Objective To investigate the effect of blood specimen collection from umbilical vein catheter on catheter usage condition and relevant complications. Methods 80 premature infants with indwelling umbilical vein catheter were divided into the blood collection group and the non-blood collec-tion group, then the hospitalization time, catheter indwelling time and rate of catheter-related complications were compared. The 40 premature infants in the blood colleetion group were subsequently divided into the experimental group in which blood was collected from umbilical vein catheter and the control group in which blood was collected from peripheral blood vessel, then the blood collection time, success rate and influence on newborns were compared. Results There was no significant difference in hospitalization time, catheter indwelling time and rate of catheter-related complications between the blood collection group and the non-blood collection group. There was statistical significance in blood collection time, success rate and adverse reaction on suffering newborns between the experimental group and the control group. Conclusions There was no obvious influence on the regular service of the catheter if only the method is correct and operating procedure is normative, also it possesses advantages such as no pain, high success rate, peripheral vascular protection, etc. So, it can be used as one of the ways to collect blood speci-men for critical newborns.

Objective:To explore the status and obstacle factors of exercise in elderly maintenance hemodialysis (MHD) patients, so as to provide a clinical evidence for exercise guidance and targeted intervention in elderly maintenance hemodialysispatients.Methods:A mixed method of consistent parallel design was adopted. A total of 180 elderly MHD patients in two ClassⅢ hospitals of Kunshan in December 2021 were enrolled using convenience sampling method and investigated by questionnaire. The statas of exercise and exercise self-efficacy were researched. Objective sampling method was used to interview 17 elderly MHD patients with semi-structured interviews. The obstacle factors of exercise were investigated.Results:A total of 180 valid questionnaires were collected in the quantitative study. The highest metabolicequivalent of leisure time physical activity was 1 188 MET-min/w, the lowest was 0 MET-min/w, and the median was 396 MET-min/w. Pearson correlation analysis showed that there was a positive correlation between exercise self-efficacy and physical activity in elderly MHD patients ( P<0.05). Qualitative study extracted 3 themes and 9 subthemes, including lack of exercise knowledge, low self-efficacy, family and social environment resource limitation. Conclusions:Elderly MHD patients lack ideal exercise state. In clinical practice, medical staff should popularize exercise knowledge, improve patients' exercise self-efficacy, carry out family support education, increase social support, and select suitable exercise methods and develop individualized exercise programs according to patients' disease characteristics, so as to improve their exercise status.

Objective To investigate the state of nursing professional values of student nurses and its changing patterns during different internship stages .Methods To investigate a group of 120 student nurses before and after the internship stages with Nursing Professional Values Scale-R( NPVS-R) .Results The results showed significant differences of nursing professional values during different stages of internship .During the stage of pre-internship:[female:(105.87 ±14.56), male(100.49 ±5.56)];[college students:(108.98 ± 14.56), bachelor students: (106.49 ±5.56)]; [single child: (100.87 ±14.56), non-single child:(105.49 ±5.56)];[limited economic access: (105.87 ±14.56), wealthy: (100.49 ±5.56)], and the differences were significant (t=2.47, 2.22, 2.41, 2.47, respectively;P<0.05).During the stage of post-internship [female:(107.54 ±15.12), male: (101.39 ±6.43)]; [ college students: (111.54 ±15.12), bachelor students:(108.39 ±6.43)]; [ single child: (103.54 ±15.12), non -single child:(107.39 ± 6.43)];[limited economic access: (107.54 ±15.12), wealthy: (102.39 ±6.43)], and the differences were significant (t=2.52, 2.30, 2.44, 2.59, respectively;P<0.05).During the stage of pre-internship:trust scored (3.64 ±0.51), responsibility safety scored (3.39 ±0.46), action reliability scored (3.09 ± 0.54), care provide level scored (3.39 ±4.45).During the stage of post -internship, the scores were (3.95 ±0.45), (3.45 ±0.54), (3.12 ±0.66), (3.41 ±4.41).Conclusions The start of nursing professional values among student nurses was relatively low .In clinical teaching and training , the instructors should put emphasis on professional values and emotion .When educating and demonstrating the student nurses , instructors can lift the professional values so that it can be established properly .

Life-space, as a multidimensional structure, is an important indicator for measuring individual movement. Since the first proposal of life-space in 1985, it has gradually been applied in multiple fields. At present, the development of life-space in foreign countries is becoming increasingly mature, while there is little research on this aspect in China. This article reviews the definition, evaluation tools, and application progress of life-space in cardiac rehabilitation, so as to provide reference for the research and application of life-space in home-based cardiac rehabilitation in China.

Objective:To observe the effects of alendronate (ALN) on the expression of autophagy signaling pathway related proteins LC3, Beclin-1 and P62 in the muscle tissue of mice with denervated skeletal muscle atrophy, and to explore the potential molecular biological mechanism of ALN in the treatment of skeletal muscle atrophy.Methods:Thirty males C57BL/6 mice were divided into three groups with 10 mices in each group by random number method, including blank control group: sciatic nerve exposed without resection, model group: sciatic nerve exposed and resection, ALN group: sciatic nerve resection +ALN intervention. At the intervention stage, mices were given 1 mg/kg ALN by intragastric administration. The weight of gastrocnemius muscle was weighed by wet weight method. Atpase staining was used to distinguish muscle fiber types. HE staining was used to observe the arrangement and cross-sectional area of gastrocnemius muscle fibers in each group, and further quantitative analysis was performed by Image J 1.48 software. Western blotting and immunohistochemical staining were performed to detect the expressions of MHC and MuRF1 as well as LC3, Beclin-1 and P62 in gastrocnemius tissues of each group.Results:The weight of gastrocnemius muscle in the model group 137±7.80 mg was significantly lower than that in the blank control group 203±10.34 mg, which proved that the denervation muscle atrophy mouse model was successfully established. After intervention, the gastrocnemius muscle weight of ALN group 177±11.65 mg was significantly higher than that of model group, and the muscle mass was significantly improved. HE staining showed that muscle fibers in the model group were loosely arranged and the cross-sectional area was significantly smaller than that in the blank control group, and there were more blue stains among muscle fibers. Atpase staining showed that the distribution of type II muscle fibers in the model group was increased compared with that in the blank control group, and the distribution of type II muscle fibers in the ALN group was decreased compared with that in the model group, but higher than that in the blank control group. The results showed that the most widely distributed muscle fiber cross-sectional area was 600-800μm 2 in the blank control group, 200-400 μm 2 in the model group, and 400-600 μm 2 in the ALN group. The results of quantitative calculation of muscle fiber cross-sectional area by Image J 1.48 showed that the mean value of muscle fiber cross-sectional area in the model group was (352±18) μm 2, which was significantly reduced compared with the blank control group 794±20 μm 2. After ALN treatment, muscle fiber cross-sectional area recovered somewhat. The mean muscle fiber cross-sectional area of ALN group was 578±23 μm 2, which increased muscle fiber cross-sectional area by 29%. Western blotting results showed that the expressions of MHC, LC3 and Beclin-1 in model group were significantly lower than those in blank control group ( P<0.05), while MuRF1 and P62 proteins were significantly higher than those in blank control group ( P<0.05). The MHC, LC3 and Beclin-1 proteins in ALN group were significantly higher than those in model group (0.12±0.01 vs. 0.10±0.003, 0.15±0.02 vs. 0.10±0.02, 0.13±0.03 vs. 0.09±0.04). MuRF1 and P62 proteins in ALN group were significantly lower than those in model group (0.10±0.004 vs. 0.15±0.01, 0.16±0.03 vs. 0.20±0.03). MHC immunohistochemical staining showed that the expression of MHC in gastrocnemius of mice in model group was significantly lower than that in blank control group, and the expression of MHC in gastrocnemius of mice in ALN group was higher than that in model group ( P<0.05). Conclusion:ALN has a therapeutic effect on skeletal muscle atrophy, and its mechanism may be realized by moderately activating the LC3/Beclin-1 autophagy signaling pathway.

ObjectiveTo observe the variation in content of vascular endothelial growth factor （VEGF） in patients with Alzheimer's disease （AD） and to investigate efficacy of Yangxue Qingnao granule on AD and the effect on VEGF. MethodA total of 60 patients with cognitive impairment ［30 of AD and 30 of amnestic mild cognitive impairment （aMCI）］ were selected， and another 30 healthy people with Montreal Cognitive Assessment （MoCA）≥26 and age， gender， and complications insignificantly different from the patients were included as healthy control. The venous blood of aMCI group， AD group， and the healthy control group was collected at the enrollment to measure the level of serum VEGF. Then， the aMCI and AD patients were randomized into the observation group and the control group， with 30 patients in each group. The control group was given Donepezil Hydrochloride （5 mg·d^-1）， while the observation group received Donepezil Hydrochloride （5 mg·d^-1） and Yangxue Qingnao granule. MoCA was used to evaluate the severity of cognitive impairment. After the treatment for 6 months， the clinical efficacy and adverse reactions of the two groups were compared， and the serum VEGF levels were detected again by enzyme-linked immunosorbent assay （ELISA）. ResultThe serum content of VEGF in AD patients was significantly lower than that in aMCI patients and healthy people （P<0.05）. Serum VEGF levels in aMCI patients were significantly decreased compared with those in healthy people （P<0.05）. After treatment for 6 months， the serum VEGF level in the observation group was significantly higher than that before treatment， and was higher than that in the control group （P<0.05）. MoCA scores in the observation group were higher than those in control group （P<0.05）. The incidence of adverse reactions was insignificantly different between both groups. ConclusionThe serum levels of VEGF significantly decreased in aMCI and AD patients， suggesting that angiogenesis might be involved in the pathophysiological process of AD and correlated with the early stage of AD. Yangxue Qingnao granule， as a safe adjuvant therapy， showed ideal effect on aMCI and AD， as manifested by the improvement of cognitive function. The mechanism is the likelihood that it can elevate the expression of angiogenic factors such as VEGF， promote angiogenesis， and then improve the microcirculation of cortex.

Objective　To analyze the clinical efficacy and tolerance of lakosamine in the treatment of patients with focal epilepsy.Methods　Forty-four cases of focal epilepsy patients who received LCM from from March 2019 to July 2020 department of neurology,Kunming san bo hospital and the first affiliated hospital of Kunming medical university.The seizures and tolerance of the forty-four patients were followed up in February 2021.Results　After the addition of LCM drugs,the frequency of epileptic seizures in patients with follow-up time of at least 6 months was significantly reduced,the difference was statistically significant (P<0.01).The efficiency can be up to 81.81% and Retention rates can reach 83%.Conclusions　As the third generation of new Anti-seizure medications,LCM can effectively reduce the frequency of epileptic seizures in some patients with focal epilepsy.Very few patients had intolerable adverse reactions.

Objective:To explore and screen the immunophenotypic characteristics of acute promyelocytic leukemia (APL) by multiparameter flow cytometry (MFC).Methods:A retrospective and descriptive study. A total of 130 acute myeloid leukemia (AML) patients who registrated in Hebei Yanda Lu Daopei Hospital were studied, among which there were 44 classical APL (cAPL), 24 microgranular variant of APL (APLv) and 62 non-APL patients (including NPM1 mut AML and AML with KMT2A rearrangement). MFC immunotyping was used to analyze and compare the median expression intensity (MEI) of side scatter (SSC), along with the ratio of the MEI on leukemic cells with those on lymphocytes (T/L MEIR), the median fluorescence intensity (MDFI) of CD34, myeloperoxidase (MPO), CD64 and CD9 on leukemic cells, as well as the ratios of these MDFIs on leukemic cells with those on lymphocytes (T/L MDFIR). Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficiency of the multiparameters model for distinguishing cAPL and non-APL, APLv and non-APL. Results:The MEI and T/L MEIR of SSC in the cAPL group were higher than those in the APLv and non-APL groups ( P<0.05), and these two parameters in APLv group were higher than those in the non-APL group, respectively ( P<0.05). The MDFIs of CD34 in cAPL and APLv groups were higher than those in the non-APL group ( P<0.05), and the T/L MDFIR of CD34 was higher in APLv group than non-APL group ( P<0.05). The MDFIs of MPO and CD9, as well as the T/L MDFIRs in cAPL and APLv groups were both higher than those in the non-APL group, respectively ( P<0.05). The MDFI and T/L MDFIR of CD64 in the cAPL group were higher than those in non-APL group, respectively ( P<0.05). ROC curve results showed that the area under the curve (AUC) of MEI of SSC, the MDFI of CD64 and CD9, as well as the T/L MEIR of SSC and T/L MDFIR of CD9 were 0.932, 0.816, 0.893, 0.960 and 0.894 for diagnosing cAPL, respectively, and the AUC of these parameters were 0.725, 0.737, 0.791, 0.729 and 0.736 for diagnosis APLv, respectively ( P<0.05). Conclusion:MFC method can analyze and screen the immunophenotypic characteristics of APL for differential diagnosis of cAPL, APLv and non-APL patients.

Objective:To explore the optimal index of rotational displacement of femoral neck fractures by modeling the axial rotational displacement of femoral neck fractures after reduction and based on X-ray projections.Methods:Six dry human femur specimens, comprising 2 males and 4 females, were utilized in the study. Design and manufacture a proximal femur ortholateral and oblique X-ray casting jigs and mounts. The femoral neck fracture was modeled on the femoral specimen, with Pauwells 30°, 50°, and 70° models (2 each) made according to Pauwells typing. The fractures were manually repositioned with residual anterior 20°, 40° and 60° axial rotational displacements. Each fracture model was projected at different angles (pedicled 40°, pedicled 20°, vertical 0°, cephalad 20°, and cephalad 40°), and the trabecular angle and Garden's alignment index of the model were measured to observe the imaging characteristics of the fracture line on the medial oblique and lateral oblique radiographs.Results:In the presence of a 20° and 40° anterior rotational displacement following reduction of a femoral neck fracture, the trabecular angle in the rotationally displaced group was not significantly different from that of the anatomically repositioned group in various projection positions. However, when a residual rotational displacement of 60° was present, the trabeculae appeared blurred at most projection angles in the Pauwells 30° and 50° models, failing to measure trabecular angles. In the Pauwells 70° fracture model, the trabecular angle in the rotational displacement group was significantly different from that in the anatomical reduction group. In anteroposterior radiographs, when the anterior rotation displacement was 60° in the Pauwells 70° group, Garden's contralateral index showed an unsatisfactory restoration (150°, 142°), whereas all rotationally displaced models in the Pauwells 30° and Pauwells 50° groups had a Garden's contralateral index of >155°, which achieved an acceptable restoration. In lateral radiographs, all rotational displacement models with Garden's alignment index>180° failed to achieve acceptable repositioning, and the larger the Pauwells angle the greater the Garden's alignment index at the same rotational displacement. In the internal oblique position with a bias towards the foot side, the image showed partial overlap between the femoral head and the shaft, making it difficult to assess the quality of the reduction. Conversely, when projected cephalad, the femoral neck appeared longer, particularly at a projection angle of 40° cephalad, allowing for clear observation of the fracture line and the anatomy of the proximal femur. The trabeculae were not well visualized in the external oblique position.Conclusion:There are limitations in applying the trabecular angle to assess the axial rotational displacement of the femoral head after reduction of femoral neck fractures. The Pauwells 70° with residual rotational anterior displacement of 60° was the only way to detect axial rotational displacement of the femoral head on anteroposterior radiographs Garden's alignment index. For the determination of axial rotational displacement of the femoral head, the Garden's alignment index on lateral radiographs provides higher reliability.

Sarcopenia, referred to as myopenia, is a systemic syndrome characterized by decreased muscle mass and muscle strength, and decline of motor function.The elderly are a high incidence group of myopenia.With the aging of the world's population becoming increasingly severe, the incidence rate of sarcopenia has also increased, which has brought a heavy burden to the elderly family and society, and has become an important social health problem for the elderly.At present, there are more and more researches on sarcopenia, but the pathogenic factors of sarcopenia are complex and diverse.The prevention and treatment of sarcopenia still need to be further explored and studied.The establishment of an ideal animal model is the key premise and basis for the related research of sarcopenia.In this paper, the different modeling methods, advantages and disadvantages as well as the scope of application of sarcopenia animal models are described, which can provide reference and help for the subsequent animal experimental research of sarcopenia.