Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Recently, accumulating evidence suggests that high bilirubin level is involved in the pathophysiology of schizophrenia. High bilirubin level during early childhood may increase the risk of being suffered from schizophrenia after adulthood, and schizophrenia patients with high bilirubin level have aggravated psychiatric symptoms. As compared with other psychiatric patients and general population, schizophrenia patients usually have relatively higher bilirubin level; high bilirubin level is associated with acute psychotic states, positive symptoms, and poor prognosis in patients with schizophrenia. This article reviews the relation between bilirubin and schizophrenia and its potential pathophysiological mechanism in order to provide a new direction for the study of schizophrenia pathogenesis and auxiliary diagnosis.

Objective To investigate the diagnostic values of ultrasonography combined with serum cancer antigen 125 (CA125),serum carbohydrate antigen 199 (CA199),serum carcinoembryonic antigen (CEA) in ovarian malignant tumors.Methods From November 2015 to December 2017,140 patients with ovarian cancer admitted to the hospital were selected as subjects,and ultrasound examination was carried out with IU22 ultrasound diagnostic instrument.The patients were divided into 92 cases of benign ovarian tumors and 4-8 cases of malignant ovarian tumors through pathological diagnosis.The serum CA125,CA199 and CEA of all patients were detected by automatic biochemical analyzer,and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of four combined detection in ovarian malignancies.Results The coincidence rate of ultrasound diagnosis in ovarian benign tumor patients was significantly higher than that in ovarian cancer patients (P ＜ 0.05).The levels of serum CA125,CA199 and CEA in benign ovarian tumors were significantly lower than those in malignant ovarian tumors (P ＜0.05),and the levels of serum CA125,CA199 and CEA in patients with stage Ⅰ to Ⅱ were significantly lower than those in stage Ⅲ to Ⅳ (P ＜ 0.05).The area of serum CA125,CA199 and CEA under the ROC curve was 0.788,0.750 and 0.708,respectively.The boundary points of diagnosis were 50.61 U/ml,36.47 U/ml and 4.32 ng/ml,respectively.The area under the combined diagnosis curve of the serum CA125,CA199 and CEA was 0.832.The sensitivity,specificity and accuracy of the combined detection were higher than that of single index detection and serum combined detection.Conclusions Ultrasound combined with serum CA125,CA199 and CEA levels detection can improve the sensitivity,specificity and accuracy of diagnosis of ovarian benign and malignant tumors,which has certain clinical value.

Objective? To investigate the correlation between post traumatic growth, social support and resilience in patients with breast cancer, and to provide reference for intervention programme on enhancing positive psychological quality. Methods? Totally 180 patients with breast cancer from 4 ClassⅢ Grade A hospitals in Jiangsu Province were selected by convenience sampling method from June to October in 2018. They were investigated with General Information Questionnaire, Post Traumatic Growth Inventory (PTGI), Social Support Rating Scale (SSRS), and Connor-Davidson Resilience Scale (CD-RISC). Results? In breast cancer patients, the total scores of PTGI, SSRS and CD-RISC were (62.52±17.59), (35.15±9.29) and (56.51±18.33) scores. Correlation analysis showed that the total scores of PTGI and its each dimension were positively correlated with the total scores of SSRS, as well as the total scores of CD-RISC and its each dimension (P＜0.01); the total scores of SSRS and its each dimension were positively correlated with the total scores of CD-RISC and its each dimension (P＜ 0.01). Multivariate linear regression analysis showed that resilience, methods of disease detection, and treatment plans were independent influencing factors of PTG in patients with breast cancer. Both social support and resilience could positively predict PTG, whose path coefficients were 0.493 and 0.302, respectively. Resilience was a mediator of social support and PTG. The indirect effect was 0.080. Conclusions? Resilience plays an important role in mediating between social support and PTG in patients with breast cancer. The resilience training could promote patients' PTG ability .

Objective? To assess the application effects of internet-delivered cognitive-behavioral therapy(ICBT) on symptom management in cancer patients. Methods? All randomised controlled trials (RCTs) about applying ICBT in symptom management in cancer patients in the following databases were searched from the establishment date up until 20th August 2018: Web of Science, PubMed, Cochrane Library, Embase, CBMdisc, Chinese National Knowledge Infrastructure databases(CNKI) and Wanfang. After literature screening, data extraction and quality evaluation, RevMan 5.3 software was used for meta-analysis. Results? Finally, 11 RCT studies were included, totaling 2329 subjects. The results showed that ICBT was beneficial to improve mental distress [SMD=5.02, 95%CI (0.80, 9.25), P=0.02], sleep quality [SMD=0.35, 95%CI (0.02, 0.68), P=0.04]and cancer-related fatigue [SMD=0.50, 95%CI (0.01, 0.99), P=0.04]; but ICBT did not have depression relieving effects in cancer patients (P＞0.05). Conclusions? ICBT is beneficial to reduce psychological pain, improve sleep quality and alleviate cancer-related fatigue in cancer patients, but it has no obvious advantage in alleviating depression. Future studies still need to focus on specific cancer types and validate them with multi-center, large-sample and long-term intervention studies.

Objective To summarize the international current status of anesthesia nursing research. Methods The nursing papers were searched across the databank of PubMed and Web of science between 1946 and 2017 and 2012 and 2017,respectively to look into the external characteristics of international anesthesia nursing publications. Using the methods of common words analysis, cluster analysis and citation analysis, we analyzed high frequency subjects and highly cited articles from 2012-2017, analyzing the highlights in the anesthesia nursing. Results 5,041 articles from 1946-2017 were included. The number of articles in anesthesia nursing field was relatively small in first 30 years,increasing year by year since 1970s and speeding up since 1990s.The average number of articles from 2012-2017 was all above 150.The 5,041 articles distributed in 1,260 journals.The top 10 journals accounted for 24.36% of the total number (1228/5041).The articles were mainly published in the developed countries in Europe and America.The hot spots in anesthesia nursing research included anesthesia management and pain management,professional skills of anesthesia nurses and medical team collaboration,intervention on psychological status and complications among perioperative patients. Conclusions The research of anesthesia nursing aboard has attracted more and more attention and formed several research highlights.Domestic research in the field is still at the early stage and in the future,domestic scholars can draw on foreign research highlights to carry out relevant research.

Objective To summarize the key points of nursing care in reservation of catheters in 11 cases of nasopharyngeal carcinoma patients who received concurrent chemo-radiotherapy with symptomatic thrombosis after ultrasound-guided implantation of double-lumen PICCs(PowerPICC).Methods From January,2014 to December,2015,totally 11 cases with symptomatic venous thromboembolism were identified among 109 cases of nasopharyngeal carcinoma patients receiving concurrent radiotherapy and chemotherapy,and observation and nursing care were provided at the early stage of thrombosis and during thrombosis.Results All double-lumen PICCs were reserved,and no recurrence or aggravation of thrombosis was recorded to the end of the treatment.The duration of carrying PICCs was 67～89(77.45±6.65) days.Conclusion With careful treatment and nursing,PICC catheter-related complications can be reduced and the duration of carrying catheters can be prolonged,which leads to accomplishment of the treatment plan for patients.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.

Objective To identify the potential correlation of serum 25-hydroxyvitamin D3 [25 (OH)D3]and C-reactive protein (CRP) with coronary artery disease.Methods We measured the serum 25 (OH)D3 and CRP levels in 416 suspected coronary heart disease patients who underwent coronary angiography.Gensini scores were used to assess the severity of coronary stenosis.Based on the results of coronary angiography,the 416 patients were divided into normal group (n =246),stable angina group (n =110),and acute coronary syndrome (ACS) group (n =60).Results The serum levels of 25 (OH) D3 in the normal group and stable angina group were significantly higher than that in the ACS gropu [(33.15 ± 20.95) nmol/L vs.(15.55 ±5.7) nmol/L,(28.93 ± 16.45) nmol/Lvs.(15.55 ± 5.7) nmol/L,bothP＜0.001].TheCRPlevelin the normal group was significantly lower than those in the stable angina group and the ACS group [(4.33 ± 0.12) rng/Lvs.(5.68 ± 0.25) mg/L,(4.33 ± 0.12) mg/Lvs.(5.73 ± 0.31) mg/L,bothP＜0.001].The serum 25 (OH)D3 was not correlated with CRP or Gensini score in the normal group.In the ACS group,the serum 25 (OH) D3 was negatively correlated with CRP level and Gensini score (r =-0.026,P =0.045 ; r =-0.256,P =0.048),while CRP level was positively correlated with Gensini score (r =0.459,P ＜0.001).Inthe stable angina group,the serum 25 (OH)D3 was also negatively correlated with CRP level and Gensini score (r =-0.211,P =0.027; r =-0.208,P =0.029),and the latter two were positively correlated (r =0.574,P ＜ 0.001).Conclusions Low serum 25 (OH) D3 levels are associated with coronary artery stenosis.Combining with CRP,it may be involved in the pathogenesis of coronary heart disease through inflammatory mechanism.

BACKGROUND:Recently, studies on three-dimensional reconstruction and biomechanics became more and more. Three-dimensional models of organs were established by modeling software based on image data using computer. Mechanical analysis was conducted using finite element analysis software. After literature retrieval, we found that the principle of three-dimensional reconstruction of human organs is not clear, and the process description is relatively simple. Some is not accorded with the fact. Above studies cannot guide related research. OBJECTIVE:To explore the principle, process, results and further application of three-dimensional reconstruction models of organs, and to provide evidence for future studies. METHODS:We retrieved China National Knowledge Infrastructure for representative literatures about three-dimensional reconstruction of human organs using the computer, and analyzed the principle, process, results and further application of three-dimensional reconstruction models of organs. RESULTS AND CONCLUSION:In combination with established three-dimensional bone models, we explained the principle, process, and application of three-dimensional reconstruction in detail, and laid the theoretical foundation for subsequent biomechanical research. With continuous development of tissue engineering technology, scholars have begun to study the pathogenesis of bone injury from various angles and different aspects so as to better prevent and treat this disease. The related research is stil in its primary stage, and stil needs further investigations.