Objective To explore the potential categories of exercise perception in elderly hip arthroplasty(HA)patients,analyze the prediction factors of different categories,and provide references for clinical nursing.Methods A convenience sampling method was used to select elderly HA patients treated in 6 orthopedic wards of 2 tertiary A hospitals in Guilin from October 2024 to February 2025.The general data questionnaire,Exercise Benefits and Barriers Perception Scale for Hip/Knee Throplasty Patients,Tampa Scale of Kinesiophobia,the 5-Factor Modified Frailty Index,and Self-Efficacy for Rehabilitation Outcome Scale were used for investigation.Latent profile analysis was used to identify the potential categories of exercise perception of elderly HA patients,and decision tree model was used to explore the core predictive factors of different profile.Results 222 valid questionnaires were collected,with an effective response rate of 96.52％.A total of 222 elderly HA patients were divided into 3 profiles:high benefit-low barrier group(19.82％),low benefit-high barrier group(22.07％),and mild barrier group(58.11％).Frailty,kinesophobia,rehabilitation self-efficacy,residence,educational level and daily exercise were significant predictors of latent profiles(P＜0.05),and the frailty was located in the root node of the decision tree model.Conclusion The level of exercise perception in elderly HA patients needs to be improved,and shows population heterogeneity.Medical staff should prioritize interventions for low benefit-high barrier and mild-barrier groups,implementing targeted strategies based on profile characteristics and predictive factors to improve their exercise perception.

Objective To explore the potential categories of exercise perception in elderly hip arthroplasty(HA)patients,analyze the prediction factors of different categories,and provide references for clinical nursing.Methods A convenience sampling method was used to select elderly HA patients treated in 6 orthopedic wards of 2 tertiary A hospitals in Guilin from October 2024 to February 2025.The general data questionnaire,Exercise Benefits and Barriers Perception Scale for Hip/Knee Throplasty Patients,Tampa Scale of Kinesiophobia,the 5-Factor Modified Frailty Index,and Self-Efficacy for Rehabilitation Outcome Scale were used for investigation.Latent profile analysis was used to identify the potential categories of exercise perception of elderly HA patients,and decision tree model was used to explore the core predictive factors of different profile.Results 222 valid questionnaires were collected,with an effective response rate of 96.52％.A total of 222 elderly HA patients were divided into 3 profiles:high benefit-low barrier group(19.82％),low benefit-high barrier group(22.07％),and mild barrier group(58.11％).Frailty,kinesophobia,rehabilitation self-efficacy,residence,educational level and daily exercise were significant predictors of latent profiles(P＜0.05),and the frailty was located in the root node of the decision tree model.Conclusion The level of exercise perception in elderly HA patients needs to be improved,and shows population heterogeneity.Medical staff should prioritize interventions for low benefit-high barrier and mild-barrier groups,implementing targeted strategies based on profile characteristics and predictive factors to improve their exercise perception.

Severe acute pancreatitis-associated acute lung injury (SAP-ALI) is a serious disease associated with high mortality. Emodin has been applied to alleviate SAP-ALI; however, the mechanism remains unclear. We report that the therapeutic role of emodin in attenuating SAP-ALI is partly dependent on an exosomal mechanism. SAP rats had increased levels of plasma exosomes with altered protein contents compared to the sham rats. These infused plasma exosomes tended to accumulate in the lungs and promoted the hyper-activation of alveolar macrophages and inflammatory damage. Conversely, emodin treatment decreased the plasma/pancreatic exosome levels in the SAP rats. Emodin-primed exosomes showed less pro-inflammatory effects in alveolar macrophages and lung tissues than SAP exosomes. In detail, emodin-primed exosomes suppressed the NF-κB pathway to reduce the activation of alveolar macrophage and ameliorate lung inflammation by regulating PPARγ pathway, while these effects were amplified/abolished by PPARγ agonist/antagonist. Blockage of pancreatic acinar cell exosome biogenesis also exhibited suppression of alveolar macrophage activation and reduction of lung inflammation. This study suggests a vital role of exosomes in participating inflammation-associated organ-injury, and indicates emodin can attenuate SAP-ALI by reducing the pancreatic exosome-mediated alveolar macrophage activation.

Objective To evaluate the value of the systemic immune-inflammatory index (SII), CEA, Cyfra21-1, and NSE in predicting and diagnosing bone metastasis of lung cancer. Methods The clinical data of 618 patients with lung cancer were retrospectively analyzed. According to the bone metastasis at baseline, the data of the diagnosis group (patients with bone metastasis at baseline and patients without bone metastasis during follow-up) and the prediction group (patients with bone metastasis during follow-up and patients without bone metastasis during follow-up) were analyzed to determine the correlation between the above indicators and lung cancer bone metastasis. Results Predictive group: SII≥850 and NSE≥58.64 ng/ml were independent risk factors and independent predictors for lung cancer bone metastasis. The AUC of the combined SII+NSE model was 0.662, with a sensitivity of 54.5% and a specificity of 74.5%; it was superior to the predictive value of single factor (95%CI: 0.596-0.728; P < 0.001). Diagnostic group: lung adenocarcinoma, SII≥951.6, CEA≥5.14 ng/ml, NSE≥20.15 ng/ml, and Cyfra21-1≥3.94 ng/ml were independent risk factors for bone metastasis in lung cancer patients (P < 0.05). The AUC of SII alone in the diagnosis of lung cancer bone metastasis was 0.754. The AUC of the SII+Cyfra21-1 combined model was 0.82 which was the largest, with a sensitivity of 74% and a specificity of 78.5%; it was superior to any univariate AUC (P < 0.05). Conclusion The levels of SII, CEA, Cyfra21-1, and NSE in the bone metastasis group are significantly higher than those in the non-bone metastasis group. The predictive and diabnostic values would be improved further when SII combined with other single risk factors.

Multiple markers that related to gastric cancer has been widely used in clinical, to predict its occurrence, development and prognosis. Serum level of fibrinogen (FIB) and neutrophil to lymphocytes ratio (NLR) respectively as representative indicators of coagulation system and inflammation, can predict the prognosis of patients with gastric cancer and survival time. The rise of fibrinogen is associated with enhanced capacity of the gastric tumor cells proliferation, invasion and migration. High NLR is associated with significantly induced survival of patients with gastric cancer. The combination of fibrinogen and NLR (F-NLR) combines the advantages of each individual indicator in predicting the occurrence, development and prognosis of cancer. It has shown a great prognostic potential in gastric cancer, and can be widely applied in prospect.

Objective To report the treatment effects of open reduction and internal fixation with bone plate through a small posterior heel plus tarsal canal incision on closed calcaneal fractures.Methods A retrospective study was done of the 20 patients (25 feet) who had been treated at Ward One,Department of Orthopaedics,People's Hospital of Yunfu from February 2016 to February of 2019 for closed calcaneal frac-tures by open reduction and internal fixation with bone plate through a small posterior heel plus tarsal canal incision.They were 16 males and 4 females,aged from 16 to 60 years.According to the Sanders classification,there were 3 cases of type Ⅱ,15 cases of type Ⅲ and 2 cases of type Ⅳ.Their fractures were reduced by traction,extruding,prying and direct visualization through the tarsal canal window;the bone plates were inserted through a small incision at the back of the heel and fixated by screws.Postoperative observation was done to address fracture healing,and length,width,height,B(o)hler angle and Gissane angle of the affected calcaneus,as well as functional recovery of the ankle-hindfoot by the American Orthopaedic Foot and Ankle Society (AOFAS) evaluation.Results The operation time for a single foot ranged from 45 min to 70 min,averaging 64.5 min;the intraoperative fluoroscopy for a single foot ranged from 3 times to 6 times,averaging 4.5 times.Local skin necrosis of about 0.5 cm x 0.3 cm appeared in one foot after operation but responded to dressing change.No other wound complications occurred.Their follow up was carried out for 6 to 36 months (average,17.3 months).The fractures healed well with well-shaped bony callus and flat articular surface after 4 to 6 months.The length (80.5 mm ±4.2 mm),width (44.8 mm ±5.2 mm),height (44.4 mm ±3.0 mm),B(o)hler angle (25.0° ± 5.1 °) and Gissane angle (113.8 ° ± 8.6°) of the calcaneus at the last follow up were significantly improved than the preoperative values (79.4 mm ± 4.5 mm,50.5 mm ± 6.3 mm,40.0 mm ±4.4 mm,12.0°± 13.8° and 107.0°± 13.3°) (all P ＜ 0.05).By the AOFAS ankle-hindfoot scale,functional recovery of the foot was excellent in 20,good in 3 and fair in 2 cases,giving an excellent to good rate of 92％.Conclusion In the treatment of closed calcaneal fractures,open reduction and internal fixation with bone plate through a small posterior heel plus tarsal canal incision may lead to fine outeomes due to its advantages of small incision and fine fracture reduction.

Objective To observe the targeting function of high affinity anti-EGFR monoclonal antibody (Cetuximab)conjugated superparamagnetic iron oxide-dopamine (anti-EGFR-PEG-SPIO) lung cancer cells via epidermal growth factor receptor (EGFR),as well as the feasibility for surveillance of tumor targeting with MRI.Methods Nanoparticles (NPs)of anti-EGFR-PEG-SPIO and PEG-SPIO were prepared,and the morphology of nanoparticles was observed with transmission electron microscope (TEM).The hydrodynamic diameter and R2 values of nanoparticles before and after conjugation with anti-EGFR were performed with dynamic light scattering (DLS) and MRI.MRI was performed in incubation with anti-EGFR-PEG-SPIO and PEG-SPIO after 2 h in vitro.The cellular uptake of anti-EGFR-PEG-SPIO and PEG-SPIO was further evaluated using Prussian blue staining and TEM.Results Anti-EGFR-PEG-SPIO and PEG-SPIO showed signal intensity of H460 cells on T2WI,decreased significantly compared with PEG-SPIO.The rate of signal intensity change was -58.2％,-82.7％,-94.4％ and-98.3％,respectively,at iron concentrations of (0,10,20,40,80 μg/ml) of antiEGFR-PEG-SPIO.Prussian blue staining and TEM showed that a lot of intracellular irons of anti-EGFR-PEG-SPIO were observed in H460 cells,but few of PEG-SPIO.Conclusion The effect of active targeting via anti-EGFR in EGFR overexpressed cells can be achieved with anti-EGFR-PEG-SPIO in H460 cells in vitro,and the targeting delivery process could be monitored with 3.0T MRI.

Objective To establish a quality standard for compound Heishen granules .Methods Scrophulariae Radix and Belamcandae Rhizoma were identified by TLC .HPLC was used to determine the content of cinnamic acid ,tectoridin and irisflo-rentin .The HPLC was performed on a column of Kromasil-C18 (150 mm × 4 .6 mm ,5 μm)with a mobile phase of acetonitrile (A)-0 .1％ hydrochloric acid (B)at a temperature 30 ℃ .The detection wavelength was set at 270 nm and the flow rate at 1 ml/min .Results The TLC method had good specificity without interference from negative control .The calibration curve showed a good linear relationship within the range of 16 .22-113 .57μg/ml for cinnamic acid(r=0 .9998) ,48 .19-337 .34μg /ml for tectoridin(r= 0.9998)and 16.40-114.80 μg/ml for irisflorentin(r= 0.9999) .The average recoveries were 99.23％ , 98.82％ ,99.17％ .Conclusion The established method is rapid ,accurate and reproducible .It can be used in the quality control of compound Heishen granules .

Objective To research the reliability and validity of the N-QOL Chinese version system.Methods A total of 260 nocturia patients were surveyed by the Chinese version of N-QOL and the reliability and validity of the Chinese version of N-QOL were assessed.Results Cronbach's α of the total questionnaire and two dimensions were 0.899,0.672 and 0.799,respectively.The split-half reliability was 0.828 and re-test reliability was 0.796.The correlation coefficients of scores of the items with its subordinate dimensionality were 0.595～0.854,and those with the total scores were 0.578～0.754.Two common factors were found through exploratory factor analysis,which explained the percent of 57.20％ rotation sums of squared loadings.Conclusions The reliability and validity of the Chinese version of N-QOL were good,so it could be used to evaluate the life quality of nocturia patients.

Objective To investigate the effects of modafinil,a new wake-promoting agent,on simulated flight performance during 48 h sleep deprivation(SD).Method Six male healthy young volunteers were exposed to two periods of 48 h continuous wakefulness during the crossover experiment.In one period,three 200 mg doses of modafinil were given and in the other,separated by two weeks,matching placebos were administered.The SD time started from 8:00 of the first day to 8:00 of the third day.Drug was given at 0:00,16:00 of the second day and 0:00 of the third day.Flight performance in J7-E flight simulator was tested at 21:00 of the first day and 1,3,5,7 h after each drug administration.Result The scores of simulated flight performance in the placebo group decreased with time during SD and became significant at 1:00～7:00 of the third day.Numbers of errors increased with time during SD,especially in the left ascending turn stage and the descending & landing stages.Compared with the placebo,flight performance was significantly increased after the third administration of modafinil.Numbers of errors during 48 h SD and at 1:00～7:00 of the third day in modafinil group was 19% and 40% lower than those in placebo group respectively.Conclusion Simulated flight performance during 48 h SD is significantly improved after repeated administration of modafinil,especially when the impacts of SD and the circadian trough are combined.