Objective To explore medical institution-led exercise training interventions,prelimina-ry preventive measures,and comprehensive health service strategies for elderly adults.Methods Sixty elderly adults from communities under the jurisdiction of primary hospitals who voluntarily participated in the training and met the inclusion criteria were divided into 75 to 79 years old group and 80 to 84 years old group.Elastic bands exercise were selected as the method for physical training for elderly community members.A total of three sets(9 items)of exercise,including upper and lower limb mus-cle strength exercises and balance as well as coordination training,were designed.The training period lasted for 12 weeks,with each session lasting 1 hour,three times a week.The medical team partici-pated in training supervision and follow-up evaluations throughout the process,dynamically adjusting the training intensity based on individual needs.Results Comprehensive safety and support meas-ures significantly improved training participation and completion rates.No sports injuries or adverse events occurred throughout the process,and all participants completed the training plan.After train-ing,statistically significant differences were observed in grip strength,five-times sit-to-stand test duration,Berg Balance Scale(BBS)scores,and Timed Up and Go(TUG)test results(P＜0.05),indicating effective physical fitness improvement.Conclusion Elastic band exercises are a suitable mode for physical improvement training among elderly adults,significantly enhancing muscle strength in the limbs and trunk and improving balance function.The positive communication and in-teraction in group activities significantly boost elderly adults'confidence in healthy living,leading to notable improvements in their mental state.

ObjectiveTo analyze drug resistance status and risk factors in elderly tuberculosis patients in Ninghai County of Zhejiang Province， and to provide basis for prevention and control of drug-resistant tuberculosis. MethodsClinical data were collected from 142 elderly tuberculosis patients （with positive sputum culture） who were diagnosed and treated in medical institutions in Ninghai from 2016 to 2020. The risk factors of drug resistance were analyzed by Chi-square test and logistic regression model. ResultsThe overall drug resistance rate was 33.80%， and the drug resistance rate in patients with recurrent pulmonary tuberculosis was significantly higher than that in patients with initial pulmonary tuberculosis， and the difference was statistically significant. Multivariate unconditional logisitic regression analysis showed that irregular medication and disease recurrence were independent risk factors for multidrug resistance in the elderly patients. ConclusionThe drug resistance rate in elderly tuberculosis patients in Ninghai is high. It is necessary to strengthen the management and supervision of tuberculosis in the community， and to carry out effective health education and visit for elderly patients， especially for newly treated patients， and to avoid treatment failure caused by irregular medication and interruption of treatment.

Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.

Objective To investigate the correlation between quantitative perfusion histogram parameters of DCE-MRI and tumor tissue microvessel density(MVD) in patients with lung cancer.Methods 30 patients with lung cancer confirmed by pathology who underwent preoperative DCE-MRI were enrolled in this retrospective study .Quantitative perfusion histogram pa-rameters( including median, mean, skewness, kurtosis, energy, entropy) were measured for each patient using Exchange mo-dle.Using the Immunohistochemical method to detect the expression of CD34 in tumor tissue, and counting the number of mi-crovessels under microscope.SPSS 19.0 was used to carry out statistical analysis.The correlation between MVD and quantita-tive perfusion histogram parameters of DCE-MRI measured by exchange model was evaluated by Pearson linear correlation anal-ysis.Results There was no significant difference in MVD and each quantitative perfusion histogram parameters between the three different pathological groups of lung cancer(P >0.05).Ktrans perfusion histogram parameters(mean, 25％, 50％, 50％, 75％, 90％, 95％), Kep perfusion histogram parameters(entropy, 10％, 25％, 50％, 75％, 90％), Fp perfusion histogram parameters( mean, 25％, 50％, 75％, 90％, 95％) and Vp perfusion histograms parameters ( entropy, 75％, 90％, 95％ ) were positively correlated with MVD(P<0.05).Ktrans perfusion histogram parameters(energy) and Vp perfu-sion histogram parameters(skewness, kurtosis, energy) were negatively correlated with MVD(P<0.05).There was no signifi-cant correlation between Ve perfusion histogram parameters and MVD(P>0.05).Conclusion There was a certain correla-tion between the perfusion histogram parameters of DCE-MRI and MVD,suggesting that the quantitative perfusion histogram of DCE-MRI in lung cancer can reflect the MVD value of cancer tissue .

Objective To compare prenatal ultrasonography and MRI in view of the accuracy in the diag-nosis of congenital cystic adenmatiod malformation(CAMM)of the lung. Methods From January 2014 to Octo-ber 2015,68 fetus who were examined with both prenatal ultrasonography and MRI and diagnosed as CAMM by pathological findings after operation or autopsy in our study. Taking the final pathological diagnosis of fetal CCAM genotyping as the gold standard,the accuracy of prenatal ultrasonography and MRI were compared in the diagnosis of CAMM of the lung.P<0.05 was considered as statistically significant. Results The alignment degree of prena-tal ultrasound in the diagnosis of CAMM was significantly larger than that of MRI examination to the pathological di-agnosis.Conclusion Prenatal ultrasound is an important method for diagnosing CCAM before pregnancy with high accuracy and affordability.

Objective To study the feasibility and results of laparoscopic surgery for cholelithiasis in elderly patients over 80 years old.Methods A retrospective study was conducted on 53 patients over 80 years old who underwent laparoscopic surgery for cholelithiasis from January 2015 to April 2017.Results The operation was successfully carried out on 53 patients.The intraoperative blood loss was 5 ～ 300 ml.The operation time was (93.5 ±41.2) minutes and the postoperative hospital stay was (11.0 ± 3.7) days.Postperative complications included bile leakage (n =5),intra-abdominal infection (n =1),pulmonary infection (n =5),wound seroma (n =2).There were no perioperative deaths.Conclusion Laparoscopic surgery for cholelithiasis was safe and efficacious in elderly patients over 80 years old.

To investigate the effects of Mycobacterium tuberculosis heat shock protein 65(HSP65)on Treg/Th17 immune balance in ApoE-knockout(ApoE-/-)mice, ApoE-/- mice with a high-cholesterol diet were immunized with M. tuberculosis HSP65. Sera were obtained for measurement of anti-HSP65 antibodies by ELISA; the effect of administration of different antigens was investigated, respectively, using flow cytometry analysis on the number of CD4+CD25+Foxp3+Tregs and CD4+IL-17+ Th17; the production of cytokines(IL-10, TGF-β1, IL-17 and IL-21)by these cells were determined by ELISA; total plasma cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels were detected by biochemical autoanalyzer. Atherosclerotic lesions were measured by lipid deposition stained with oil red O. The results demonstrated that the levels of anti-HSP65 IgG antibodies were increased significantly in Mycobacterium tuberculosis HSP65-treated ApoE-/- mice, revealed obvious decrease in Treg number, Treg related cytokines(IL-10, TGF-β1)levels and significant increase in Th17 number, Th17 related cytokines(IL-17 and IL-21)levels, the levels of TC, TG, HDL-C and LDL-C did not change between groups, while the atherosclerotic lesions significantly increased. Results indicate that M. tuberculosis HSP65 could interrupt the Th17/Treg immune balance in ApoE-/- mice, suggesting a potential role in the formation and progression of atherosclerosis.

Objective To study the feasibility and results of laparoscopic anatomical liver resection for hepatolithiasis.Methods A retrospective study was conducted based on the clinical data of 103 patients who underwent laparoscopic anatomical liver resection from June 2007 to July 2013.Results Total laparoscopic anatomical liver resection was successfully carried out in 97 patients.The mean operation time was 225.5 minutes,the blood loss was 50 ～ 1 000 ml and the mean postoperative hospital stay was 11.4 days.Postoperative complications included bile leakage (n =18),abdominal cavity infection (n =3),pulmonary infection (n =4),wound seroma (n =3),right hepatic duct injury (n =1).There was no perioperative death.Conclusion Laparoscopic anatomical liver resection for hepatolithiasis is a feasible,practical,and minimally invasive procedure.

Objective By discussion on the construction of school-community health education network,we can identify suitable community practice ways of improving students' comprehensive ability,enrich community health teams and meet the health demand of community residents.Methods Take Grade 08 and Grade 09 as the test classes.Two classes were selected from each grade,one class was set as the experimental group,the other was named as the control group.The communication skills,critical thinking skills,teamwork skills and the ability of getting the specific knowledge after the community practice for a year were compared between the two groups in each grade separately.At the same time,we assessed the community residents from the following four aspects,knowing about the health information,residents' health beliefs,their change in attitude,their adoption of healthy behaviors,and compared their knowledge of health information about three diseases.Results The results showed that the four mentioned abilities of the experimental groups were significantly improved.The community residents' health information awareness rate after the health education was significantly different compared with that before.There was no significant difference among three other levels.Conclusions Construction of school-community health education network can improve the students' comprehensive quality,it is beneficial to the survival and the development of health schools,and it can meet the needs of community residents,enrich the community health service team,and can also promote the change of teaching ideas.

Objective To evaluate the safety and feasibility of laparoscopic right hemi-hepatectomy for hepatolithiasis.Methods The clinical data of 3 patients who underwent laparoscopic right hemi-hepatectomy were analyzed retrospectively.Results In 2 patients the operation was performed successfully.The operative time was 340 min and 300 min,and the intraoperative blood loss was 800 ml and 400 ml.There was no need for blood transfusion.There was a small amount of bile leakage (30-60 ml/day) in these 2 patients.The postoperative hospital stay was 9 d and 11 d.The third patient was converted to open surgery because of profuse bleeding.All the 3 patients recovered well from surgery.Conclusions Total laparoscopic right hemi-hepatectomy for hepatolithiasis was safe and feasible.