Objective To investigate the decreasing pattern of activities of daily living (ADL) in patients with dementia. Methods A total of 204 patients with dementia were collected,among which 106 cases were with Alzheimer's diseases(AD),54 cases with vascular dementia(VD),44 cases with other types of dementia.According to the scores of mini-mental state examination(MMSE),mild,moderate and severe dementia were 42 cases,37 cases and 125 cases,respectively.All of them were assessed by Barthel index(BI) and compared among degrees of dementia,between AD and VD,and levels of education. Results The most reserved items were bowel movement (48.5 ％),urination (44.1 ％) and grooming (40.2％),while the most vulnerable items were climbing stairs (25.5％) and bathing(18.1％).With increasing impairment of cognition,the scores of BI were getting decreasing. There were significant differences among severe [(23.20 ± 29.27)scores],moderate[(65.54 ± 26.35) scores] and mild [(87.38 ± 22.69) scores] groups (x2 =99.686,P =0.000). Basic ADL were more reserved in AD (16.98％-53.77％) compared with VD (1.85％-33.33％) patients.No significant differences were found(x2 =3.653,P=0.161)among patients with education of primary school and below [(40.1 ± 39.0) scores],middle school[(45.3 ± 39.6 ) scores],and high school and above[(53.1 ± 37.7) scores]. Conclusions Among patients with dementia,bowel control,bladder control and grooming are well reserved,climbing stairs and bathing are vulnerable functions.Basic activities of daily living may be affected by cognitive status and the types of dementia but not levels of culture.

Objective To investigate the correlation between serum interleukin-8 (IL-8 )and immunoglobulin/complement 3A (IgA/C3)and immune imbalance in Henoch-Schonlein Purpura(HSP)in children,and provide evidence and guidance for clinical therapy of HSP.Methods Serum IL-8 was measured by Enzyme-linked immunosorbent assay(ELISA),and IgA and C3 were de-tected by automatic biochemistry analyzer,and calculate the ratio of IgA/C3.Results Serum IL-8 levels were (389±5 1.68)ng/L, significantly higher than that in healthy children (P < 0.05 ).Serum IgA levels were(306.2 ± 32.21 )mg/L,significantly higher (P <0.05).Serum C3 levels were (1 14.5 ±20.7)mg/L,of no statistical difference.IgA/C3 were (3.041 ±0.508 5),significantly higher(P <0.05).There was a positive correlation between IL-8 and IgA/C3 (r =0.534,P <0.05 ).Conclusion The children of HSP has cytokine and immunoglobulin disturbance,and presents a hyperreactivity in both humoral immunity and cellular immunity. Positive correlation between IL-8 and IgA/C3 was observed.

Objective:Managing 33-C3 femur fractures with medial wall bone defects poses a significant challenge for orthopedic surgeons.The gold standard treatment for arbeitsgemeinschaftfür osteosynthesefragen(AO)/orthopedic trauma association(OTA)33-C3 distal femur fractures with medial wall bone defects remains elusive.This study employs finite element analysis to compare the stability and mechanical behavior of 3 internal fixation patterns(single lateral distal locking plate,retrograde intramedullary nail,and dual plates)for 33-C3 femur fractures with medial wall bone defects.The aim is to provide a theoretical basis for the selection of internal fixation modalities in clinical practice. Methods:Enrollment included a 43-year-old male volunteer weighing 60 kg,without a history of femur fracture.Bilateral femur normality was verified through X-ray and CT scan assessments.A finite element simulation model of AO/OTA 33-C3 distal femur fracture with medial wall bone defect was established.Three fixation methods,named single lateral locking plate(single-plate group),retrograde intramedullary nail(retrograde intramedullary nail group),and dual plates(dual-plate group),were evaluated using finite element analysis under an axial load of 300 N.The assessment included an examination of von Mises stress distribution,shear stress,and displacement patterns at the internal fixation and femur fracture sites. Results:The finite element analysis revealed that dual-plate fixation effectively reduced the concentration of von Mises stress at the plate on the fracture site.Under full weight-bearing conditions,the maximum von Mises stress in the implants occurred at the distal femur defect level,with values of 149.30,59.281,and 58.03 MPa for single-plate fixation,retrograde intramedullary nail,and dual-plate fixation methods,respectively.Similarly,the maximum shear stress in the implants was 77.867,30.136,and 33.505 MPa for single-plate fixation,retrograde intramedullary nail,and dual-plate fixation methods,respectively,all presenting at the distal femur defect level.The maximum relative displacements of implants during compressive loading were 1.34,1.25,and 0.83 mm for the single-plate,retrograde intramedullary nail,and dual-plate groups,respectively.Consistently,the maximum loading-point displacements of fracture sites were 1.529,1.264,and 0.880 mm for the single-plate fixation group,retrograde intramedullary nail group,and dual-plate fixation group,respectively.Furthermore,at the distal femur defect level,the maximum von Mises stress was 72.682,112.430,and 40.716 MPa for the single-plate,retrograde intramedullary nail,and dual-plate fixation groups,respectively. Conclusion:Dual-plate fixation demonstrates superior biomechanical outcomes and exhibites the lowest maximum von Mises stress and shear stress,along with minimal relative movements between fracture fragments.This configuration offers optimal mechanical stability for managing AO/OTA 33-C3 distal femur fractures with medial wall bone defects.Consequently,dual-plate fixation emerges as a better treatment strategy for patients presenting with comminuted intra-articular distal femur fractures accompanied by medial wall bone defects.

The internal organs and meridians were associated with Yin and Yang, five elements, six qi, and time and space, based on the holistic view of heaven, earth and human, according to Huangdi Neijing. The syndrome differentiation system of six meridians and Zang Fu meridians were established by Shanghan Zabing Lun, on the basis of the three Yin, three Yang, six meridians, and five Zang system in Huangdi Neijing. We put forward the concept of the six meridians syndrome differentiation system of circular motion, considering that the six meridians syndrome differentiation system actually implies the theory of circular motion. The syndrome differentiation system was constructed with the circular model of one qi circulating around the road, rising left and falling right, corresponding up and down, and maintaining conservation in the middle as the core, integrating Yin and Yang, five elements, six qi, Zang Fu and meridians, qi, blood and body fluid, and the integration of heaven, earth and human, focusing on "disease location and disease nature", taking classical prescriptions as the main treatments, and cooperating with external treatments such as acupuncture and moxibustion. We organically combined the circular motion with the syndrome differentiation of the six meridians, systematically interpreted the physiological bases, pathological changes, progressive patterns, and the treatments, based on syndrome differentiation, by inheriting the classical thinking mode of Hetu, Luoshu,Zhouyi, Huangdi Neijing, ShennongHerbal Classic, and Shanghan Zabing Lun.