Objective To evaluate the effect of PRECEDE-PROCEED model in elder patents with diabetes.Methods 70 elder patients with diabetes were divided into the control group (34 cases)and the intervention group(36 cases) randomly.Routine nursing care was used in the control group,while the PRECEDE-PROCEED model was used in the intervention group in addition.Compared the level of FBG and the 2hPG betweenthe two groups.Results Before and after the intervention,the difference of FBG and 2hPG was not significant between the two groups,P＞ 0.05.Two weeks after the intervention,the incidence rate of hypoglycemia in the intervention group was 8.3％(3/36),which was significant lower than that of in the control group (29.4％,10/34),thex2=5.137,P＜0.05.Conclusion PRECEDE-PROCEED model can be well-applied to decrease hypoglycemia in elder patients with diabetes.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.

Objective The goal of this study is to understand the function of FKBP51 in resistant to high fat diet-induced obesity using FKBP51 knockout ( KO) mice and in vitro adipocyte differentiation.Methods Four-week old male FKBP51 KO and wild type ( WT) mice were fed separately with regular or high fat diet for 6 weeks.The body weight and food consumption were recorded weekly, the energy expenditure differences ( O2 consumption, CO2 production, respiratory exchange ratio, and heat production) of each group were monitored using the MM-100 metabolism cages system for 24 hours, then the liver from the above animals were stained with the Oil red-O to detect the lipid accumulation and the expression of metabolic genes.In addition, induction of adipocyte differentiation of immortalized MEF cells from WT and FKBP51 KO mice were used to observe the effect of FKBP51 gene on lipogenesis.Results Compared to WT mice, FKBP51 KO mice has less weight increment, and less lipid accumulation in the liver, but with no difference on food consumption during high-fat diet fed.Moreover, FKBP51 KO mice exhibited more O2 consumption, CO2 production and heated production under both RD and HF diet conditions.The PEPCK, G6Pase and UCP-1 genes up-regulation.In addition, lipid content was reduced in FKBP51 gene deficient MEF cells after adipocyte differentiation.Conclusions The FKBP51 gene plays an important role in high fat diet-induced obesity through the energy metabolism enhancement and lipogenesis inhibition.

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student’s t test, and Pearson’s correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

Objective:To investigate the effects of forced-air warming blankets combined with conventional warming strategies on the quality of postoperative recovery and cognitive recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods:This was a prospective, randomized, controlled trial.A total of 70 patients aged 65-75 years, who were classified as American Society of Anesthesiologists(ASA)grade-Ⅱ or Ⅲ, undergoing the laparoscopic radical resection of colorectal cancer under general anesthesia, were enrolled.Patients were randomly divided into two groups: the forced-air warming group(group FAW, n=35)and the conventional warming group(group CW, n=35). The inadvertent perioperative hypothermia(IPH), postoperative shivering, postoperative agitation, anesthesia recovery time and other postoperative complications were compared between the two groups.The post-operative quality of recovery scale(PQRS)was used to evaluate the quality of postoperative recovery and the recovery of cognitive function before and 1, 3, and 7 days after operation.Results:As compared with the group CW, the group FAW showed that the incidences of IPH, postoperative shivering and agitation were decreased(5.7% vs.22.8%, 2.8% vs.28.6%, 5.7% vs.31.4%, χ2=4.200, 10.057 and 7.652, P=0.042, 0.003 and 0.006), and the satisfaction degree of patients was increased at 48 hours after operation( P<0.01). The postoperative wake-up time was prolonged in the group CW as compared with the group FAW( P<0.01). Compared with the group CW, the proportion of patients with excellent overall recovery quality was increased in the group FAW 1 day after surgery( P<0.05). There was no significant difference in general recovery quality and cognitive recovery between the two groups at 3 and 7 days after operation. Conclusions:For elderly patients undergoing laparoscopic radical resection of colorectal cancer, the forced-air warming blanket combined with conventional warming strategies is more helpful to decrease the incidence of IPH, reduce postoperative shivering and improve the overall recovery quality at 1 day after operation, but no significant effect on postoperative recovery of cognitive function is found.

Objective:To develop and validate a liquid chromatography-tandem mass spectrometry method for determining levofloxacin in plasma sample from pediatric patients.Method:This is a prospective, observational study. The clinical residual plasma samples from healthy individuals for physical examination in Children's Hospital Affiliated to Zhengzhou University were collected as blank matrix. Plasma samples from five pediatric patients who did not receive levofloxacin or ciprofloxacin in the department of Respiration were collected for methodological evaluation. In addition, 34 clinical plasma samples from 22 pediatric patients (9 males and 13 females; mean age (8.1±3.7) years) using levofloxacin was collected, and their plasma concentrations were determined. Using ciprofloxacin as the internal standard, levofloxacin in plasma samples was quantified by liquid chromatography-tandem mass spectrometry following protein precipitation using acetonitrile. A C18 column (Shim-pac GIST-HP C18, 2.1 mm×100 mm, 3 μm) and mobile phase composed of water (containing 0.1% formic acid) and acetonitrile (containing 0.1% formic acid) with gradient elution at a flow rate of 0.4 ml/min were used to separate levofloxacin. The column temperature was 40 ℃, injection volume was 1 μl and the total analysis time was 9 min. Levofloxacin and ciprofloxacin were ionized with an ESI source in positive ion mode and detected in multiple reaction monitoring (MRM) mode. The detected ions of levofloxacin and ciprofloxacin were m/z 362.10→318.1 and 332.15→231.05, respectively. The method′s specificity, sensitivity, linearity, precision, accuracy, recovery rate, stability, matrix effect, and carry-over were validated. All statistical analyses were performed with SPSS statistical software (version 17.0). The normality of the data was detected by the K-S test. A P<0.05 was considered statistically significant for two tailed tests. Results:The LC-MS/MS method showed a good linearity within the range of 0.062 5-20 mg/L, with the lower detection limit of levofloxacin of 0.062 5 mg/L. The calibration curve for levofloxacin was Y=0.093X+0.010 ( R2>0.99). Under different quality control levels, the accuracy ranged from 92.57% to 104.39%, and the intra-day and inter-day imprecision ranged from 2.32% to 9.35%. These values were not affected by the normal matrix, 5% hemolysis matrix and 15% hyperlipidemia matrix. Furthermore, the levofloxacin plasma samples were stable in the short term. A total of 34 plasma samples from 22 patients were collected and analyzed. Only 2 plasma samples were below the lower limit of quantification, while the other plasma concentrations of levofloxacin were ranged from 0.091 to 6.755 mg/L. Cmax was (5.52 ± 1.09) mg/L. Conclusion:The LC-MS/MS method meets the requirements of the reference method and requires a small sample size (50 μl), making it suitable for the determination of levofloxacin in plasma from pediatric patients.

Objective:To analyze the change trends and risk factors of mesothelioma disease burden in Jiangsu Province from 1990 to 2019.Methods:In January 2022, using the 2019 Global Burden of Disease Study Data, the Joinpoint regression model was used to analyze the change trends of incidence, mortality, disable-adjusted life years (DALY) and premature mortality of mesothelioma residents in Jiangsu Province from 1990 to 2019, and the attribution level of mesothelioma risk factors was estimated by population attributing fraction.Results:The standardized incidence rates of mesothelioma in Jiangsu Province from 1990 to 2019 ranged from 0.07/10 5 to 0.09/10 5, with an average annual percentage change (AAPC) of -1.1% ( t=-13.56, P<0.001). AAPCs in males and females were -0.3% ( t=-2.18, P=0.029) and -1.6% ( t=-11.39, P<0.001), respectively. The standardized mortality rates of mesothelioma ranged from 0.07/10 5 to 0.09/10 5, the AAPC was -1.1% ( t=-12.23, P<0.001), AAPC was -1.6% ( t=-14.09, P<0.001) for females, and there was no significant change in males ( t=-1.83, P=0.068). The premature mortality was 0.004%-0.006%, the AAPC was -1.0% ( t=-4.40, P<0.001), AAPC was -1.7% ( t=-13.72, P<0.001) for females, and there was no significant change in males ( t=-0.68, P=0.495). The standardized DALY rates ranged from 1.86/10 5 to 2.32/10 5, the AAPC was -0.9% ( t=-11.08, P<0.001), AAPC was -1.6% ( t=-11.05, P<0.001) for females, and there was no significant change in males ( t=-0.95, P=0.343). Both the standardized years of life lost (YLL) rate and the standardized years lived with disability (YLD) rate showed a decreasing trend, and the AAPCs were -0.9% ( t=-7.66, P<0.001) and -1.0% ( t=-12.88, P<0.001), respectively. The proportion of YLL in DALY was more than 98.5%. Among the risk factors for mesothelioma burden attribution, the AAPC attributed to occupational asbestos exposure of DALY was 1.4% ( t=3.43, P=0.001). The AAPC of DALY rate of standardized attribution was -1.7% ( t=-12.11, P<0.001) . Conclusion:The overall burden of mesothelioma in Jiangsu Province is decreasing, occupational asbestos exposure is still the main risk factor of mesothelioma in Jiangsu Province, and early diagnosis and treatment should be strengthened.

Objective To assess the association between the concentration of the air pollutant PM2.5 and daily outpatient visits for respiratory disease. Methods All records of daily outpatient visits to three hospitals in Shenzhen from January 1 to December 31, 2013 were collected. Daily air pollution monitoring and meteorology data from the same period were also collected in Shenzhen. The data were analyzed using a semiparametric generalized additive model with Poisson distribution of time series analysis controlling for long-term and seasonal trends, flu, DOW, public holidays, and meteorological factors. The excess risk (ER) of respiratory disease and its 95%CI value were calculated, along with the incremental increase of 10 μg/m3 in PM2.5 concentration. Results Number of outpatient visits for respiratory diseases totaled 1 428 672 (daily range:1 790-5 228). The annual average PM2.5 concentration was 40.2μg/m3 (daily range:7.2-137.1μg/m3). The lag1 factor had the most significant impact on the lag effect. We estimated that a 10 μg/m3 increase in day-before PM2.5 concentration was associated with a 1.809% (95% CI:1.709%-1.909%) ER of visits for respiratory disease. After controlling for other pollutants (NO2, CO, and O3), the effect remained stable. When NO2, CO, and O3 were introduced separately, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of daily outpatient visits for respiratory disease was 1.814% (95% CI:1.706%-1.923%), 2.780% (95% CI: 2.668%-2.892%), and 1.513% (95% CI: 1.403%-1.624%), respectively. With simultaneous control of NO2 and O3, NO2 and CO, and CO and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 1.369% (95% CI: 1.242%-1.497%), 2.709% (95% CI: 2.590%- 2.828% ), and 2.577% (95% CI: 2.452%- 2.702% ), respectively. With simultaneous control of NO2, CO, and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 2.370% (95% CI: 2.231%-2.509%). Conclusions PM2.5 can increase the risk of outpatient visits for respiratory disease in Shenzhen.

Objective:To analyze the change trends and risk factors of mesothelioma disease burden in Jiangsu Province from 1990 to 2019.Methods:In January 2022, using the 2019 Global Burden of Disease Study Data, the Joinpoint regression model was used to analyze the change trends of incidence, mortality, disable-adjusted life years (DALY) and premature mortality of mesothelioma residents in Jiangsu Province from 1990 to 2019, and the attribution level of mesothelioma risk factors was estimated by population attributing fraction.Results:The standardized incidence rates of mesothelioma in Jiangsu Province from 1990 to 2019 ranged from 0.07/10 5 to 0.09/10 5, with an average annual percentage change (AAPC) of -1.1% ( t=-13.56, P<0.001). AAPCs in males and females were -0.3% ( t=-2.18, P=0.029) and -1.6% ( t=-11.39, P<0.001), respectively. The standardized mortality rates of mesothelioma ranged from 0.07/10 5 to 0.09/10 5, the AAPC was -1.1% ( t=-12.23, P<0.001), AAPC was -1.6% ( t=-14.09, P<0.001) for females, and there was no significant change in males ( t=-1.83, P=0.068). The premature mortality was 0.004%-0.006%, the AAPC was -1.0% ( t=-4.40, P<0.001), AAPC was -1.7% ( t=-13.72, P<0.001) for females, and there was no significant change in males ( t=-0.68, P=0.495). The standardized DALY rates ranged from 1.86/10 5 to 2.32/10 5, the AAPC was -0.9% ( t=-11.08, P<0.001), AAPC was -1.6% ( t=-11.05, P<0.001) for females, and there was no significant change in males ( t=-0.95, P=0.343). Both the standardized years of life lost (YLL) rate and the standardized years lived with disability (YLD) rate showed a decreasing trend, and the AAPCs were -0.9% ( t=-7.66, P<0.001) and -1.0% ( t=-12.88, P<0.001), respectively. The proportion of YLL in DALY was more than 98.5%. Among the risk factors for mesothelioma burden attribution, the AAPC attributed to occupational asbestos exposure of DALY was 1.4% ( t=3.43, P=0.001). The AAPC of DALY rate of standardized attribution was -1.7% ( t=-12.11, P<0.001) . Conclusion:The overall burden of mesothelioma in Jiangsu Province is decreasing, occupational asbestos exposure is still the main risk factor of mesothelioma in Jiangsu Province, and early diagnosis and treatment should be strengthened.

Objective To assess the association between the concentration of the air pollutant PM2.5 and daily outpatient visits for respiratory disease. Methods All records of daily outpatient visits to three hospitals in Shenzhen from January 1 to December 31, 2013 were collected. Daily air pollution monitoring and meteorology data from the same period were also collected in Shenzhen. The data were analyzed using a semiparametric generalized additive model with Poisson distribution of time series analysis controlling for long-term and seasonal trends, flu, DOW, public holidays, and meteorological factors. The excess risk (ER) of respiratory disease and its 95%CI value were calculated, along with the incremental increase of 10 μg/m3 in PM2.5 concentration. Results Number of outpatient visits for respiratory diseases totaled 1 428 672 (daily range:1 790-5 228). The annual average PM2.5 concentration was 40.2μg/m3 (daily range:7.2-137.1μg/m3). The lag1 factor had the most significant impact on the lag effect. We estimated that a 10 μg/m3 increase in day-before PM2.5 concentration was associated with a 1.809% (95% CI:1.709%-1.909%) ER of visits for respiratory disease. After controlling for other pollutants (NO2, CO, and O3), the effect remained stable. When NO2, CO, and O3 were introduced separately, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of daily outpatient visits for respiratory disease was 1.814% (95% CI:1.706%-1.923%), 2.780% (95% CI: 2.668%-2.892%), and 1.513% (95% CI: 1.403%-1.624%), respectively. With simultaneous control of NO2 and O3, NO2 and CO, and CO and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 1.369% (95% CI: 1.242%-1.497%), 2.709% (95% CI: 2.590%- 2.828% ), and 2.577% (95% CI: 2.452%- 2.702% ), respectively. With simultaneous control of NO2, CO, and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 2.370% (95% CI: 2.231%-2.509%). Conclusions PM2.5 can increase the risk of outpatient visits for respiratory disease in Shenzhen.