ObjectiveTo evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.MethodsThis was a two-arm randomized controlled trial wherein 80 patients were recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group received conventional orthopedic treatment, whereas the intervention group received TEAS and conventional treatment. The intervention group received TEAS 3 times a week for 30 min each time for 8 weeks. The primary outcomes were muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris and gastrocnemius muscles, whereas the secondary outcome measure was echo intensity (EI). Data were collected before the fixation operations (baseline assessment) and 4 and 8 weeks after intervention.ResultsCompared with baseline, the MT and CSA were reduced in both groups by the end of treatment, whereas EI increased in both groups. At week 4, the reduction in the rectus femoris CSA in the intervention group was significantly lower than that in the control group (P = .02); however, the between-group differences in the MT and EI (all P .05) were not significant. No serious adverse events were observed in either group.ConclusionOur study showed that TEAS can improve muscle atrophy by attenuating the decline in the muscle CSA. Because this was only a pilot trial, subsequent studies will need longer follow-ups and larger sample sizes.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective The effect of metal precrown restoration of distal proximal maxillofacial caries in the first de-ciduous molar on the composite resin filling of mesio-adjacent maxillofacial caries in the second deciduous molar was in-vestigated.Methods A total of 80 children aged 4-8 who visited our clinic were selected,and 120 teeth were examined.Two consecutive deciduous molars in one jaw were considered a single case when the distal proximal maxillary surface of the first deciduous molar and the mesial proximal maxillary surface of the second deciduous molar simultaneously had caries.The teeth were randomly divided into two groups:group A(68 cases),in which the first and second molars were repaired with composite resin,and group B(52 cases),in which the first deciduous molar was repaired with metal pre-crown after composite resin filling and the second deciduous molar was filled with composite resin.The two groups were compared in terms of the success rate of composite resin filling in the second deciduous molar.Results At 3 months,no significant difference(P＞0.05)was found between groups A(92.65％)and B(96.15％).At 6 months,no significant difference(P＞0.05)was observed between groups A(89.71％)and B(94.23％).At 12 months,statistically significant dif-ference(P＜0.05)was found between groups A(73.53％)and B(88.46％);At 24 months,statistically significant differ-ence(P＜0.05)was found between groups A(66.18％)and B(86.54％).Conclusion Compared with composite resin fill-ing of the first deciduous molar,the metal precrown resto-ration of the first deciduous molar can improve the suc-cess rate of composite resin filling of the second decidu-ous molar.

Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis（PTB）.Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed，including 628 cases with favourable treatment outcomes（favourable group）and 98 cases with unfavourable treatment outcomes（unfavourable group）. After excluding the lost to follow-up cases and non-tuberculosis-related death cases，there were 659 survival cases（survival group）and 16 cases of tuberculosis-related death（fatal group）. Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes，42 cases died from non-tuberculosis causes，32 cases lost follow-up，16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60（ OR=2.515，95% CI 1.461-4.330），retreatment of tuberculosis（ OR=2.502，95% CI 1.255-4.989），chronic obstructive pulmonary disease（ OR=2.796，95% CI 1.607-4.865），respiratory failure（ OR=6.373，95% CI 2.320-17.506），hypoproteinemia（ OR=3.149，95% CI 1.876-5.286）and elevated C-reactive protein（ OR=1.007，95% CI 1.002-1.012）were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients（all P<0.01）；retreated pulmonary tuberculosis（ OR=4.542，95% CI 1.182-17.449），complicated respiratory failure（ OR=14.186，95% CI 3.038-66.252）and body mass index<18.5 kg/m 2（ OR=5.179，95% CI 1.333-20.119）were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients（ P<0.05 or <0.01）. Conclusion:The older age，low BMI，hypoproteinemia，elevated C-reactive protein，comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.

Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis（PTB）.Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed，including 628 cases with favourable treatment outcomes（favourable group）and 98 cases with unfavourable treatment outcomes（unfavourable group）. After excluding the lost to follow-up cases and non-tuberculosis-related death cases，there were 659 survival cases（survival group）and 16 cases of tuberculosis-related death（fatal group）. Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes，42 cases died from non-tuberculosis causes，32 cases lost follow-up，16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60（ OR=2.515，95% CI 1.461-4.330），retreatment of tuberculosis（ OR=2.502，95% CI 1.255-4.989），chronic obstructive pulmonary disease（ OR=2.796，95% CI 1.607-4.865），respiratory failure（ OR=6.373，95% CI 2.320-17.506），hypoproteinemia（ OR=3.149，95% CI 1.876-5.286）and elevated C-reactive protein（ OR=1.007，95% CI 1.002-1.012）were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients（all P<0.01）；retreated pulmonary tuberculosis（ OR=4.542，95% CI 1.182-17.449），complicated respiratory failure（ OR=14.186，95% CI 3.038-66.252）and body mass index<18.5 kg/m 2（ OR=5.179，95% CI 1.333-20.119）were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients（ P<0.05 or <0.01）. Conclusion:The older age，low BMI，hypoproteinemia，elevated C-reactive protein，comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.

Objective:To analyze the influencing factors related to false-negative results of interferon-γ release assay (IGRA) QFT-GIT in patients with confirmed pulmonary tuberculosis.Methods:Clinical data of 389 patients with bacteriologically confirmed pulmonary tuberculosis who underwent QFT-GIT in Quzhou Hospital Affiliated to Wenzhou Medical University between January 1 and December 31 2020 were retrospectively analyzed. Univariate and multivariate logistic regression were used to analyze the influencing factors related to the false-negative results of QFT-GIT.Results:Among 389 confirmed patients, 347 cases had positive QFT-GIT results and 42 cases had negative results. Univariate analysis showed that the false-negative results of QFT-GIT were associated with low BMI, reduced CD4 + T lymphocyte count, decreased lymphocyte count, increased C-reactive protein, negative sputum smear, anemia, diabetes mellitus, malignant tumor and sepsis ( P<0.05 or P<0.01). Multivariate conditional logistic regression analysis showed that BMI <18.5 kg/m 2( OR=1.585, 95% CI 1.076-2.336), complicated with diabetes( OR=5.157, 95% CI 2.340-11.365), malignant tumors ( OR=5.596, 95% CI 2.048-15.295)and sepsis ( OR=4.141, 95% CI 1.042-16.459) were independent risk factors for the false-negative results of QFT-GIT ( P<0.05 or P<0.01). Conclusion:When the pulmonary tuberculosis patients are extreme emaciation, complicated with diabetes, malignant tumor or sepsis, the QFT-GIT results will be false negative.

Objective: To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention. Methods: Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model. Results: A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780). Conclusions The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.

Dental implantation is a popular way to replace natural teeth. Its prognosis is affected by a number of factors including periodontitis. A large number of studies have shown the incidence of peri-implant disease and implant failure rate in periodontal compromised patients are higher than periodontal healthy patients. Peri-implant disease is closely related to the pathogens in periodontitis. What's more, the long-term success of dental implants is affected by multiple risk factors of periodontitis such as regular oral hygiene maintenance and smoking. This paper reviews the survival rate, the pathogens and the prognosis of implants in periodontal compromised patients.

OBJECTIVE:To observe the clinical efficacy of qianliexin combined with tamsulosin hydrochloride and finasteride in the treatment of elderly benign prostatic hyperplasia.METHODS:Ninety-four patients diagnosed as benign prostatic hyperplasia in our hospital during May.2012-Oct.2014 were selected and divided into observation group (48 cases) and control group (46 cases) according to even and odd admission number.Both groups received Finasteride tablet 5 mg,po,qd.Basedon this,control group was additionally given Tamsulosin hydrochloride sustained-release capsules 0.2 mg,po,qd;observation group was additionally given Qianliexin capsules 2.5 g,po,tid,on the basis of control group.Clinical efficacies of 2 groups were observed as well as IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score before and after treatment.RESULTS:Clinical total response rate of observation group was 93.75％,which was significantly higher than 76.09％ of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in IPSS,BS,IIEF-5 score,ultrasonic measurement indexes and TCM syndrome score between 2 groups (P＞0.05).After treatment,IPSS and BS score,prostate volume (PV),residual urine(RU),each item score and total score of TCM syndrome were significantly decreased in 2 groups,while IIEF-5 score and Qmax were increased significantly;the observation group was significantly better than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Qianliexin combined with tamsulosin hydrochloride and finasteride shows significant therapeutic effi cacy for elderly benign prostatic hyperplasia,and is helpful to improve prostate symptoms and TCM syndromes,reduce PV and RU,and improve sexual function.