Objective:To explore the influencing factors of neutrophil to lymphocyte ratio (NLR) in patients with chronic heart failure (CHF) and the relationship between NLR and cardiac contractile function.Methods:From September 2016 to May 2018, 135 CHF patients were enrolled in the cardiovascular department of Fenyang hospital, Shanxi Province for prospective research.According to the level of NLR, the patients were divided into three groups: low NLR group (<2.3, 46 cases), middle NLR group (≥2.3~≤4.3, 45 cases), high NLR group (>4.3, 44 cases). The basic clinical data, laboratory examination data and noninvasive cardiac hemodynamic indexes of the three groups were compared.Results:(1) By comparing the data of different NLR groups, we found that there were significant differences in (N-terminal pro-brain natriuretic pepfide, NT-proBNP)( F=4.485, P=0.013), total bilirubin( F=6.085, P=0.003), albumin( F=3.695, P=0.027). (2)NLR was correlated with NT proBNP, total bilirubin, albumin( r=0.267, 0.256, -0.243, P=0.002, 0.003, 0.005, respectively). (3)Multiple linear regression analysis showed that NLR of CHF patients was correlated with left ventricular ejection fraction (LVEF), NT proBNP, total bilirubin and albumin (standard regression coefficients were -0.239, 0.223, 0.247 and -0.213, respectively, P<0.05). (4) Pearson correlation analysis showed that NLR and cardiac output ( r=-0.173, P=0.045), cardiac index ( r=-0.175, P=0.042), LVEF ( r=-0.278, P=0.001), maximum ejection velocity ( r=-0.207, P=0.016), systolic index ( r=-0.214, P=0.013), hearther index(HI) ( r=-0.179, P=0.038), cardiac work (CW) ( r=-0.235, P=0.006), cardiac workindex (CWI)=( r=-0.244, P=0.004) were negatively correlated. Conclusion:NT-proBNP, total bilirubin, albumin and LVEF are the factors that affect the NLR of patients with CHF.NLR has a certain value in the evaluation of CHF, therapeutic effect and prognosis prediction.

{L-End}Objective To analyze the local muscle response under continuous ergonomic workload by simulating manual lifting, and to screen the sensitive metabolic biomarkers during fatigue process. {L-End}Methods A total of 13 healthy male volunteers were selected as the study subjects using simple random sampling method. Study subjects underwent repetitive simulated manual lifting for four periods (T1 to T4), each lasting 12 minutes. The degree of work-related fatigue in the forearm, upper arm, shoulder, back, and leg muscles, and the whole body was accessed using Borg 6-20 Rating of Perceived Exertion (RPE) Scale. The venous blood samples were collected from elbow between each two periods to detect the levels of eight metabolic biomarkers: ammonia, lactate, creatine kinase, lactate dehydrogenase (LDH), C-terminal telopeptide of type Ⅰ collagen (CTX-Ⅰ), C-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ), cartilage oligomeric matrix protein (COMP), and calcium ions. {L-End}Results The RPE scores of the study subjects for the muscles of five body parts and the whole body increased with the increasing lifting periods (all P<0.01). Fatigue was observed in all target muscles, with overall body fatigue occurring in the T2 period. The levels of ammonia, lactate, creatine kinase, LDH, COMP, and calcium ions in the serum of study subjects were higher in the T1 to T4 periods than in the T0 period (all P<0.05). The serum CTX-Ⅰ level was higher in the T1 and T3 periods than that in the T0 period (all P<0.05) , and the serum CTX-Ⅱ level was higher in the T1, T2 and T4 periods than that in the T0 period (all P<0.05). The level of these eight serum metabolic biomarkers fluctuated during the T1 to T4 periods. The serum creatine kinase level increased with the period of lifting (all P<0.05). The serum lactate level was higher in the T3 period than those in the T1 and T2 periods (all P<0.05). The serum LDH and calcium ion levels were higher in the T2 to T4 periods than that in the T1 period (all P<0.05). The serum COMP level was higher in the T2 and T3 periods than that in the T1 period (all P<0.05). Except for CTX-Ⅰ, the levels of other seven metabolic markers in serum were higher in individuals after fatigue than before fatigue (all P<0.05). {L-End}Conclusion Serum metabolic biomarkers such as ammonia, lactate, creatine kinase, calcium ions, LDH, CTX-Ⅱ, and COMP exhibit significant changes before and after fatigue. These metabolic biomarkers could be used as sensitive biomarkers for evaluating muscle fatigue during repetitive works.

Objectives:To search, evaluate, and summarize the evidence related to the application management of over-the-counter (OTC) medications for constipation in the elderly, providing evidence-based support for the rational use of these medications.Methods:A systematic search was conducted through computerized decision support systems, guideline websites, professional association websites, and databases for clinical decisions, guidelines, evidence summaries, and expert consensus on the management of OTC medications for constipation in the elderly. The search period spanned from January 2018 to March 2023. The quality of the literature was independently assessed, and evidence was extracted. The 2014 version of the Joanna Briggs Institute (JBI) evidence grading system was used to determine the levels of evidence.Results:A total of 18 article were included, consisting of two clinical decisions, five guidelines, seven expert consensus statements, and four evidence summaries. These covered five areas: medication principles for elderly individuals with different characteristics, medication selection, medication monitoring, health education, and precautions, culminating in a total of 30 best evidence.Conclusions:This study summarizes the best evidence for the management of OTC medications for constipation in the elderly, providing evidence-based support for the rational application of these medications.

Objective:To study the differences of different signal processing method of surface electromyography (sEMG) in judging muscle fatigue.Methods:From July to October 2019, based on the model of simulated manual lifting operation, the original sEMG signals from 13 volunteers of brachial radial muscle, brachial two-headed muscle, triangle muscle, left vertical spine muscle, right vertical spine muscle and lateral femoral muscle were collected in the operation activities. Three different electromyography signal processing methods (all signal from motion beginning to the end, peak signal and ehe specified motion signal) were used to analyze the original data in time domain (RMS) and frequency domain (MDF) , the data difference between different electromyography signal processing methods was analyzed by using Wilcoxon rank and sum test and nonlinear curve fitting method.Results:The age of the subjects of the simulated lifting operation was (24.31±2.02) years old, height (173.78±4.84) cm, weight (66.28±5.58) kg, body mass index (BMI) 21.94±1.58. The thickness of triceps skinfold was (14.08±4.86) mm, and the thickness of the skin fold under the scapula was (15.54±3.59) mm. After processing the original signal data by using different sEMG signal interception methods, the normality test, Levene's test, and the Wilcoxon test showed that, except for the MDF index of the brachial two-headed muscle, the differences in the RMS and MDF signals of the other muscles were statistically significant ( P<0.016) . The all signal processing method dealed with data distribution dispersion better than other methods, and the rate of change of RMS signal slope was higher than other methods. Non-linear regression results showed that all signal processing method had low volatility in processing data, and the regression equation had a high degree of fit. Conclusion:Different electromyography signal processing methods have differences. The all signal processing method which intercepts from starting point to the end point of action cycle has the least data volatility, and electromyography time domain and frequency domain index with the highest sensitivity of time, which is suitable for the application of surface electromyography to judge muscle fatigue in dynamic and complex operations.

Objective:To study the differences of different signal processing method of surface electromyography (sEMG) in judging muscle fatigue.Methods:From July to October 2019, based on the model of simulated manual lifting operation, the original sEMG signals from 13 volunteers of brachial radial muscle, brachial two-headed muscle, triangle muscle, left vertical spine muscle, right vertical spine muscle and lateral femoral muscle were collected in the operation activities. Three different electromyography signal processing methods (all signal from motion beginning to the end, peak signal and ehe specified motion signal) were used to analyze the original data in time domain (RMS) and frequency domain (MDF) , the data difference between different electromyography signal processing methods was analyzed by using Wilcoxon rank and sum test and nonlinear curve fitting method.Results:The age of the subjects of the simulated lifting operation was (24.31±2.02) years old, height (173.78±4.84) cm, weight (66.28±5.58) kg, body mass index (BMI) 21.94±1.58. The thickness of triceps skinfold was (14.08±4.86) mm, and the thickness of the skin fold under the scapula was (15.54±3.59) mm. After processing the original signal data by using different sEMG signal interception methods, the normality test, Levene's test, and the Wilcoxon test showed that, except for the MDF index of the brachial two-headed muscle, the differences in the RMS and MDF signals of the other muscles were statistically significant ( P<0.016) . The all signal processing method dealed with data distribution dispersion better than other methods, and the rate of change of RMS signal slope was higher than other methods. Non-linear regression results showed that all signal processing method had low volatility in processing data, and the regression equation had a high degree of fit. Conclusion:Different electromyography signal processing methods have differences. The all signal processing method which intercepts from starting point to the end point of action cycle has the least data volatility, and electromyography time domain and frequency domain index with the highest sensitivity of time, which is suitable for the application of surface electromyography to judge muscle fatigue in dynamic and complex operations.

Antibodies, Monoclonal, Murine-Derived ; adverse effects ; Antineoplastic Agents ; adverse effects ; Humans ; Lung Diseases, Interstitial ; chemically induced ; Rituximab ; Waldenstrom Macroglobulinemia ; drug therapy

Objective: To investigate the antibacterial property and biological activity of Ti dental implant with antimicrobial peptide Pac-525 coatings, and to study the effect of peptide Pac-525 coatings on Porphyromonas gingivalis's antibacterial performance and osteoblast proliferation and adhesion. Methods: After ultrasonic micro arc oxidation, alkali treatment and silane treatment, forty-five pure titanium specimens were exposed to antibacterial peptide Pac-525 in different concentration (0.25, 0.50, 0.75 g/L). The titanium specimens in the control group were only treated with ultrasonic micro arc oxidation, alkali treatment and silane treatment. The morphologies of coatings were observed by scanning electron microscope (SEM), and the element changes were detected by energy spectrum analyzer. Orange acridine-ethidium bromide double staining was used to detect the average percentage of live bacteria and biofilm thickness, after the specimens in each group and Porphyromonas gingivalis were co-cultured for 72 hours. Cell counting Kit-8 method and immunofluorescence staining were used to test the proliferation of osteoblasts, the number and growth morphologies of adherent cells, respectively. Results: SEM and energy spectrum analysis showed that the Pac-525 particles loaded on the surface of the coating, and the C and N elements in the Pac-525 coating group were significantly more than those in the control group. The average percentage of living bacteria in the control group, 0.25, 0.50 and 0.75 g/L antimicrobial peptides were 0.58%, 0.45%, 0.34% and 0.28%, respectively, and the difference between each group was statistically significant (P<0.05). The biofilm thickness of Porphyromonas gingivalis in 0.50 and 0.75 g/L antibacterial peptide group were (98.3±1.2) and (94.5±2.5) μm respectively, which were significantly less than those in control group and 0.25 g/L antibacterial peptide group [(117.6±1.5) and (118.0±1.3) μm] (P<0.05), respectively. The number of bone cell adhesion and proliferation of all antimicrobial peptides were significantly greater than those in the control group (P<0.05), and the cells stretched better. Conclusions The antibacterial peptide coating of titanium implants could inhibit the formation of bacterial biofilm. It had good antibacterial properties and could promote the adhesion and proliferation of osteoblasts.

OBJECTIVE: To analyze the relationship between the blood biochemical indexes and the local muscle fatigue of operators with local muscle fatigue caused by moderate-load repetitive manual lifting. METHODS: Five healthy male volunteers were selected as the research subjects. They repeatedly performed simulated manual lifting operation for four periods(T1-T4), 10 minutes per period. Each period was suspended for 3 minutes to be accessed for the rating of perceived exertion(RPE) score of local muscle. Meanwhile, their venous blood was collected to be detected for serum calcium ion, creatine kinase, cartilage oligomeric matrix protein(COMP), ammonia, lactic acid, lactate dehydrogenase(LDH), C-reactive protein(CRP), and collagen type Ⅱ C terminal telopeptide(CTX-Ⅱ). RESULTS: The RPE score and serum creatine kinase level of the subjects increased with the increasing of lifting time(P<0.05). Serum calcium ion levels in time periods T2, T3 and T4 were higher than that in T1(P<0.05). Serum COMP levels in T3 and T4 were higher than that in T1(P<0.05). The levels of ammonia,lactic acid, LDH, CRP and CTX-Ⅱ in each time period showed no statistical significance(P>0.05). Serum creatine kinase, calcium ion and LDH levels were positively correlated with RPE score(correlation coefficient were 0.840, 0.512, 0.741, respectively, P<0.01). CONCLUSION: Serum creatine kinase is a sensitive, effective and objective index reflecting muscle fatigue, which is suitable for evaluating the fatigue process of moderate-load repetitive activities. Serum calcium ion has a good correlation with muscle fatigue, and serum COMP can reflect muscle fatigue to some extent.

OBJECTIVE: To assess the effect of ergonomic factor load on work-related musculoskeletal disorders(WMSDs) in shipyard workers. METHODS: A total of 751 shipyard workers were selected as the research subjects using judgment sampling method. The exposure level of adverse ergonomic factors was assessed using the Quick Exposure Check method. The prevalence of WMSDs was investigated using the revised Musculoskeletal Disorders Investigating Questionnaire of our research group, and the relationship between them was analyzed. RESULTS: The proportions of high or very high level of work load exposure to the neck, back, shoulder and hand in shipyard workers from high to low were 66.4%, 63.5%, 59.8% and 43.7%(P<0.01) respectively. The proportions of occupational stress, driving, vibration and working rhythm at high or very high exposure level were 20.0%, 4.1%, 22.9% and 3.2%, respectively. The prevalence of WMSDs in four body parts of shipyard workers from high to low was the back, neck, hand and shoulder(the prevalence were 44.2%, 31.2%, 26.9% and 26.6%, respectively, P<0.01). After excluding the influence of confounding factors, multiple logistic regression analysis showed that the higher the labor load exposure level and longer of the vibration tool using, the higher the risk of shoulder WMSDs [odds ratio(OR) and 95% confidence interval(CI) were 1.25(1.04-1.51) and 1.33(1.05-1.69), respectively, P<0.05]. The higher the level of occupational stress, the higher the risk of back and neck WMSDs [OR(95%CI) was 1.29(1.05-1.58) and 1.42(1.15-1.77), respectively, P<0.05]. CONCLUSION: There was a dose-effect relationship between the exposure level of shoulder load, the time of using vibration tools and the shoulder WMSDs, and there was a dose-effect relationship between the occupational stress level and the WMSDs in the back and neck.