AimsTo describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision‐making phase of treatment‐seeking.BackgroundPrevious attempts to reduce the treatment‐seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID‐19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential.DesignMeta‐synthesis.Data sourcesWe searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022.MethodsWe screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies.ResultsTwenty‐one studies were included, identifying four themes and nine sub‐themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self‐sacrifice.ConclusionDeciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID‐19 pandemic.Implications for the profession and/or patient careDetails of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated.ImpactResults would help healthcare professionals to implement individualised management of decision‐making of treatment‐seeking among AMI patients, and improve medical records of patients' prehospital experiences.Reporting MethodThe Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings.Patient or Public ContributionTwo AMI patients contributed to the data synthesis by giving simple feedback about the final themes.

Background: Bladder cancer is the most common malignant neoplasm of the urinary system. Compound Kushen injection (CKI) is a Chinese medicinal preparation that has been used clinically to treat various types of cancers for more than 20 years. However, the pharmacological effect of CKI on bladder cancer requires further clarification.Methods: Network pharmacology combined with bioinformatics was used to elucidate the therapeutic mechanism and potential targets of CKI in bladder cancer. The mechanism by which CKI is effective against bladder cancer was further verified in vitro using the human bladder cancer cell line T24.Results: Network pharmacology analysis identified 35 active compounds and 268 target genes of CKI. Bioinformatics data mining revealed 5500 differentially expressed genes associated with bladder cancer. Common genes of CKI and bladder cancer suggested that CKI exerts anti-bladder cancer effects by regulating genes such as MMP-9, JUN, EGFR, and ERK1. Functional enrichment analysis indicated that CKI has a therapeutic effect on bladder cancer by synergistically regulating certain biological processes, including cell proliferation, cell migration, and cell apoptosis. In addition, Kyoto Encyclopedia of Genes and Genomes enrichment analysis implicated pathways related to cancer, bladder cancer, and the PI3K-Akt signaling pathway. Consistently, cell experiments indicated that CKI could inhibit proliferation and migration of T24 bladder cancer cells, and induce their apoptosis. Moreover, RT-qPCR and western blot results indicated that CKI may treat bladder cancer by downregulating gene and protein expression levels, respectively of MMP-9, JUN, EGFR, and ERK1.Conclusions: CKI can inhibit proliferation and migration, and induce apoptosis of T24 bladder cancer cells through multiple biological pathways and targets. CKI also has significant effects on regulation of key genes and proteins associated with bladder cancer. Overall, our findings provide solid evidence and deepen current understanding of the therapeutic effects of CKI for bladder cancer, and further support its clinical use.

Aims We sought to explore the latent classifications of psychosocial adaptation in young and middle-aged patients with acute myocardial infarction (AMI) and analyze the characteristics of different profiles of AMI patients. Methods and results A cross-sectional study was performed in 438 Chinese young and middle-aged patients with AMI. The investigation time was 1 month after discharge. Three different self-report instruments were distributed to the participants, including the Psychosocial Adjustment to Illness Scale, the Perceived Stress Scale, and the Social Support Rating Scale. The 7 dimensions of the Psychosocial Adjustment to Illness Scale was then used to perform a latent profile analysis. All participants signed informed consent forms in accordance with the ethical principles of the Declaration of Helsinki. Finally, a total of 411 young and middle-aged AMI patients were enrolled. Three distinct profiles were identified, including the “well-adapted group” (44.8%), “highlight in psychological burdens group” (25.5%), and “poorly adapted group” (29.7%). The influencing factors included stress perception, social support, occupational type, and marital status (p < 0.05). Conclusion The psychosocial adaptation of young and middle-aged AMI patients can be divided into 3 profiles. Clinical nurses can carry out individualized psychological interventions according to the characteristics of patients in different potential profiles to improve the psychosocial adaptation of patients and the prognosis of their disease.

Background: Bladder cancer is the most common malignant neoplasm of the urinary system. CompoundKushen injection (CKI) is a Chinese medicinal preparation that has been used clinically to treat varioustypes of cancers for more than 20 years. However, the pharmacological effect of CKI on bladder cancerrequires further clarification.Methods: Network pharmacology combined with bioinformatics was used to elucidate the therapeuticmechanism and potential targets of CKI in bladder cancer. The mechanism by which CKI is effective againstbladder cancer was further verified in vitro using the human bladder cancer cell line T24.Results: Network pharmacology analysis identified 35 active compounds and 268 target genes of CKI.Bioinformatics data mining revealed 5500 differentially expressed genes associated with bladder cancer.Common genes of CKI and bladder cancer suggested that CKI exerts anti-bladder cancer effects byregulating genes such as MMP-9, JUN, EGFR, and ERK1. Functional enrichment analysis indicated thatCKI has a therapeutic effect on bladder cancer by synergistically regulating certain biological processes,including cell proliferation, cell migration, and cell apoptosis. In addition, Kyoto Encyclopedia of Genes andGenomes enrichment analysis implicated pathways related to cancer, bladder cancer, and the PI3K-Aktsignaling pathway. Consistently, cell experiments indicated that CKI could inhibit proliferation andmigration of T24 bladder cancer cells, and induce their apoptosis. Moreover, RT-qPCR and western blotresults indicated that CKI may treat bladder cancer by downregulating gene and protein expression levels,respectively of MMP-9, JUN, EGFR, and ERK1.Conclusions: CKI can inhibit proliferation and migration, and induce apoptosis of T24 bladder cancer cellsthrough multiple biological pathways and targets. CKI also has significant effects on regulation of key genesand proteins associated with bladder cancer. Overall, our findings provide solid evidence and deepen currentunderstanding of the therapeutic effects of CKI for bladder cancer, and further support its clinical use.

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