Objective To develop a cryogenic gripper for soft tissues used in tensile test for secure fixation of soft tissues without damages.Methods Based on the principle of coolant evaporator,we reconstructed copper pipes in novel architecture for fixing the soft tissues.Results This cryogenic gripper could firmly grip wet nylon thread of 3 mm in diameter and its holding force was(499.14?1.05)N and its temperature could be kept at(-20?1)℃.Conclusion The function of this gripper developed by coolant cryogenic technology is satisfactory and reliable,and its continuance is not concerned with time.

This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Objective To explore the application effect of postural animation video instruction mode in elderly patients undergoing epidural anesthesia. Methods A total of 300 patients with epidural anesthesia were registered from January 2015 to February 2016. The patients were divided into trial group and control group with 150 cases each. The trial group was preoperatively interviewed by the postural anatomy video instruction mode, and the control group was only preoperatively interviewed by oral interpretation. The epidural anesthesia effect and anxiety between the two groups were compared. Results The difference of anesthesia posture and anatomical position, the average time of epidural puncture, the success rate of one puncture and the degree of anxiety before and after mission were 90.67% (136/150), (14.50 ± 10.20) s, (425.60 ± 78.30) s, 97.33% (146/150) and (21.65 ± 6.62) points respectively. The control group was 22.00%(33/150), (112.60 ± 60.80) s, (589.40 ± 90.70)s, 82.67%(124/150) and (6.65 ± 5.40) points respectively. There were significant differences between the two groups (χ2=8.79, t=13.54-19.88, all P < 0.01). Conclusions The postural anatomical video teaching mode can relieve anxiety, improve the degree of fit of epidural anesthesia and the success rate of puncture, shorten the time of posture, thus shorten the average time of epidural puncture, improve the quality of nursing in the operating room, work efficiency.

To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.
Adult ; Diabetes Mellitus, Type 2 ; genetics ; Diagnosis, Differential ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Medicine, Chinese Traditional ; Pedigree ; Yin Deficiency ; genetics

Objective To investigate the correlations of plasma homocysteine(Hcy)levels with cerebral white matter lesion(WML)severity and cognitive impairment in elderly hypertension patients.Methods A retrospective case-control study was conducted.Ninty-eight elderly patients with hypertension were enrolled.Based on the presence or absence of hyperhomocysteinemia(hypertension with plasma Hcy levels ≥10μmol/L was defined as H-type hypertension),patients were divided into two groups:a control group(n =48) and an H-type hypertension group(n =50).The degree of WML was rated by the Fazekas scale using magnetic resonance imaging(MRI)analysis.Neuropsychological examinations including mini-mental state examination(MMSE)and Montreal cognitive assessment (MoCA)were taken to assess cognitive function.The degree of WML and cognitive impairment were compared between the two groups.Correlations of plasma Hcy levels with the degree of WML and cognitive impairment were analyzed.Results Compared with the control group,scores of the Fazekas scale(3.2 ± 1.0 vs.2.5 ± 1.0,P ＜0.05) and deep white matter hyperintensity on MRI(1.7 ± 0.8 vs.1.3±0.7,P＜0.05)increased,and scores of MMSE(24.9±3.3 vs.27.7±1.8,P＜0.05)and MoCA(18.6±3.9 vs.25.0±3.0,P＜0.05)decreased in the H-type hypertension group.Plasma Hcy levels were positively correlated with the degree of WML (r =0.430,P ＜ 0.01) and negatively correlated with cognitive function(r=-0.406 in MMSE and-0.663 in MoCA,P＜0.01).Multivariate logistic regression showed that Hcy,fasting blood-glucose,deep WML,low-density lipoprotein cholesterolin,age and systolic pressure were influencing factors for cognitive impairment (P ＜ 0.01).Conclusions WML and cognitive function are worse in elderly H-type hypertension patients than in hypertension patients with normal Hcy levels.WML and cognitive impairment are aggravated with increased plasma Hcy levels.The plasma Hcy level may be an effective clinical indicator of cognitive function in elderly people with hypertension.

Objective:To investigate the prevalence of sarcopenia and associated factors in hospitalized elderly patients.Methods:This was a cross-sectional study.A total of 578 patients admitted to the Geriatrics Department of our hospital were consecutively recruited according to the admission criteria.Patients were divided into the sarcopenia group(n=202, 34.95%)and non-sarcopenia group(n=376, 65.05%)based on the diagnostic criteria(2014)of the Asian Working Group for Sarcopenia.Their clinical data and laboratory parameters were collected.All patients underwent comprehensive geriatric assessment.Results:(1)The detection rate of sarcopenia in these hospitalized patients was 34.95%.(2)Age, free thyroxine(FT4), and the prevalences of diabetes and osteoporosis and the incidence of falls in the past year were higher while body mass index(BMI), calf circumference, hemoglobin(Hb), albumin(ALB), triglycerides(TG), low-density cholesterol(LDL), glycosylated hemoglobin(HbA1c)and free triiodothyronine(FT3)were lower in sarcopenia patients than in non-sarcopenia patients, with statistical significance.Scores on the mini-mental state examination(MMSE)and activities of daily living(ADL)were lower in sarcopenia patients than in non-sarcopenia patients while scores on nutritional risk screening 2002(NRS2002)and the FRAIL scale were higher, all with statistical significance.(3)Binary logistic regression analysis revealed that osteoporosis and FRAIL score were risk factors for sarcopenia( OR=9.083 and 2.505, P<0.001)and BMI, calf circumference and ADL score were protective factors for sarcopenia( OR=0.735, 0.774 and 0.967, P<0.05). (4)ROC analysis showed that the areas under the curve for FRAIL score, BMI, calf circumference and ADL score were 0.832, 0.805, 0.841 and 0.812, respectively, with threshold values at 2.5 points, 23.52 kg/m 2, 32.5 cm and 92.5 points.(5)The chi-square test for sarcopenia screening using various related factors found osteoporosis, calf circumference <32.5 cm and ADL <90 points had higher sensitivity(0.787, 0.807, 0.817)while FRAIL ≥ 3 points and BMI <23.5 had slightly lower sensitivity(0.683, 0.708), with each related factor having a high negative detection rate(0.833-0.888). Conclusions:The prevalence of sarcopenia in hospitalized elderly is more than 1/3.Osteoporosis and FRAIL score are risk factors for sarcopenia.BMI, calf circumference and ADL score are protective factors for sarcopenia.All relevant factors have practical clinical value and can be used for preliminary screening of sarcopenia.

Objective:To compare the diagnosis and respiratory outcomes of preterm infants with bronchopulmonary dysplasia (BPD) based on two criteria and to analyze the criteria's predictive value for adverse respiratory system outcomes.Methods:Clinical data of preterm infants with gestational age less than 32 weeks admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2014 to September 2020 were retrospectively analyzed. The diagnosis and classification of all the subjects were based on two definitions developed by the American National Institute of Child Health and Human Development (NICHD) in 2001 and 2018. The severity of pulmonary diseases in eligible infants was quantified with pulmonary scores. The incidence of BPD and respiratory outcomes in infants diagnosed with the two criteria were compared. The logistic predictive model was adopted to analyze the predictive value of the two criteria for adverse long-term respiratory outcomes.Results:The study enrolled 240 infants, among which 138 (57.5%) were male. Infants who met the 2001 and 2018 definitions of BPD accounted for 52.9% (127/240) and 24.0% (57/237), respectively. The rate of pneumonia, mechanical ventilation duration, and overall oxygen duration of the infants who met the 2018 definition were significantly higher or longer than those who met the 2001 definition [84.2% (48/57) vs. 63.7%(79/124), χ2=7.84; 24.0 d (7.0-34.5 d) vs. 9.0 d (4.0-26.0 d), Z=－3.01; 66.0 d (49.0-81.5) vs. 47.0 d (38.0-63.8 d), Z=－3.86, P<0.01]. The incidence of adverse respiratory system outcomes and death of the infants who met the 2018 definition were significantly higher than those who met the 2001 definition [38.6% (17/44) vs. 20.9% (19/91), P<0.05]. Of the 180 infants diagnosed with BPD using the 2001 definition, 67 did not meet the 2018 definition and were all discharged before a corrected age of 45 weeks without oxygen requirement. Only 4.3% (2/47) of those with follow-up data were re-hospitalized twice or more due to pulmonary diseases. The predicted value of the 2018 definition for early death or adverse respiratory outcomes in infants was significantly higher than that of 2001, with the areas under the curves of 0.871 and 0.840, respectively. The area difference under the curve was 0.031 ( Z=2.09, P=0.037). Conclusions:Compared with the one in 2001, the 2018 definition of BPD is stricter, which could be able to identify BPD infants with severer pulmonary status and outcomes and is unlikely to miss cases with adverse respiratory outcomes. The 2018 definition performs well in predicting death or adverse respiratory outcomes in early infancy.

Objective To explore the application effect of multi-component home-based exercise in elderly patients with osteoporosis and frailty.Methods A total of 52 elderly patients with osteoporosis and frailty were recruited from the osteoporosis clinic of a tertiary hospital in Nanjing,Jiangsu Province from March to August 2022 using the convenience sampling method.Subjects were randomly divided into an experimental group and a control group with 26 cases in each group by the random number table.The experimental group was given the home-based exercise program,while the control group maintained the daily lifestyle.Short Physical Performance Battery(SPPB),grip strength,Frail Scale and Chinese Osteoporosis-targeted Quality of Life Questionnaire(COQOL)of the 2 groups were compared at 12 weeks and 24 weeks,and bone mineral density(BMD)was analyzed after 24-week intervention.Results The scores in the experimental group had significant statistical differences in SPPB,grip strength,Frail Scale and COQOL compared with those in the control group after 12-week and 24-week intervention(P＜0.05).The BMD of total hip of the experimental group was significantly higher than it in the control group(P＜0.05).Conclusion The home-based exercise program can help the elderly with osteoporosis and frailty to improve the physical function and upper body strength,improve the frailty state,and enhance the quality of life,and it may be one of the effective intervention methods to prevent and reverse the frailty state of osteoporosis patients.

Objective:To compare the adjuvant chemotherapy project and survival prognosis of patients with stage Ⅱ/Ⅲ colon cancer in different age groups.Methods:In this retrospective study, the clinical data of 770 colon cancer patients undergoing radical resection were collected in the First Affiliated Hospital of Soochow University from Jan 2013 to Dec 2017. Patients were categorized into 3 groups based on age at onset of colon cancer: young group (18-49 years old, 112 cases), middle-aged group (50-64 years old, 351 cases) and older group (65-75 years old, 307 cases).Results:The young group had fewer complications, and the probability of cancer deposit, vascular tumor thrombus and nerve invasion was lower than the middle-aged and older group (12.5% vs. 15.4% vs. 14.3%; 7.1% vs. 9.4% vs. 8.5%; 2.7% vs .8.8% vs. 5.5%), but the probability of signet-ring cell carcinoma and mucinous adenocarcinoma was higher (5.4% vs. 1.4% vs. 1.6%; 14.3% vs. 11.4% vs. 13.4%), the proportion of patients with stage Ⅲ was greater (49.1% vs. 45.0% vs. 47.2%), and they were more willing to receive postoperative chemotherapy (83.9% vs. 81.8% vs. 60.3%). Among patients with stage Ⅱ and Ⅲ colon cancer, the young group and the middle-aged group were 3-4 times more likely to receive adjuvant chemotherapy than the elderly group [ OR=4.153 (95% CI:1.964-8.785), 2.906 (95% CI:1.845-4.579), 3.120 (95% CI:1.310-7.429), 3.588 (95% CI: 1.964-6.556)]. Of those patients who received chemotherapy, young and middle-aged patients had a higher percentage of multiagent regimen use than older patients [ OR=2.050 (95% CI:0.937-4.488), 2.750 (95% CI:1.536-4.923)]. Among patients treated with surgery alone, no significant differences were observed in survival among age groups. Among patients who received surgery and adjuvant chemotherapy, a significantly better survival was observed for young and middle-aged patients with stage Ⅲ [ HR=0.284 (95% CI:0.127-0.632), 0.521 (95% CI:0.333-0.816)] than their older counterparts. Conclusions:Among patients with stage Ⅱ/Ⅲ colon cancer, young and middle-aged patients are more likely to undergo adjuvant chemotherapy and use more radical chemotherapy regimen. Young and middle-aged patients with stage Ⅱ colon cancer had overuse of chemotherapy, but did not result in expected survival improvement.

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.