Objective To evaluate autonomic nerve preserving extended operation (ANPEO) for rectal cancer in the protection of postoperative urinary and male sexual functions.[WT5”HZ]Methods [WT5”BZ] 80 Dukes B and C cases underwent ANPEO for rectal cancer, including 10 cases with unilateral ANPEO. Result was compared with that of 25 cases undergoing traditional extended radical operation. [WT5”HZ] Result [WT5”BZ] Among 70 cases with bilateral ANPEO and 10 cases with unilateral ANPEO normal postoperative erectile was maintained in 97 1% vs 70%, ejaculatory functions in 92 9% vs 50%, ability of sexual intercourse in 91% vs 40%, and orgasm in 88 5% vs 40% respectively. In 25 cases without ANPEO extended operation sexual functions were all lost. 3/80 cases with ANPEO suffered temporary urinary dysfunction, 23/25 cases without ANPEO suffered temporary urinary dysfunction and 7 with long term dysfunction [WT5”HZ]Conclusions [WT5”BZ] ANPEO is effective to reduce the postoperative urinary and sexual dysfunction while maintaining the radical cure for the cancer.

Objective To investigate the methods and clinical significances of preserving the pectoral nerve(PN) and intercosto-brachial nerve(IBN) in modified radical mastectomy. Methods Eighty-seven patients suffering from breast cancer in stage Ⅰ and Ⅱ were randomly divided into 2 groups. Transpectoral anterior approach was used on patients in group A(n=52),with axillary lymph node dissection, preservation of the pectoralis minor muscles, PNS and IBNS. Patients in group B(n=35) were operated on through transpectoral posterior approach, with dissection of pectoralis minor muscles, sections of PNS and IBNS. Results No case in group A and 28 cases(80%) in group B suffered from postoperative atrophy of pectoralis major muscles(P

Objective To observe the effect of Bacillus coagulans tablets Combined with minus Xiaoyao powder, Nifuratel nystatin soft capsule in treatment of VVC. Methods A total of 108 cases of VVC. patients were randomly divided into 2 groups:observation group and control group. In the observation group (n=54), patients were given vaginal placement of Nifuratel nystatin soft capsule, 1 capsule daily, for 6 days;oral administration of minus Xiaoyao powder, 1 agent daily, for 7 days; and oral administration of Bacillus coagulans tablets, 3 tablets one time, 3 times a day, for 14 days, double dose at first. In control group (54 cases), patients were given vaginal placement of Nifuratel nystatin soft capsule, 1 capsule daily, for 6 days;and oral placement of vitamin C tablet, 1 tablet one time, 3 times a day,for 14 days. The short-term effect and the long-term recurrence of were observed 3-7 days, 1 months, 3 months, 6 months after stopping drug treatment. Results 3 days after stopping drugs, the effective rate in the observation group and the control group was 92.59%and 81.48%, respectively, the difference between the two groups was statistically significant (P<0.05) . 6 months after stopping drugs, the recurrence rate was 9.26% in the observation group, and 20.37% in the control group, the difference was statistically significant (P<0.05) . Conclusion For Vaginal candidiasis, on the basis of antifungal therapy, giving Bacillus coagulans tablets for regulation of intestinal micro ecological environment, and traditional Chinese medicine minus Xiaoyao powder for clearing heat and removing dampness, soothing the liver, can significantly improve the short term and long term curative effects,and reduce the recurrence rate.

Objective:To systematically integrate qualitative studies of impediments to help-seeking behavior in victims of elder abuse.Methods:A computer search of PubMed, the Cochrane Library, Web of Science, PsyINFO, Scopus, China Biology Medicine disc, China Knowledge Network, Vipshop, and Wanfang was conducted to collect qualitative studies on help-seeking in abused older adults, with search time from establishment of the database to February 2022. The literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care quality assessment criteria, and the results were integrated using the Meta integration method.Results:A total of 9 papers were included, 32 results were extracted and grouped into 9 categories, and 3 integrated results were synthesized including the role of personal factors, the influence of cultural values, and the lack of effective support networks.Conclusions:Seeking help after elder abuse is a complex process influenced by a variety of personal, social and cultural factors. Awareness of seeking help after abuse should be raised, attention should be paid to the physical and mental health of the elderly, and professional assistance and counseling services should be provided.

Objective:To investigate the spiritual health status of nurses in elderly care institutions, analyze the potential categories of spiritual health of nurses in elderly care institutions and explore the influencing factors of different categories.Methods:This study was a cross-sectional survey. From April to July 2022, 352 nurses from 15 elder care institutions in Shandong province were selected to conduct a questionnaire survey on demographic characteristics and spiritual health. Potential profile analysis was used to identify different spiritual health categories, and one-way ANOVA and ordered logistic regression were used to test the differences in population characteristics.Results:There were group heterogeneity in the spiritual health of nurses in elderly care institutions, which were divided into "high level stable type" (34.66%), "medium level type" (44.89%) and "low self transcendence type" (20.45%). Ordered logistic regression showed that age ( OR = 1.054, OR 95% CI: 1.031-1.078, P<0.01), self-assessment health ( OR = 3.034, OR 95% CI: 1.478-6.221, P<0.01), and spiritual learning and training experience ( OR = 2.221, OR 95% CI: 1.370-3.600, P<0.01) were protective factors of spiritual health. Single parent families ( OR = 0.018, OR 95% CI: 0.002-0.197, P<0.01) and working 12 to 16 hours a day ( OR = 0.029, 95% CI: 0.009-0.091, P<0.01), working more than 16 hours a day ( OR = 0.046, 95% CI: 0.018-0.119, P<0.01) were risk factors for spiritual health. Conclusions:There are three potential categories of nurses′ spiritual health in the elderly care institutions, and different categories of nurses have different characteristics. Institutional managers should carry out targeted interventions according to different characteristics to improve their spiritual health.

Objective:To systematically analyze the influencing factors for fear of falling in the elderly.Methods:Computer search was used to search CNKI, VIP, Wanfang Database, China Biology Medicine disc, PubMed, Web of Science, EBSCO and Cochrane Library to obtain studies on the influencing factors for fear of falling in the elderly. The search time was from the establishment of the database to February 2023. Meta-analysis of data was performed using RevMan 5.3 software.Results:A total of 21 articles were included, including 16 cross-sectional studies, 3 case-control studies and 2 cohort studies and containing 27 025 older adults. The results of Meta-analysis showed that old age ( OR=1.64, 95% CI: 1.22-2.19) , female ( OR=2.19, 95% CI: 1.44-3.35) , chronic disease ( OR=1.61, 95% CI: 1.36-1.90) , fall history ( OR=2.89, 95% CI: 2.28-3.66) , depression ( OR=1.94, 95% CI: 1.39-2.71) , frailty ( OR=8.05, 95% CI: 4.01-16.16) , low activities of daily living ( OR=2.47, 95% CI: 2.05-2.96) , poor mobility ( OR=1.39, 95% CI: 1.17-1.65) and the need to use a walking aid ( OR=1.87, 95% CI: 1.42-2.48) were risk factors for fear of falling in the elderly ( P<0.05) . Conclusions:There are many risk factors for fear of falling in the elderly , including advanced age, female , chronic diseases, fall history, depression, frailty, low activities of daily living, poor mobility and the need to use walking aids. Due to the limitations of the number and quality of included studies, the above conclusions still need to be verified by more high-quality studies.

Objective: To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages. Methods: Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent. Results: The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (F=42.324, 10.220, 8.660, 11.254, 29.795, 31.305, 23.742, 27.738 and 34.638, all at P<0.001). The percentage of mature neutrophils in active stage BU group and quiet stage BU group were (73.10±10.21)% and (62.40±12.09)%, which were significantly higher than (54.95±6.07)% in healthy control group.The percentage of mature neutrophils in active stage BU group was significantly higher than that in quiet stage BU group (P<0.05). The percentages of non-cytotoxic T, NK lymphocytes, granular T and NK lymphocytes in active stage BU group and quiet stage BU group were significantly lower than that in healthy control group, the percentage of non-cytotoxic T, NK lymphocytes and granular T, NK lymphocytes in active stage BU group were significantly lower than those in quiet stage BU group (all at P<0.05). The percentage of immature granulocytes after treatment was significantly higher than that before treatment in improvement stage BU group (t=-2.469, P=0.036). Conclusions Increase of peripheral blood mature neutrophil was observed in BU patients, which may help to monitor the inflammatory activity of BU.

Diabetes mellitus(DM)is a disease syndrome characterized by chronic hyperglycaemia.A long-term high-glucose environment leads to reactive oxygen species(ROS)production and nuclear DNA damage.Human umbilical cord mesenchymal stem cell(HUcMSC)infusion induces significant antidiabetic effects in type 2 diabetes mellitus(T2DM)rats.Insulin-like growth factor 1(IGF1)receptor(IGF1R)is important in promoting glucose metabolism in diabetes;however,the mechanism by which HUcMSC can treat diabetes through IGF1R and DNA damage repair remains unclear.In this study,a DM rat model was induced with high-fat diet feeding and streptozotocin(STZ)administration and rats were infused four times with HUcMSC.Blood glucose,interleukin-6(IL-6),IL-10,glomerular basement membrane,and renal function were examined.Proteins that interacted with IGF1R were determined through coimmunoprecipitation assays.The expression of IGF1R,phosphorylated checkpoint kinase 2(p-CHK2),and phosphorylated protein 53(p-p53)was examined using immunohistochemistry(IHC)and western blot analysis.Enzyme-linked immunosorbent assay(ELISA)was used to determine the serum levels of 8-hydroxydeoxyguanosine(8-OHdG).Flow cytometry experiments were used to detect the surface markers of HUcMSC.The identification of the morphology and phenotype of HUcMSC was performed by way of oil red"O"staining and Alizarin red staining.DM rats exhibited abnormal blood glucose and IL-6/10 levels and renal function changes in the glomerular basement membrane,increased the expression of IGF1 and IGF1R.IGF1R interacted with CHK2,and the expression of p-CHK2 was significantly decreased in IGF1R-knockdown cells.When cisplatin was used to induce DNA damage,the expression of p-CHK2 was higher than that in the IGF1R-knockdown group without cisplatin treatment.HUcMSC infusion ameliorated abnormalities and preserved kidney structure and function in DM rats.The expression of IGF1,IGF1R,p-CHK2,and p-p53,and the level of 8-OHdG in the DM group increased significantly compared with those in the control group,and decreased after HUcMSC treatment.Our results suggested that IGF1R could interact with CHK2 and mediate DNA damage.HUcMSC infusion protected against kidney injury in DM rats.The underlying mechanisms may include HUcMSC-mediated enhancement of diabetes treatment via the IGF1R-CHK2-p53 signalling pathway.