Objective:To explore the application effect of pathway nursing combined with multimodal exercise intervention in patients with tumor-associated sarcopenia under multi-disciplinary team.Methods:Using the convenient sampling method, a total of 120 patients with tumor-associated sarcopenia who visited Cancer Center of Henan Provincial People 's Hospital from January 2020 to December 2021 were selected as the research objects. They were divided into the observation group ( n=60) and the control group ( n=60) according to the random number table method. The control group received routine nursing care, while the observation group received multi-disciplinary team pathway nursing combined with multimodal exercise. Skeletal Muscle Mass Index (SMI) , Hand Grip Strength (HGS) , daily walking speed, Cancer Fatigue Scale (CFS) and Irritability, Depression and Anxiety Scale (IDA) scores were compared and analyzed between the two groups. Results:After 4 weeks of intervention, HGS and daily walking speed in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . After 4 weeks of intervention, the total score of CFS in the observation group was lower than that in the control group, and the scores of physical fatigue, emotional fatigue and cognitive fatigue in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . After 4 weeks of intervention, the total IDA score of the observation group was lower than that of the control group, and the scores of anxiety, depression, extroversion and introversion stimulation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Multi-disciplinary team pathway care combined with multimodal exercise can improve the physical fitness of patients with tumor-associated sarcopenia, increase the level of physical activity, relieve fatigue and reduce negative emotions such as anxiety, depression and irritation.

Objective To explore the correlation of serum thyroid hormones with glucose and lipid metabolism in children with type 1 diabetes (T1DM) whose thyroid functions with normal.Methods 50 T1DM and 71 healthy children were enrolled in our study.Their blood glucose,lipid,HbA1c and thyroid functions were determined.Results Compared with the control group,patients with T1DM had higher low density lipoproteincholesterol (LDL-C),triglyceride(TG),fasting blood glucose (FBG) and HbA1c while with lower high density lipoprotein-cholesterol (HDL-C),thyroid Stimulating Hormone (TSH),and free triiodothyronine (FT3) (P＜0.05).In children with T1DM,TSH was positively correlated with LDL-C (r=0.175,P=0.034),total cholesterol (TC)(r=0.187,P=0.009) and TG(r=0.206,P=0.005) while negatively correlated with FBG(r=-0.187,P=O.018) and HbA1c (r=-0.264,P＜0.001).FT3 was negatively correlated with TG (r=-0.185,P=O.012),FBG (r=-0.193,P=O.O07) and HbA1c 0=-0215,P=0.002).But there were no correlations of FT4 with glucose or lipid metabolism.Conclusion TSH and FT3 are significantly correlated with glucose and lipid metabolism in children with T1DM.

Objective To construct the prokaryotic expression vector of human esophageal cancer related gene 4 (ECRG4), to purify the recombinant ECRG4 protein and to verify the biological function of the recombinant ECRG4 protein. Methods DNA recombination technology was utilized to construct the ECRG4 protein prokaryotic expression vector. The recombinant ECRG4 protein was purified with the transformation of escherichia coli. Then the purity of the recombinant ECRG4 protein was examined by using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis. Furthermore, esophageal cancer EC-18 cell line was treated by recombinant ECRG4 protein (10 μg/ml) for phosphate buffer (PBS) 48 h respectively, and the tumor cell cycle change was examined by using flow cytometry. Results SDS-PAGE analysis showed that the high purity of recombinant ECRG4 protein was obtained and the ECRG4 protein prokaryotic expression vector was successfully constructed. The cell proportion of G1 phase in PBS control group was lower than that in the recombinant ECRG4 protein group [(60.4 ±2.1) ％ vs. (71.6 ±1.8) ％; t= 25.695, P= 0.002]. The cell proportion of S phase in PBS control group was higher than that in the recombinant ECRG4 protein group [(24.6±1.4) ％ vs. (16.5±1.0) ％; t= 36.905, P= 0.001]. The cell proportion of G2/M phase in PBS control group was higher than that in the recombinant ECRG4 protein group [(15.0 ±1.1) ％ vs. (11.9 ±0.8) ％; t=6.471, P=0.023], which indicated that the recombinant ECRG4 protein could induce the G1 phase arrest of EC-18 cells. Conclusion The ECRG4 protein prokaryotic expression vector is successfully constructed. And the recombinant ECRG4 protein has an active biological function in esophageal carcinoma.

Objective To investigate the etiology and clinical manifestations of patients with suspected pertussis under 2 years old.Methods A total of 90 patients under 2 years old with suspected pertussis were collected prospectively from July 2015 to June 2016.Nasopharyngeal secretions and clinical data were obtained.Bordetella pertussis was detected by polymerase chain reaction (PCR).Patients were classified into pertussis group if the PCR was positive,or pertussis syndrome group if negative.Other 13 respiratory viruses and atypical pathogens were also detected,and bacterial culture was performed.Pathogens and clinical manifestations were compared between groups.For normal distributed data,continuous variables between groups were compared using two-sample t-test,while categorical variables between groups were compared using chi-square test.Results A total of 90 suspected cases were included,including 46 males and 44 females.Age ranged from 33 days to 18 months,and the median age was 3 months.Thirty-five cases (38.9％) were positive for Bordetella pertussis PCR (the pertussis group),the age ranged from 34 days to 13 months,the median age was 2 months.Fifty-five cases (61.1 ％) were negative (the pertussis syndrome group),with the age ranging from 33 days to 18 months,and the median age was 4 months.In pertussis group,there was a higher percentage of hospitalization history in 1 month before onset than that of the pertussis syndrome group,and the difference was statistically significant (x2=4.496,P＜0.05).Patients in pertussis group were more likely to have cyanosis and cough at night (x2=4.234 and 10.960,both P＜0.05),and the course of pertussis was longer than that in pertussis syndrome (t=3.402,P＜0.05).The length of hospital stay before pertussis onset in pertussis group was longer than that in the pertussis syndrome group (P＜0.05).The mean white blood count in pertussis group was (22.00±9.42) × 109/L,and that in pertussis syndrome group was (16.31±8.10) × 109/L,and the difference between the two groups was statistically significant (t=3.049,P＜0.05).In pertussis group and pertussis syndrome group,influenza virus A was detected in 22 and 44 cases,respectively;rhinovirus in 16 and 25 cases,respectively;parainfluenza virus in 5 and 12 cases,respectively;respiratory syncytial viruses in 3 and 6 cases,respectively.Conclusions Patient who presents with cyanosis,cough at night and high white blood cell count is more likely to have pertussis.Influenza viruses A,humanrhinovirus and human parainfluenza viruses are common pathogens to be found in patients with suspected pertussis under 2 years of age.

Objective:To analyze the clinical characteristics of monkeypox patients.Methods:The clinical data and laboratory findings of 4 patients with monkeypox patients diagnosed at Yiwu Central Hospital in July 2023 were analyzed. Herpes fluid and skin tissue samples were collected, the viruses were isolation and cultured in African green monkey kidney cells (Vero) and identified with whole gene sequencing.Results:All four patients were male, aged 24-35 years. All patients had male-to-male behavior within 21 days before onset of the disease. Among them, one patient has AIDS and one patient has syphilis. Four patients presented with perineal skin lesions with itching, and 3 patients were found to have enlarged lymph nodes upon admission. Laboratory testing: lymphocyte abnormality (4.57×10 9/L) in 1 case; increased procalcitonin (0.25 ng/mL) in 1 case; elevated IL-10 levels ( 7.11 ng/L and 9.42 ng/L) in 2 cases; increased IL-6 (66 ng/L) and IL-4 (3.24 ng/L) in 1 case, respectively. One case had abnormal myocardial zymogram with a elevated lactate dehydrogenase level of 313 U/L. The monkeypox virus was isolated from lesion tissue and herpes fluid, and the whole gene sequencing identified it as the B. 1.3 subtype of the IIb evolutionary branch, exhibiting typical pathological effects on Vero cells. Conclusion:The clinical manifestations of the 4 monkeypox patients confirmed in Zhejiang province are mild, patients had a definitive history of male-to-male sexual behavior and the virus strains belong to the B. 1.3 lineage of the IIb evolutionary branch.

Objective:To investigate the relationship between central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO 2) and left ventricular ejection fraction(LVEF) in acute myocardial infarction. Methods:Clinical data of patients with acute myocardial infarction admitted to the Intensive Care Unit of Fujian Provincial Hospital from November 2019 to October 2021 were retrospectively analyzed. LVEF was measured by bedside echocardiogram. The patients were divided into the normal LVEF group (LVEF ≥ 52%) and decreased LVEF group (LVEF < 52%) according to LVEF. The differences in general information and hemodynamic parameters between the two groups were compared. The normality of the above data was tested by the Jarque-Bera test. Correlation analysis of hemodynamic indices with LVEF was performed. Binary logistic regression was used to analyze the risk factors associated with the decrease in LVEF. The feasibility of diagnosing LVEF decline with Pcv-aCO 2 was assessed using receiver operating characteristic (ROC) curve. Results:Seventy-two patients with acute myocardial infarction were included for analysis, including 25 patients in the normal LVEF group and 47 patients in the decreased LVEF group. Pcv-aCO 2 was significantly higher in the decreased LVEF group than that in the normal LVEF group [(7.13±1.19) mmHg vs. (5.41±1.23) mmHg, P<0.01]. There was a negative correlation between LVEF and Pcv-aCO 2 ( rs= -0.740, P<0.01). The area under the ROC curve for Pcv-aCO 2 was 0.849 (95% CI: 0.758-0.939, P<0.01). The binary logistic regression analysis showed that Pcv-aCO 2 was an independent risk factor for decreased LVEF ( OR=2.251, 95% CI: 1.326-3.820). Conclusions:To a certain extent, the increase of Pcv-aCO 2 can predict the decrease of LVEF in acute myocardial infarction.

Objective To analyze the influence of total hip arthroplasty (THA) on the process of proximal femoral bone remodeling by using the Wolff bone remodeling theory. Methods According to control equation of bone remodeling, the program of bone remodeling was written in Python language. Preoperative femur model and postoperative femur and prosthesis finite element models were established respectively in ABAQUS software. The process of bone reconstruction before and after THA operation was compared to analyze the effect of prosthesis implantation on mechanical properties of the femur in the middle and long term after THA operation. Results The stress in proximal femur continued to decrease after prosthesis implantation, and the stress site was transferred from the femoral head to the prosthesis, resulting in an obvious stress shielding phenomenon. Bone loss in the stress shielding area was serious. The femoral shaft cortical bone became thinner and the stress shielding was relieved. The medial side at the bottom of the prosthesis was compressed, and the stress was significantly higher than that of the lateral side, where the bone was unevenly distributed. Conclusions After THA operation, obvious stress shielding occured at proximal medial side of the femur, leading to bone loss and prosthesis loosening. The difference in stress levels on both sides at the bottom of the prosthesis resulted in an uneven bone distribution, causing the discordance between the prosthesis and the femur, as well as postoperative pain in the middle part of the thigh.