To compare gait parameters during single-task and dual-task walking in older adults, and to examine differences in dual-task costs between individuals with high versus low balance abilities under different task conditions.

Objective: To assess the dynamic changes of microcirculation at acupoints in patients with primary dysmenorrhea and cold congelation and blood stasis syndrome using laser speckle blood flow imaging. Methods: Patients with primary dysmenorrhea and cold coagulation and blood stasis syndrome (primary dysmenorrhea group, n=53) and healthy female college students(control group, n=57) who met the inclusion and exclusion criteria from October 2020 to July 2022 were enrolled at Hebei University of Chinese Medicine. On the premenstrual and first day of menstruation, a laser speckle blood flow imaging system was used to measure the microcirculation blood flow perfusion on the surface of acupoints related to the conception, thoroughfare, and governor vessels, and stomach, spleen, and bladder meridians in the abdomen and lumbosacral regions. The dynamic changes in microcirculation were calculated based on the difference in average blood flow perfusion at each acupoint before and after menstruation. Receiver operating curve (ROC) analysis was used to analyze the diagnostic efficacy of dynamic changes in microcirculation on the surface of each acupoint. The microcirculation sensitization rate of acupoints was calculated. Results: Compared with the control group, the dynamic changes in microcirculation at the following acupoints in the primary dysmenorrhea group were increased (P<0.05): conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]); left thoroughfare vessel (left Huangshu[KI16], left Zhongzhu[KI15], left Siman[KI14], left Qixue[KI13], left Dahe[KI12], left Henggu[KI11]); left stomach meridian (left Tianshu[ST25], left Wailing[ST26], left Qichong[ST30]); left spleen meridian (left Daheng[SP15], left Fujie[SP14]); right thoroughfare vessel (right Huangshu[KI16], right Zhongzhu[KI15], right Siman[KI14], right Qixue[KI13], right Dahe[KI12], right Henggu[KI11]); right stomach meridian (right Wailing[ST26], right Daju[ST27], right Shuidao[ST28], right Guilai[ST29], right Qichong[ST30]); and right spleen meridian (right Fujie[SP14]). The area under the ROC curve of conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]), thoroughfare vessel (right Siman[KI14], left Huangshu[KI16], right Qixue[KI13], right Zhongzhu[KI15], right Dahe[KI12], left Zhongzhu[KI15], left Siman[KI14], right Huangshu[KI16], left Qixue[KI13], right Henggu[KI11], left Henggu[KI11], left Dahe[KI12]); stomach meridian (left Tianshu[ST25], right Guilai[ST29], left Wailing[ST26], right Shuidao[ST28], right Daju[ST27], right Wailing[ST26], right Qichong[ST30], left Qichong[ST30]), and spleen meridian (left Daheng[SP15], left Fujie[SP14], right Fujie[SP14]) was 0.610-0.682 (P<0.05). Compared with the control group, the sensitization rate of some acupoints in the primary dysmenorrhea group increased (P<0.05). Conclusion With the onset of menstruation, the blood flow perfusion of some acupoints in the abdomen (thoroughfare, and conception vessels, and stomach and spleen meridians) of patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome increased, and the status of acupoints changed from a resting state to an active state. These acupoints are sensitive in patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome and have a certain diagnostic efficacy, providing a basis for further analyzing the efficacy and mechanism of acupuncture and moxibustion to treat primary dysmenorrhea with cold blood coagulation and blood stasis syndrome.

Objective This study aims to explore the impact of patient gratitude on nurse creativity and examine the me-diating role of job satisfaction and the moderating role of safety climate.Methods In May 2023,a questionnaire survey was con-ducted among all nurses in two county-level public hospitals in Yangquan City,using the Patient Gratitude Scale,Creativity Scale,Job Satisfaction Scale,and Safety Climate Scale.A total of 448 valid questionnaires were collected.Mediation and moder-ation effects were tested using SPSS 20.0 and Model 4 and Model 7 in the Process v3.0 plugin.Results Patient gratitude showed a significant positive correlation with job satisfaction and creativity(r=0.558,0.591,P<0.01),and job satisfaction showed a significant positive correlation with creativity(r=0.581,P<0.01).Job satisfaction partially mediated the relationship between patient gratitude and creativity(mediation effect value=0.1850,95%confidence interval[0.1190:0.2484]),ac-counting for 34.76%of the total effect.Safety climate moderated the relationship between patient gratitude and job satisfaction(β=-0.048,P<0.05).Conclusion Patient gratitude has a positive impact on nurse creativity through job satisfaction.Ad-ditionally,safety climate moderates the relationship between patient gratitude and job satisfaction.

BACKGROUND:Scaffold materials serve as platforms that provide space and structure,playing a crucial role in the regeneration of cartilage tissue.Scholars from around the world are exploring different approaches to fabricate more ideal scaffold materials. OBJECTIVE:To review the design principles and preparation methods of cartilage scaffolds,and to further explore the advantages and limitations of various preparation methods. METHODS:Literature searches were conducted on the databases of CNKI,WanFang Data,PubMed,and FMRS from 1998 to 2023.The search terms were"cartilage repair,cartilage tissue engineering,cartilage scaffold materials,preparation"in Chinese and English.A total of 57 articles were ultimately reviewed. RESULTS AND CONCLUSION:(1)The articular cartilage has a unique structure and limited self-repair capacity after injury.Even if self-repair occurs,the newly formed cartilage is typically fibrocartilage,which is far inferior to normal articular cartilage in terms of structure and mechanical properties.It is difficult to maintain normal function and often leads to degenerative changes.Currently,the design and fabrication of scaffold materials for cartilage repair need to consider the following aspects:biocompatibility and biodegradability,suitable pore structure and porosity,appropriate mechanical properties,and bioactivity.(2)Research on the preparation of cartilage scaffolds has made significant progress,continuously introducing new preparation methods and optimization strategies.These methods have their advantages and disadvantages,providing more possibilities for customized preparation and functional design of cartilage scaffolds according to specific requirements.

BACKGROUND:Gait is one of the optimal indicators of functional status in older adults.Gait parameters are associated with adverse health outcomes in older adults. OBJECTIVE:To summarize and compare the practical value of gait parameters,and to review the progress of research on spatio-temporal parameters and the risk of adverse health outcomes in older adults. METHODS:PubMed,Web of Science,and CNKI were searched for relevant literature published from January 2010 to June 2023 using the search terms of"gait speed,walking speed,step length,cadence,step frequency,step time,walking base,aged and elderly"in English and Chinese,respectively.A total of 52 papers were finally included for the systematic review. RESULTS AND CONCLUSION:Currently,researchers have focused on three basic temporal-spatial parameters,namely,step speed,step length and step frequency,to explore their association with adverse health outcomes in older adults.Reduced gait speed in older adults may increase the risk of falls,all-cause mortality,and may be an independent predictor of all-cause mortality.Older adults with slow gait speed are at higher risk of cognitive decline,and may be the preferred gait parameter in assessing cognitive impairment in older adults.Older adults with slow gait speed are more likely to have debilitating or common chronic illnesses,and are at higher risk of hospitalization and public care.Step length is positively correlated with individual height and lower limb length,but age-induced shortening of step length is not related to height or lower limb length,and shortening of step length reflects reduced physical function in older adults,and shortening of step length is a risk factor for falls and cognitive decline in older adults.Stride frequency is often used as a measure of exercise intensity,and a stride frequency of≥100 steps/minute is predictive of all-cause mortality,and slowing of step frequency may lead to a higher risk of falls,hospitalization and all-cause mortality in older adults.Changes in gait parameters are closely related to the level of physical fitness in older adults,and there may be a bidirectional relationship between the two.The results of the study will provide a theoretical basis for further improving risk screening in clinical populations,refining health risk assessment in the elderly,improving health protection and promoting active health in the elderly.

Objective:To explore the effect of job insecurity on work engagement, and examine the mediating role of job satisfaction and the moderating role of occupational proactive behavior.Methods:Using the convenient sampling method, nurses from Southern University of Science and Technology Hospital and Jiangyou Second People's Hospital were selected as the research objects in July 2022. General information questionnaire, Occupational Insecurity Scale, Occupational Satisfaction Scale, Work Engagement Scale and Occupational Proactive Behavior were used for questionnaire investigation. A total of 598 valid questionnaires were collected. Model 4 and Model 7 in the SPSS 22.0 Process were used to test the mediating effect and the moderated mediating effect respectively.Results:Occupational insecurity was negatively correlated with occupational satisfaction and work engagement ( r=-0.202, -0.165, P<0.01) , while occupational satisfaction was positively correlated with work engagement ( r=0.549, P<0.01) . Work satisfaction played a completely mediating role in the effect of job insecurity on work engagement (mediating effect value: -0.090 9, 95% confidence interval: -0.14 - -0.04) , accounting for 65.30% of the total effect. Occupational active behavior positively moderated the relationship between job insecurity and job satisfaction (β=0.07, P<0.01) . Conclusions:Nurses' work engagement is at a high level, but occupational insecurity will reduce nurses' job satisfaction and thus reduce their work engagement. Nurses with high occupational proactive behavior can alleviate the weakening of job insecurity on job satisfaction.

Objective:To explore the association between location of lower extremity deep venous thrombosis and incidence of pulmonary embolism in patients with lower extremity fracture during hospitalization.Methods:A retrospective study was conducted of the 1,620 patients who had been treated for lower extremity fracture and deep vein thrombosis from October 2014 to November 2019 at Department of Orthopaedic Trauma, Honghui Hospital. They were 726 males and 894 females, aged from 18 to 98 years (average, 64.0 years). By the anatomical location of thrombosis, they were divided into a proximal thrombosis group and a distal thrombosis group; by the laterality of thrombosis, they were divided into a bilateral thrombosis group and a unilateral thrombosis group which was further divided into a left thrombosis subgroup and a right thrombosis subgroup. The incidences of pulmonary embolism were compared between 2 corresponding groups and subgroups.Results:Pulmonary embolism occurred in 13 of the 1,400 patients with distal thrombosis and in 12 of the 220 patients with proximal thrombosis; the incidence of pulmonary embolism in the proximal thrombosis group (5.45%, 12/220) was significantly higher than that in the distal thrombosis group (0.93%, 13/1,400) ( P<0.001). Pulmonary embolism occurred in 10 of the 337 patients with bilateral thrombosis and in 15 of the 1,283 patients with unilateral thrombosis; the incidence of pulmonary embolism in the bilateral thrombosis subgroup (2.97%, 10/337) was significantly higher than that in the unilateral thrombosis group (1.17%, 15/1,283) ( P=0.017). Pulmonary embolism occurred in 5 of the 677 patients with left thrombosis and in 10 of the 606 patients with right thrombosis; the incidence of pulmonary embolism in the right thrombosis subgroup (1.65%, 10/606) was insignificantly higher than that in the left thrombosis subgroup (0.74%, 5/677) ( P=0.129). Conclusions:In patients with lower extremity fracture, those with proximal or bilateral thrombosis are more prone to pulmonary embolism than those with distal or unilateral thrombosis, but the possibility of pulmonary embolism cannot be ignored clinically in those with distal or unilateral thrombosis.

Objective:To evaluate the effects of weight-bearing area compression injury of the femoral head on the prognosis of elderly acetabular fractures after open reduction and internal fixation.Methods:A retrospective analysis of 36 elderly patients with acetabular fractures treated with open reduction and internal fixation during January 2014 to January 2018 were conducted. All patients with compression injury of the weight-bearing area of the femoral head, including 22 males and 14 females with 73.2±6.5 years old (range 60-87 years old), were included. The compression injury of weight-bearing area of the femoral head was not treated. According to the Letournel-Judet classification of acetabular fractures, there were 14 cases with both-column, 12 cases with anterior column and posterior hemitransverse, 4 cases with T type, 4 cases with transverse, and 2 cases with posterior column+ posterior wall. A total of 14 cases were accompanied by acetabular joint surface compression, while 29 cases were accompanied by joint dislocation. The Merle d'Aubigné score was used to evaluate the hip function during follow-up. The Matta classification method was used to evaluate the results of acetabular fracture reduction. The Kellgren-Lawrence classification standard and Ficat-Alert staging method were used to evaluate the traumatic arthritis of the hip and femoral head necrosis, respectively. During the follow-up, the femoral head necrosis with stage III, IV, or traumatic arthritis III, IV, or with indications for joint replacement was defined as surgery failure. CT scans of the pelvis were performed before and at 2-5 days after operation. The compression size of the femoral head on the coronal and axial planes of the CT scan was calculated for the compression volume. The compression severity was divided into small (<1 cm 3), medium (1-2 cm 3) and large (>2 cm 3) according to the volume. Binary Logistic regression analysis was used to analyze whether the postoperative measurement of the femoral head compression volume was associated with the risk of surgical failure. Results:All patients were followed up for 34.7±8.9 months (range 25-54 months). There were 7 cases with large compression of femoral head, 14 cases with medium, and 15 cases with small pre-operatively. However, there were 12 cases, 10 cases and 14 cases with large, medium and small at 2-5 days after operation, respectively. Six cases were excellent reduction, 22 cases were good, and 8 cases were poor. Thus, the excellent and good rate was 78% (28/36). At the last follow-up, Merle d'Aubigné score was excellent in 2 cases, good in 8 cases, fair in 5 cases, and poor in 21 cases. The excellent and good rate was 28% (10/36). There were 20 cases with surgery failure with 56% (20/36) failure rate. There were no statistically significant differences in the patient's age, body mass index, operation duration, blood volume, fracture type, fracture reduction, combined acetabular joint surface compression, and combined joint dislocation between the two groups. However, there was a statistically significant difference in the frequency distribution of compression volume in the weight-bearing area of the femoral head after surgery (χ 2=22.047, P<0.001). In patients with large, medium, and small-volume compression of the femoral head weight-bearing area, the surgery failure rates were 92%, 80%, and 7%, respectively. The large and medium-volume compression of the femoral head weight-bearing area were independent risk factors for surgical failure. Conclusion:Open reduction and internal fixation can be used to treat elderly patients with acetabular fractures combined with femoral head compression injury. Despite satisfactory reduction for acetabular fractures, the larger volume of femoral head compression affects the clinical outcomes with extremely high rate of surgical failure within 2 years.

Circulating tumor DNA(ctDNA) is the DNA fragment released into blood by tumor cells.Wheather it presents or not and its plasma concentration are closely related to the prognosis of patients. The common detection methods of ctDNA include digital polymerase chain reaction,second-generation sequencing,methylation detection technology and so on. Detecting specific point mutations or methylation of ctDNA can not only assist in the diagnosis of pancreatic cancer,but also be expected to identify pancreatic cancer at an early stage. Detecting ctDNA after operation can help predicting tumor recurrence and metastasis effectively,so that patients with high recurrence and metastasis risks can be intervened in advance. Accordingly,this article intends to review detection technology of ctDNA and its clinical applications in the early diagnosis of pancreatic cancer,the prediction of tumor recurrence and metastasis after surgery,and the evaluation of patient prognosis.

Circulating tumor DNA(ctDNA) is the DNA fragment released into blood by tumor cells.Wheather it presents or not and its plasma concentration are closely related to the prognosis of patients. The common detection methods of ctDNA include digital polymerase chain reaction,second-generation sequencing,methylation detection technology and so on. Detecting specific point mutations or methylation of ctDNA can not only assist in the diagnosis of pancreatic cancer,but also be expected to identify pancreatic cancer at an early stage. Detecting ctDNA after operation can help predicting tumor recurrence and metastasis effectively,so that patients with high recurrence and metastasis risks can be intervened in advance. Accordingly,this article intends to review detection technology of ctDNA and its clinical applications in the early diagnosis of pancreatic cancer,the prediction of tumor recurrence and metastasis after surgery,and the evaluation of patient prognosis.