Objective:To understand the real experience and needs of early exercise rehabilitation in elderly patients with total hip arthroplasty (THA), so as to provide a preliminary basis for intervention research to meet the needs of patients.Methods:Using the purposive sampling method, a total of 12 elderly patients with THA from the First Affiliated Hospital of Naval Medical University from June to September 2021 were selected as the research objects for semi-structured in-depth interviews. Colaizzi 7-step method was used to analyze, summarize and extract the data.Results:The early exercise rehabilitation experience and needs of elderly THA patients could be summarized into four themes such as postoperative exercise being a difficult journey, the need for professional support, the need for external support and internally driven needs and 14 sub themes.Conclusions:There are various problems and needs for early exercise rehabilitation in elderly patients undergoing THA. It is necessary to strengthen communication among doctors, nurses and patients, understand their true feelings and provide personalized care and rehabilitation guidance to improve their treatment experience and enhance their satisfaction.

Objective To explore the therapeutic effect of bicyclol(BIC)on rat model of myocardial fibrosis and its possible mechanism.Methods Twenty-four SPF male SD rats were randomly di-vided into sham group,model group,low-and high-dose groups,with 6 rats in each group.Except for the sham group,all other groups were injected with 5 mg/(kg·d)isoproterenol by tail vein to establish myocardial fibrosis model,and the low-and high-dose groups were administered by ga-vage with 100 and 200 mg/(kg·d)BIC,respectively for 14 consecutive days.HE staining and Masson staining were used respectively to observe the severity of myocardial injury and fibrosis.Western blot assay was employed to detect the protein expression of Collagen Ⅰ,Collagen Ⅲ,al-pha smooth muscle actin(α-SMA),methyltransferase-like protein 3(METTL3),α-ketoglutarate-dependent dioxygenase AlkB homolog 5(ALKBH5)and YTH domain family protein 1(YTHDF1)in rat myocardium.Results Compared with the sham group,myocardial cell necrosis and myocardial fibrosis were significantly more serious in the model group.Low-and high-dose BIC treatment reduced myocardial cell rupture and necrosis and myocardial fibrosis when com-pared with the model group.The expression levels of Collagen Ⅰ,Collagen Ⅲ,α-SMA,METTL3 and YTHDF1(P＜0.05)were significantly higher,and that of ALKBH5(0.58±0.02 vs 0.88±0.07,P＜0.05)was notably lower in the myocardial tissues of the model group than the sham group.While,both doses of BIC treatment significantly reversed above changes in protein levels(P＜0.05).Conclusion BIC can effectively alleviate myocardial structural damage and interstitial collagen deposition in rats with isoproterenol-induced myocardial fibrosis,and its mechanism may be related to m6A methylation modification.

Objective:To design a programmed evaluation process,and to explore its application effect in the management of medical equipment in emergency department.Methods:The information management platform was constructed based on IntelliJ IDEA and Java language with browser and server(B/S)architecture,a programmed evaluation process was designed to manage medical equipment in the emergency department.From 2021 to 2022,27 medical devices in use in the emergency department of Beijing Friendship Hospital,Capital Medical University were selected,the programmed evaluation process and the post-evaluation process were adopted respectively for management according to the different equipment management methods.A total of 800 equipment operation logs sampled were analyzed under the two management methods.The timeliness of equipment management,management effect and satisfaction scores of related management personnel were compared between the two management methods.Results:The average time consumption of equipment warning timeliness,timeliness of maintenance personnel's arrival and timeliness of proposed treatment methods in the programmed evaluation process management were(0.92±0.21)min,(5.43±1.08)min and(15.63±2.27)min,respectively,which were lower than those in post-evaluation process management method,the difference was statistically significant(t=13.810,16.893,16.554,P＜0.05).The failure rate of 400 logs sampled by the programmed evaluation process management method was 2.75%(11/400),which was lower than that of the post-evaluation process management method,the regular maintenance completion rate was 99.75%(399/400),which was higher than that of the post-evaluation process management method,the difference was statistically significant(x2=18.841,10.778,P＜0.05).The equipment maintenance time and equipment maintenance cost of the programmed evaluation process management were(9.32±1.18)days and CNY(201,600±50,500),respectively,which were lower than those of the post-evaluation process management method,and the difference was statistically significant(t=12.663,37.213,P＜0.05).The satisfaction scores of maintenance engineers,medical staff and patients in equipment use management for the programmed evaluation process management were(97.25±2.44),(98.63±4.57)and(97.16±3.09),respectively,which were higher than the post-evaluation process management method,and the differences were statistically significant(t=21.284,8.206,5.933,P＜0.05).Conclusion:The application of programmed evaluation process to the equipment management of emergency department of the hospital can effectively improve and make up for the loopholes and deficiencies in the conventional equipment management,improve the effect of equipment management,reduce the frequency of equipment failure,and ensure the safe and stable operation of equipment.

Objective:To explore the risk factors related to delayed pleural effusion in multiple trauma patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 145 multiple trauma patients admitted to the First Affiliated Hospital of Soochow University from January 2022 to October 2023, including 99 males and 46 females, aged 18-81 years [56.0(46.5, 64.5)years]. Based on whether delayed pleural effusion developed after injury, the patients were divided into delayed pleural effusion group ( n=66) and non-delayed pleural effusion group ( n=79). The clinical data of the patients in both groups were collected, including gender, age, underlying disease (diabetes mellitus and hypertension), cause of injury (traffic injury, blow injury, fall from height, and others), comorbid injuries (traumatic brain injury, maxillofacial fracture, clavicular fracture, scapular fracture, sternal fracture, spinal fracture, multiple rib fracture, pneumothorax, lung contusion, and pelvic fracture), severity of injury [injury severity score (ISS) and abbreviated injury scale (AIS) score for the chest], location and number of rib fractures, vital signs at admission (body temperature, heart rate, respiration, systolic blood pressure, diastolic blood pressure), and clinical test indices [white blood cells (WBC), hemoglobin (Hb), platelets (PLT), total protein (TP), albumin (ALB), C-reactive protein (CRP), procalcitonin (PCT), fibrinogen (FIB), fibrin degradation product (FDP), D-dimer (D-D), aspartate transaminase (AST), alanine transferase (ALT), and creatinine (Cr)]. Univariate analysis was conducted to assess the correlation between the forementioned factors and the development of delayed pleural effusion after multiple traumas. Multivariate Logistic regression analysis was used to determine the independent risk factors for the development of delayed pleural effusion after multiple traumas. Results:The results of univariate analysis showed that multiple rib fracture, pneumothorax, pulmonary contusion, chest AIS score, posterior rib fracture, number of rib fractures, TP, ALB, CRP, PCT and FDP were correlated with delayed pleural effusion in multiple trauma patients ( P<0.05 or 0.01); whereas gender, age, underlying disease, cause of injury, sternal fracture, spinal fracture, clavicular fracture, scapular fracture, pelvic fracture, maxillofacial fracture, traumatic brain injury, anterior rib fracture, ISS, vital signs at admission, WBC, Hb, PLT, FIB, D-D, AST, ALT, and Cr were not correlated with delayed pleural effusion in multiple trauma patients ( P>0.05). The results of multivariate Logistic regression analysis revealed that lung contusion ( OR=3.96, 95% CI 1.59, 9.85, P<0.01), ALB ( OR=0.79, 95% CI 0.66, 0.94, P<0.01), and CRP ( OR=1.02, 95% CI 1.01, 1.03, P<0.01) were significantly correlated with delayed pleural effusion in multiple trauma patients. Conclusion:Lung contusion, ALB, and CRP are the independent risk factors for delayed pleural effusion in multiple trauma patients.

Objective·To explore the correlation among perceived social support,rehabilitation self-efficacy and rehabilitation exercise adherence of in-patients after hip/knee arthroplasty,and examine the mediating role of rehabilitation self-efficacy in the correlation between perceived social support and rehabilitation exercise adherence.Methods·A convenience sampling method was used,and 141 post-total hip/knee arthroplasty inpatients in the bone and joint ward of the First Affiliated Hospital of Naval Medical University(Shanghai Changhai Hospital)from October 2021 to February 2023 were selected as the study subjects.The general demographic data,such as age and gender,and the information of disease and operation were assessed by using General Data Questionnaire.The adherence to rehabilitation exercise in patients after hip/knee arthroplasty was assessed by using the Rehabilitation Exercise Adherence Scale(REAS);the self-efficacy of rehabilitation exercise was assessed by using the Self-Efficacy for Rehabilitation Outcome Scale(SER);the social support level of individual subjective feelings of the patients was assessed by using the Perceived Social Support Scale(PSSS).Pearson's correlation analysis was used to test the correlation between the variables,and Bootstrap method was used to investigate the mediating role of rehabilitation self-efficacy in the correlation between perceived social support and rehabilitation exercise adherence.Results·A total of 167 questionnaires were distributed and 141 valid questionnaires were recovered,with a valid recovery rate of 84.4%.The age range of the 141 patients after hip/knee arthroplasty was 26?84 years old,and the average age was(64.75±10.74)years old.The total score of SER of the patients after hip/knee arthroplasty was(100.45±21.71),the total score of PSSS was(68.29±10.89),and the total score of REAS was(11.93±2.29).Pearson's correlation analysis results showed that there was a significant correlation between SER score and PSSS score,SER score and REAS score,and PSSS score and REAS score in patients after hip/knee arthroplasty.The mediation effect analysis showed that the indirect effect of perceived social support on rehabilitation exercise adherence was significant(effect value 0.033,95%CI 0.017?0.058,P<0.05),and the direct effect of perceived social support on rehabilitation exercise adherence was not significant(effect value 0.027,95%CI-0.008 ? 0.065,P>0.05).Conclusion·Perceived social support positively predicts rehabilitation exercise adherence,and rehabilitation self-efficacy fully mediates the correlation.Direct intervention in rehabilitation self-efficacy is superior to moderating the level of perceived social support.

Objective To investigate the impact of intravenous inject esketamine before operation on postoperative fatigue syndrome(POFS)in patients undergoing laparoscopic radical surgery for colorectal cancer.Methods Sixty-two patients,41 males and 21 females,aged 34-64 years,BMI 18-25 kg/m2,ASA physical statusⅠ orⅡ,scheduled for laparoscopic radical surgery for colorectal cancer under general anesthesia,were randomly assigned into two groups:the esketamine group(group E)and the control group(group C),31 patients in each group.Group E received a single intravenous injection of esketamine 0.25 mg/kg 5 minutes before surgery,while group C received sodium chloride 5 ml.The intravenous analgesia program was identical between the two groups.The jugular venous blood samples were taken for determination of serum concentrations of tumor necrosis factor-α(TNF-α)and superoxide dismutase(SOD)10 minutes before anesthesia,at the end of operation,and 12 and 24 hours after operation.Identity-consequence fatigue scale(ICFS-10)score were performed 1 day before surgery,3,5,and 7 days after op-eration,respectively,and the occurrence of POFS(ICFS-10 score＞24 points)were recorded.The time of extubation and the occurrence of adverse reactions such as coughing,delirium and restlessness during awak-ening,the complications of systems postoperatively,and the postoperative hospitalization time were recorded.Results Compared with group C,the concentration of serum TNF-α were significantly decreased while the concentration of serum SOD were significantly increased at the end of operation,12 and 24 hours after operation(P＜0.05),ICFS-10 score 3,5,and 7 days after operation,and the incidence of POFS 7 days after operation were significantly decreased(P＜0.05).There were no significant differences in extu-bation time,coughing,delirium and restlessnes,the complications postoperatively,and postoperative hospi-talization time between the two groups.Conclusion A single intravenous injection of esketamine can reduce the incidence of POFS in patients undergoing laparoscopic radical surgery for colorectal cancer,and no postoperative adverse reactions increased.

Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.

Objective:To analyze the differences in whole blood selenium (Se), zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), and iron (Fe) levels of rural older adults among areas with different soil selenium levels, and explore the main factors associated with the six nutrient elements status, so as to provide a basis for further evaluating the health risks of people in areas with different soil selenium levels.Methods:Four administrative villages were randomly selected from the Se-deficient (soil Se content < 0.175 mg/kg), Se-sufficient (soil Se content 0.175 - < 0.400 mg/kg), Se-rich (soil Se content 0.400 - < 3.000 mg/kg) and Se-excessive (soil Se content ≥3.000 mg/kg) areas, respectively, in Enshi Tujia and Miao Autonomous Prefecture (Enshi Prefecture) of Hubei Province in 2017 - 2018. And 100 elderly people aged 60 years or older (half male and half female) were randomly selected as the survey subjects in each servey site. The basic information such as general demography and lifestyle was collected through face-to-face questionnaires. Physical examination was performed and fasting venous blood was collected in the morning. The contents of blood Se, Zn, Cu, Mg, Ca, and Fe were determined by inductively coupled plasma mass spectrometry. The main factors associated with the six nutrient elements status were analyzed.Results:A total of 416 subjects were included, including 208 males and 208 females, whose average age was (72.43 ± 5.25) years, and body mass index (BMI) was (22.67 ± 3.49) kg/m 2. There were significant differences of blood Se, Zn, Cu, Mg, Ca and Fe levels between the areas with different Se levels ( Z/F = 288.30, 3.24, 14.81, 29.14, 131.28, 3.37, P < 0.05). Compared with Se-deficient and Se-sufficient areas, blood Se level was higher in Se-rich and Se-excessive areas and blood Zn level was lower in Se-excessive area ( P < 0.05); compared with Se-sufficient area, blood Cu level was lower in Se-deficient, Se-rich and Se-excessive areas, but blood Mg and Ca levels were higher ( P < 0.05), and the blood Fe level was lower in Se-excessive area ( P < 0.05). There were significant differences in the deficiency rates of Se, Zn, Cu, Mg, Ca and Fe among the elderly in different Se level areas (χ 2 = 140.83, 15.39, 31.90, 17.49, 157.60, 30.33, P < 0.01). There were significant differences in blood Zn, Cu, Ca and Fe levels between two gender groups ( P < 0.05); the blood Zn and Fe levels of the smokers were higher than those of the non-smokers, and the blood Cu level was lower than that of the non-smokers ( P < 0.05); the blood Zn and Fe levels of the drinkers were higher than those of the non-drinkers ( P < 0.05). Conclusions:The levels of six nutrient elements in the whole blood of the elderly in areas with different soil Se levels are different. To assess the health risks of the population in areas with different soil Se levels, it is necessary to consider the levels of multiple nutrient elements at the same time.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

Objective To evaluate the analgesic effect of tetrodotoxin (TTX) in four types of acute pain models and provide experimental support for its rational application. Methods Mice or rats were intramuscularly pretreated with morphine (1 mg/kg) or TTX (0, 0.5, 1, 2, 4 and 8 μg/kg) 40 min before acetic acid writhing test, formalin stimulation test, hot plate test or tail flick test. Pain response or pain threshold were recorded, and inhibition rate was calculated during the tests. The arachidonic acid of serum was determined by Elisa. Results Significant analgesic effects were observed with morphine in all four acute pain models. TTX dose-dependently reduced the number of writhing induced by acetic acid and inhibited the pain response induced by formalin during phase I and phase II, with the highest inhibition rate of more than 80.00% in two pain models. TTX showed analgesic effect in tail flick test and hot plate test, with the highest inhibition rate of 25.00% and 19.79%, respectively. Both acetic acid and formalin increased arachidonic acid in animal serum, but TTX had no significant inhibitory effect on the releasing of arachidonic acid. Conclusion TTX showed significant analgesic effect in the chemical stimulation pain models induced by acetic acid and formalin, but limited analgesic effect was observed on the physical stimulation pain model induced by heat (hot plate and hot water). TTX may produce analgesic effect by blocking the inflammatory mediators mediating pain response.