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Objective:To use structural equation modeling to identify the indicator variables of intrinsic ability vitality among the elderly population.Methods:The study collected data on seven variables commonly used to measure vitality and mobility, including body mass index, weight loss, calf circumference, grip strength, gait speed at 4 m, up and go, and up and sit, from the comprehensive geriatric assessment(CGA)of patients admitted to the Department of Geriatrics of Beijing Hospital between May 2020 and May 2022.The study used a structural equation model to explore and verify the indicator variables of activity, utilizing exploratory factor analysis, confirmatory factor analysis, and correlation analysis.Results:The study conducted an exploratory factor analysis on seven variables, which resulted in two latent variables named vitality and locomotion.Body mass index, weight loss, and calf circumference were found to reflect vitality, while grip strength, 4 m-walking speed, time up and go test, and standing up and down test were found to reflect locomotion.Confirmatory factor analysis indicated that the measurement model was well-constructed and the indicator variables of vitality and locomotion were reasonably assigned[ χ2/ df=35/13, CFI=0.96, RMSEA(95% CI)=0.06(0.04, 0.08)].Correlation analysis showed that grip strength had a stronger correlation with locomotion-related variables than vitality-related variables( for grip strength and locomotion=0.33, for grip strength and vitality=0.21). Conclusions:The intrinsic ability and vitality of elderly individuals can be assessed through various means, including body mass index, weight loss, and calf circumference.However, grip strength is considered a more appropriate measure for reflecting locomotion rather than overall vitality.
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@#Objective To compare the clinical efficacy of subxiphoid video-assisted thoracoscopic surgery (XVATS) and conventional intercostal VATS (CVATS) extended thymectomy for myasthenia gravis (MG). Methods The clinical data of MG patients who underwent extended thymectomy in the Department of Thoracic Surgery of Xuzhou Central Hospital from October 2016 to October 2021 and finished the follow-up were retrospectively reviewed. They were divided into an XVATS group and a CVATS group according to the procedure. The perioperative variables and clinical efficacy of the two groups were compared. Results A total of 84 patients were collected, including 43 males and 41 females, with a mean age of 52.3 years. There were 41 patients in the XVATS group and 43 patients in the CVATS group. There was no mortality, cardiopulmonary thrombosis, prolonged air leak, or mediastinal infection. Additionally, the CVATS group recorded 5 (11.6%) patients of conversion to open thoracotomy, 1 (2.3%) patient of postoperative MG crisis, 1 (2.3%) patient of bleeding in thorax, and 1 (2.3%) patient of chylothorax. The operation time (127.4±50.4 min vs. 122.9±38.6 min), intraoperative bleeding [46.9 (25.7, 79.2) mL vs. 45.7 (21.9, 92.1) mL], incidence of complications [0 vs. 7.0% (3/43)], chest tube duration (4.3±1.9 d vs. 4.8±2.8 d), follow-up time (19.1±8.5 months vs. 22.5±13.7 months), the proportion of residual mediastinal fat tissue [12.2% (5/41) vs. 4.7% (2/43)], and total MG remission rate [29.3% (12/41) vs. 51.2% (22/43)] were not statistically different between the two groups (P>0.05). However, the two groups showed significantly different incidence of conversion to open thoracotomy [0 vs. 11.6% (5/43), P=0.024], postoperative hospital stay time (8.2±3.3 d vs. 11.4±5.8 d, P=0.003) and total drainage volume [396.7 (173.8, 542.5) mL vs. 218.8 (102.1, 430.0) mL, P=0.038]. Conclusion XVATS extended thymectomy is technically safe and feasible; however, more evidence is warranted before the recommendation of this approach for the treatment of MG.
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@#Objective To explore the feasibility of early chest tube removal following single-direction uniportal video-assisted thoracoscopic surgery (S-UVATS) anatomical lobectomy. Methods The clinical data of consecutive VATS lobectomy by different surgeons in Xuzhou Central Hospital between May 2019 and February 2022 were retrospectively reviewed. Finally, the data of 1 084 patients were selected for analysis, including 538 males and 546 females, with a mean age of 61.0±10.1 years. These patients were divided into a S-UVATS group with 558 patients and a conventional group (C-UVATS) with 526 patients according to the surgical procedures. The perioperative parameters such as operation time, blood loss were recorded. In addition, we assessed the amount of residual pleural effusion and the probability of secondary thoracentesis when taking 300 mL/d and 450 mL/d as the threshold of chest tube removal. Results Tumor-negative surgical margin was achieved without mortality in this cohort. As compared with the C-UVATS group, patients in the S-UVATS group demonstrated significantly shorter operation time (P<0.001), less blood loss (P=0.002), lower rate of conversion to multiple-port VATS or thoracotomy (P=0.003), but more stations and numbers of dissected lymph nodes as well as less suture staplers (P<0.001). Moreover, patients in the S-UVATS demonstrated shorter chest tube duration, less total volume of thoracic drainage and shorter postoperative hospital stay, with statistical differences (P<0.001). After excluding patients of chylothorax and prolonged air leaks>7 d, subgroup analysis was performed. First, assuming that 300 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, patients in the S-UVATS group would report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Second, assuming that 450 mL/d was the threshold for chest tube removal, as compared with the C-UVATS group, the S-UVATS group would also report less residual pleural effusion and less necessitating second thoracentesis with residual pleural effusion>500 mL (P<0.05). Further multivariable logistic regression analysis indicated that S-UVATS was significantly negatively related to drainage volume>1 000 mL (P<0.05); whereas combined lobectomy, longer operation time, more blood loss and air leakage were independent risk factors correlated with drainage volume>1 000 mL following UVATS lobectomy (P<0.05). Conclusion The short-term efficacy of S-UVATS lobectomy is significantly better than that of the conventional group, indicating shorter operation time and less chest drainage. However, early chest tube removal with a high threshold of thoracic drainage volume probably increases the risk of secondary thoracentesis due to residual pleural effusion.
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Objective:To establish a multi-component exercise intervention program for the elderly with frailty, assess its effectiveness on improving the severity of frailty, and examine the effects of different intervention modes.Methods:174 elderly people in a community in Beijing were randomly divided into three groups.The control group did not receive special intervention.The health education group received lectures, demonstrations and pamphlets on basic knowledge about frailty and instructions about a multi-component sports program.The multi-component exercise training program group was trained for three months via regular videos delivered through a WeChat app.The severity of frailty and exercise adherence of subjects in the three groups were compared.Results:166 subjects completed the study.Frailty phenotype(FP)scores of the health education group and the WeChat app group were lower than those at baseline( P<0.05).After intervention, FP scores of the control group, the health education group and the WeChat app group were 1(1, 2), 1(0, 1)and 1(0, 1), respectively, and there were differences among the three groups after intervention( H=15.539, P<0.05).There were 10 subjects(17.2%)in the control group, 15(25.9%)in the health education group and 28(48.3%)in the WeChat app group who experienced reversal from frailty or pre-frailty to no frailty( χ2=12.770, P=0.002).The number of people who reversed to no frailty in the WeChat app group was higher than in the control group( χ2=11.536, P=0.001)and the health education group( χ2=5.659, P=0.014).The numbers of people with frailty in the control group, health education group and WeChat app group were 9(15.5%), 1(1.7%)and 1(1.7%), respectively( χ2=13.040, P=0.001), with the numbers of frailty cases in the health education group and the WeChat app group lower than in the control group( χ2=7.552, 7.210, P=0.006, 0.007).The percentage of people completing the exercise program in the WeChat app group was higher than in the control group( χ2=49.366, P<0.001)and also in the health education group( χ2=26.481, P<0.001), while the percentage of people completing the exercise program in the health education group was higher than in the control group( χ2=6.171, P=0.013). Conclusions:The multi-component exercise program can improve the frailty state of the elderly, and the intervention method based on the WeChat app has clear advantages in improving frailty and enhancing exercise adherence.
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Objective:To investigate the ideal body mass index(BMI)range for hospitalized older adults with good functional ability.Methods:Data on inpatients thorough comprehensive geriatric assessment, including sex, age, BMI, ethnicity, and 9 functional indicators(basic daily mobility, instrumental daily mobility, frailty, cognition, depression, sleep, swallowing function, somatic activity, and grip strength)were collected in the geriatric department between January 2020 and November 2022.To determine the ideal BMI range, Logistic regression was used to analyze the dose-response relationships between BMI and functional ability.The findings were then validated by looking at the 5%-95% range of BMI among elderly people with normal functional ability.Results:A total of 1 950 hospitalized elderly adults were included in the study, with the age ranging from 60-103(77.2±8.9)years and women making up 50.8% of the participants.The average BMI was(23.4±3.6)kg/m 2; 8.9%(n=174)of the participants were low body weight and 8.7%(n=171)obese.Between 12.1%-66.0% of patients showed deterioration in the indicators of functional ability.With a higher BMI, there was a trend of decreasing functional ability in the elderly.Compared with people with a BMI between 20.0-24.9 kg/m 2, a BMI<20.0 kg/m 2 was a risk factor for bodily functional abnormality( OR: 1.49-2.06, all P<0.01). There was no clear risk for functional abnormality if the BMI was between 28.0-29.9 kg/m 2.In fact, in this BMI range, there was even a protective effect for grip strength and cognitive ability( OR=0.42, 0.25, both P<0.01). Of 214 elderly participants with normal values in all parameters, the 95% confidence interval of BMI ranged from 19.8 to 28.8 kg/m 2. Conclusions:To maintain appropriate functional ability for elderly inpatients, the optimal BMI range is between 20.0 kg/m 2 and 29.9 kg/m 2.
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ObjectiveTo explore the effect and mechanism of Zuojinwan （ZJW） in the treatment of ulcerative colitis （UC） through network pharmacology and experimental validation. MethodUsing network pharmacology and molecular docking， the active components and potential mechanism of ZJW in treating UC were preliminarily identified. Forty-eight male C57BL/6J mice were randomly divided into a normal group， a model group， a sulfasalazine group （300 mg·kg-1）， and low-， medium-， and high-dose ZJW groups （1.82， 3.64， 7.28 g·kg-1）. The UC model was induced by dextran sulfate sodium （DSS）， and oral administration of drugs began on the third day of modeling， lasting for 7 days. The general condition of mice was observed daily， and the disease activity index （DAI） was evaluated. Hematoxylin-eosin （HE） staining was performed to observe histopathological changes in colon tissue. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of tumor necrosis factor （TNF）-α， interleukin （IL）-6， and IL-10 in mouse serum. The molecular mechanism was validated using Western blot. ResultNetwork pharmacology predicted that the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway might be a key pathway in the regulation of UC by ZJW. Molecular docking results showed good binding ability between the key components of ZJW and core targets. Animal experiment results showed that compared with the normal group， the model group had shortened colon length （P<0.01）， increased DAI scores， spleen index， colon tissue pathology scores， and levels of TNF-α and IL-6 in serum （P<0.05， P<0.01）， increased PI3K， phosphorylated Akt （p-Akt）， and B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax） expression in colon tissue （P<0.05， P<0.01）， and decreased serum IL-10 levels and colon tissue Bcl-2 protein expression （P<0.01）. Compared with the model group， the ZJW groups showed significant improvement in UC symptoms， relieved colon tissue pathological damage， downregulated levels of inflammatory cytokines TNF-α and IL-6 in serum （P<0.01）， inhibited expression of PI3K， p-Akt， and Bax proteins in colon tissue （P<0.05， P<0.01）， and increased serum IL-10 levels and colon tissue Bcl-2 protein expression （P<0.01）， with the high-dose group showing the best effect. ConclusionZJW effectively alleviates DSS-induced UC， and its mechanism may be related to the inhibition of the PI3K/Akt signaling pathway and regulation of apoptosis-related protein expression.
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Objective:To analyze the present situation of comprehensive geriatric assessment(CGA).Methods:By using the convenient sampling method, 191 departments across the country that applied to try out the Jing-Yi-Hui comprehensive geriatric assessment system developed by the Department of Geriatrics of Beijing Hospital from November 2020 to March 2021 were investigated.Through the self-designed questionnaire to investigate the basic situation of the department, the implementation of CGA and training needs.Results:CGA has been carried out in 104 departments(54.5%). There is no statistically significantly difference in the implementation rate of CGA among different levels of hospitals, different regions where hospitals are located and different cities where hospitals are located.Among the departments that have carried out CGA, 28 departments(26.9%)have carried out out-patient CGA, 57 departments(54.8%)have completed CGA by random staff of departments, 87 departments(83.7%)use paper questionnaires, and 51 departments(49.0%)had less than 10 cases per month for completing CGA.Among the 87 departments that did not carry out CGA, 68 departments(78.2%)were unable to charge fees, and 64 departments(73.6%)were short of professionals.More than 90% of the departments have CGA training needs.Conclusions:CGA in China is still in its infancy, and the development of CGA in geriatrics in various places is poor, and it is generally faced with the dilemma of being unable to charge fees and lack of standardization.
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Objective:To investigate the level of intrinsic capacity in community-dwelling elderly people and the influencing factors, in order to provide supporting evidence for the improvement of intrinsic capacity, formulation of management strategies, and promotion of quality of life for the elderly.Methods:A cross-sectional survey was carried out from November 2020 to December 2020 with 236 community-dwelling elderly people in Beijing, who were recruited through a convenience sampling method.The investigation used questionnaires for general data and influencing factors for intrinsic capacity, and the World Health Organization intrinsic capacity questionnaire.Multivariate logistic regression was used to analyze the influencing factors for intrinsic capacity of the elderly.Results:Among 236 community-dwelling elderly people, 132(55.9%)had fair intrinsic capacity(≥4 points)and 104(44.1%)had poor intrinsic capacity(<4 points), with an average score of(3.39±0.95). Multiple Logistic regression analysis results showed that sex( OR=2.005, 95% CI: 1.093-3.676, P=0.025), age( OR=1.727, 95% CI: 1.043-2.860, P=0.034), social participation( OR=0.321, 95% CI: 0.170-0.604, P<0.001), entertainment( OR=2.073, 95% CI: 1.079-3.985, P=0.029), exercise( OR=2.975, 95% CI: 1.761-3.784, P=0.039), sleep( OR=0.508, 95% CI: 0.265-0.973, P=0.041), and emotions( OR=0.436, 95% CI: 0.196-0.970, P=0.042)were influencing factors for intrinsic capacity of community-dwelling elderly people. Conclusions:The intrinsic capacity of community-dwelling elderly people is in the middle range.Sex, age, social participation, entertainment, exercise, sleep, and emotions can affect intrinsic capacity.Therefore, intervention strategies based on influencing factors and improvement of lifestyles can help maintain good intrinsic capacity and reduce adverse effects of major health events.
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Objective To explore the polymorphism of microbial community after laparoscopic abdominal exploration by using bacterial 16s ribosomal DNA (16S rDNA) sequencing technology. Methods New Zealand rabbits were divided into model group and control group. The rabbits in the model group were operated by portable laparoscopy, and the rabbits in the control group were not treated. One week later, the peritoneal effusions of the model group and the control group were taken for 16S rDNA sequencing to analyze the microbial community polymorphism. To explore the changes of microbial community in peritoneal effusion in the model group compared with the control group. Results After 16S rDNA sequencing, bioinformatics was used to determine the microbial communities. Inter group difference analysis showed a good similarity of microbial communities between the two groups. OTU taxonomic analysis and species composition analysis (Rank-Abundance curve and Venn diagram) found that the microbial community level of the model group was significantly higher than that of the control group. Alpha diversity analysis (Sobs, Ace, Shannon, Simpson) showed that the richness and diversity of microbial community in the model group were higher than those in the control group. Microbial composition analysis showed that the number of miscellaneous bacteria in the model group increased by about 30% compared with the control group. The species differences between the two groups were tested for significance. It was found that Pasteurellales, Neisseria and Tsukamurella increased significantly. Conclusion The diversity of microbial communities in peritoneal effusion increases after laparoscopic abdominal exploration in New Zealand rabbits, and the most significant increases are Pasteurella, Neisseria and Tsukamura.
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With the acceleration of aging process and the increase of average life in China, the number of disabled elderly in China is also growing rapidly, which undoubtedly brings a heavy care burden and pressure to families and society.Facing the great challenges brought by aging, the increasing evidences show that only by reducing the incidence of disease and disability from the source, improving the health level of the elderly, prolonging their healthy life and realizing healthy aging, we can fundamentally alleviate the great pressure brought by the aging society.The concept of motor function maintenance and health promotion of the elderly has become an important link and breakthrough to realize healthy aging and active health.Facing the requirements of active health medicine and the development trend of science and technology in the future, it is imperative to deeply study the motion characteristics and function maintenance of the elderly, and promote the development of sports medicine with innovative technologies such as internet, big data and artificial intelligence.In the future, we will continue to improve the assessment and maintenance system for motor function of the elderly, develop and optimize functional maintenance products that meet the exercise needs of the elderly, and actively build an elderly-friendly sports environment support system, thereby promoting the healthy China strategy and realize healthy aging to the greatest extent.
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Objective:To investigate the relationship of urinary 8-oxoguanosine(8-oxoGsn)with muscle mass, muscle strength, advanced glycation end products(AGEs), trace elements, heavy metals and other health-related indictors in different age groups of the Beijing area.Methods:A cross-sectional research was conducted.Healthy adults aged 25 to 93 years who sought health examination in the Health Examination Center of Beijing Hospital were recruited.Participants were divided into the young and middle-aged group and the elderly group with age 60 as the cutoff.Urinary 8-oxoGsn levels were detected by mass spectrometry and adjusted using urine creatinine values.Body composition was measured by multifrequency bioelectrical impedance analysis(BIA). Grip strength, 6-meter walking speed and 5-times sit to stand test were conducted by experienced team members.Skin autofluorescence was used to detect skin AGEs.A portable optical scanner was used to detect heavy metals and trace elements using reference points of the palm.Levels of fasting blood glucose, glycosylated hemoglobin, high-density lipoprotein and other common blood biochemical indicators were measured.Results:A total of 106 subjects were enrolled, including 68 in the young and middle-aged group and 38 in the elderly group.The proportion of patients with hypertension(14 ases or 36.8% vs.7 ases or 10.3%), systolic blood pressure[130(120, 140) vs.120(110, 126)mmHg], fasting blood glucose[5.7(5.2, 5.9)mmol/L vs.5.2(4.9, 5.5)mmol/L], glycosylated hemoglobin[6.0(5.7, 6.2)% vs.5.7(5.4, 5.9)%], 8-oxoGsn/Cre[1.9(1.4, 2.6) vs.1.3(1.0, 1.6)], AGEs(2.44±0.46 vs.2.01±0.29), 5-times sit to stand test scores[7.8(6.9, 9.8)s vs.6.0(5.0, 6.8)s], magnesium(31.4±7.2 vs.27.7±6.4), mercury(0.013±0.003 vs.0.008±0.003)and silver[0.011(0.010, 0.012) vs.0.010(0.009, 0.011)]were higher in the elderly group than in the young and middle-aged group, while grip strength[28.0(22.0, 35.1)kg vs.36.6(28.5, 49.1)kg], fat-free mass[44.9(37.5, 51.1)kg vs.53.3(42.4, 58.5)kg], trunk muscle mass[21.0(17.5, 23.9)kg vs.25(19.8, 27.4)kg], appendicular skeletal muscle mass[20.9(17.6, 23.9)kg vs.24.9(19.8, 27.3)kg], calcium[273.3(219.1, 480.0) vs.457.8(428.5, 489.1)], cobalt[0.029(0.027, 0.031) vs.0.031(0.028, 0.034)], selenium[1.44(0.93, 1.71) vs.1.61(1.53, 1.68)]and nickel[3.5(3.3, 4.0)*10 -3vs.3.8(3.6, 4.1)*10 -3]were lower in the elderly group than in the young and middle-aged group( P<0.05). Urinary 8-oxoGsn/Cre levels were positively correlated with age, time of 5-times sit to stand test, AGEs, fasting blood glucose, mercury and aluminum( rs=0.443, 0.292, 0.357, 0.205, 0.316 and 0.214, P<0.05), and negatively correlated with trunk muscle mass, appendicular skeletal muscle mass, fat-free mass, grip strength, silicon and manganese( rs=-0.334, -0.333, -0.332, -0.366, -0.246 and -0.234, P<0.05), with statistical significance. Conclusions:Increased urinary 8-oxoGsn/Cre levels are correlated with decreased muscle mass, poor physical function, accumulation of AGEs, decreased trace element levels and increased heavy metal levels.Therefore, 8-oxoGsn has the potential to be a broadly representative and sensitive indicator for health assessment.
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Porphyromonas gingivalis (P. gingivalis) is the main pathogen of chronic periodontitis (CP). It has been found in recent years that P. gingivalis is associated with the occurrence and development of Alzheimer's disease (AD). P. gingivalis infection may increase the risk of AD, but the pathogenesis remains unclear. In vitro and animal experiments showed that inhibition of gingipains, the main virulence factor of P. gingivalis, could reduce neurodegeneration, decrease the deposition of beta-amyloid protein and control the progression of AD. This article reviews the research progress between P. gingivalis and AD in recent years, and provides references for exploring new prevention and treatment strategies of AD.
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@#Objective To investigate the clinical characteristics of uniportal and three-port subxiphoid video-assisted thoracoscopic surgery (XVATS) extended thymectomy. Methods The clinical data of 60 consecutive patients of XVATS thymectomy in Xuzhou Central Hospital from January 2017 to May 2019 were retrospectively analyzed. There were 29 males and 31 females, with an average age of 53.1 (27.0-76.0) years. The patients were divided into an uniportal XVATS group (30 patients) and a three-port XVATS group (30 patients). The clinical effectiveness was compared between the two groups. Results There was no significant difference in age, sex, body mass index, tumor size, intraoperative blood loss, postoperative time of thoracic tube indwelling and thoracic drainage, or postoperative hospitalization time between the two groups (P>0.05). There was no perioperative mortality, conversion to thoracotomy, thrombosis or mediastinal infection. The operation time of the uniportal XVATS group was significantly longer than that of the three-port group (87.5±19.0 min vs. 75.8±15.7 min, P=0.012). Besides, patients in the uniportal group had significantly lower pain score during 3-14 postoperative days than that of the three-port group (P=0.001). Conclusion Uniportal XVATS extended thymectomy is feasible with less pain as compared with the patients using three-port XVATS, but it needs longer operation time at initial stage.
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@#Objective To explore the feasibility and short-term efficacy of uniportal and three-port single-direction video-assisted thoracoscopic surgery (S-VATS) anatomical lobectomy for lung cancer. Methods Clinical data of 60 lung cancer patients, including 40 males and 20 females with an average age of 62.2±9.0 years, who received S-VATS anatomic lobectomy and systematic lymph nodes dissection by the same surgeon in our hospital between July 2016 and January 2019 were retrospectively analyzed. These patients were divided into a uniportal S-VATS group and a three-port S-VATS group according to surgical procedures, with 30 patients in each group. The clinical data of the two groups were compared. Results There was no conversion to thoracotomy, surgical port addition, or mortality in this cohort, with tumor-negative surgical margin. There was no statistical difference in the operation time between the two groups (70.8±16.4 min vs. 73.7±14.3 min, P>0.05). Meanwhile, both groups showed similar intraoperative blood loss, stations and numbers of dissected lymph nodes, incidence of operation-related complications, duration and volume of chest tube drainage, as well as postoperative hospital stay (P>0.05). Besides, pain score of the patients in the uniportal S-VATS group was significantly lower than that of the three-port S-VATS group on postoperative 3-14 d (P<0.05). The mean duration of follow-up was 10 months, and all the patients were survived without tumor recurrence or metastasis. Conclusion The transition from three-port S-VATS to uniportal S-VATS anatomical lobectomy for treatment of lung cancer is feasible. However, further studies are needed to elucidate the optimal resection sequence of pulmonary vessels.
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In the past ten years, the research and application of microbiome has continued to increase. The microbiome has gradually become the research focus in the fields of life science, environmental science, and medicine. Meanwhile, many countries and organizations around the world are launching their own microbiome projects and conducting a multi-faceted layout, striving to gain a strategic position in this promising field. In addition, whether it is scientific research or industrial applications, there has been a climax of research and a wave of investment and financing, accordingly, products and services related to the microbiome are constantly emerging. However, due to the rapid development of microbiome sequencing and analysis related technologies and methods, the research and application from various countries have not yet unified on the standards of technology, programs, and data. Domestic industry participants also have insufficient understanding of the microbiome. New methods, technologies, and theories have not yet been fully accepted and used. In addition, some of the existing standards and guidelines are too general with poor practicality. This not only causes obstacles in the integration of scientific research data and waste of resources, but also gives related companies unfair competition opportunity. More importantly, China still lacks national standards related to the microbiome, and the national microbiome project is still in the process of preparation. In this context, the experts and practitioners of the microbiome worked together and developed the consensus of experts. It can not only guide domestic scientific research and industrial institutions to regulate the production, learning and research of the microbiome, the application can also provide reference technical basis for the relevant national functional departments, protect the scale and standardized corporate company's interests, strengthen industry self-discipline, avoid unregulated enterprises from disrupting the market, and ultimately promote the benign development of microbiome-related industries.
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Humans , China , Consensus , Industry , MicrobiotaABSTRACT
Objective:To survey the attitudes and influencing factors towards advance -care planning(ACP)among elderly inpatients and their family members.Methods:A total of 197 elderly inpatients and 248 family members were enrolled by using a convenience sampling method, and they were investigated by a questionnaire.The differences in attitudes towards the nutrition support in the state of frailty and the advanced life support at the end of life between patients and their family members, and the influencing factors for making a living will were analyzed.Results:Compared with elderly inpatients, the proportions of their family members, who had heard of ACP/advance directives(ADs)(58.9% or 146/248 vs.41.6% or 82/197, χ2=13.070, P=0.000), who had discussed death(89.9% or 223/248 vs.55.3% or 109/197, χ2=69.334, P=0.000), who would make a living will(88.7% or 220/248 vs.46.7% or 92/197, χ2=92.461, P=0.000), who would know the true condition(97.2% or 241/248 vs.89.8% or 177/197, χ2=10.349, P=0.001), were significantly elevated.Towards the choice of tube feeding, percutaneous endoscopic gastrojejunostomy and deep-vein catheter insertion, family members had more positive attitudes than did patients themselves( χ2=42.996, 11.446 and 27.704, P=0.000, 0.003 and 0.000). Towards the life support during end-of-life including ventilator-assisted ventilation, electric defibrillation, extracorporeal cardiac compression and hemodialysis, there was no significant difference in attitudes between patients and family members( χ2=0.569, 1.866 and 4.337, P=0.752, 0.393 and 0.114), and the proportion of disapproval was higher in family members.The influencing factors for making a living will were the awareness of ACP/ADs( OR=0.187, 95% CI: 0.096-0.366, P=0.000)and having discussed death with family members( OR=0.450, 95% CI: 0.231-0.878, P=0.019). Conclusions:The proportion of elderly inpatients who are willing to make a living will is low in China, and its influencing factors are the awareness of ACP/ADs and having discussed death with family members.Thus, the promotion and education of ACP/ADs should be strengthened.
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Objective To investigate the effect of antithrombotic strategies on cerebrovascular events in aged patients with nonvalvular artial fibrillation(nvAF).Methods The clinic data of 101 patients aged 80 years and over with nvAF admitted from January 2005 to June 2016 were retrospectively analyzed.The stroke and transient ischemic attack (TIA) occurred in 29 patients (28.7％,stroke/TIA group) and the remaining 72 patients were assigned in non-stroke/TIA group.The antithrombotic schemes and the antithrombotic drug-related bleeding were compared between two groups.Results Among 101 patients,there were 70 cases receiving antiplatelet therapy,19 cases receiving anticoagulation therapy and 12 cases receiving no antithrombotic therapy.The nvAF history was longer in the stroke/TIA group than that in non-stroke/TIA group [15.0(8.0,17.5) vs.6.0(3.0,12.8),Z=-3.645,P＜0.01];the proportion of anticoagulation therapy was higher in non-stroke/TIA group than that in stroke/TIA group (18/72 vs.1/29,x2=5.778,P＜0.01).The occurrence of medication-related bleeding was 15.6％(14/90) in patients with antiplatelet therapy and 12.0％(3/25) in patients with anticoagulation therapy (x2=0.196,P=0.658).There was no significant difference in the first time of stroke/TIA attack among patients with different antithrombotic schemes(x2=0.859,P=0.651).Conclusion The aged patients with nvAF are in a high risk of thromboembolism,but the proportion of using antithrombotic therapy is low.Anticoagulation therapy has a protective effect against the occurrence of stoke/TIA without increasing the risk of bleeding,which makes anticoagulation therapy advisable in the elderly patients.
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Objective To construct and authenticate the lentiviral-mediated overexpression of mouse mitochondrial-targeted-8-oxoguanine DNA-glycosylase 1 (mito-OGG1) gene and the lentiviral-mediated short hairpin RNA (shRNA) down-regulation of OGG1 gene expression model in 661W cells.Methods Constructed the target plasmids,including pLenti-EF1a-EGFP-P2A-Puro-CMV-Mito-OGG1-3Flag (pLenti-OGG1-GFP) and pLKD-CMV-G&PR-U6-shRNA (pLKD-shRNA).293T cells were used to obtain green fluorescent protein (GFP)-tagged lentiviral vector of interest by using a second generation lentivirus packaging system.293T cells were also used for the virus titer estimation.The multiplicity of infection (MOI) of 661W cells was detected by fluorescence microscopy.A stable transfected cell line was screened by puromycin.Immunofluorescence was used to detect transfection efficiency and cytochrome C oxidase Ⅳ (COXⅣ)-OGG1 co-localization.OGG1 mRNA and protein expression levels were detected by real-time qantitative PCR (QPCR) and Western blot.Results Sequencing results showed that the inserted sequence in the over-expression plasmid was consistent with the mouse OGG1 (NM_010957.4) gene sequence in the gene library.The original lentiviral titer after packaging and purification was between 2.0× 107to 6.0× 107 TU/ml.The optimal MOI of 661W cells was 40,and puromycin with a concentration of 4.0 μg/ml successfully screened stable transformation.The transfection efficiency was up to 100％ after screening.Immunofluorescence demonstrated successful co-localization of OGG1 and COXⅣ.The relative expression levels of OGG1 mRNA in the blank control group,OGG1 group,overexpression control group,shRNA group and low expression control group were 1.000±0.000,41.581±12.206,0.888±0.056,0.239±0.121 and 1.081±0.083,and the relative expression levels of OGG1 protein were 1.029±0.153,1.657 ± 0.237,0.752 ± 0.143,0.471 ± 0.149 and 1.036 ± 0.185,respectively,with significant differences between them (F=44.654,30.948;both at P＜0.05),the relative expression levels of OGG1 mRNA and protein in the OGG1 group were significantly higher than those in the overexpression control group,the relative expression levels of OGG1 mRNA and protein in the shRNA group were significantly lower than those in the lower expression control group,with significant differences between them (all at P＜0.05).Conclusions The mitoOGG1 overexpression and OGG1 knockdown models of 661W cells are successfully constructed,which provides the preliminary experimental basis for follow-up study.
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Along with the accelerated aging process,the close attentions are paied to a series of medical and social issues concerning the care of the elderly in China.Increasing discussions on the life expectancy and the quality of life at the end of life in the elderly havebeenproceeded.This paper reviews the related concepts and practical processes of advance care planning(ACP),analyzes the ACP-facing problems in the elderly population in China,and makes recommendations.
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Objective To explore the application potential of forced expiratory volume in three second/forced vital capacity (FEV3/FVC) in early lung diseases,such as early airway obstruction and mild gas trap.Methods A total of 288 patients (excluding those with restrictive ventilation dysfunction) who underwent pulmonary function examination in the pulmonary function room of our hospital from January 2014 to October 2017 were collected.288 patients were divided into three groups.Group A:FEV3/FVC and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) were normal;Group B:FEV3/FVC decreased alone;Group C:FEV1/FVC decreased.The general data and pulmonary function indexes of the three groups were compared.Results Compared with group A,group B had lower FEV1 ％ and diffusion capacity for carbon monoxide of the lung (DLCO％),but higher total lung capacity (TLC％),residual volume (RV％) and RV/TLC.Compared with group B,group C had higher TLC ％,RV％,RV/TLC％,while FEV1％,DLCO％ reduce more remarkably.There were significant differences in the three groups of small airway function (P ≤ 0.01).FEV3/FVC was positively correlated with max expiratory at 50％ FVC (MEF50％),max expiratory at 75％ FVC (MEF25％) and maximal mid expiratory flow (MMEF％).The correlation coefficients were respectively 0.613,0.610,0.608 (P ≤0.01).When FEV3/FVC serves as an indicator to determine airway obstruction,the specificity of it is 45.7％,sensitivity 98.5％,and negative predictive value 99％,positive predictive value 35.5％.Conclusions FEV3/FVC individual decline is the indication of early lung diseases such as mild airway obstruction,mild gas trap and diffuse disorder.