Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

ObjectiveTo explore the effect of tele-supervised home-based pulmonary music therapy on respiratory function, exercise capacity and clinical symptoms in patients with chronic obstructive pulmonary disease (COPD). MethodsA total of 96 COPD patients admitted to the Second People's Hospital of Lianyungang from January, 2023 to June, 2024 were selected. They were divided into control group and observation group (48 cases each) using block randomization combined with a random number table. The control group received routine treatment and nursing intervention, while the observation group added tele-supervised home-based pulmonary music therapy, for six months. Evaluations were conducted before intervention and one, three and six months after intervention. ResultsThree cases in the control group and two in the observation group dropped out. Compared to the control group, the observation group was better in forced expiratory volume in one second percentage of predicted (FEV₁%) level six months after intervention (χ² = 10.481, P < 0.001), maximal inspiratory pressure three months (Z = -2.045, P = 0.044) and six months (Z = -3.643, P = 0.033) after intervention, maximal expiratory pressure three months (Z = 2.111, P = 0.036) and six months (Z = 4.025, P < 0.001) after intervention, exercise capacity one month (t = 2.266, P = 0.028), three months (t = 3.943, P = 0.028) and six months (t = 6.703, P < 0.001) after intervention, fatigue scores three months (Z = -4.352, P < 0.001) and six months (Z = -5.718, P < 0.001) after intervention, clinical symptoms three months (t = -2.698, P = 0.007) and six months (t = -2.898, P = 0.003) after intervention, and clinical control levels three months (t = -3.402, P < 0.001) and six months (t = -5.036, P < 0.001) after intervention. ConclusionTele-supervised home-based pulmonary music therapy is beneficial in improving respiratory function, exercise capacity, fatigue, clinical symptoms and clinical control levels in patients with COPD.

Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Objective:To investigate the effects of the Epley and Semont procedures with varying lateral angles of the head on posterior semicircular canal benign paroxysmal positional vertigo （PC-BPPV）. Methods:A total of 115 patients with unilateral PC-BPPV were randomly divided into five groups: Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group, with 23 patients in each group. Corresponding reduction treatments were performed. Results:The total effective rates for the Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group were 95.7% （22/23）, 4.3% （1/23）, 30.4% （7/23）, 52.2% （12/23）, and 87.0% （20/23） respectively. The inefficiencies were 4.3% （1/23）, 95.7% （22/23）, 69.6% （16/23）, 47.8% （11/23）, and 13.0% （3/23）. Statistically significant differences were observed in the total effective rates among the five groups （χ²=54.11, P<0.01）. The total effective rates in the Semont group, Semont+10° group, and Semont+20° group were significantly different from that of the Epley group （P<0.01）, while no statistically significant difference was found between the Semont+30° group and the Epley group （P= 0.608>0.012 5）. Conclusion:Among the four Semont methods with different lateral lying angles, the total effective rate of reduction treatment increased with the elevation of the lateral lying angle on the affected side. The efficacy of the Semont+30° group in treating PC-BPPV was not significantly different from the Epley group's reduction effect, which was markedly superior to that of the other four Semont methods at different angles. Therefore, the Semont+30° reduction technique is recommended for the treatment of PC-BPPV.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Benign Paroxysmal Positional Vertigo/therapy* ; Head ; Posture ; Semicircular Canals/physiopathology* ; Treatment Outcome

Objective: To analyze the temporal changes in lipid levels in patients following acute pancreatitis(AP) and explore the factors associated with post-AP serum triglyceride( TG) level changes. Methods: Patients diag- nosed with AP were included in this study. Clinical data were collected retrospectively , and lipid profile data from follow-up visits after discharge were tracked. Kaplan-Meier(K-M) curves were used to stratify follow-up duration ,iodine content detection. Thyroid volume was measured using a fully digital ultrasound imaging system , and goiter prevalence was calculated. Results: A total of 141 patients with 306 follow⁃up visits were included. Spearman correlation analysis showed a mild increase in lipid levels over time post⁃discharge : TG( r = 0. 159 , P = 0. 005) , total cholesterol(TC)( r = 0. 231 , P < 0. 000 1) , high⁃density lipoprotein cholesterol( HDL⁃C) ( r = 0. 181 , P = 0. 002) , and apolipoproteinA1 ( ApoA1) ( r = 0. 371 , P <0. 000 1) . In the univariate linear mixed model , male gender(β = 0. 160 ,P = 0. 007) , body mass index(BMI) (β= 0. 017 , P = 0. 007) , diabetes history(β = 0. 138 , P = 0. 030) , smoking history(β = 0. 166 ,P = 0. 004) , and recurrent AP(β = 0. 119 , P = 0. 029) were significantly associated with Lg(TG) levels (P < 0. 05) . In the multivariate model , BMI( β = 0. 019 , P = 0. 042) , smoking history ( β = 0. 155 , P = 0. 049 ) , and recurrent AP( β =0. 148 , P = 0. 032) remained significantly positively correlated with changes in Lg(TG) levels after AP , albeit with a low correlation strength (r < 0. 200) . Conclusion Lipid levels , including TG , TC , HDL⁃C and ApoA1 , tend to increase over time in AP patients after discharge , with this trend being more pronounced in those with hypertriglyceridemic acute pancreatitis. Post⁃AP TG levels are significantly influenced by BMI at the time of onset , smoking history and recurrent AP.

Objective To explore the application of the Montreal cognitive assessment(MoCA)scale in the early postoperative cognitive function of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 181 patients with aSAH hospitalized in Department of Neurosurgery,First Affiliated Hospital of Wenzhou Medical University from November 2021 to May 2022 were collected,and the scores of each dimension of the patients were evaluated using MoCA scale;Using gender,age,educational level,hypertension,responsible aneurysm diameter,Hunt-Hess grade,and surgical method as variables,the relationship between these factors and the scores of each dimension of the MoCA scale was studied.Logistic regression was used to analyze the influencing factors of low score dimensions and postoperative cognitive function.Results 61 cases(36.31％)had normal cognitive function(≥26 points).The results of multifactorial analysis of language dimensions showed that there was a statistically significant difference in the comparison of educational background,age,surgical method,Hunt-Hess grade,and the presence or absence of cognitive dysfunction(P<0.05);The results of multifactor analysis of delayed memory showed that there was a statistically significant difference in the occurrence of cognitive dysfunction among educational background,Hunt-Hess classification,alcoholism,family history of stroke,and surgical methods(P<0.05).Conclusion The incidence of early postoperative cognitive dysfunction in patients with aSAH is high;The scores of language and delayed memory were the lowest;Low cultural background,advanced age,craniotomy methods,and high Hunt-Hess scores are more likely to cause damage to language and delayed memory dimensions.

Objective:To investigate the situation of continuing medical education (CME) among obstetricians and gynecologists from Beijing's general hospitals at the secondary level or above in 2018 and 2023, and to provide a reference for standardizing CME for obstetricians and gynecologists in the future.Methods:We performed questionnaire surveys and interviews with 164 obstetricians and gynecologists in Beijing to investigate the status of completion of CME, the reasons for incompletion, the preferred modes to complete CME, and the preferred contents and forms of CME. SPSS 26.0 software was used for data analysis. The rate was compared using the chi-squared test.Results:Due to the impact of coronavirus disease 2019, the 2023 survey showed that 79 (48.17%) participants completed CME in an online mode, and 76 (46.34%) participants completed CME in an mostly online mode, with a significantly increased degree of satisfaction with CME compared with the 2018 survey ( P<0.05); 49 (29.88%) participants believe that online education is superior to traditional CME, and 69 (42.07%) participants believe that online education is comparable to traditional CME. The main advantages of the online education mode are flexible time and location and cost savings. "Hoping to improve my professional level" is the main purpose to participate in CME in both 2018 and 2023 surveys [124 (75.61%) vs. 127 (77.44%)]. "Professional skills and techniques" and "New advances in the specialty" are the contents of most interest. Conclusions:Obstetricians and gynecologists should raise the awareness to participant in CME. Relevant departments should establish a standardized system and an effective supervision and management mechanism, and take flexible education modes with the use of the Internet. Online education can achieve similar teaching effects and also improve learners' satisfaction.

Objective Corruption is the most common cadaver phenomenon in forensic practice and an important basis for inferring time of death(PMI),but the definition of corruption degree and the construction of model inference models have always been difficult in the practice of forensic science.Methods In this study,the late postmortem phenomena were observed.Meanwhile,the microbial flora structure of gut and gravesoil and the nature of gravesoil were detected,for analyzing the changes before and after the key moment of abdominal rupture which naturally happened during the cadaver decay.Results The results found that from the macroscopic and microscopic levels,there were significant differences in cadaver decay,including microbial flora structure and gravesoil properties before and after the key moment of the natural abdominal rupture during cadaver decay.The phenomena are highly observable and can be accurately judged by forensic examinations,as well as related means in the field of biology and physiochemistry.In this study,this critical event was called Rupture Point.Conclusion The Rupture Point can be used as an important node for the assessment of cadaver decay degree in the practice of forensic medicine.It can be utilized for a cut-off point as well when constructing PMI inference models based on microbial flora structure changes.The accuracy of PMI inference models can be improved when the models were constructed in segments.