BACKGROUND:It has been proved clinically that adhesion of fibrous scar with the dura mater or nerve root after lumbar operation is an important factor for postoperative symptoms,such as postoperative pain and numbness. OBJECTIVE:To verify the inhibitory effect of autologous ligamentum flavum on the formation of epidural fibrous scar after lumbar surgery and explore the possible molecular biological mechanism. METHODS:Forty-eight Japanese white rabbits(6-8 months old)were randomly divided into three groups:a ligamentum flavum preservation group,a ligamentum flavum non-preservation group,and an autologous fat reposition group.A lumbar laminectomy model was established in all the three groups of rabbits,and rabbit epidural tissues were collected at 3 and 6 weeks after modeling.Hematoxylin-eosin staining was used to observe histological changes and the number and density of fibroblasts,VG staining was used to observe the percentage of collagen fiber area,and immunohistochemistry was used to observe the expression of transforming growth factor β1 and Smad3 proteins. RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that fibroblasts in the ligamentum flavum preservation group were few and loosely arranged,while the cells in the ligamentum flavum non-preservation and autologous fat reposition groups were more numerous and closely arranged.The number density of fibroblasts in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05);however,there was no significant difference between the latter two groups.VG staining results showed that the collagen fibers in the ligamentum flavum preservation group were sparse and distributed unevenly,while a lot of red collagen fibers were gathered in the ligamentum flavum non-preservation and autologous fat reposition groups.The area percentage of collagen fibers in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.The results of immunohistochemistry showed that the degree of positive staining of retained histone the ligamentum flavum preservation group was significantly lower than that of the other two groups.The absorbance value of transforming growth factor β1 and Smad3 in the ligamentum flavum preservation group was significantly lower than that in the other two groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.To conclude,there are different degrees of epidural fibrous scar formation after lumbar surgery.If the ligamentum flavum is preserved,it can help to reduce the number of epidural fibroblasts as well as the formation of collagen fibers,thus reducing the adhesion of the fibrous scar tissue to the dural sac and nerve root.The mechanism is not only a purely mechanical blockade,but also to reduce the formation of epidural fibrous scar by interfering with the transforming growth factor β1/Smad3 signaling pathway.

Objective: To investigate the trends in mortality and life loss of gastric cancer in Wenzhou City, Zhejiang Province from 2014 to 2023, so as to provide the evidence for formulating the prevention and control strategy for gastric cancer. Methods: The surveillance on causes of death data of permanent residents in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2014 to 2023. The crude mortality of gastric cancer was calculated, and standardized by the data from the Sixth Chinese National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL) and rate of potential years of life lost (PYLLR). The characteristics of mortality and life loss of gastric cancer in different genders and age groups were described. The trends in mortality and PYLLR of gastric cancer were analyzed using the average annual percent change (AAPC). Results: Totally 17 080 deaths were reported due to gastric cancer in Wenzhou City from 2014 to 2023, accounting for 12.58% and ranking third in the order of malignant tumor deaths. The crude mortality of gastric cancer was 20.73/105, and the standardized mortality was 15.22/105, showing decreasing trends (AAPC=-3.311%, -6.470%, both P<0.05). The crude mortality of gastric cancer was 29.22/105 in men and 11.61/105 in women, with standardized mortality rates of 20.81/105 and 8.74/105 (both P<0.05). The crude mortality of gastric cancer appeared a tendency towards a rise with increasing age (P<0.05), reaching the highest rate of 225.88/105 in the group aged 80 to <85 years. The PYLL and PYLLR of gastric cancer were 107 607.50 person-years and 1.37‰. The PYLLR appeared a tendency towards a decline from 2014 to 2023, with AAPC of -6.667% (P<0.05). Conclusions The mortality and PYLLR of gastric cancer in Wenzhou City appeared a tendency towards a decline from 2014 to 2023. Men and the elderly populations were the key groups for the prevention and treatment of gastric cancer.

Objective To investigate the population density and seasonal fluctuations of Aedes albopictus in Guangzhou City, Guangdong Province, from 2021 to 2023, so as to provide insights into A. albopictus control and management of dengue fever. Methods The surveillance of A. albopictus density was performed in all surveillance sites assigned across all streets (townships) in Guangzhou City during the period from January to December from 2021 to 2023. The surveillance frequency was twice every half month from May to September, and once every month for the rest of a year. In each surveillance period, A. albopictus mosquito larvae were captured from indoor and outdoor small water containers in residential areas, parks, medical facilities, schools, other government sectors and social organizations, construction sites, special industries and others for mosquito species identification. Adult mosquitoes were captured using electric mosquito suction apparatus for species identification and gender classification. Adult mosquitoes and mosquito eggs were collected with mosquito and egg traps at the breeding and dwelling places of Aedes mosquitoes for identification. The mosquito oviposition index (MOI), Breteau index (BI), adult mosquito density index (ADI) and standard space index (SSI) were calculated. The A. albopictus density was classified into grades 0, 1, 2 and 3 in each surveillance site, with Grade 0 density defined eligible, and the eligible rate of A. albopictus density was calculated at all surveillance sites each year from 2021 to 2023. In addition, the changing trends in MOI, SSI, BI and ADI of A. albopictus were analyzed in Guangzhou City from 2021 to 2023. Results The eligible rates of A. albopictus density were 61.69%, 68.75% and 55.15% in surveillance sites of Guangzhou City from 2021 to 2023 (χ² = 297.712, P < 0.001), and appeared a tendency towards a reduction followed by a rise each year, which gradually reduced since January, maintained at a low level during the period between May and October, and gradually increased from November to December. The MOI, SSI, BI and ADI of A. albopictus all appeared a tendency towards a rise followed by a reduction in Guangzhou City during the period between January and December from 2021 to 2023. The BI of A. albopictus peaked in the first half of June in 2021 (4.03), the first half of July in 2022 (3.89) and the last half of August in 2023 (5.02), and the SSI of A. albopictus peaked in the last half of June in 2021 (0.93), the last half of May in 2022 (0.59), and the last half of June (0.94) and the first half of September in 2023 (1.12). In addition, the MOI of A. albopictus peaked in the first half of May in 2021 (8.64), the first half of June in 2022 (8.96), and the last half of May (10.21) and the last half of June in 2023 (10.89), and the ADI of A. albopictus peaked in the first half of June in 2021 (3.41), the last half of June in 2022 (4.06), and the first half of July in 2023 (3.61). Conclusions The density of A. albopictus is high in Guangzhou City during the period from May to October, and the risk of local outbreak caused by imported dengue fever is high. Persistent intensified surveillance of the density and seasonal fluctuation of A. albopictus is recommended and timely mosquito prevention and control is required according to the fluctuation in the A. albopictus density.

Objective: To investigate the trends in mortality and life loss due to falls among the elderly in Wenzhou City, Zhejiang Province, so as to provide the basis for formulating prevention and control measures for falls among the elderly. Methods: The data on fall-related deaths among the elderly aged 60 and above in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2015 to 2023. The crude mortality was calculated and standardized using the data from the Sixth National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL), average years of life lost (AYLL), and potential years of life lost rate (PYLLR). The trends in mortality and life loss among the elderly were analyzed using the annual percent change (APC) and average annual percent change (AAPC). Results: There were 11 378 deaths due to falls among the elderly in Wenzhou City from 2015 to 2023, with a crude mortality of 82.67/100 000 and a standardized mortality of 65.32/105, which appeared no significant changing trend (AAPC=3.401%、2.995%,both P>0.05). There was a tendency towards a rise from 2019 to 2023 (APC=12.592%、11.507%, both P<0.05). The majority of falls occurred at home, with 6 312 cases accounting for 55.48%. The primary types of fall-related deaths were slips, trips, and falls on the same level, with 8 541 cases representing 75.07%. The crude mortality and standardized mortality of falls in males were 76.63/105 and 60.86/105, which were lower than that in females at 88.72/100 000 and 70.33/100 000 (both P<0.05), and the trends were consistent with the overall population. The crude mortality of falls among the elderly increased with age (P<0.05). From 2015 to 2023, the crude mortality of falls among the elderly aged 60 to <65 years showed an upward trend (AAPC=4.860%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). The PYLL was 5 123 person-years, the AYLL was 0.45 years per person, and the PYLLR was 0.37‰. From 2015 to 2023, PYLL showed an upward trend (AAPC=5.477%, P<0.05). The PYLL, AYLL, and PYLLR for males were 3.08 times, 3.48 times, and 2.67 times those of females, respectively. Conclusions From 2015 to 2023, the mortality of falls among the elderly in Wenzhou City had remained relatively stable. However, PYLL showed an upward trend. Males and older seniors were key groups for falls prevention. It is recommended to enhance health education and promote age-friendly home modifications to prevent falls among the elderly.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

OBJECTIVE:Knee adduction moment and knee adduction angular impulse enlargement is the main biomechanical risk factor of knee osteoarthritis.According to the survey,a change in the foot progression angle could effectively change the motion mode of patients with knee osteoarthritis.However,the impact of toe-in and toe-out on knee adduction moment and knee adduction angular impulse in young and elderly patients did not reach a consensus.Therefore,this study comprehensively discussed the effect of foot progression angle on knee adduction moment and knee adduction angular impulse in different populations through meta-analysis and provided a reference for the treatment of knee osteoarthritis. METHODS:By June 2022,searches were conducted on Web of Science,EBSCO,PubMed and CNKI databases using"foot progression angle,knee adduction moment,knee adduction angular impulse,gait"as Chinese and English search terms.Self-controlled randomized controlled studies analyzing the effects of toe-in and toe-out on knee adduction moment bimodality and knee adduction angular impulse were included.The cochrane bias risk assessment tool was utilized to make a quality evaluation of the literature.Stata 15.1 software was used for subgroup analysis to determine the effect of foot progression angle on knee adduction moment and knee adduction angular impulse.Meta-regression analysis was used to further determine characteristics of outcome indicators(knee adduction moment,knee adduction angular impulse)changing with foot progression angle. RESULTS:(1)A total of 15 self-control trials and 2 randomized controlled trials(455 subjects)were included in the meta-analysis.All of the included articles were of medium to high quality.(2)The meta-analysis results showed that the toe-in gait could reduce the first peak of knee adduction moment(SMD=-0.380,95%CI:-0.710 to-0.060,P=0.022)and knee adduction angular impulse(SMD=-1.470,95%CI:-2.160 to-0.770,P<0.001)in young patients.The toe-out gait reduced the second peak of knee adduction moment(SMD=-0.720,95%CI:-1.010 to-1.440,P<0.001)in young patients.In addition,toe-in gait could reduce the first peak of knee adduction moment in elder patients(SMD=-0.550,95%CI:-0.800 to-0.300,P<0.001),but increase the second peak knee adduction moment of elderly(SMD=0.280,95%CI:-0.010 to 0.560,P=0.047).The toe-out gait could decrease the second peak knee adduction moment in this population(SMD=-0.510,95%CI:-0.830 to-0.190,P=0.002).(3)Meta-regression showed that the greater the toe-out in elderly patients,the lower the second peak knee adduction moment. CONCLUSION:(1)Toe-in reduced the first peak knee adduction moment and knee adduction angular impulse in young knee osteoarthritis patients aged 18 to 34 years.Since knee adduction moment and knee adduction angular impulse were associated with medial knee loading and knee osteoarthritis incidence,toe-in gait intervention may be a suitable rehabilitation strategy for young patients.(2)Toe-in increased the second peak of knee adduction moment in older knee osteoarthritis patients over 60 years of age,which may exacerbate knee osteoarthritis in this population.However,the second peak of knee adduction moment during walking in this population decreases as the toe-out increases,contributing to a reduction in medial knee loading,suggesting that older patients may consider using toe-out gait during walking.

Objective: To investigate the mortality and life loss of female breast cancer in Wenzhou City, Zhejiang Province from 2014 to 2022, so as to provide the evidence for prevention and control of breast cancer. Methods: Data of female breast cancer deaths in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management information System from 2014 to 2012. The mortality of breast cancer was calculated, and standardized by the data from the Sixth Chinese National Population Census in 2010 (Chinese-standardized rate) and the world standard population first introduced by Segi (world-standardized rate). The life loss were measured using potential years of life lost (PYLL), rate of potential years of life lost (PYLLR) and average years of life lost (AYLL). The trends in mortality, PYLLR and AYLL were analyzed using the average annual percent change (AAPC). Results: Totally 2 523 deaths were reported due to breast cancer from 2014 to 2022, ranking fifth in the order of female malignant tumor deaths. The crude mortality of female breast cancer was 7.13/105, showing an increasing trend with AAPC of 2.186% (P<0.05). The Chinese population-standardized mortality and global population-standardized mortality were 5.93/105 and 4.39/105, showing no significant trend with AAPC of -0.617% and -0.602% (both P>0.05), respectively. The crude mortality of female breast cancer appeared a tendency towards a rise with age (P<0.05). The crude mortality of breast cancer in females aged 65 years and older showed an increasing trend (AAPC=3.283%, P<0.05), but there were no significant tendency aged 15 to <45 years and 45 to <65 years (AAPC=-1.011% and -1.850%, both P>0.05). The PYLL, PYLLR and AYLL of breast cancer were 41 227.50 person-years, 1.23‰ and 19.44 years per person, respectively. AYLL showed a decreasing trend (AAPC=-1.969%, P<0.05), and PYLLR showed no significant trend (AAPC=-0.527%, P>0.05). Conclusions The mortality of female breast cancer in Wenzhou City appeared a tendency towards a rise from 2014 to 2022, and AYLL appeared a downward trend. Females aged 65 years and older were the key groups for the prevention and control of breast cancer.

Objective:To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies(IIMs)patients receiving conventional treatment.Methods:Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were in-cluded.The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics,laboratory features,peripheral blood lymphocytes,immunological indicators,and therapeutic drugs.Results:Among the 635 patients included,518 patients finished the follow-up,with an average time of 36.8 months.The total complete clinical response rate of IIMs was 50.0％(259/518).The complete clinical response rate of dermatomyositis(DM),anti-synthetase syn-drome(ASS)and immune-mediated necrotizing myopathy(IMNM)were 53.5％,48.9％and 39.0％,respectively.Fever(P=0.002)and rapid progressive interstitial lung disease(RP-ILD)(P=0.014)were observed much more frequently in non-complete clinical response group than in complete clinical re-sponse group.The aspartate transaminase(AST),lactate dehydrogenase(LDH),D-dimer,erythrocyte sedimentation rate(ESR),C-reaction protein(CRP)and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group.As for the treat-ment,the percentage of glucocorticoid received and intravenous immunoglobin(IVIG)were significantly higher in non-complete clinical response group than in complete clinical response group.Risk factor analysis showed that IMNM subtype(P=0.007),interstitial lung disease(ILD)(P=0.001),eleva-ted AST(P=0.012),elevated serum ferritin(P=0.016)and decreased count of CD4+T cells in peripheral blood(P=0.004)might be the risk factors for IIMs non-complete clinical response.Conclu-sion:The total complete clinical response rate of IIMs is low,especially for IMNM subtype.More effec-tive intervention should be administered to patients with ILD,elevated AST,elevated serum ferritin or decreased count of CD4+T cells at disease onset.

【Objective】 To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. 【Methods】 A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. 【Results】 A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ²=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ²=9.403, 14.921,P<0.01). 【Conclusions】 The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.

Objective To analyzes the current status and hot spots of nursing of adverse drug reactions in chemotherapy for cancer patients,and provides reference for future research.Methods Literature related to the nursing of chemotherapy adverse drug reactions in cancer patients from 2018 to 2022 was retrieved from CNKI,Wanfang and VIP databases,and statistical analysis was conducted using bibliometrics.CiteSpace information visualization software was used to describe and analyze high-frequency keywords and to describe their graphs.Results A total of 1112 literatures were included,distributed in 256 domestic journals,and 537 literatures were co-authored,with a co-authored rate of 48.29％.Gastrointestinal reaction,cancer-induced fatigue,traditional Chinese medicine nursing,evidence-based nursing,negative emotion are the hot issues in this field.Conclusion The future nursing intervention for adverse reactions of cancer patients should adopt evidence-based nursing method to develop intervention programs.The research in this field has the problems of small sample size and single institution.It is suggested that the cooperation between authors and institutions should be strengthened in the future research,so as to build a closer cooperation network and a stable cooperation group.To construct nursing intervention plan and effect evaluation criteria suitable for nursing of adverse reactions of chemotherapy drugs in cancer patients.To ensure the safety of the intervention process,we should actively carry out multidisciplinary collaboration.