Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

【Objective】 To retrospectively analyze the blood transfusion of 322 patients with Stanford type A aortic coarctation in our hospital, and to explore the influencing factors of perioperative blood transfusion in patients and evaluate the effect. 【Methods】 The patients with Stanford A type aortic coarctation who underwent surgical treatment in our hospital from October 2020 to October 2023 were selected to analyze the differences in blood transfusion and the monitoring of blood routine and coagulation function between different surgical modalities, and to evaluate the influencing factors of massive blood transfusion. 【Results】 The intraoperative allogeneic red blood cell transfusion rate was 63.98% and the perioperative allogeneic red blood cell transfusion rate was 85.71% in patients with Stanford type A aortic coarctation. The intraoperative red blood cell, plasma, cryoprecipitates and platelet transfusion volumes for the Bentall procedure were (3.75±3.81) U, (608.13±314.77) mL, (15.25±8.39) U and (1.53±0.78) therapeutic doses, respectively, and had no difference compared with those for Sun′s procedure with the transfusion volume of (3.13±4.04) U, (707.61± 461.21) mL, (15.79±6.59) U and (1.54±0.64) therapeutic doses and those for Bentall&Sun’s procedure with the transfusion volume of (3.04±4.41) U, (813.48±582.02) mL, (18.39±6.43) U and (1.76±0.58) therapeutic doses(P>0.05). Preoperative hemoglobin levels were significantly lower in patients treated with Bentall procedure (127.75±23.17) g/L and in patients treated with Sun′s procedure (126.07±16.14) g/L than in patients treated with Bentall & Sun′s procedure(133.17±18.12) g/L(P<0.05). Postoperative hemoglobin, APTT and platelet counts were not statistically different between groups(P>0.05). Perioperative erythrocyte massive infusion accounted for 53.42%. The length of hospital days(days) in the massive transfusion group (23.83±9.74) was significantly higher than that in the conventional transfusion group (31.71±22.98), and the mortality rate in the massive infusion group 34.88% was significantly higher than that in the conventional transfusion group (5.33%)(P<0.05), and the hemoglobin level (g/L) at discharge in the massive infusion group(95.65±11.58)was lower than that in the conventional transfusion group(101.93±15.77)(P<0.05). 【Conclusion】 Blood transfusion is necessary to ensure the perioperative treatment of patients with acute Stanford type A aortic coarctation. Massive transfusion of red blood cells is accompanied by an increase in mortality rate and prolonged hospital stay. The test of coagulation function is helpful in guiding the use of blood components, and individualized restrictive transfusion strategy can reduce unnecessary blood transfusion and is conductive to patient safety.

Objective:To explore the method of developing a canal-shaped implant template using a combined automatic pre-planning and 3D printing technology, and assess its impact on dose and efficacy improvement.Methods:Retrospective analysis of 15 patients with advanced cervical cancer admitted to the Affiliated Cancer Hospital of Guangxi Medical University from September 2020 to September 2022 was performed. Patients had characteristics such as vaginal stump recurrence, tumor eccentric growth, and previous hysterotomy, etc. Three-dimensional images were obtained by CT scan after automatic pre-planning. The PMT 3D software was used to analyze digital imaging and communications in medicine (DICOM) radiotherapy data, capture the coordinates of the pre-planned stay points to establish the implant channel, and generate the size and shape of the canal-shaped implant template based on patients' physiological structure. Dosimetric parameters, such as conformity index (CI), were evaluated. The changes of tumor size before and after treatment were analyzed by paired t-test. Results:Fifteen patients were treated with the canal-shaped implant template. The CI was 0.74±0.26, the total radiation dose (HR-CTV) D 90% (EQD 2, α/β=10) was (85.5±6.8) Gy, and the D 2 cm3 (EQD 2, α/β=3)for bladder, rectum, small intestine, and colon were (72.2±4.2), (65.8±6.1), (65.2±4.4), and (69.8±3.7) Gy, respectively, meeting clinical needs. After the treatment, the tumor volume was significantly decreased. The template had a good fit with the vaginal cavity, and a small amount of air gap on the sidewall did not affect the dose. Non-parallel needle insertion increased the utilization of the cavity space and implant needles. Conclusion:The method of developing the canal-shaped implant template using automatic pre-planning and 3D printing technology is efficient and effective, meets the requirements of modern precise radiotherapy, and has practical clinical value.

OBJECTIVE To analyze the evolution of the focus of Chinese pharmaceutical administration, so as to improving the effectiveness of drug regulation. METHODS Through word frequency and social network analysis, the word cloud and network graph were visualized for the evolution process of Chinese drug regulatory policies, and the different evolutionary characteristic of policies content were analyzed using graph density, clustering coefficient, betweenness centrality, degree centrality and other indicators. RESULTS There were differences in network characteristics in different periods, the overall network connection tended to be tight, the structure tended to be optimized, and the connection between individual network subgroups was gradually complicated. However, the number of subgroups decreased in 2018—2022, and the core nodes were transferred. CONCLUSION In the current special period of “epidemic economy”, it is necessary to broaden the special policy areas and strengthen the coordination and intersection of policy concerns.

【Objective】 To analyze the blood transfusion strategies in extracorporeal membrane oxygenation (ECMO) recievers in our hospital, so as to explore the clinical application and efficacy of blood transfusion in patients on ECMO. 【Methods】 Data from patients on ECMO treatment in our hospital from October 2017 to October 2021 was collected. The blood transfusion data and coagulation monitoring indexes during different ECMO modes were analyzed, and the efficacy of blood transfusion was evaluated. 【Results】 No difference in the number of blood transfusions was noticed by ECMO treatment modes.The transfusion units of red blood cells, plasma and platelets in VA mode were (28.35±14.60) U, (7 367.78±5 194.33) mL and (7.04±5.10) therapeutic volumes, which were higher than those in VV mode, i. e. (18.67±21.50) U, (4 836.67±6 640.50) mL and (3.60±7.47) therapeutic dose, respectively.In VA-ECMO mode, the Hb level and platelet count before ECMO treatment were (126.44±23.9) g/L and (223.84±67.62) × 10⁹/L, which were significantly higher than those after treatment (91.02±21.48) g/L and (172.86±127.73)×10⁹/L.In VV-ECMO mode, the APTT before ECMO treatment was (35.28±8.73) s, which was shorter than that after treatment (41.96±13.69) s. The levels of fibrinogen, Hb and platelet count were (3.80±1.85) g/L, (123.81±33.77) g/L and (175.72±98.91)×10⁹/L, which were significantly higher than the levels after treatment (2.78±1.08) g/L, (92.31±17.38) g/L and (125.31±98.14)×10⁹/L, respectively. 【Conclusion】 There are differences in the amount of blood transfusion among different modes of ECMO treatment. As blood transfusion is a necessary support to ensure ECMO treatment, the monitoring of coagulation index is conducive to reduce blood transfusion, improve the efficiency of blood transfusion and benefit to patient safety.

OBJECTIVE：To study the r elationship between corporate social responsibility ，financing constraints and corporate performance of listed pharmaceutical companies ，so as to provide reference for pharmaceutical enterprises to fulfill their social responsibility in China. METHODS ：Taking 211 A-share listed pharmaceutical companies in China from 2015 to 2018 as samples ， using corporate performance as explained variables ，corporate social responsibility and financing constraints as explanatory variables，asset size ，equity nature ，growth，R&D investment ，marketing investment and annual as control variables ，a multiple regression equation was constructed to study the relationship among corporate social responsibility performance ，financial constraints and corporate performance and put forward the suggestions. RESULTS ：Corporate social responsibility had a significant positive impact on corporate financial performance ；in the promotion of corporate social responsibility on corporate performance ， finacing constratins couldn ’t inhibit the promote function. CONCLUSIONS ：In China ’s pharmaceutical industry ，the awareness of corporate social responsibility needs to be improved ；pharmaceutical enterprises actively perform social responsibility will interactively promote corporate performance. The overall financial constraints faced by Chinese pharmaceutical enterprises are not high，and enterprises which facing financial constraints will better improve their performance by fulfilling corporate social responsibility. It is suggested that the government should promote the legislative process of corporate social responsibility ； pharmaceutical enterprises should enhance the awareness of social responsibility and pay attention to the impact of financing constraints；investors should pay real-time attention to the responsibility information and actual performance of pharmaceutical enterprises.

Objective : To evaluate the safety and immunogenicity of a split-virion quadrivalent influenza vaccine. Methods : The healthy people aged three years or over in Wuyang County and Xiping County of Henan Province were divided into the experimental group, control group 1 and control group 2, and were vaccinated with split-virion quadrivalent influenza vaccines, split-virion trivalent influenza vaccines (without B/Victoria) and a split-virion trivalent influenza vaccines (without B/Yamagata) , respectively. The hemagglutination inhibition (HI) antibodies were detected before and after immunization. The incidence rate of adverse events following immunization (AEFI) , HI antibody positive conversion rate, the protection rate of HI antibodies and the growth of geometric mean titer (GMT) were calculated and compared with the standard of Food and Drug Administration (FDA). Results: Totally 2 924 people were recruited, with 975 in the experimental group, 974 in the control group 1 and 975 in control group 2. The incidence rate of AEFI in the experimental group was 11.7%, higher than 7.9% in control group 1 and 8.8% in control group 2 (P < 0.05) during 30 minutes and 8 days after inoculation. The positive conversion rates of HI antibodies of H1N1, H3N2, By and Bv in the experimental group were 78.5%, 53.3%, 78.3% and 62.9%, respectively. The rate differences of the positive conversion rates of HI antibodies of By between the experimental group and control group 2, and of Bv between the experimental group and control group 1 were 42.1% (95%CI: 38.0%-46.2%) and 33.2% (95%CI: 28.9%-37.5%) , with both lower limits of 95%CI more than -0.10. The GMT increase of HI antibodies was more than 2.5 times in the three groups. The protective rates of HI antibodies of H1N1, H3N2, By and Bv in the experimental group were 87.7%, 98.7%, 93.6% and 77.2%, respectively. The protective rates of HI antibodies of By in control group 2 and Bv in control group 1 were 71.1% and 51.0%, both lower than those in the experimental group (P < 0.05). Conclusions After the inoculation of the quadrivalent influenza vaccine, the positive conversion rates (>40%) , protection rates (>70%) and GMT increase (>2.5 times) of HI antibodies of H1N1, H3N2, By and Bv all meet the quality standards of FDA. The safety and immunogenicity of the quadrivalent influenza vaccine are not inferior to those of the trivalent influenza vaccine.

OBJECTIVE: To investigate the expression profile of long non-coding RNAs (lncRNA) and identify potential lncRNA-related competing endogenous RNAs (ceRNA) in placenta accrete spectrum disorders (PAS). METHODS: Five tissue specimens of placental implantation and 5 adjacent normal placental tissues were collected from cesarean section deliveries complicated by PAS in our hospital between December, 2017 and June, 2018. Human microarrays were used to identify the lncRNAs that were differentially expressed in PAS, and 5 of the identified lncRNAs were further validated using qRT-PCR. GO and KEGG pathway analyses were performed to indentify the most significant enrichment functions. A ceRNA network was constructed based on ENST00000511361 (RP5-875H18.4), NR_027457 (LINC00221) and NR_126415 (FOXP4-AS1) to pinpoint the potential lncRNAs-related ceRNA. RESULTS: A total of 329 lncRNAs and 179 mRNAs were identified to have differential expression in PAS. The results of qRT-PCR were consistent with the human microarrays results. Transforming growth factor-β (TGF-β) signaling pathway was the most significantly enriched pathway. The constructed ceRNA network suggested that RP5-875H18.4--miRNA-218--SLIT2 had a potential ceRNA regulatory mechanism in PAS. CONCLUSIONS The differentially expressed lncRNAs are involved in the occurrence and progression of PAS possibly by regulating the TGF-β signaling pathway. The ceRNA network of RP5-875H18.4--miRNA-218--SLIT2 may play a role in the occurrence of PAS.

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.Methods Fifty-four patients of both sexes,aged 18-64 yr,with body mass index of 20-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective video-assisted thoracoscopic thymectomy,were allocated into 2 groups (n =27 each) using a random number table method:sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P).After routine anesthesia induction in two groups,anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P.Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1.2).The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1,2,4,24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump,requirement for rescue analgesia and development of nausea and vomiting were recorded at T7.Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P＞0.05).Compared with group S,the intensity of pain was significantly alleviated at T2,and VAS scores and morphine consumption were decreased at T3,4 in group P (P＜0.05).There were no significant differences between group P and group S in VAS scores or consumption of morphine at T5-7,or pressing times of analgesia pump,requirement for rescue analgesia or incidence of nausea and vomiting at T7 (P＞0.05).Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.

Objective To determine the relationship between neuronuscular block induced by cisatracurium for tracheal intubation during anesthesia induction and types of myasthenia gravis (MG).Methods Sixty-five patients of both sexes with MG,aged 20-75 yr,weighing 53-92 kg,with body height of 155-185 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective videoassisted thoracoscopic thymectomy,were enrolled in the study.Among the 65 patients,there were 8 patients with ocular MG (type Ⅰ),19 patients with mild generalized MG (type]Ⅱ a),33 patients with subacute generalized MG (type Ⅱ b),2 patients with acute MG (type Ⅲ) and 3 patients with late severe MG (type Ⅳ).Neuromuscular monitoring was initiated when the patients lost consciousness after induction of anesthesia.Cisatracurium was administrated with the initial dose of 0.05 mg/kg,and if T1 depression was less than 95％ within 6 min,cisatracurium 0.015 mg/kg was intravenously injected until T1 depression was more than 95％.The patients were then tracheally intubated.The amount of cisatracurium consumed for intubation,onset time (from the beginning of cisatracurium injection to T1 depression ＞95％) and recovery time (recovery of T4/T1 to 25％ of control height) of neuromuscular block were recorded.T1 depression ＞ 95％ within 6 min after administration of 1-fold ED95 cistracuriun was defined as sensitivity to muscle relaxants.The requirement for cistracurium ＞ 1-fold ED95 when T1 depression ＞ 95％ was defined as insensitivity to muscle relaxants.The proportion of sensitivity/insensitivity was calculated.Results There was no significant difference in the amount of cisatracurium consumed for intubation and onset time and recovery time of neuromuscular block between patients with type Ⅰ and those with type Ⅱ a (P＞0.05).Compared with patients with type Ⅰ and type]Ⅱ a,the amount of cisatracurium consumed for intubation was significantly decreased,the proportion of sensitivity/insensitivity was increased,the onset time was shortened,and the recovery time was prolonged in patients with type Ⅱ b (P＜0.05).Conclusion With the severity of MG,the consumption of cisatracurium is gradually decreased when used for tracheal intubation during anesthesia induction,and the sensitivity is gradually increased in the patients with MG.