Objective:To understand the predictive effect of orthostatic hypotension on frailty in nursing homes, and the effect of frailty on heart rate and blood pressure in supine positionand orthostatic position.Methods:A total of 214 elderly cases in three nursing homes (the Golden Years of Jinjialing Retirement Life Center, Hangzhou Boyang Pension Service Co., Ltd, Hangzhou Langhe International Medical Care Center) were interviewed by the general information questionnaire, the Frail Scale and Barthel Index. Systolic blood pressure, diastolic blood pressure, and heart rate were measured by electronic sphygmomanometer in supine position and orthostatic position of 1 and 3 minutes.Results:The incidence of frailty combined with orthostatic hypotension was 26.64%(57/214) in the elderly in nursing homes. The incidence of orthostatic hypotension in the robust elderly, pre-frailty and frailty gradually increased, 14.29%(5/35), 20.00%(12/60), 47.90%(57/119). The differences of heart rate and systolic blood pressure in supine position between the elderly with and without frailty were significant ( t=2.16, 3.25, P<0.05), the differences of systolic pressure difference in orthostatic position of 1 and 3 minutes between the elderly with and without frailty were significant ( H=3.16, 4.08, P<0.01). There was significant difference in systolic pressure between the prefrail elderly and the elderly without frailty in lying position ( t=2.02, P<0.05). The differences of systolic and diastolic pressure differences in orthostatic position of 3 minutes between the frail elderly and pre-frail elderly were significant ( H=3.13,2.44, P<0.05). Ordered Logistic regression analysis showed that orthostatic hypotension was a risk factor for frailty ( OR=2.425, 95% CI were 1.133-4.988, P<0.05). Conclusions:Elderly adults with orthostatic hypotension in nursing homes have a higher prevalence of frailty. Frailty also impairs blood pressure regulation during postural changes. Nurses should attach importance to the assessment, education and intervention of frailty and orthostatic hypotension.

Gingival recession could result in root exposure, dental hypersensitivity and poor aesthetics. It has been demonstrated that varieties of root coverage procedures can significantly improve gingival recession in short-term (≤6 months), of which coronally advanced flap combined with connective tissue graft is the gold standard technique for treatment of gingival recession. It could obtain the optimally complete root coverage and maintain long-term stability (≥2 years). However, clinical knowledge about the long-term effectiveness of the other alternative graft materials remain very limited. Based on the existing clinical evidence, this article reviews coronally advanced flap, coronally advanced flap combined with connective tissue graft or alternative graft materials, with particular attention to the long-term stability of them, in order to provide reference for the design of further clinical trials and the plan of clinical treatments.

The geriatrics department of Zhongnan Hospital covers all subspecialties of internal medicine with six separated wards, so it is difficult to manage and teach the students who participate in standardized training for resident physicians. In the residents' standardized training of geriatrics department, the interactive support platform named micro-teaching assistant was applied to carry out teaching activities such as classroom check-in, classroom testing and classroom discussion of teaching rounds and small lectures. It not only effectively manages the teaching order, but also improves students' enthusiasm and autonomy by encouraging them to participate in classroom interaction actively. The case analysis quiz and interactive discussion have a good effect on consolidating and deepening the students' professional knowledge, and improving the ability of clinical analysis and problem solving. The attendance rates, class discussion and test scores were recorded in a real and objective way, so that teachers can observe the whole process of students' learning and then make a formative assessment. At the same time, teachers are urged to adjust the teaching contents and progress in time, so as to achieve the goal of promoting "teaching" and "learning" mutually.

Objective To investigate the effect of resveratrol (RSV) on epithelial-mesenchymal transition of MDA-MB-231 cells by down-regulating POLD1 expression. Methods CCK-8 was used to detect the effect of RSV on the activity of MDA-MB-231 cells. POLD1-OE and POLD1-NC cell lines were constructed by transfecting MDA-MB-231 cells with recombinant lentivirus. Western blot was used to detect the expression of POLD1, E-cadherin, N-cadherin and Vimentin after RSV treatment. Transwell invasion experiment and the scratch test were used to detect the cells invasion and migration abilities of each experimental group. Results RSV could significantly inhibit the survival of MDA-MB-231 cells, reduce the expression of POLD1, N-cadherin and Vimentin, increase the expression of E-cadherin, and inhibit the abilities of cell invasion and migration. Increasing the POLD1 expression could reduce the above-mentioned biological effects of RSV on MDA-MB-231 cells. Conclusion RSV could significantly inhibit the viability and EMT of MDA-MB-231 cells by down-regulating the expression of POLD1.

Objective:To construct the pregnancy risk prediction model of chronic kidney disease (CKD) pregnant women by analyzing their renal function and pregnancy outcome in the first trimester.Method:Totally 313 CKD women with 322 pregnancies who had deliveries in Peking University First Hospital from March 2009 to December 2018 were retrospectively analyzed. The history of kidney disease and renal function in the first trimester were collected, and the relationship between CKD and premature delivery, low birth weight infants, severe preeclampsia and fetal loss were analyzed.Result:Among 322 pregnancies with CKD, 120 (37.3%, 120/322) had adverse pregnancy outcomes. CKD stage, serum creatinine, urea, albumin, hemoglobin, 24-hour urine protein quantity and whether complicated with hypertension were independent predictors of adverse pregnancy outcome. A prediction model logit (P)=2.107+0.255×24-hour urine protein quantitative (g/24-hour)-0.107×albumin (g/L)+1.677×whether complicated with hypertension (1 or 0)+ 0.639×CKD stage was established. The area under curve value of the model was 0.812, the best threshold, sensitivity, specificity and Yoden index were 0.436, 0.658, 0.856 and 0.802, respectively.Conclusion:CKD stage, serum albumin, 24-hour urine protein quantity in the first trimester and hypertension are the main risk factors of adverse pregnancy outcome, which could predict the occurrence of adverse pregnancy outcome of CKD pregnant women and deserve further study.

Objective:To fully learn about the iodine nutrition level and the status quo of prevention and control of iodine deficiency disorders (IDD) among children aged 8 - 10 years and pregnant women in Southern and Northern Xinjiang of Xinjiang Production and Construction Corps (hereinafter referred to as the Corps), and to provide a basis for consolidating the prevention and control effect of IDD and proposing sustainable prevention and control strategies.Methods:From May to November 2020, IDD monitoring was carried out within the Corps. ⑴Salt iodine monitoring: in 14 divisions of the Corps, 1 regiment was selected in each division from five directions of East, West, South, North and Middle, and 4 companies were selected from each regiment and edible salt samples were collected from the homes of 15 Corps employees to test for salt iodine. ⑵Monitoring of urinary iodine and goiter: in 13 divisions of the Corps, 1 regiment was selected from each division according to five directions of East, West, South, North and Middle, and 40 children aged 8 - 10 years (age balanced, half male and female) from one primary school and 20 pregnant women were selected as the survey subjects. Once random urine sample was collected from children and pregnant women to detect urinary iodine; the thyroid volume of children was measured and the goiter rate was calculated.Results:⑴A total of 4 149 salt samples were tested, the median salt iodine was 27.3 mg/kg, the coverage rate of iodized salt was 99.9% (4 146/4 149), the qualified rate of iodized salt was 98.1% (4 069/4 146), and the consumption rate of qualified iodized salt was 98.1% (4 069/4 149). Among them, 1 197 and 2 952 salt samples were tested in Southern and Northern Xinjiang of the Corps, the median salt iodine was 26.7 and 27.5 mg/kg, respectively; the coverage rate of iodized salt was 99.7% (1 194/1 197) and 100.0% (2 952/2 952), respectively; the qualified rate of iodized salt was 95.0% (1 134/1 194) and 99.4% (2 935/2 952), respectively; the consumption rate of qualified iodized salt was 94.7% (1 134/1 197) and 99.4% (2 935/2 952), respectively; and the differences between regions were statistically significant ( P < 0.05). ⑵A total of 2 602 urine samples of children aged 8 - 10 years were detected, and the median urinary iodine was 186.5 μg/L; the median urinary iodine of children (800 and 1 802) in Southern and Northern Xinjiang of the Corps was 181.9 and 188.5 μg/L, respectively. A total of 1 247 urine samples of pregnant women were detected, and the median urinary iodine was 192.6 μg/L; the median urinary iodine of pregnant women (397 and 850) in Southern and Northern Xinjiang of the Corps was 182.2 and 200.3 μg/L, respectively. ⑶A total of 2 602 children aged 8 - 10 years were examined for thyroid volume, and the goiter rate was 1.2% (31/2 602); the goiter rate of children in Southern and Northern Xinjiang of the Corps was 1.4% (11/800) and 1.1% (20/1 802), respectively. Conclusion:In 2020, the Corps has reached the elimination standard of IDD by divisions, and children aged 8 - 10 years and pregnant women are generally at an appropriate iodine level.

Objective To explore the association between iron metabolism indexes and the risk of gestational diabetes mellitus(GDM)in pregnant women with advanced age.Methods A total of 292 pregnant women,whose age were≥35 years old and gave birth in Taicang First People's Hospital from April 2021 to April 2023,were retrospectively included and divided into GDM group and non-GDM group.The differences of iron metabolism indexes[serum ferritin(SF),serum iron(SI)and hemoglobin(Hb)]measured from the 20 to 24 weeks of gestation were compared between the two groups.Multivariable Logistic regression model was used to explore the association of SF,SI and Hb with GDM.Based on the data of single nucleotide polymorphism from IEU OpenGWAS(http://gwas.mr-cieu.ac.uk/)and FinnGen datasets,two samples Mendelian randomization analysis were conducted to explore the causal relationship between iron metabolism indexes and GDM by using the methods of Inverse Variance Weighted(IVW).Results In the maximally ad-justed multi-factor logistic models,the statistically significant association between SF measured from 20 to 24 weeks of gestation and the risk of GDM was found[odds ratio(95％confident interval)=1.02(1.01-1.04),P=0.001].The association between Hb and GDM was marginally significant[odds ratio(95％confident interval)=1.04(1.00-1.07),P=0.044],but no association between SI and GDM reached statistical significance.However,Mendelian randomization analysis showed there was no significant evidence for causal association between SF,Hb and GDM.Conclusion SF examined at 20 to 24 weeks of gestation could be used as a biomarker of GDM in the pregnant women with advanced age,but no evidence supported the causal association between SF and GDM.

Ischemic stroke (IS) is the result of a combination of multiple risk factors, and its pathogenesis involves multiple systemic physiological and pathological changes. Recent studies have found that the activation of renin-angiotensin system (RAS) is closely related to the development of IS. In this review, we mainly summarize the generation of RAS and pathogenesis of RAS in IS.

Objective:To develop radiopharmaceuticals for targeted alpha therapy (TAT), a simple and useful 225Ac- 213Bi generator was developed to provide a short half-life α-emitter 213Bi. Methods:DIPEX resin was used as the stationary phase of the generator, a Sep-Pak Alumina N Plus Light Cartridge column was utilized as the column to construct the generator, and hydrochloric acid was used as the eluent. The γ spectrometer was used to determine the purity of the eluted 213Bi and verify the method to measure the radioactivity of 225Ac and 213Bi by using radioisotope calibrators. The elution curves of the generator at various settings were analyzed to find the best elute and storage conditions. Results:Using commercial 225Ac, 100 mg DIPEX resin and a Sep-Pak Alumina N Plus Light Cartridge column, a 225Ac- 213Bi generator with a column volume of 0.35 ml was constructed, which could be eluted 213Bi with a syringe drenched with hydrochloric acid. The produced 213Bi was pure, and the measured half-life was (45.75±0.12) min, which was consistent with the theoretical value (45.6 min). CRC ? calibrators with setting numbers of #086 and #018 could measure the activity of 225Ac and 213Bi with the average errors of -2.6% and + 0.2% respectively. The eluent for the 225Ac- 213Bi generator was 2 mol/L hydrochloric acid, of which 320 μl was required only to get 90% elution yield. The generator was recommended to be stored directly in the eluent to avoid drying. Conclusion:The 225Ac- 213Bi generator can be constructed to obtain 213Bi for TAT.

Objective To investigate the characteristics of human papillomavirus (HPV) prevalence and genotype distribution of 18 535 cases in Yuncheng . Methods A sample of 18535 residents who underwent HPV testing in our hospital from August 2020 to September 2023 were enrolled, and HPV genotyping was done to all samples. Then the rate of HPV infection, age distribution, genotype distribution, and multiple infections were statistically analyzed. Results Of the 18,535 subjects included, a total of 4,639 tested positive for HPV, demonstrating a positive rate of 25.03%. The positive rate of HPV infection varied among different age groups (χ²=29.587, P<0.05), with higher rates found in <25 years old group (29.61%) and >60 years old group (25.89%). Overall, 23 genotypes, covering 5315 viruses, were detected. There were 5 low-risk genotypes with the highest percentage of HPV42 (9.29%), and there were 18 high-risk genotypes with HPV52, HPV58, HPV66 and HPV53, subtypes as the most frequent subtypes, accounting for 13.64%, 8.97%, 7.41% and 7.04%, respectively. The type of HPV infection was predominantly single infections, with an overall single infection rate of 21.62% (4008/18535), which accounted for 86.40% (4 008/4 639) of all positive cases, and a multiple genotype infections rate of 3.40% (631/18535). The 25-34 year old group accounted for the largest proportion of single infections (25.12%), while the <25 year old group accounted for the largest proportion of multiple genotype infections (30.74%). Conclusion The prevalence rate of HPV infection in Yuncheng is 25.03%, with a higher positive rate in the <25 years age group and the >60 years age group. A total of 23 HPV genotypes are detected, of which the main genotypes are HPV42, HPV58, HPV66 and HPV53, and the type of infection is dominated by single infections.