The effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients / 中华护理杂志

Objective To explore the effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients.Methods By convenience sampling method,74 patients with breast cancer subthreshold depression who received chemotherapy in the breast department of a tertiary hospital in Guangxi from July 2021 to August 2022 were selected as the research subjects.According to the order of admission time,the patients admitted from February 2022 to August 2022 were taken as an experimental group,and the patients admitted from July 2021 to January 2022 were taken as a control group,with 37 cases in each group.On the basis of routine nursing,the experimental group implemented a mobile health intervention model based on self-determination theory.The control group received routine nursing,with every 21 days for 1 cycle and a total of 4 cycles of intervention.Before and after the intervention,the Centre for Epidemiological Studies Depression Scale(CES-D),Hamilton Rating Scale for Depression(HAMD-17),Basic Psychological Needs Satisfaction Scale(BPNS)and Functional Assessment of Cancer Therapy-Breast(FACT-B)were used to evaluate the intervention effect.Results 34 patients in the experimental group and 36 patients in the control group completed the study.After intervention,the CES-D score and HAMD-17 score of the 2 groups were lower than those before intervention(P＜0.05);the CES-D score and HAMD-17 score of the experimental group were lower than those of the control group,and the difference was statistically significant(t=7.748,P＜0.001;t=8.150,P＜0.001).The BPNS scores of the 2 groups were higher than those before the intervention,and the BPNS score of the experimental group was significantly higher than that of the control group(t=-6.534,P＜0.001).The scores of FACT-B in the 2 groups were higher than those before the intervention,and the scores of FACT-B in the experimental group were significantly higher than those in the control group(t=-4.579,P＜0.001).Conclusion The mobile health intervention model based on self-determination theory can improve the subthreshold depression,self-determination and quality of life of breast cancer patients.

Effectiveness of exercise on sleep quality in patients with Parkinson's disease:a Meta-analysis / 中华护理杂志

Objective To evaluate the effectiveness of exercise for people with Parkinson's disease on sleep quality.Methods Computerized retrieval of PubMed,Web of Science,Embase,the Cochrane Library,CINAHL,CN-KI,WanFang Data,VIP,CBM was conducted to collect randomized controlled trials about the effect of exercise on people with Parkinson's disease from inception to December,2022.There were 2 researchers who independently screened the literature,extracted the data and evaluated the risks of bias in the included studies.Meta-analysis was performed using RevMan 5.4 software.Results A total of 13 studies were included,with 874 patients.The result of meta-analysis show that the overall effect size of exercise intervention on sleep quality for people with Parkin-son's disease is significant(SMD=-0.54,95％CI=[-0.90,-0.19],P＜0.01).Subgroup analysis show that the maxi-mum effect size of intervention frequency is 4-5 times/week(SMD=-0.75);the maximum effect size of exercise intensity is light intensity(SMD=-2.19);the maximum effect size of a single intervention time is 40-55 minutes(SMD=-0.69);the maximum effect size of exercise type is traditional Chinese exercise(SMD=-0.63);the maximum ef-fect size of intervention cycle is 12 weeks(SMD=-0.66).Conclusion Exercise intervention has significantly ef-fects to improve sleep quality on Parkinson's disease patients.It is a more effective way to improve sleep quality by exercising 4-5 times per week,while each exercise lasts about 40-55 min for 12 weeks in Traditional Chinese Medicine exercise with light intensity.

Review of drug utilization research based on real-world data / 药学实践与服务

In recent years, the rapid development of medical information technology has made it critical to analyze large-scale diagnosis and therapeutic data and extract rules based on real medical environment. This has become an essential approach for marketing evaluation and regulatory decision-making of drugs and devices both domestically and internationally. Real world study （RWS）, as a novel methodology for clinical evaluation of drugs in the field of drug utilization research （DUR）, have presented opportunities and challenges for observational studies in assessing actual efficacy or effectiveness. However, despite being a popular methodological approach among scholars in the field, there are still limitations and deficiencies when analyzing population medication characteristics in RWS. Systematic evaluation research methods have not yet been established, leading to inadequate generation of real-world evidence （RWE）. The research design, methodological pathways, evaluation indicators, confounding factors, and bias management involved in DUR based on real-world data （RWD） were reviewed in this artical with the intention of providing guidance for further exploration into DUR.

Effect of acupuncture combined with low frequency rTMS on comorbid mild-to-moderate depressive disorder and insomnia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism.@*METHODS@#A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05).@*CONCLUSION@#Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.

Risk factors associated with malignant vasovagal syncope in children / 中华儿科杂志

Objective: To analyze the clinical characteristics and risk factors of malignant vasovagal syncope (VVS) in children. Methods: This was a case-control study. The data of 368 VVS patients who were treated in the Department of Cardiology, Children's Hospital, Capital Institute of Pediatrics from June 2017 to December 2021 was collected and analyzed. They were divided into malignant VVS group and non-malignant VVS group according to the presence of sinus arrest, and then their demographic characteristics were compared. The children with malignant VVS and complete clinical information were recruited into the case group and were matched by age and sex (1∶4 ratio) with non-malignant VVS patients during the same period.Their clinical characteristics and lab tests were compared. Independent sample t test, Mann Whitney U or χ2 test was used for comparison between groups.Logistic regression was used to analyze the risk factors for malignant VVS in children. Results: Eleven malignant VVS and 342 non-malignant VVS met the inclusion and exclusion critera. Eleven malignant VVS and 44 non-malignant children were recruited in the case-control study. Ten patients of the 11 malignant VVS had a cardiac arrest occurring at 35 (28, 35) minutes of the head-up tilt test, and the duration of sinus arrest was (9±5) s. One patient had syncope occurring while waiting for drawing blood, and the duration of sinus arrest was 3.4 s. The children with malignant vasovagal syncope were younger than non-malignant VVS patients (9 (7, 10) vs. 12 (10, 14) years old, P<0.05), and had higher mean corpuscular hemoglobin concentration (MCHC) and standard deviation of the mean cardiac cycle over 5-minute period within 24 hours ((347±9) vs. (340±8) g/L, (124±9) vs. (113±28) ms, both P<0.05). Logistic regression analysis showed that MCHC was an independent risk factor for malignant VVS in pediatric patients (OR=1.13, 95%CI 1.02-1.26, P=0.024). Conclusions: The onset age of malignant VVS was younger, with no other special clinical manifestations. MCHC was an independent risk factor for malignant VVS.

Mechanism of Xuebijing Injection in treatment of sepsis-associated ARDS based on network pharmacology and in vitro experiment / 中国中药杂志

The aim of this study was to investigate the effect and molecular mechanism of Xuebijing Injection in the treatment of sepsis-associated acute respiratory distress syndrome(ARDS) based on network pharmacology and in vitro experiment. The active components of Xuebijing Injection were screened and the targets were predicted by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). The targets of sepsis-associated ARDS were searched against GeneCards, DisGeNet, OMIM, and TTD. Weishengxin platform was used to map the targets of the main active components in Xuebijing Injection and the targets of sepsis-associated ARDS, and Venn diagram was established to identify the common targets. Cytoscape 3.9.1 was used to build the "drug-active components-common targets-disease" network. The common targets were imported into STRING for the building of the protein-protein interaction(PPI) network, which was then imported into Cytoscape 3.9.1 for visualization. DAVID 6.8 was used for Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment of the common targets, and then Weishe-ngxin platform was used for visualization of the enrichment results. The top 20 KEGG signaling pathways were selected and imported into Cytoscape 3.9.1 to establish the KEGG network. Finally, molecular docking and in vitro cell experiment were performed to verify the prediction results. A total of 115 active components and 217 targets of Xuebijing Injection and 360 targets of sepsis-associated ARDS were obtained, among which 63 common targets were shared by Xuebijing Injection and the disease. The core targets included interleukin-1 beta(IL-1β), IL-6, albumin(ALB), serine/threonine-protein kinase(AKT1), and vascular endothelial growth factor A(VEGFA). A total of 453 GO terms were annotated, including 361 terms of biological processes(BP), 33 terms of cellular components(CC), and 59 terms of molecular functions(MF). The terms mainly involved cellular response to lipopolysaccharide, negative regulation of apoptotic process, lipopolysaccharide-mediated signaling pathway, positive regulation of transcription from RNA polyme-rase Ⅱ promoter, response to hypoxia, and inflammatory response. The KEGG enrichment revealed 85 pathways. After diseases and generalized pathways were eliminated, hypoxia-inducible factor-1(HIF-1), tumor necrosis factor(TNF), nuclear factor-kappa B(NF-κB), Toll-like receptor, and NOD-like receptor signaling pathways were screened out. Molecular docking showed that the main active components of Xuebijing Injection had good binding activity with the core targets. The in vitro experiment confirmed that Xuebijing Injection suppressed the HIF-1, TNF, NF-κB, Toll-like receptor, and NOD-like receptor signaling pathways, inhibited cell apoptosis and reactive oxygen species generation, and down-regulated the expression of TNF-α, IL-1β, and IL-6 in cells. In conclusion, Xuebijing Injection can regulate apoptosis and response to inflammation and oxidative stress by acting on HIF-1, TNF, NF-κB, Toll-like receptor, and NOD-like receptor signaling pathways to treat sepsis-associated ARDS.

Safety and feasibility of right colectomy via a transvaginal approach: early experience from a single center / 中华胃肠外科杂志

Objective: To investigate the safety and feasibility of performing right colectomy via a transvaginal approach. Methods: This was a retrospeltive cohort study. Data of 30 patients who had undergone transvaginal laparoscopic right colectomy (transvaginal group) and 23 women who had undergone laparoscopic right colectomy (laparoscopic group) from January 2019 to March 2022 in the Division of Colorectal Surgery, Department of General Surgery, Peking Union Medical College Hospital were collected retrospectively. The inclusion criteria for the transvaginal group were as follows: (1) post-menopausal woman; (2) transverse diameter of the tumor < 6 cm; and (3) diagnosis of benign polyps that were unresectable by endoscopy, mucinous tumors of the appendix, or confirmed right colon cancer not requiring D3 lymphadenectomy. The inclusion criteria for the laparoscopic group were as follows: (1) pathologically confirmed adenocarcinoma or high-grade intraepithelial neoplasia; (2) lesion located from the cecum to the right third of the transverse colon; and (3) clinically stage T1-4NanyM0. The exclusion criteria for the laparoscopic group were as follows: (1) distant metastasis discovered during surgical exploration; (2) multiple organ resection required or R0 resection not possible; or (3) conversion to open surgery required. Safety was evaluated on the basis of intra- and post-operative complications. Feasibility was assessed by postoperative recovery and quality of operative specimen. The body mass index was lower in the transvaginal than the laparoscopic group (22.0±3.1 kg/m2 vs. 24.1±2.6 kg/m2, t=2.617, P=0.012). Results: Among the 30 transvaginal laparoscopic right colectomies, 26 were pure transvaginal surgeries, three required laparoscopic assistance because of difficulties with anastomosis (n=2) or abdominal adhesions (n=1), and one required conversion to laparoscopic surgery because of vascular injury. Compared with the laparoscopic group, the transvaginal group had a longer surgery time (175.0 [147.5, 216.3] minutes vs. 120.0 [100.0, 120.0] minutes, U=63.000, P<0.001) and more blood loss (30.0 [10.0, 50.0] ml vs. 23.0 [10.0, 20.0] ml, U=208.000, P=0.011). The incidence of intraoperative complications (16.7% [5/30) vs. 0, P=0.061] was comparable between the two groups. In the transvaginal group, the sites of intraoperative injuries were bladder (n=3), ileocecal artery (n=1), and right uterine artery (n=1). The incidence of postoperative complications (20.0% [6/30] vs. 17.4% [4/23], χ2<0.001,P>0.999) was also comparable between the two groups. Clavien-Dindo grade III postoperative complications occurred in two patients in the transvaginal group (one patient had a pelvic hematoma that required embolization; the other had a vesico-vaginal fistula that required surgery). Postoperative visual analogue scale scores were significantly lower (P<0.001) in the transvaginal group. Times to first flatus, ambulation, and first intake and duration of postoperative hospital stay were comparable between the two groups (P>0.05). The proportion of specimens of moderate quality was 83.3% (25/30) in the transvaginal group and 100% (23/23) in the laparoscopic group; this difference is not significant (P=0.061). Among patients who underwent D2 lymph node dissection, the number of lymph nodes examined was comparable between the transvaginal (n=23) and laparoscopic groups (n=7) (18 [15, 27] vs. 20 [16, 29], U=69.500, P=0.589). Conclusion: Transvaginal right colon surgery is associated with less postoperative pain than laparoscopic surgery, but is not yet the preferred alternative because of the incidence of surgical complications.

Research progress of circadian rhythm and circadian clock gene regulation in the development of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

With the development of society, the incidence of myopia and the population of myopia has increased year by year, which has become a major public health problem. Therefore, the research on the pathogenesis and prevention and control measures of myopia is imminent. In recent years, the role of the biological clock in the development of myopia has gradually attracted scholars interest. Now the author starts from the impact of the biological clock on the axial length, retina and choroid in the development of myopia. In order to provide new ideas for the study of prevention and control measures and the pathogenesis of myopia, a brief review is made from the perspective of contemporary society and disrupted body clock.

The effectiveness of closed-loop oxygen therapy for adult non-mechanical ventilation patients: a Meta-analysis / 中国实用护理杂志

Objective:To evaluate the effect of closed-loop therapy system in adult non-mechanical ventilation patients in order to provide evidence-based basis for promoting the safety of oxygen therapy.Methods:Randomized controlled trials of closed-oxygen therapy system on the percentage within SpO 2 target, the incidence of hypoxaemia or hyperoxia, oxygen consumption, the mean oxygen therapy days, as well as the length of hospital stay in adult non-mechanical ventilation patients were searched in PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, VIP from inception to June 30, 2022. Data extraction, and literature quality evaluation were performed by two researchers independently, RevMan 5.3 was used for meta-analysis. Results:A total of 5 articles including 502 patients were included. The results showed that the closed oxygen therapy system could significantly improve the percentage of time within SpO 2 target of patients ( SMD=1.56, 95% CI 1.22-1.90, Z=9.04, P<0.001) and reduce the percentage of time with hypoxaemia ( SMD=-0.35, 95% CI-0.50--0.19, Z=4.37, P<0.001) or hyperoxia ( SMD=-0.91, 95% CI-1.07--0.75, Z=11.04, P<0.001) of patients. Moreover, the mean oxygen flow rate of closed oxygen therapy ( SMD=-0.64, 95% CI-1.25--0.03, Z=2.07, P<0.05), the mean oxygen therapy days ( SMD=-0.55, 95%, CI-1.06--0.03, Z=2.08, P<0.05), as well as the length of hospital stay ( SMD=-1.68, 95% CI-2.22--1.14, Z=6.11, P<0.001) were lower than those of patients with manual adjustment systems. Conclusion:The closed oxygen therapy system can promote the safety of oxygen use, but it needs clinical application to further explore.

Research progress and future prospect of hernia and abdominal wall surgery in China / 中华消化外科杂志

In recent years, due to the increasing population of ageing and obesity, the incidence rate of hernia is increasing year by year, which has become a social problem that needs to be focused. Although starting late, the hernia and abdominal wall surgery has developed rapidly in recent years in China, and many remarkable achievements have been made. The development of hernia and abdominal wall surgery is inseparable from the progress of medical technology, the continuous innovation of materials, the improvement of perioperative management concept and the improvement of registration and follow-up system. The authors investigate the relevant research at home and abroad in recent years, and summarize and prospect the materials science, the daytime surgery and the registration and follow-up system, in order to provide reference for the future development of hernia and abdominal wall surgery.

Summary of the best evidence for the energy and protein intake targets and calculation in critically ill patients / 中华危重病急救医学

Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.

Distribution pattern and related factors of single osteoporotic vertebral compression fractures / 中华骨科杂志

Objective:To identify the anatomical distribution of and factors related to single-segment osteoporotic vertebral compression fractures (OVCF).Methods:The radiology and clinical data of 944 patients with single-segment OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 175 males and 769 females, aged 72.1±9.6 years (range, 45-97 years). The anatomical distribution of OVCF was quantified. The demographics, comorbidity profile, spine trauma, back pain duration, vertebral compression degree, and bone mineral density of the OVCF patients in different anatomical segments were summarized and compared.Results:Of the 944 single-segment OVCF, 864 were located in the lower thoracic and lumbar spine that peaked at L 1 (Modal-1 group), and 80 were located in the middle and upper thoracic spine (Modal-2 group) that peaked at T 7, demonstrating an asymmetric bimodal distribution. The difference in the female/male ratio between the two groups was insignificant (χ 2=0.06, P=0.803). Patients in Modal-2 were aged 75.0±9.8 years and on average older than the patients (aged 71.8±9.6 years) in Modal-1 ( t=2.78, P=0.005). The female patients in Modal-2 (aged 75.0±9.6 years) were significantly older than that (aged 71.2±9.3 years) in Modal-1 ( t=3.17, P=0.002). The ratio of back pain duration for <1 week in Modal-2 (43.8%) was lower than that in Modal-1 (60.2%), and the ratio of back pain for 1-weeks (28.8%) was significantly higher than that (15.5%) in Modal-1 (χ 2=11.50, P=0.009). The most frequently reported spine traumas in Modal-2 (50.0%) were heavy lifting injury, lumbar sprain, and strenuous cough, which were significantly different from and less apparent than the fall on ground or crush injury to the spine (64.1%) in Modal-1 (χ 2=60.71, P<0.001). The anterior to posterior height ratio of the fractured vertebrae in Modal-2 was 0.78±0.13, 0.83±0.14, 0.84±0.13, and 0.78±0.18 in the OVCF patients complaining of back pain for <1 week, 1-weeks, 2-weeks, and >4 weeks respectively, showing no significant difference between groups ( F=1.01, P=0.009). In Modal-1, the anterior to posterior height ratio of the fractured vertebrae was lower in the OVCF patients complaining of back pain for 2-weeks (0.80±0.15) and >4 weeks (0.77±0.19) than in those with back pain for <1 week (0.85±0.11) and 1-weeks (0.86±0.14), with sinificant differences ( P<0.05). 32.4% (306/944) of the OVCF patients had one of the following geriatric comorbidities: hypertension, diabetes mellitus, coronary heart disease, cerebral infarction, and chronic obstructive pulmonary disease. The OVCF patients in Model-2 had higher comorbidity of coronary heart disease (21.3%) and cerebral infarction (36.3%) than those in Model-1 (11.6% and 20.3%). Bone mineral density information was available from 371 patients (308 females). In the age groups of <70, 70-, and >80 years, no significant difference was detected in the T-score values of the lumbar spine or hip joint between the OVCF patients in Model-1 and Model-2 ( F=0.13, P=0.880; F=0.62, P=0.538). Conclusion:Single-segment OVCF feature an asymmetric bimodal distribution that is demarcated by the T 10 vertebrae. The distribution pattern is not determined by gender or baseline bone mineral density but highlights the risk of mechanical stress and vertebral fragility within a specific segment. OVCF in the middle and upper thoracic spine is less frequent but common in older patients with higher comorbidity of coronary heart disease and cerebral infarction, which tend to be caused by less apparent spine trauma and maintain vertebral compression but complain of long back pain duration.

The incidence and risk factors of lumbodorsal fasciitis in osteoporotic vertebral compression fractures / 中华骨科杂志

Objective:To identify the incidence and risk factors related to lumbodorsal fasciitis in acute osteoporotic vertebral compression fractures (OVCF).Methods:The clinical data of 1182 acute OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 219 males and 963 females, aged 72.19±9.39 years (range, 45-98 years). The demographics, comorbidity profile, spine trauma, back pain duration, and vertebral fracture number of the OVCF with or without lumbodorsal fasciitis were summarized and compared. The independent risk factors of lumbodorsal fasciitis were identified by binary logistic regression analysis.Results:There were 532 cases of OVCF complicated with lumbodorsal fasciitis among 1,182 patients, and the incidence was 45.01%. The OVCF with fasciitis had higher ratio of males (23.5%, 125/532) than the OVCF without (14.5%, 94/650) fasciitis (χ 2=15.82, P<0.001). The OVCF with fasciitis were aged 74.57±9.21 years and significantly older than the OVCF (aged 70.24±9.60 years) without fasciitis ( t=7.85, P<0.001). The highest proportion of patients with OVCF combined with fasciitis was ≥80 years old (36.1%, 192/532), while most (34.6%, 225/650) of the OVCF without fasciitis were aged 60-70 years (χ 2=56.27, P<0.001). The OVCF with fasciitis had higher ratio of no evident spine trauma (37.0%, 197/532) and multiple vertebral fractures involving ≥3 vertebra (10.5%, 56/532) than the OVCF without fasciitis [26.3% (171/650), 3.2% (21/650); χ 2=17.67, P<0.001; χ 2=40.63, P<0.001]. The ratio of pre-hospital back pain >4 weeks was higher in the OVCF with (20.7%, 110/532) than without (7.4%, 48/650) fasciitis (χ 2=62.46, P<0.001). The OVCF with fasciitis had higher comorbidity of hypertension (52.8%, 281/532), coronary heart disease (14.7%, 78/532), and cerebral infarction (24.8%, 132/532) than the OVCF without fasciitis [42.8% (278/650), 9.9% (64/650), 17.9% (116/650); χ 2=11.85, P<0.001; χ 2=6.42, P=0.011; χ 2=8.56, P=0.003]. The OVCF with fasciitis had higher ratio of two comorbidities (23.7%, 126/532) than the OVCF without fasciitis (16.1%, 105/650) (χ 2=21.15, P<0.001). Binary logistic regression analysis showed significantly higher risk of lumbodorsal fasciitis in males than in females ( OR=1.69, P=0.001), in age group 60-<70、70-<80 and ≥80 years than in <60 years ( OR=2.28, P=0.002; OR=2.64, P<0.001; OR=4.90, P<0.001), in back pain for 2-<4 weeks and >4 weeks than in ≤1 week ( OR=1.70, P=0.005; OR=3.81, P<0.001), and in multiple fractures involving 2 and ≥3 vertebra than in single vertebrae ( OR=1.75, P=0.003; OR=3.36, P<0.001). Conclusion:Up to 45% of acute OVCF have concurrent lumbodorsal fasciitis. Male, aged ≥60 years, pre-hospital back pain ≥2 weeks, and fractures in ≥2 vertebra are independent risk factors of lumbodorsal fasciitis in OVCF.

The effects of transcranial magnetic stimulation on the expression of P2X7R and GFAP in the prefrontal cortex and hippocampus of mice modeling chronic depression / 中华物理医学与康复杂志

Objective:To investigate any effect of repeated transcranial magnetic stimulation (rTMS) on the expression of P2X7 receptor (P2X7R) and glial fibrillary acid protein (GFAP) in the prefrontal cortex and hippocampus of mice modeling depression.Methods:Thirty C57BL/6 mice were divided into a control group ( n=10) and a depression group ( n=20). The mice of the control group were raised in group (five mice per cage), while those of the depression group were kept alone for six weeks to induce depression. Among them, 16 were successfully modeled and randomly divided into a model group ( n=8) and an rTMS group ( n=8). The rTMS group received five sessions per week of 10Hz rTMS for 4 weeks. Any changes in depression-like behavior were observed and the expression of P2X7R and GFAP in the prefrontal cortex and hippocampus was measured. Results:Compared to the control group, a significant decrease was observed in the sucrose consumption rate in the sucrose preference test, in the distance moved in the open field test and in the expression of GFAP protein. But there was a significant increase in the immobile time in the tail suspension test and in the expression of P2X7R protein in the prefrontal cortex and hippocampus in the model group. At the conclusion of the experiment the differences in the sucrose consumption rate, the distance moved, GFAP protein expression, immobile time and P2X7R protein expression between the rTMS and the model group were all statistically significant.Conclusion:rTMS can reduce depression-like behavior, at least in mice. That may be related to inhibiting P2X7R expression and promoting GFAP expression in the prefrontal cortex and hippocampus.

The effects of clinical rehabilitation pathway management on intubation time, dysfunction and medical cost for stroke survivors after tracheotomy / 中华物理医学与康复杂志

Objective:To document any effect of clinical rehabilitation pathway management on intubation time, dysfunction and medical expenditure associated with tracheotomy after a stroke.Methods:A total of 154 stroke survivors undergoing tracheotomy were randomly divided into an observation group and a control group, each of 77. Both groups were given routine rehabilitation, while the observation group was additionally provided with clinical rehabilitation pathway management during the rehabilitation intervention. Kaplan-Meier analysis was performed before the experiment and after 2, 4 and 6 weeks of treatment. Clinical pulmonary infection scores (CPISs), scores on the Chelsea Physical Function Assessment Scale (CPAx) and hospitalization cost were compared between the two groups.Results:The median extubation time of the observation group (2d) was significantly shorter than that of the control group (10d). After 2, 4 and 6 weeks of treatment, the average CPIS scores of the observation group were in each case significantly lower than those before treatment and the control group′s averages at the same time points, even though after 4 and 6 weeks of treatment the control group′s average CPIS scores had improved significantly. After 2, 4 and 6 weeks of treatment, the average CPAx scores of the observation group were significantly higher than those before treatment and better than the control group′s averages, even though the control group too had improved significantly compared with before the treatment. Hospitalization days, total hospitalization cost, antibiotic cost and laboratory examination cost of the observation group were, on average, significantly lower than those of the control group.Conclusion:Rehabilitation path management can shorten the period of intubation, prevent pulmonary infections, relieve dysfunction, and reduce medical expenses for stroke survivors after a tracheotomy. It is worthy of clinical promotion.

Influencing factors for inadequate bowel preparation of colonoscopy of different colonic segments / 中华消化内镜杂志

Objective:To investigate the influencing factors for inadequate bowel preparation of colonoscopy.Methods:A total of 677 patients who underwent colonoscopy at Peking Union Medical College Hospital from December 2021 to January 2023 were recruited, and all patients underwent standardized bowel preparation by using 3 L polyglycol electrolyte powder with fractional dose. The quality of bowel preparation was assessed by Boston bowel preparation scale, and the influencing factors for inadequate bowel preparation were analyzed by logistic regression analysis.Results:The rate of inadequate bowel preparation was 31.5% (213/677). Among the patients with inadequate bowel preparation, 85.4% (182/213) inadequate bowel preparation was only in proximal colon, 14.1% (30/213) was in both proximal and distal colon, and 0.5% (1/213) was only in distal colon. Inadequate bowel preparation in distal colon and total colon were combined into inadequate bowel preparation in distal colon. The results of logistic regression analysis showed that inadequate bowel preparation in proximal colon was more likely to occur in men ( P=0.001, OR=2.253, 95% CI: 1.399-3.629), outpatients ( P<0.001, OR=4.175, 95% CI: 2.410-7.231), those with no family history of colorectal cancer ( P=0.001, OR=2.117, 95% CI: 1.365-3.284), and diagnostic colonoscopy ( P=0.003, OR=1.978, 95% CI: 1.261-3.102). And spinal disease ( P=0.044, OR=7.430, 95% CI: 1.051-52.511), outpatients ( P<0.001, OR=135.577, 95% CI: 29.135-630.883),non-compliance of dietary requirements ( P=0.006, OR=4.772, 95% CI: 1.576-14.453), adverse reaction during bowel preparation ( P=0.015, OR=4.341, 95% CI: 1.329-14.179), no family history of colorectal cancer ( P=0.003, OR=7.110, 95% CI: 1.912-26.438), and poor last stool character ( P=0.001, OR=25.922, 95% CI: 3.779-177.832) were risk factors for inadequate bowel preparation in distal colon. Conclusions:The inadequate bowel preparation of colonoscopy mainly occurs in proximal colon, and the risk factors for the inadequate bowel preparation vary in different colonic segments. Therefore, the specific interventions should be performed according to the character of different colon segments to improve the quality of bowel preparation.

Bibliometric analysis of brucellosis by CiteSpace / 药学实践与服务

Objective To perform a visual bibliometric analysis of hot spots as well as areas of Brucella disease research by searching brucellosis related literature. Methods A thematic search was conducted in the web of science core set database using Brucella disease or brucellosis as keywords to retrieve literature between January 1985 and December 2021. CiteSpace was used to visualize the countries, institutions, authors, and keywords in the retrieved relevant literatures. Results A total of 4 495 eligible articles studies were included, with the United States being the most populous country and the University of Sao Paulo being the most influential. Jilin University and Shihezi University in Xinjiang, China were relatively influential in this field. For the key words analysis, the top 3 of high-frequency words were infection, diagnosis, abortion, and in the 12 clusters formed, the clusters formed by #1, #4 were larger and the research hotspot continued. Keywords in the last five years including human brucellosis, immunity, zoonotic disease, were highlighted. Conclusion Study analysis suggested that human brucellosis with zoonosis was a research hotspot, more scholars focused on the infectious route and other exposure risks of cattle as intermediate hosts, epidemiological studies on brucellosis or will be new trends.

Systematic evaluation of prehospital external hemostatic dressings / 军事医学

Objective To evaluate the effectiveness,safety and operability of different types of pre-hospital topical hemostatic dressings given the limited clinical evidence of pre-hospital topical hemostatic dressings so as to provide reference for the subsequent establishment of a comprehensive index system.Methods A systematic review method was used to sift through and summarize the evaluation indexes of zeolite,kaolin and chitosan.Results Fifteen studies were included,only one of which was randomized controlled trial(RCT)study,and the rest were descriptive studies,involving military and civilian subjects.All the three types of hemostatic dressings in the included studies had good haemostatic effects,but the amount of data was too limited to compare the haemostatic effects between different types.Except for zeolite wounds that were likely to be burned by exothermic heat,the other types caused few adverse reactions but with unclear operability.There was no data on stability and economy in the selected literature.Conclusion Considering the ideal hemostatic agent and the standard requirements of Chinese expert consensus,it is recommended that the indicators in follow-up studies include efficacy,safety,operability,stability and economy,and that preclinical animal studies be included to supplement related indicators.

Etiological and clinical features of hand, foot and mouth disease caused by coxsackievirus A10 in Qingdao city, 2014—2021 / 中华微生物学和免疫学杂志

Objective:To investigate the molecular features of hand, foot and mouth disease (HFMD) caused by coxsackievirus A10 (CVA10) in Qingdao and analyze the clinical features of mild and severe cases.Methods:A total of 6 677 cases of HFMD routinely monitored by Qingdao Women and Children Hospital from 2014 to 2021 were enrolled. Throat swab samples were collected. Clinical data of these cases were retrospectively analyzed. Virus nucleic acid was extracted from the samples and the serotypes of enteroviruses were identified. The VP1 genes of CVA10 strains were amplified and sequenced. A phylogenetic tree based on the VP1 gene sequences was constructed using MEGA7. 0 software. SPSS23.0 software was used for statistical analysis.Results:There were 285 cases positive for CVA10, including 183 males and 102 females, and children under five years old accounted for 89.8%. Most of CVA10 infection occurred between the months of April to September. The count of white blood cells, the percentage of neutrophils, the concentration of hemoglobin, and the levels of aspartate aminotransferase and alanine transaminase were significantly higher in severe patients than in mild patients. Besides, chest radiography and brain CT revealed more abnormalities in severe patients, and the duration of ECG monitoring was longer in them. Compared with mild cases, severe cases developed rash early than fever with rash mostly on buttocks ( P<0.05). Phylogenetic analysis showed that most of the CVA10 strains circulating in Qingdao between 2014 and 2021 belonged to clade Ⅰ, and there were two variations A23V and I283V in the amino acid sequence of clade Ⅰ. Conclusions:This study showed that children of all ages were susceptible to CVA10, especially those under five years old. CVA10 showed complex and diverse epidemic trends in different regions and years.

Correlation of gene mutations and microsatellite instability in colorectal cancer tissues with clinicopathological features of patients / 肿瘤研究与临床

Objective:To explore KRAS, NRAS, BRAF gene mutations and microsatellite instability(MSI) in colorectal cancer tissues as well as their correlation with the clinicopathological characteristics of patients.Methods:The clinicopathological data of 473 colorectal cancer patients in Shanxi Province Cancer Hospital from October 2020 to May 2021 were retrospectively analyzed. The mutation status of KRAS, NRAS and BRAF gene in the paraffin tissues were detected by using amplification refractory mutation system (ARMS) method. Polymerase chain reaction (PCR)-capillary electrophoresis was used to analyze MSI status, and the correlation of the clinicopathological characteristics of patients with gene mutations and MSI status was analyzed.Results:The mutation rates of KRAS, NRAS and BRAF were 45.03% (213/473), 2.96% (14/473) and 5.50% (26/473), respectively in 473 patients with colorectal cancer. No case harbored both 2 gene mutations was detected. The mutation rate of KRAS gene in well differentiated adenocarcinoma was higher than that in poorly differentiated adenocarcinoma [47.4% (175/369) vs. 36.5% (38/104), χ2 = 3.89, P = 0.049]. NRAS mutation rate in female was higher than that in male [5.0% (10/202) vs. 1.5% (4/271), χ2 = 4.86, P = 0.027], and the NRAS mutation rate in patients with tumor diameter ≤ 3 cm was higher than that in those with tumor diameter >3 cm [7.1% (7/98) vs. 1.9% (7/375), P = 0.013]. BRAF mutation rate of tumors located in colon was higher than that in rectum [11.7% (20/171) vs.2.0% (6/302), χ2 = 19.81, P < 0.001]; BRAF mutation rate in poorly differentiated tumor was higher than that in well differentiated tumor [10.6% (11/104) vs. 4.1% (15/369), χ2 = 6.62, P = 0.010]; BRAF mutation rate in patients with mucus was higher than that in those without mucus [10.9% (11/101) vs. 4.0% (15/372), χ2 = 7.19, P = 0.007]; BRAF mutation rate in patients with lymphatic metastasis was higher than that in patients without lymphatic metastasis [8.2% (15/182) vs.3.8% (11/291), χ2 = 4.29, P = 0.038]. The incidence of high frequency MSI (MSI-H) in 473 colorectal cancer tissues was 7.19% (34/473). The incidence of MSI-H in colon was higher than that in rectum [14.0% (24/171) vs. 3.3% (10/302), χ2 = 18.82, P < 0.001]; the incidence of MSI-H in patient with poor differentiated tumor was higher than that in those with well differentiated tumor [17.3% (18/104) vs. 4.3% (16/369), χ2 = 20.46, P < 0.001]; the incidence of MSI-H in patients with mucus was higher than that in those without mucus [11.9% (12/101) vs. 5.9% (22/372), χ2 = 4.24, P = 0.039]; and the incidence of MSI-H in patients without lymphatic metastasis was higher than that in patients with lymphatic metastasis [10.0% (29/291) vs. 2.7% (5/182), χ2 = 8.75, P = 0.003]. In addition, the incidence of MSI-H was on the rise in patients with BRAF mutation ( P < 0.001). Conclusions:KRAS, NRAS, BRAF gene mutations and MSI status are correlated with the clinicopathological characteristics of patients with colorectal cancer; there is a close relationship between MSI-H and BRAF mutation.