Objective To observe the effects of different levels of stroke volume variation(SVV) directed fluid therapy on prognosis in elderly surgery patients. Methods One hundred and fifty-six patients (ASA gradeⅠorⅡ) having underwent abdominal surgery were selected, and the patients were divided into 3 groups according to the level of SVV with 52 cases each:low SVV group (SVV 3%-6%), middle SVV group (SVV 7% - 10%) and high SVV group (SVV 11% - 14%). Each group accepted different fluid therapy strategy. The intraoperative index, postoperative recovery index and complications were compared. Results The volume of crystalloid and volume of colloform in low SVV group and middle SVV group were significantly higher than those in high SVV group: (2 365 ± 517) and (2 080 ± 378) ml vs. (1 820 ± 579) ml, (1 105 ± 220) and (898 ± 239) ml vs. (559 ± 166) ml, and those in low SVV group were significantly higher than those in middle SVV group, and there were statistical differences (P<0.05). The urine volume in low SVV group was significantly higher than that in high SVV group:(717.4 ± 289.0) ml vs. (511.8 ± 326.3) ml, and there was statistical difference (P<0.05). The first exhaust time in high SVV group was significantly shorter than that in low SVV group:(81.2 ± 27.5) h vs. (98.9 ± 32.5) h, and there was statistical difference (P<0.05). The first level and above nursing time, postoperative hospital stay and total length of hospital stay in middle SVV group were significantly shorter than those in high SVV group and low SVV group: (4.4 ± 2.8) d vs. (5.3 ± 3.2) and (6.4 ± 3.7) d, (13.8 ± 5.2) d vs. (17.7 ± 8.4) and (19.5 ± 8.9 ) d, (22.7 ± 10.4) d vs. (26.8 ± 13.1) and (30.6 ± 10.3) d, and there were statistical differences (P<0.05). The incidence of stomal leak in high SVV group was significantly higher than that in low SVV group: 17.3% (9/52) vs. 3.8% (2/52), the incidences of postoperative infection in high SVV group and middle SVV group were significantly lower than that in low SVV group: 5.8% (3/52) and 5.8% (3/52) vs. 26.9% (14/52), and there was statistical difference (P<0.05). Conclusions The SVV 3% - 6% in elderly surgery patients may increase the risk of postoperative infection and prolong the time of hospitalization. But the SVV 7% - 10% may have a better postoperative recovery, and this level could be a better goal of perioperative fluid therapy in elderly surgery patients.

ObjectiveTo investigate and compare the efficacy, safety, and cost effectiveness in the treatment of painful osteoporotic vertebral compression fractures ( OVCFs ) with percutaneous vertebroplasty (PVP) and kyphoplasty(PKP). MethodsSeventy-two patients (96 vertebrae) with painful OVCFs were treated by PVP (n ＝34) or PKP (n ＝38) under radiological monitoring. After bone biopsy needle into the compressed vertebra, bone cement (polymethylmethacrylate) was injected in PVP group, and that was inserted followed by the inflation of vertebra to create cavities in PKP group. The fluoroscopy time, total amount of bone cement injected, and cost were recollected respectively. The score of visual analogue scale point( VAS, 10-point scale)was determined at before the procedures, and 24 hours, one week, and one month after the procedures.Pain relief and complications were observed.The Cobb angle and vertebral heights of the anterior, middle, and posterior border were measured pre-and post-operative. ResultsThe two procedures were technically successful in all patients. The follow-up ranged from 1. 0 to 34. 0 months [mean time, (8. 9 ±3.2) months]. The Mean fluoroscopy time of treating per vertebra in PVP group was ( 11. 1 ± 10. 6 ) min, which was significant shorter than that ( 23.5 ± 13. 0) min in PKP group( P ＜0. 05 ).The mean total cost per patient was (5127. 2 ± 502.3 ) yuan in PVP group, which were strikingly lower than that(32 301.4 ±3204. 6) yuan in PKP group (P ＜0. 05).(3)There was no significant difference( P ＞0. 05 ) in average cement volumes in PVP group [ (4. 9 ± 1.1 ) ml]and PKP group [ (5.4 ± 1.7 ) ml]. Pain relief of was observed in 94. 1％ (32/34) of PVP group and in 92. 1％ (35/38) of PKP group. The score of VAS at pre-operation was (8. 3 ±0. 4 vs 7.9 ±0. 8) ,and at post-operative 24 h (2. 9 ±0. 9 vs 2. 8 ± 1. 2),1 week (2.6 ± 0. 9 vs 2.6 ± 1. 1 ), and 1 month (2.6 ± 0. 9 vs 2. 5 ± 1.3 ) were no difference at PKP and PVP group(P ＜0.05). There was significant difference between pre- and post-operative time point in each group. The Cobb angle, anterior and middle height of vertebra was corrected in both PVP and PKP group. In PVP group, the preoperative Cobb angle, anterior and middle height of vertebra was (24. 2 ± 3.8 )°,( 19. 1 ± 1.4) mm, (25. 2 ± 1.0) mm, which was significant different ( P ＜ 0. 05 ) from that of ( 19.4 ±3.9)°, (21.0 ± 1.5) mm, (27.0 ± 1.2) mm at pre-operation.In PKP group,there was significant difference (P ＜ 0. 05 ) in the preoperative Cobb angle, anterior and middle height of vertebra [(25. 1 ±5.0)°vs(10.7 ±2.8)°, (19.5 ± 1.5) mm vs (24.3 ± 1.9) mm, (25.4 ± 1.1) mm vs (29.7 ±1.3) mm, respectively]. As to the above index, the overall correcting effect in PKP was much better than that in PVP( P ＜0. 05 ). Cement leakage occurred in 9 cases in PVP group and 3 cases in PKP group ( P ＜0. 05 ) but no symptoms. There were no major complications during operation in the two groups. Conclusion PVP and PKP are effective and safe in the treatment of painful OVCFs but PVP is more cost effective than PKP.

Potassium metabolism in young adult men exercising in the heat for six consecutive days and the effect of potassium deficiency in mice and rats induced by low potassium diet during heat exposure were observed. Increased potassium loss in sweat and lower potassium intake resulted in negative potassium balance. Individuals with a negative potassium balance had lower se- rum potassium levels and higher body temperature after exercise. Potassium deficient mice accomplished less work done (2.372 vs 4.253 Kg.M) but exih-ibited a markedly greater rate of heat gain (1.36 vs 0.87℃/Kg.M) as compared to the controls. The survival rate and cellular energy metabolism also decreasedThese observations suggest that prevention from potassium deficiency must be emphasized during prolonged physical activity under hot environments. According to the linear regression equations between potassium intake and balance, it is proposed that the potassium requirements in mild and medium physical activity in the heat are 40 and 60 mEq/day respectively, and the allowance of potassium in the latter may be 70-80 mEq/day.

Objective: To investigate the effect of gross total resection on the local control and survival of patients with stage IV neuroblastoma (NB) and analyze the extent of surgical resection of primary tumors that affects patient survival. Methods: A total of 96 patients with stage Ⅳ NB who were admitted to the Sun Yat-Sen University Cancer Center between January 2000 and December 2011 were analyzed. The patients were treated with combined-modality therapy, including chemotherapy, surgery, and/or radiotherapy. The patients were divided according to the extent of surgical resection of primary tumor into the following groups: group A, biopsy or tumor removal of less than 50% of the primary lesion; group B, incomplete resection of more than 50% but less than 90% of the lesion; group C, removal of more than 90% of the lesion; and group D, complete resection with or without macroscopic residual tumors. The survival rates of each group were analyzed. Results: The median age of the 96 patients was 4.4 years, ranging from 1.2-18.8 years. The overall 3-year progression-free survival (PFS) and overall survival (OS) of the total patients were 32.8% and 36.7%, respectively. A total of 24 cases were assigned in group A, 10 in group B, 23 in group C, and 39 in group D. Subgroup analysis revealed that the 3-year PFS rate was 17.5% for group A, 20.0% for group B, 45.1% for group C, and 40.5% for group D. The PFS rates were not statistically significant-ly different between groups A and B (P=0.352) and between groups C and D (P = 0.792). However, the OS was higher in groups C and D than that in groups A and B. The 3-year PFS rates were 42.2% and 17.8% for groups C and D (P<0.001), respectively. Conclu-sion: Resection extension of more than 90% of the primary tumor combined with chemotherapy and (or) radiation therapy can improve the survival of patients with stage Ⅳ NB. However, this treatment modality does not affect the treatment outcomes for minimal gross tu-mor residuals.

Objective: To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing. Methods: Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated. Results: The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05). Conclusion The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.

Objective: To describe the status of cardiovascular health (CVH) of children and adolescents aged 6-16 years in Beijing during 2017-2018. Methods: The school-based Cardiovascular and Bone Health Promotion Program(SCVBH) was conducted from November 2017 to January 2018. 15 391 children and adolescents aged 6-16 years were selected from grade 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Haidian Districts of Beijing by using a cluster sampling method. Seven cardiovascular health indicators, including smoking, body mass index, dietary intake, physical activity, blood pressure, blood glucose, and total cholesterol, were categorized as poor, intermediate, and ideal according to American Heart Association (AHA) criteria. The status of CVH was evaluated according to the criteria of the ideal CVH related behaviors and factors defined by AHA. Results: The proportion of children and adolescents with an ideal smoking, dietary intake and physical activity indicators reached 99.2%(4 982/15 108), 19.7%(2 921/14 805), 17.8% (2 499/14 056), respectively. The proportion of children and adolescents with 7 and 4-5 ideal cardiovascular health indicators was 1.7%(209/12 560) and 65.1%(8 176/12 560). The proportion of children and adolescents with 4-7 ideal cardiovascular health indicators, 2-4 ideal health behavior indicators and 2-3 ideal health factors was significantly higher in urban than that in rural all P values<0.001. The proportion of females with 4-7 ideal cardiovascular health indicators, 2-4 ideal health behavior indicators and 2-3 ideal health factors was significantly higher than that in males (all P values<0.001). Conclusion The prevalence of ideal cardiovascular health of children and adolescents aged 6-16 years in Beijing during 2017-2018 was very low, particularly for healthy dietary intake and physical activity. Effective public health interventions should be implemented to improve the status of cardiovascular health of them.

Objective: To investigate the sleep status in children and adolescents and explore the relationship between the sleep and high blood pressure in them. Methods: Data was from the Schoolbased Cardiovascular and Bone Health Promotiow Program (SCVBH) in Beijing. And 13 471 children and adolescents aged 6-16 years were selected from grades 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Tongzhou Districts of Beijing during 2017-2018 by using a cluster sampling method. Self-reported questionnaires were used to collect the demographic characteristics, lifestyle habits of children and adolescents. The blood pressure was measured by electronic sphygmomanometer. Multiple logistic regression model was used to analyze the association between sleep and hypertension risk. Results: The sleep duration was (8.4±1.1) hours. The prevalence of high blood pressure was 15.0%(2 021/13 471). The incidence of mouth breathing, slobber, snoring, and suffocate was 28.4%(3 823/13 471), 23.6%(3 184/13 471) and 18.7%(2 513/13 471), 2.8%(378/13 471) respectively. After adjusting for age, gender, snoring, mouth breaking, slobber, suffocate, the time for bed and sleep duration, we found that snoring and sleep duration (5.0-6.9 h) were both associated with high blood pressure (OR=1.49, 95%CI:1.32-1.69; OR=1.53, 95%CI: 1.28-1.81). Conclusion Snoring and sleep duration were positively associated with high blood pressure in this study. Interventions focusing on sleep status should be developed to reduce the incidence of high blood pressure in children and adolescents.

Objective To evaluate the nutritional status of elderly patients with cardiovascular by short-form mini-nutritional assessment ( MNA-SF ) , implement nursing interventions for malnourished patients, in order to reduce their risk of malnutrition and to improve their nutritional status. Methods The MNS-SF was used to evaluate the nutritional level of hospitalized patients, and mini-nutritional assessment ( MNA ) was utilized for malnutrition patients. The nursing interventions were implemented among malnutrition or malnutrition potential patients. Results Comparing before and after nursing interventions, the scores of MNA-SF and MNA had high uniformity (r=0. 773,0. 805;P<0. 01). After interventions, the scores of MNA-SF and MNA were (12.48 ±0.65) and (25.34 ±1.29) higher than the scores when admitted (t=12.377,15.120;P<0.01). After nursing interventions, the leukomonocyte was (1. 44 ± 0. 66) × 109/L, red cell (3. 90 ± 0. 52) × 1012/L, hemoglobin (120. 26 ± 15. 93) g/L, hematocrit (0. 360 ± 0. 055), albumin (36. 27 ± 3. 78) g/L, globin (29. 92 ± 7. 44)g/L, which were all higher than those before interventions (t=2. 529, 4. 937, 5. 726, 3. 947, 5. 547, 2. 125;P<0. 05);the patients′blood lipid level was (3. 93 ± 0. 90) mmol/L, TG (1. 02 ± 0. 53) mmol/L, LDL-C (1. 09 ± 0. 29) mmol/L and HDL-C (2. 08 ± 0. 58) mmol/L better than those before interventions (t=2. 875, 3. 633, 3. 557, 5. 727;P<0. 01). Conclusions The utilization of MNA-SF and MNA can simple, effective screen out malnutrition risk patients, and then the nursing interventions can reduce the risk of malnutrition in elderly patients with cardiovascular and improve the nutritional status of the patients.

Objective To understand the association between body fat distribution and calcaneal bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing. Methods Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12?year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 15 030 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, body composition and calcaneus bone mineral density were conducted. The relation of fat mass percentage (FMP), trunk to total fat ratio (TrTFR), trunk to limb fat ratio (TrLFR), limb to total fat ratio (LTFR) and viscera to total fat ratio (VTFR) with calcaneus BMD were assessed using the multivariate linear regression models after adjusting for possible confounding effects. The central fat distribution types were divided into 4 groups including type 1: both trunk fat and visceral fat greater than the sex?and age?specific internal P75; type 2: barely trunk fat greater than P75; type 3: barely visceral fat greater than P75; type 4: both trunk fat and visceral fat greater than P75. The central fat distribution types were included into the model in the form of dummy variables to analyze its relationship with calcaneal BMD. The sex?and age?specific z?scores of fat distribution indicators and BMD were calculated. Results A total of 15 030 participants aged (11.4 ± 3.3) years (50.2% boys) were involved in the analysis. In both genders, after adjusting for age, height, lean mass index, smoking, drinking, physical activity, milk intake, vitamin D and calcium supplementation, FMP, TrTFR, TrLFR and VTFR were negatively correlated with calcaneal BMD (all P value<0.05), while LTFR was positively associated with calcaneal BMD (all P values<0.05). Compared to the central fat distribution type 1, the regression coefficients (95% CI ) of type 2, 3 and 4 were-0.253 (-0.418,-0.087),-0.385 (-0.567,-0.204) and-0.428 (-0.487, -0.369) in boys, respectively; the regression coefficients (95% CI) of type 3 and 4 were -0.158 (-0.301,-0.015) and-0.226 (-0.290,-0.163), respectively. Conclusion Body fat distribution and central fat distribution in children and adolescents were correlated with calcaneus bone mineral density.

Objective To investigate the association between blood lipid and calcaneus bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing. Methods Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12?year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 14 303 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, blood lipid and calcaneus BMD were conducted. Multivariate linear regression was applied to quantify the association between calcaneal BMD as a dependent variable and blood lipid level as an independent variable after adjusting for the potential confounding factors. Furthermore, quantile regression was used to analyze the association between blood lipid level and different percentiles (P25, P50 and P75) of ultrasonic velocity values of bone mineral density, and parallel test was conducted for regression coefficients of different percentiles. Results A total of 14 303 participants aged (11.4 ± 3.3) years (49.9% boys) were involved in the analysis. The mean age of 14 303 participants was (11.0±3.3) years. 7 142 boys accounted for 49.9%. The mean±SD of calcaneal BMD, total cholesterol (TC), low density lipoprotein?cholesterol (LDL?C), and high density lipoprotein?cholesterol (HDL?C) were (1 540.9±33.8) m/s, (3.90±0.76), (2.18±0.62), and (1.40±0.32) mmol/L, respectively. The P50 (P25, P75) of triglyceride (TG) was 0.69 (0.49-0.94) mmol/L. After the adjustment of age, height, smoking, drinking, vitamin D and calcium supplementation, dairy intake, physical activity, FMI, and MMI, a significantly inverse association (P<0.05) between TG level and calcaneus BMD was observed in both genders, which the regression coefficients (95%CI ) in boys and girls were -0.064 (-0.085,-0.044) and-0.073 (-0.094,-0.053), respectively. Conclusion The level of BMD was associated with TG in boys and girls. Therefore, it is important to prevent children from hypertriglyceridemia for the bone health promotion.