Immunohistochemical and Morphometric Assessment on the Biological Function and Vascular Endothelial Cells in the Initial Process of Cortical Porosity in Mice With PTH Administration.

To clarify the cellular mechanism of cortical porosity induced by intermittent parathyroid hormone (PTH) administration, we examined the femoral cortical bone of mice that received 40 µg/kg/day (four times a day) human PTH (hPTH) (1-34). The PTH-driven cortical porosity initiated from the metaphyseal region and chronologically expanded toward the diaphysis. Alkaline phosphatase (ALP)-positive osteoblasts in the control mice covered the cortical surface, and endomucin-positive blood vessels were distant from these osteoblasts. In PTH-administered mice, endomucin-reactive blood vessels with TRAP-positive penetrated the ALP-positive osteoblast layer, invading the cortical bone. Statistically, the distance between endomucin-positive blood vessels and the cortical bone surface abated after PTH administration. Transmission electron microscopic observation demonstrated that vascular endothelial cells often pass through the flattened osteoblast layer and accompanied osteoclasts in the deep region of the cortical bone. The cell layers covering mature osteoblasts thickened with PTH administration and exhibited ALP, α-smooth muscle actin (αSMA), vascular cell adhesion molecule-1 (VCAM1), and receptor activator of NF-κB ligand (RANKL). Within these cell layers, osteoclasts were found near endomucin-reactive blood vessels. In PTH-administered femora, osteocytes secreted Dkk1, a Wnt inhibitor that affects angiogenesis, and blood vessels exhibited plasmalemma vesicle-associated protein, an angiogenic molecule. In summary, endomucin-positive blood vessels, when accompanied by osteoclasts in the ALP/αSMA/VCAM1/RANKL-reactive osteoblastic cell layers, invade the cortical bone, potentially due to the action of osteocyte-derived molecules such as DKK1.

Observation of the efficacy of elongated needle therapy in treating patients with â ¢B prostatitis of stagnant dampness-heat syndrome. / 芒针治疗湿热瘀阻证⠢Båž‹å‰åˆ—è ºç‚Žæ‚£è€ çš„ç–—æ•ˆè§‚å¯Ÿ.

OBJECTIVES: To observe the clinical efficacy in patients with ⅢB prostatitis of stagnant dampness-heat syndrome treated with elongated needle therapy. METHODS: A total of 90 patients with ⅢB prostatitis of stagnant dampness-heat syndrome were selected and randomly divided into a treatment group(45 cases, 2 dropped out) and a control group(45 cases, 1 dropped out) using a random number table method. The control group was treated with oral administration of Qianlie Shutong Capsule, 3 capsules per dose, 3 times a day for a total of 4 weeks. The treatment group received elongated needle therapy at Qihai(CV6), Zhongji(CV3), bilateral Zhibian(BL54) and Shuidao(ST28), with one treatment per day for 4 weeks. Before and after treatment, the traditional Chinese medicine syndrome score, National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI) score were compared between the two groups, and the clinical efficacy was compared after treatment. RESULTS: Compared with that before treatment, the control group showed significant decrease in traditional Chinese medicine syndrome score, testicular pain, urinary frequency, unending remnants of urine, scrotal wetness, yellowish urine, urinary symptoms, and quality of life scores after treatment(P<0.05)；the treatment group showed significant decrease in traditional Chinese medicine syndrome score, and perineal pain, groin pain, pelvic pain, testicular pain, scrotal wetness, yellowish urine scores, NIH-CPSI total score, pain symptoms, urinary symptoms, and quality of life scores after treatment(P<0.05). After treatment, the treatment group showed significantly lower traditional Chinese medicine syndrome score, and perineal pain, groin pain, pelvic pain, testicular pain scores, NIH-CPSI total score, pain symptoms, and quality of life scores than those of the control group(P<0.05). The effective rate in the treatment group (63.64%, 28/43) was significantly higher than that in the control group (88.37%, 38/44, P<0.05). CONCLUSIONS: Elongated needle therapy can significantly improve the traditional Chinese medicine syndrome score, NIH-CPSI total score, and pain symptom scores in patients with ⅢB prostatitis of stagnant dampness-heat syndrome. It can significantly improve the cure rate in these patients and is particularly effective in relieving pain.

Giant Parotid Abscess With Significant Skin Necrosis: A Case Report.

Poor blood glucose control is a common predisposing factor for parotid abscesses; however, extensive skin necrosis secondary to parotid abscesses has rarely been reported. In this article, we present the case of a 70-year-old man with poor glycemic control admitted to our hospital with swelling, congestion, and pain in the right parotid region that had gradually increased over 15 days prior to presentation. Based on the clinical, imaging, and laboratory findings, the patient was diagnosed with a giant parotid abscess with extensive skin necrosis caused by Klebsiella pneumoniae. The abscess responded poorly to long-term treatment with intravenous broad-spectrum antibiotics, and the patient underwent daily Bacillus exchange with blood glucose level management and electrolyte monitoring via routine blood tests. At the 3 month follow-up, complete resolution of the right parotid gland abscess and skin rupture was observed.

Verbalized arithmetic principles correlate with mathematics achievement.

BACKGROUND: When mathematical knowledge is expressed in general language, it is called verbalized mathematics. Previous studies on verbalized mathematics typically paid attention to mathematical vocabulary or educational practice. However, these studies did not exclude the role of symbolic mathematics ability, and almost no research has focused on verbalized mathematical principles. AIMS: This study is aimed to investigate whether verbalized mathematics ability independently predicts mathematics achievement. The current study hypothesized that verbalized mathematics ability supports mathematics achievement independent of general language, related cognitive abilities and even symbolic mathematical ability. SAMPLE: A sample of 241 undergraduates (136 males, 105 females, mean age = 21.95, SD = 2.38) in Beijing, China. METHODS: A total of 12 tests were used, including a verbalized arithmetic principle test, a mathematics achievement test, and tests on general language (sentence completion test), symbolic mathematical ability (including symbolic arithmetic principles test, simple arithmetic computation and complex arithmetic computation), approximate number sense ability (numerosity comparison test) and several related cognitive covariates (including the non-verbal matrix reasoning, the syllogism reasoning, mental rotation, figure matching and choice reaction time). RESULTS: Results showed that the processing of verbalized arithmetic principles displayed a significant role in mathematics achievement after controlling for general language, related cognitive abilities, approximate number sense ability and symbolic mathematics ability. CONCLUSIONS: The results suggest that verbalized mathematics ability was an independent predictor and provided empirical evidence supporting the verbalized mathematics role on achievement as an independent component in three-component mathematics model.

The structure correspondence hypothesis predicts how word and sentence in language correlate with term and principle in mathematics.

The association between language and mathematics is an important debated topic. Here, we proposed a structure correspondence hypothesis to explain under what conditions language and mathematics are closely related. According to the hypothesis, there would be an association when they have equivalent structure. One hundred and fifty high school students were recruited to finish mathematical and language tests at the element level (i.e., geometric term processing and word analogy) and at the low-dimensional combination level (i.e., geometric principle processing and sentence completion) as well as the tests to measure cognitive covariates (general intelligence and spatial processing). After controlling for age, gender and cognitive covariates, geometric term processing and word analogy were closely correlated, and geometric principle processing and sentence completion were significantly correlated. No other correlations were found. The results support the structure correspondence hypothesis and provide a new perspective of structure of language and verbalized mathematics for the relation between language and mathematics.

Peer victimization and children's internet addiction in China: a moderated mediation model.

Background: Peer victimization used to be considered as a crucial risk factor for children addicted to the internet. Whereas some victimized ones are function better than would be expected. Variability across individuals indicates that it is necessary to understand how children cope with being bullied and why they do not exhibit maladaptive outcomes. Objective: We explored the underlying mechanisms by testing whether subjective well-being was a mediator between peer victimization and Internet addiction and whether the mediation effects conditioned on the levels of parent-child relationship (PCR). Methods: Data were collected from 65, 868 elementary school students in China (Mage = 9.56 years, SD = 0.62, 54.0% male) using four questionnaires. Results: We found that: (1) subjective well-being can partially mediate the relationship of the two variables; and (2) PCR can moderate direct path and second half of the intermediary process. These moderating effects were stronger for children with higher PCR vs. lower PCR, as a strong PCR can help children to deal with intense emotions and to access effective resources to obtain support. Conclusion: This study deepens our understanding of how peer victimization leads to internet addiction, identifies a supportive PCR as a crucial factor that strengthens the resilience of child victims, and highlights the value of focusing on improving the relationship between parents and children in intervening internet addiction related to peer victimization.

Enabling giant thermopower by heterostructure engineering of hydrated vanadium pentoxide for zinc ion thermal charging cells.

Flexible power supply devices provide possibilities for wearable electronics in the Internet of Things. However, unsatisfying capacity or lifetime of typical batteries or capacitors seriously limit their practical applications. Different from conventional heat-to-electricity generators, zinc ion thermal charging cells has been a competitive candidate for the self-power supply solution, but the lack of promising cathode materials has restricted the achievement of promising performances. Herein, we propose an attractive cathode material by rational heterostructure engineering of hydrated vanadium pentoxide. Owing to the integration of thermodiffusion and thermoextraction effects, the thermopower is significantly improved from 7.8 ± 2.6 mV K-1 to 23.4 ± 1.5 mV K-1. Moreover, an impressive normalized power density of 1.9 mW m-2 K-2 is achieved in the quasi-solid-state cells. In addition, a wearable power supply constructed by three units can drive the commercial health monitoring system by harvesting body heat. This work demonstrates the effectiveness of electrodes design for wearable thermoelectric applications.

Global burden and trends of three common road injuries from 1990 to 2019 and the implications for prevention and intervention.

BACKGROUND: Analysis on the burden of specific types of road injuries (RIs) in the previous Global burden of disease (GBD) studies is lacking. The present work aimed to analyze the burden of three common RIs using the updated data of the GBD 2019, which would inform policy-making. METHODS: Data on cyclist road injuries (CRIs), motorcyclist road injuries (MRIs), and motor vehicle road injuries (MVRIs) were extracted from the GBD 2019. Trends of age-standardized rate (ASR) were predicted using estimated annual percentage change (EAPC) from 1990 to 2019. RESULTS: Over the past three decades, the global incident ASRs of CRIs and MRIs presented increasing trends, but that of MVRIs declined slightly. However, trends of death and disability adjusted life years (DALYs) caused by three common RIs decreased in most regions and countries. Particularly, trends in ASRs of years of life lost (YLLs) cuased by RIs decreased more pronouncedly than that of years of life lived with disability (YLDs). The burden of three common RIs showed significant social and demographic characteristics. Low-middle and middle socio-demographic index (SDI) areas had a heavy burden of RIs, particularly CRIs and MRIs. However, the high SDI area undertook a relatively low burden, and presented more pronounced downward trends in death and DALYs. CONCLUSIONS: The burden and changing trends of three common RIs were geographically heterogeneous. The findings highlighted that increasing incident trends of RIs needed more cost-effective measures of prevention and intervention.

The novel oncogenic factor TET3 combines with AHR to promote thyroid cancer lymphangiogenesis via the HIF-1α/VEGF signaling pathway.

BACKGROUND: Lymphangiogenesis has been reported to play crucial roles in the metastasis of thyroid cancer (THCA), but despite the significant research on lymphangiogenesis in THCA, the precise regulatory mechanism remains unclear. METHODS: Public databases including the Cancer Genome Atlas (TCGA), TIMER, and UALCAN were used to analyze and visualize the expression of TET3 and AHR in THCA, and the correlation between these molecules were used by TIMER. Additionally, RT-PCR and Western Blot were performed to determine the mRNA and protein expression of related proteins. Plate colony formation, wound healing, cell cycle, apoptosis, angiogenesis and transwell assay were used to examine the ability of proliferation, movement, lymphangiogenesis, migration and invasion of THCA cells. RESULTS: Analysis of the TCGA database revealed higher expression levels of TET3 and AHR in tumor tissue compared to normal tissue in THCA. Additionally, a strong correlation was observed between TET3 and AHR. UALCAN database demonstrated that high expression of TET3 and AHR was associated with advanced THCA TNM stages in THCA patients. Furthermore, TET3 activation accelerated THCA cell proliferation by inducing G2/M phase arrest and suppressing apoptosis, while AHR inactivation reduced THCA cell proliferation by decreasing G2/M phase arrest and promoting apoptosis in vitro. Notably, both TET3 and AHR significantly enhanced THCA cell lymphangiogenesis, migration and invasion. Moreover, TET3 activation and AHR inactivation regulated HIF-1α/VEGF signaling pathway, which ultimately, blocked the HIF-1α/VEGF in THCA cells and impaired their movement, migration and invasion abilities. CONCLUSIONS: The combined action of TET3 and AHR to promote lymphangiogenesis in THCA through the HIF-1α/VEGF signaling pathway, and targeting them might provide a potential treatment strategy for THCA.

Meta-Analysis of Effects of Early Palliative Care on Health-Related Outcomes Among Advanced Cancer Patients.

BACKGROUND: Early palliative care (PC) has received more attention for improving health-related outcomes for advanced cancer patients in recent years, but the results of previous studies are inconsistent. OBJECTIVES: This study aimed to use meta-analysis and trial sequence analysis to evaluate the effect of early PC on health-related outcomes of advanced cancer patients. METHODS: All English publications were searched in PubMed, Web of Science, Embase, and the Cochrane Library from inception to March 2023, with a restriction that the study type was a randomized controlled trial. RESULTS: The results showed that early PC positively affected quality of life, satisfaction with care, and symptom burden reduction. However, early PC had no significant effect on anxiety or survival. Trial sequence analysis results showed that the effect of early PC on the quality of life was stable. DISCUSSION: This systematic review suggested that early PC could positively affect health-related outcomes for advanced cancer patients. Early PC can be used widely in clinical settings to improve health-related outcomes of advanced cancer. However, because of the trial sequence analysis results, further well-designed, clinical, randomized controlled trials with larger sample sizes are necessary to draw definitive conclusions.

Different cognitive mechanisms used for solving open and closed math problems.

Problem-solving skills are very important in our daily life. Almost all problem-solving studies have addressed the cognitive correlates of solving closed problems, but only limited studies have investigated the cognitive mechanisms of solving open problems. The current study aimed to systematically examine differences between the cognitive mechanisms used for solving open and closed problems. In total, the abilities of 142 high school students to solve open and closed problems were assessed, as were a series of general cognitive abilities as controlled variates. Analogical reasoning uniquely contributed to solving both open and closed math problems, after controlling for age, gender, and inductive reasoning. Reactive cognitive flexibility (measured using the Wisconsin card sorting test) and spatial working memory uniquely correlated only with solving open and closed math problems, respectively. These findings suggest that the cognitive processes used to solve open and closed math problems differ. Open and closed math problems appear to require more reactive cognitive flexibility for generation and more memory for retrieval, respectively.

Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control.

BACKGROUND: Asbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. METHODS: Data on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. RESULTS: Globally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990-2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being -0.29 (95 % confidence interval [CI]: -0.43, -0.14) and -0.27 (95%CI: -0.53, -0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. CONCLUSIONS: Decreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.

Implications of Below-Ground Allelopathic Interactions of Camelina sativa and Microorganisms for Phosphate Availability and Habitat Maintenance.

Toxic breakdown products of young Camelina sativa (L.) Crantz, glucosinolates can eliminate microorganisms in the soil. Since microorganisms are essential for phosphate cycling, only insensitive microorganisms with phosphate-solubilizing activity can improve C. sativa's phosphate supply. In this study, 33P-labeled phosphate, inductively coupled plasma mass spectrometry and pot experiments unveiled that not only Trichoderma viride and Pseudomonas laurentiana used as phosphate-solubilizing inoculants, but also intrinsic soil microorganisms, including Penicillium aurantiogriseum, and the assemblies of root-colonizing microorganisms solubilized as well phosphate from apatite, trigger off competitive behavior between the organisms. Driving factors in the competitiveness are plant and microbial secondary metabolites, while glucosinolates of Camelina and their breakdown products are regarded as key compounds that inhibit the pathogen P. aurantiogriseum, but also seem to impede root colonization of T. viride. On the other hand, fungal diketopiperazine combined with glucosinolates is fatal to Camelina. The results may contribute to explain the contradictory effects of phosphate-solubilizing microorganisms when used as biofertilizers. Further studies will elucidate impacts of released secondary metabolites on coexisting microorganisms and plants under different environmental conditions.

Burden of chronic obstructive pulmonary disease attributable to non-optimal temperature from 1990 to 2019: a systematic analysis from the Global Burden of Disease Study 2019.

Chronic obstructive pulmonary disease (COPD) has been the third leading cause of death worldwide. As the traditional risk factors (like smoking and ambient air pollution) on the burden of COPD being well characterized, the burden of COPD due to non-optimal temperature has been widely concerned. In this study, we extracted the relevant burden data of COPD attributable to non-optimal temperature from GBD 2019 and adopted estimated annual percent changes, Gaussian process regression (GPR), and age-period-cohort model to evaluate the spatiotemporal patterns, relationships with socio-demographic level, and the independent effects of age, period and cohort from 1990 to 2019. In brief, the global COPD burden attributable to non-optimal temperatures showed declining trends but was still more severe in the elderly, males, Asia, and regions with low socio-demographic index (SDI). And cold had a greater burden than heat. The inverted U-shape is expected for the relationship between SDI and the burden of COPD caused by non-optimal temperatures according to the GPR model, with the inflection point around SDI 0.45. Besides, the improvements were observed in period and cohort effects but were relatively limited in low and low-middle SDI regions. Public health managers should execute more targeted programs to lessen this burden predominantly among lower SDI countries.

Degradation of Ibuprofen in flow-through system by the Electro-Fenton Process activated by two iron sources.

The electrochemical degradation of ibuprofen (IBP) by electro-Fenton process has been studied in a flow-through system by evaluating the performance of two different iron sources, sacrificial cast iron anode and FeSO4 salt. The effect of operating conditions, including initial IBP concentration, cast iron anode location, initial FeSO4 concentration, applied current, the split current on the iron anode, solution pH, and flow rate on the efficacy of the process was evaluated. The sequence of the electrodes significantly influences ibuprofen removal. When using cast iron anode as iron source, placing the iron anode upstream achieved the best IBP removal rate. Split current of 3 mA applied on the iron anode out of 120 mA total current is the optimum current for remove 1 mg/L of IBP under a flow rate of 3 mL/min. There is a linear correlation between the applied current and the Fe2+ concentration in the FeSO4-system. The initial IBP concentration does not influence the rate of Fenton reaction. Flow rate influences the degradation efficiency as high flow rate dilutes the concentration of OH radicals in the electrolyte. FeSO4-system was less affected by the flow rate compared to the iron anode-system as the concentration of the Fe2+ was steady and not diluted by the flow rate. Both systems prefer acidic operation conditions than neutral and alkaline conditions. Iron-anode can be used as an external Fe2+ supply for the treatment for iron-free. These findings contribute in several ways to our understanding of the electro-Fenton process under flow conditions and provide a basis for how to design the reactor for the water treatment.

The Hypervelocity Impact Behavior and Energy Absorption Evaluation of Fabric.

In this work, the mechanical behavior and energy absorption characteristics of flexible fabric under hypervelocity impact (HVI) were investigated. Basalt fabric, ultra-high molecular weight polyethylene (UHMWPE) fabric, and aluminum alloy (Al) plate were chosen to be the sample materials for their excellent mechanical properties and applicative prospect in spacecraft shielding. HVI experiments had been conducted with the help of a two-stage light-gas gun facility, wherein Al projectile with 3.97 mm diameter was launched at velocities in the range 4.1~4.3 km/s. Impact conditions and areal density were kept constant for all targets. The microstructural damage morphology of fiber post-impact was characterized using a scanning electron microscope (SEM). Analysis results show that a brittle fracture occurred for Basalt fiber during HVI. On the contrary, the ductile fractures with large-scale plastic deformation and apparent thermal softening/melting of the material had happened on the UHMWPE fiber when subjected to a projectile impact. According to the HVI shielding performance and microstructural damage analysis results, it can be inferred that ductile fractures and thermal softening/melting of the material were the prevailing energy absorption behaviors of UHMWPE fabric, which leads to absorbing more impact energy than Basalt fabric and eventually, contributes the superior shielding performance.

Global Epidemiological Patterns in the Burden of Main Non-Communicable Diseases, 1990-2019: Relationships With Socio-Demographic Index.

Objectives: This study aimed to analyze spatio-temporal patterns of the global burden caused by main NCDs along the socio-economic development. Methods: We extracted relevant data from GBD 2019. The estimated annual percentage changes, quantile regression and limited cubic splines were adopted to estimate temporal trends and relationships with socio-demographic index. Results: NCDs accounted for 74.36% of global all-cause deaths in 2019. The main NCDs diseases were estimated for cardiovascular diseases, neoplasms, and chronic respiratory diseases, with deaths of 18.56 (17.08-19.72) million, 10.08 (9.41-10.66) million and 3.97 (3.58-4.30) million, respectively. The death burden of three diseases gradually decreased globally over time. Regional and sex variations existed worldwide. Besides, the death burden of CVD showed the inverted U-shaped associations with SDI, while neoplasms were positively correlated with SDI, and CRD showed the negative association. Conclusion: NCDs remain a crucial public health issue worldwide, though several favorable trends of CVD, neoplasms and CRD were observed. Regional and sex disparities still existed. Public health managers should execute more targeted programs to lessen NCDs burden, predominantly among lower SDI countries.

Prediction of Survival Time in Advanced Lung Cancer: A Retrospective Study in Home-Based Palliative Care Unit.

Background: There is a large group of patients suffering from lung cancer and receiving home hospice care in China. However, little is known about the prediction of their survival time. The purpose of this study was to determine whether quality of life independently predicts survival among advanced lung cancer survivors who are receiving home-based palliative care. Methods: In this retrospective study, we analyzed data from 937 advanced lung cancer patients who had received home-based palliative care between March 2010 and March 2020. We used Kaplan-Meier survival curves to determine the factors associated with survival time and applied the Cox proportional hazards model to examine the effect of quality of life on survival. Results: The study included 928 patients with a mean age of 63 years; and 72.1% of them were men. Factors associated with shortened survival included age, sex, place of residence, weight loss, anorexia, nausea, edema, quality of life, and Karnofsky performance status. After adjusting for other variables in a multivariate Cox proportional hazards model, we found that quality of life was an independent positive predictor of survival. Conclusions: As an independent factor predicting the survival of advanced lung cancer patients, quality of life should be taken seriously. Medical staff and healthcare workers need to pay special attention to this predictive factor since it may serve as early risk identification indicator for professionals who provide home-based palliative care, helping them to create effective personalized care plans.

Effectiveness of Acceptance and Commitment Therapy for people with advanced cancer: A systematic review and meta-analysis of randomized controlled trials.

AIMS: To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. REVIEW METHODS: Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. RESULTS: Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate. CONCLUSION: People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes. IMPACT: This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well-designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population. PROSPERO REGISTRATION NUMBER: CRD42021244568.

Effects of progressive muscle relaxation on health-related outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Progressive muscle relaxation training (PMRT) has been widely applied to improve the physical and mental health of patients. The aim of this study was to evaluate the effects of PMRT on the symptoms and quality of life (QOL) of cancer patients. METHODS: Nine databases (Web of Science, CENTRAL, PubMed, Embase, CINAHL, OpenGrey, CNKI, Wanfang, and VIP database) were searched to identify randomized controlled trials (RCTs) that assessed the effects of PMRT on health-related outcomes for cancer patients. The risk of bias of the included studies and the evidence quality were appraised using the Cochrane Risk of Bias 2.0 tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, respectively. Meta-analysis was performed using RevMan 5.4. RESULTS: Twelve RCTs sampling 1147 patients were included. PMRT showed significant effects of alleviating anxiety [standardized mean difference (SMD) = -1.32, 95% CI (-1.88, -0.75), P < 0.001] and pain [SMD = -1.02, 95% CI (-1.93, -0.11), P = 0.030], and improving QOL [SMD = 1.65, 95% CI (0.53, 2.76), P = 0.004] in cancer patients. Regarding depression, self-esteem, nausea, and vomiting, PMRT showed better effects compared to the control group. However, no significant effect of reducing fatigue was detected [SMD = -1.00, 95% CI (-2.27, 0.27), P = 0.120]. The overall quality of evidence was moderate to very low. CONCLUSION: PMRT is a promising complementary therapy that may improve the health-related outcomes of cancer patients. Future studies with rigorous research design are needed to obtain valid conclusions.