000 Declaration of Helsinki and the Declaration of Istanbul 2008. The transplant organs were from volunteer donation, and next of kin provided written informed consents of their own free will. No prisoners were used, and donors were neither paid nor coerced. METHODS: A total of 118 patients were investigated before and 3, 6, 9, and 12 months post-transplantation. The Medical Outcomes SF-36 (Chinese version) was used to measure the HRQOL. The recipients' demographic characteristics and clinical data were evaluated to determine the relative contributions to HRQOL outcomes. RESULTS: Recipients reported a mean physical component summary of 39.62 ± 6.57, 57.90 ± 9.99, 59.15 ± 8.73, 58.79 ± 8.52, and 58.72 ± 8.99 before transplantation and at 3, 6, 9, and 12 months after LT (F = 64.960, P < .001). By 3 months after transplant, patients experienced significant improvement in physical component summary (MD = 18.27, SE = 1.52, P < .001); but between 3 and 12 months, no significant improvement was observed (MD = 0.82, SE = 1.77, P = .645). Patients reported a continuous rise with means of 44.63 ± 5.35, 51.13 ± 10.25, 51.92 ± 9.72, 53.23 ± 10.34, and 55.40 ± 8.83 for the mental component summary before LT and at 3, 6, 9, and 12 months after transplant (F = 13.059, P < .001). By 3 months after transplant, patients experienced significant improvement in mental component summary (MD = 6.50, SE = 1.50, P < .001). Between 3 and 12 months, a continuous significant improvement was observed (MD = 4.27, SE = 1.92, P = .030). The generalized estimated equation showed that age, marital status, residence, disease diagnosis, transplant type, sleep disorders, gastrointestinal complications, and BODE index (body mass index, obstruction, dyspnea, exercise) were all found to be related to HRQOL. CONCLUSION: The HRQOL of LT patients improved significantly at 3 months after transplantation, but between 3 and 12 months after transplantation, the changes were not obvious. Health practitioners should pay more attention to elderly patients, unmarried patients, patients living in urban areas, patients diagnosed with pneumoconiosis, patients with left single-lung transplantation, patients with sleep disorders, patients with high BODE indexes, and patients with gastrointestinal complications.

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BACKGROUND: Early rehabilitation has been proved very important for stroke patients. However, the effective model of transitioning from early in-hospital rehabilitation to discharge rehabilitation using the collaborative remote rehabilitation nursing model has not been thoroughly studied. OBJECTIVE: To explore the feasibility and effectiveness of collaborative care model based telerehabilitation exercise training for acute stroke patients. METHODS: A randomized controlled clinical trial was conducted. Patients were recruited and randomly divided into intervention and control group. Both groups were given regular treatment and acute rehabilitation nursing instructions during hospitalization. The control group was followed by regular telephone follow-up after discharge. The intervention group received Internet-based remote rehabilitation project after discharge. Motor function, balance ability and quality of life were measured at the day of discharge, the 4th week, 8th week and 12th week after patients were discharged. The CONSORT checklist was used to check the procedure. RESULTS: A total of 61 patients completed the study, 30 cases in the intervention group and 31 cases in the control group. Both groups were significantly improved in terms of motor function and quality of life, but the intervention group showed greater improvement in Fugl-Meyer Motor Function Assessment (intervention group = 83.70 ± 4.44, control group = 75.29 ± 2.89), Berg Balance Scale (intervention group = 43.13 ± 2.32, control group = 38.29 ± 2.70) and Stroke-Specific Quality of Life Scale (intervention group = 190.57 ± 5.09, control group = 175.90 ± 5.78). Group-time interaction was significant in motor function and quality of life. CONCLUSION: Collaborative care model based telerehabilitation exercise training program can safely and effectively improve the recovery of motor function and improve the quality of life in patients with stroke.

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BACKGROUND: Evidence regarding social support in patients is mostly from cross-sectional studies. Very few studies have focused on the change in social support systems before and after hematopoietic stem cell transplantation. METHODS: A total of 191 patients were investigated before transplantation and at 30, 90 and 180 days post-transplantation. The social support for patients was evaluated by the Perceived Social Support Scale (PSSS). RESULTS: The overall PSSS scores showed a continuous decline in means from 71.29 ± 9.73 before the transplantation to 69.44 ± 10.61, 68.73 ± 10.04, and 66.37 ± 12.02 at 30, 90 and 180 days post-transplantation, respectively. In comparison to the baseline, the overall PSSS scores decreased significantly at 90 and 180 days post-transplantation (P < .05). The Generalized Estimated Equation (GEE) analysis found that patients with no transplant-related complications, higher household income, and better educational status had preferable social support. CONCLUSION: Social support presented a marked downward trend during the six month period. Patients with no transplant-related complications, higher household income and better educational status had preferable social support. Therefore, social support as a high-priority quality of life should be given close attention in the early phase of transplantation. Positive measures should be taken to improve social support in the early phase of transplantation especially among individuals undergoing this procedure for the first time.

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AIM: To identify the characteristics of fear of cancer recurrence (FCR) in breast cancer patients after surgery and investigate the relationship of FCR with demographic and medical characteristics, quality of life (QOL) and social support. METHODS: The short version of the Fear of Progression Questionnaire (FoP-Q-SF), the functional assessment of cancer therapy for breast cancer (FACT-B) and the Social Support Rating Scale were administered to the 342 breast cancer patients who had undergone surgical treatment. The analysis was performed to determine potential predictors associated with FCR. RESULTS: Of the 465 patients, 342 (73.5%) agreed to take part in the study. The mean age of participants was 51.46 ± 10.50 years (range, 30-81). Of the 342 participants, 92 (26.9%) cases were at Stage I, 131 (38.3%) cases at Stage II, 34 (9.9%) patients at Stage III and 85 (24.9%) patients at Stage IV. Among the 12 items of the FoP-Q-SF, the three greatest fears were: Item 10 'Worrying that medications could damage the body', Item 1 'Being afraid of disease progression' and Item 2 'Being nervous prior to doctors' appointments or periodic examinations'. About 68.4% of patients reported the dysfunctional level of fear of progression. Multiple linear regression analysis showed that religious belief, family income, disease stages, social support, QOL were identified as independent predictors for FCR. CONCLUSION: We found that FCR is prevalent in postoperative breast cancer patients, and is influenced by many factors. It is necessary to implement positive intervention measures to alleviate the FCR and improve the QOL of patients.

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BACKGROUND: The correlation between social support and health-related quality of life (HRQOL) has been well documented, but whether social support changes or whether social support consistently plays a significant role in the various phases of the treatment process remains unknown among hematopoietic stem cell transplantation (HSCT) patients. OBJECTIVES: The aims of this study were to assess the changing trends of HRQOL and social support and evaluate the relationship between HRQOL and social support before and after transplantation. METHODS: Measures were completed by 122 HSCT patients before and after transplantation. The measures administered included the Perceived Social Support Scale and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant questionnaire. RESULTS: The social support score presented a marked downward trend (F = 17.090, P < .001). The overall HRQOL was the lowest, 103.61 (SD, 19.14) at 1 month and increased steadily over time to 108.10 (SD, 19.58) at 3 months and 110.02 (SD, 18.00) at 6 months after HSCT. The generalized estimating equation models showed that social support consistently had a positive impact on HRQOL in the 6-month period post-HSCT. CONCLUSION: We confirmed a significant positive association between social support and HRQOL in HSCT recipients. However, it is noteworthy that the social support score declined during the 6-month period even while the HRQOL scores were increasing. IMPLICATIONS FOR PRACTICE: Social support is closely related to the HRQOL; thus, clinicians should give close attention to social support to improve the HRQOL of HSCT patients. Social support should not be overlooked during the first 6 months after transplantation.

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OBJECTIVES: The objective of this meta-analysis is to systematically review the evidence on effects of exercise interventions in comparison to usual care with respect to physical fitness, fatigue, quality of life, anxiety and depression in hematopoietic stem cell transplantation patients for a hematological malignancies. And we are more focused on the optimal opportunity to exercise in hematopoietic stem cell transplantation recipients. METHOD: Databases were searched up to June 2018. We included randomized controlled trials comparing exercise with usual care in adult patients who had a hematologic malignancy. Standard mean differences were calculated and pooled to generate summary effect sizes and 95% confidence intervals. The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality of the studies. RESULTS: This meta-analysis showed that exercise had a positive effect on lower muscle strength, fatigue and quality of life and had no effects on patients' cardiorespiratory fitness, upper muscle strength, psychosocial fitness and adverse events. Subgroup analysis showed that exercise had a favorable effect on upper/lower muscle strength, fatigue and quality of life when starting exercise pre-transplant, but exercise had no effects, except on quality of life when starting exercise after transplant. And patients in the pre-transplant exercise group did not exercise more graft vs host disease events nor deaths. CONCLUSION: Therefore, we can conclude that the optimal timing for the hematopoietic stem cell transplantation recipients to begin exercise training is before transplantation.

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OBJECTIVES: The aim of our longitudinal study was to explore changes in HRQOL over a 6-month period and to identify factors associated with the HRQOL of HSCT recipients. METHOD: Our study comprised 191 HSCT patients; their data were collected before transplantation and at 30, 90, and 180 days posttransplantation. The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire was used to assess HRQOL.We also evaluated the patients' demographic characteristics and clinical histories to determine the relative contributions of these factors to HRQOL outcomes. RESULTS: Before HSCT, the patients reported a mean overall HRQOL of 110.31 (SD, 14.99); this reached a minimum of 105.07 (SD, 18.85) at day 30 after HSCT and increased steadily over time to 106.71 (SD, 18.34) at day 90 and 108.16 (SD, 18.34) at day 180 after HSCT.Compared with baseline, overall HRQOL changed with the mean of -5.24 (SE 1.55; P = .001), and -3.60 (SE 1.55; P = .022), respectively, at 30 days and 90 days after HSCT. Overall HRQOL returned to near pretransplant levels at 180 days after HSCT (SE 1.47; P = .146).Generalized estimating equation (GEE) models showed that household income (ß = 6.590; P < .001), transplant-related complications (ß = -6.101; P < .001), and patient age (ß = 0.243, P = .045) were associated with HRQOL. CONCLUSION: The patients' overall HRQOL was severely impaired in the early stages of posttransplantation, and patients experienced the worst HRQOL at 30 days. They had improved significantly by 180 days posttransplantation. We also found that household income, transplant-related complications, and age were independent predictors of early HRQOL.We therefore concluded that the HRQOL of HSCT patients in the early stages posttransplantation deserved more attention.

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BACKGROUND: A vaccine for enterovirus 71 (EV71) is needed to address the high burden of disease associated with infection. We assessed the efficacy, safety, immunogenicity, antibody persistence, and immunological correlates of an inactivated alum-adjuvant EV71 vaccine. METHODS: We did a randomised, double-blind, placebo-controlled, phase 3 trial. Healthy children aged 6-35 months from four centres in China were randomly assigned (1:1) to receive vaccine or alum-adjuvant placebo at day 0 and 28, according to a randomisation list (block size 30) generated by an independent statistician. Investigators and participants and their guardians were masked to the assignment. Primary endpoints were EV71-associated hand, foot, and mouth disease (HFMD) and EV71-associated disease during the surveillance period from day 56 to month 14, analysed in the per-protocol population. This study is registered with ClinicalTrials.gov, number NCT01508247. FINDINGS: 10,245 participants were enrolled and assigned: 5120 to vaccine versus 5125 to placebo. 4907 (with three cases of EV71-associated HFMD and eight cases of EV71-associated disease) versus 4939 (with 30 cases of EV71-associated HFMD and 41 cases of EV71-associated disease) were included in the primary efficacy analysis. Vaccine efficacy was 90·0% (95% CI 67·1-96·9) against EV71-associated HFMD (p=0·0001) and 80·4% (95% CI 58·2-90·8) against EV71-associated disease (p<0·0001). Serious adverse events were reported by 62 of 5117 (1·2%) participants in the vaccine group versus 75 of 5123 (1·5%) in the placebo group (p=0·27). Adverse events occurred in 3644 (71·2%) versus 3603 (70·3%; p=0·33). INTERPRETATION: EV71 vaccine provides high efficacy, satisfactory safety, and sustained immunogenicity. FUNDING: China's 12-5 National Major Infectious Disease Program, Beijing Vigoo Biological.

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