Objective To observe the effects ofShenkang bolt on the IL-10 and IL-6 of patients with continous ambulatory peritoneal dialysis (CAPD).MethodsA total of 60 patients with CAPD were divided into the control group (n=30) andShenkang bolt observation group (n=30). The control group was treated with convertional treatment of CAPD, low salt, low fat, low phosphorus and high quality diet. The observation group was treated withShenkang bolt based on control group treatment. The clinic effect was detected after treatment for 8 weeks. The serum creatinine was determinated by basic picric acid method, and blood urea nitrogen was determinated by urease test. The clinic and biochemical indicator of Scr, BUN, 24h urine volume, Kt/Vurea, RRF, and ultrafiltration volume were compared between the two groups. The IL-10 and IL-6 were detected by ELISA analysis.Results After treatment, IL-10 (19.56 ± 4.38μg/mlvs. 8.98 ± 2.05μg/ml,t=4.392,P<0.01) was significantly higher in observation group than that in control group, and IL-6 (21.82 ± 3.57μg/mlvs. 49.66 ± 5.26μg/ml,t=5.264,P<0.01) was significantly lower in observation group than that in control group. The RRF (7.86 ± 2.12vs. 5.31 ± 1.62;t=2.436, P=0.046) and ultrafiltration volume (421.37 ± 81.61 ml/dvs. 321.23 ± 71.94 ml/d;t=2.617, P=0.038) was significantly higher in observation group than those in control group. ConclusionShenkang bolt could help patients with CAPD balancethe immune, suppress inflammation and improve the RRF and ultrafiltration volume.

Objective To summarize experience in pectoralis major myocutaneous (PMMC) flap reconstruction for patients undergoing head and neck surgeries. Methods We conducted a retrospective study to analyse the clinical data of 20 patients who had PMMC flap reconstruction in a head and neck surgery from March 2011 to June 2016. All patients were male,with the average age of 54 years(ranging from 27 to 71 years). The PMMC flaps of all patients survived after the surgery. Only one patient developed pharyngocutaneous fistula ,and was recovered after treatment with incision dressing. Among follow?ups for 2 to 24 months,all patients got well recovered,the swallowing and communication functions normal communication and the appearance a satisfactory. good looking. Conclusion PMMC renders effective flathe flap reconstruction with broad clinical application value is an optimal choice for patients underwent head and neck surgery with muscle or skin defect,especially for those who had postoperative radiotherapy because of its rich blood supply and it has a lot of affluent tissues,fmore flexibility inle application and higher survival rate. So it is highly applicable,especially for grass?roots hospitals.

Abstract Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.

Objective To explore the application of high-frequency color Doppler in the diagnosis of infant intussusception and the selection of reduction mode according tO the hemodynamic situations of intussusception intestine tube and blood vessel in mesentery.Methods A total of 377 cases of doubtful intussusception infants wete checked by high-frequency color Doppler.After they had been diagnosed,the hemodynamic situations of intussuscepiton intestine tube and blood vessel in mesentery were carefully observed and the ultra-sound had 3 types and then the hydrostatic enema reduction was chosen as treatment method.Results A total of 263 cases was diagnosed by highfrequency colot Doppler with rate of coincidence of 100%.Among them are 253 successful cases reduced by hydrostatic enema.The successful rate of reduction was 96.2%and the 10 failed cases were changed to be treated bv operation.The intestinal wall of intussusception tube in failure group had serious dropsy without blood flow shown.Conclusions It is accurate that the infant intussusception is diagnosed by high-frequency color Doppler.According to the hemodynamic situations of intussusceptin intestine tube and blood vessel in mesentery,the infant intussusception can be divided into 3 types as follows:type Ⅰ:the blood signal of intestinal tube and wall is up or normal,which shall be reduced by hydrostatic enema;type Ⅱ:the blood signal of intestinal tube and wall is small with high obstruction index,which shall be reduced by hydrostatic enema as possible as it can;type Ⅲ:the intestinal wall has serious dropsy with rather high obstruction index and without blood flow shown,in which the hydrostatic enema redHetion shall bebanned and the operation shall be carried out as soon as possible.

Objective To explore the ultrasonographical characteristics of placental abruption, especially the light placental abruption that was diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging, providing diagnosis data for clinical treatment. Methods With color Doppler ultrasonic and enhancement Doppler E-flow imaging, an analysis was made on the ultrasonography and clinical result of 50 patients with heavy placental abruption and 23 patients with light placental abruption. Results The diagnosis and clinical treatment of 50 patients with heavy placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement Doppler E-flow imaging were in conformity with the postnatal pathological diagnosis. The coincidence rate in diagnosis was 100%. Of 23 patients with light placental abruption who had been diagnosed by color Doppler ultrasonic combining with enhancement E-flow Doppler imaging, 19 cases' diagnosis and clinical treatment were in accordance with their postnatal pathological diagnosis and the coincidence rate was 83%, 4 cases were misdiagnosis and missed diagnosis. Of 73 patients with placental abruption, 60 cases were carried out caesarean birth and 13 cases performed natural labor. Conclusion The enhancement Doppler E-flow imaging combining with color Doppler ultrasonic can accurately diagnose the heavy placental abruption and also provide a new method for the diagnosis of light placental abruption and perform a dynamic monitoring for the treatment transfer result of it.

Objective: To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children, in order to provide evidence for clinical treatment. Methods: Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery, General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded. Results: A total of 69 patients were enrolled, including 30 boys and 39 girls, with an average age of (19.3±11.6) months and an average weight of (9.6±2.1) kg.There were 32 cases of Carpentier type Ⅰ, 30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR, while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery, and then second operation was performed on the 10^th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9±10.9) months]. During the follow-up period, no patient died or had reoperation.Aggravated MR was observed in 4 patients. Conclusions Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time, the growth potential of mitral valve should be fully considered to avoid restrained development.

Health literacy serves as the foundation of health for all. Hence the authors introduced the connotation and extension of health literate health care organization(HLHO) and related concepts. On such basis, the paper presented the construction method of HLHO from the perspective of health policy, healthcare organizations and inter-institutional cooperation, in order to improve the health literacy of the Chinese people and implement the Healthy China initiative(2019—2030).

Objective:To evaluate the role of glucagon-like peptide-1 receptor (GLP-1R) signaling pathway in sevoflurane postconditioning-induced attenuation of myocardial ischemia-reperfusion (I/R) injury in rats.Methods:Eighty SPF healthy adult male Sprague-Dawley rats, aged 8-10 weeks, weighing 300-340 g, were divided into 4 groups ( n=20 each) by a random number table method: sham operation group (group S), myocardial I/R group (group I/R), myocardial I/R plus sevoflurane postconditioning group (group ISP), and myocardial I/R plus sevoflurane postconditioning plus GLP-1R antagonist group (group ISPE). The myocardial I/R injury model was developed by ligating the left anterior descending branch of the coronary artery for 40 min followed by 2-h reperfusion in anesthetized rats.In group ISP, the rats inhaled 2.4% sevoflurane for 15 min starting from the beginning of reperfusion.In group ISPE, GLP-1R antagonist Exendin9-39 50 μg/kg (in 1 ml 0.9% normal saline) was intraperitoneally injected once a day from 28 days before development of the model, the last intraperitoneal injection was completed at 40 min before inhalation of sevoflurane, and the other treatments were the same as those previously described in group ISP.Blood samples from the abdominal aorta were collected immediately after reperfusion to determine the serum levels of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH). Then the rats were sacrificed, and the hearts were obtained for microscopic examination of the histopathological changes of myocardial tissues (by HE staining) and the ultrastructure of cardiomyocytes (with a transmission electron microscope) for determination of the myocardial infarct size (TTC staining), expression of GLP-1R in myocardium (by immunohistochemical staining), expression of GLP-1R, cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), cAMP response element-binding protein (CREB), phospho-CREB (p-CREB), B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated x protein (Bax) in myocardium (by Western blot). The ratios of p-CREB/CREB and Bcl-2/Bax were calculated. Results:Compared with group S, the serum levels of CK-MB and LDH and percentage of myocardial infarct size were significantly increased, the expression of GLP-1R was up-regulated, the expression of cAMP and PKA was down-regulated, and the p-CREB/CREB ratio and Bcl-2/Bax ratio were decreased in group I/R ( P<0.05). Compared with group I/R, the serum levels of CK-MB and LDH and percentage of myocardial infarct size were significantly decreased, the expression of GLP-1R, cAMP and PKA was up-regulated, and p-CREB/CREB ratio and Bcl-2/Bax ratio were increased in group ISP ( P<0.05). Compared with group ISP, the serum levels of CK-MB and LDH and percentage of myocardial infarct size were significantly increased, the expression of GLP-1R, cAMP and PKA was down-regulated, and the p-CREB/CREB ratio and Bcl-2/Bax ratio were decreased in group ISPE ( P<0.05). Conclusions:Sevoflurane postconditioning can attenuate myocardial I/R injury by activation of GLP-1R signal pathway and inhibition of cardiomyocyte apoptosis in rats.

The clinical characteristics and gene variations of a family with mitochondrial myopathy and ataxia caused by MSTO1 gene mutation who visited Xiangya Hospital of Central South University in October 2019 were retrospectively analyzed.The proband was an 11-year-old female, who was found to have delayed motor and language development and dysarthria at the age of 1 year and 6 months.The 9-year-old younger brother of the proband had similar symptoms at the age of 1 year and 3 months.Both the proband and her younger brother had muscle weakness and ataxia.Their head magnetic resonance imaging showed cerebellar atrophy, and their electromyography showed neuroge-nic changes.Genetic testing revealed compound heterozygous mutations in MSTO1: c.1259delG; p.G420VfsX2 and c.571 C > T; p.R191X, which were inherited from their parents, respectively.The same site mutations were found in the younger brother.After 2 weeks of " cocktail therapy" , the symptoms of the children were alleviated, and their language and movement improved.

Objective To observe the levels of serum complement C 1q, C3, C4 and factor B in different phases during normal pregnancy;To evaluate the diagnostic value and the predictive value of serum complement C1q, C3, C4 and factor B in preeclampsia (PE).Methods Three groups of subjectes were enrolled from January 2017 to March 2018 in Department of Obstetrics and Gynecology , Peking University Third Hospital.(1) 30 pregnant women in each group at 8-14 weeks, 20-26 weeks and 28-36 weeks were retrospectively selected , and the serum levels of complement C 1q, C3, C4 and B factors were measured and compared.(2)Selecting 17 cases of early-onset mild PE, 47 cases of early-onset severe PE, 24 cases of late-onset mild PE, 27 cases of late-onset severe PE, and 30 normal pregnant cases of the same gestational stage as early-onset /late-onset controls , through ANOVA analysis and comparison between two groups , this study evaluated the diagnostic value of serum complement C 1q, C3, C4 and factor B in PE.(3)To evaluate the predictive effect in PE, it analyzed serum C1q and factor B levels of pregnant women at 20-26 gestation weeks through prospective nested case-control study of 214 cases.Results The levels of serum C1q remained stable in the whole pregnancy .The levels of C3 and factor B increased at the early stage of pregnancy and remained stable after the middle stage .C4 increased early in pregnancy and then remained stable.Compared with the control group , the levels of serum C1q in all four types of PE patients were significantly decreased ( median: 169 mg/L, 161 mg/L, 165 mg/L, 163 mg/L;early-onset, late-onset control group:187 mg/L, 194 mg/L;U=130.500, 426.500, 159.500, 130.500, all P<0.05).Serum C3 levels of all the other three types of PE patients were significantly lower than those of the control groups (median:1170 mg/L, 1323 mg/L, 1223 mg/L;early-onset, late-onset control groups: 1438 mg/L, 1434 mg/L;U =379.000, 246.000, 160.000, all P <0.05 ), except for the early-onset mild PE (1275 mg/L).Serum C4 levels of patients with early/late onset severe PE were significantly lower than those of the control groups ( median: 140 mg/L, 142 mg/L;early-onset, late-onset control groups:223 mg/L, 235 mg/L;U =329.500, 136.500, both P <0.001 ) .Serum factor B levels showed no statistical difference among 3 early on-set groups or among 3 late on-set groups ( early-onset group median:332 mg/L,318 mg/L,early-onset control group 312 mg/L;late-onset group median:316 mg/L,314 mg/L, late-onset group 303 mg/L;χ2 =5.990, 1.77, all P>0.05).33 (15.4％) cases developed PE out of 214 pregnant women with PE risk factors .Compared to those who didn′t develop PE , it showed no statistical difference of serum C1q, C3, C4, and factor B levels at 20-26 gestational weeks of the women who subsequently developed PE ( C1q:175 mg/L vs.184 mg/L; C3:1523 mg/L vs.1467 mg/L; C4:230 mg/L vs.229 mg/L;FB:344 mg/L vs.320 mg/L;U=2090.000, 1575.000, 2058.500, 1362.000, all P>0.05).Compared to those of the healthy pregnant controls , it showed no statistical difference of serum C1q, C3 and C4 levels of 20-26 gestational weeks of the women who subsequently developed PE (C1q:175 mg/L vs.190 mg/L; C3:1523 mg/L vs.1428 mg/L; C4:230 mg/L vs.227 mg/L; U=353.000, 395.000, 493.500, all P >0.05),while it showed statistical difference (344 mg/L vs.306 mg/L;U=233.500, P=0.007) for factor B.Conclusions Serum C1q level of PE patients significantly decreased, which can be used as potential indicators of PE diagnosis , but serum C1q, C3, C4 level of 20-26 gestational weeks cannot predict risk of PE .Factor B cannot serve as serum index of PE diagnosis , but its serum levels at 20-26 gestational weeks werer higher than those of normal pregnant controls , factor B may be a potential predictor , but need further verification .