Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective To study the diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis.Methods From June 2021 to March 2022,4 patients suspected uncomplicated acute colonic diverticulitis who then underwent colonoscopy,and endoscopic irrigation treatment was performed after confirming.The endoscopic imaging of acute colonic diverticulitis was summarized.The changes of abdominal pain symptoms and prognosis of the patients were evaluated.The levels of white blood cell(WBC)and C-reactive protein(CRP)in serum before and after treatment were measured.Results 4 patients were diagnosed as uncomplicated acute colonic diverticulitis underwent colonoscopy.Two cases were located in the ascending colon and the other two in the cecum.Endoscopic imaging characteristics included mucosal hyperemia and swelling of diverticular orifice and nearby area,purulent secretions,purulent fur and fecalith at the diverticular orifice.After treatment,the symptom of abdominal pain was relieved,the levels of WBC and CRP in serum were lower than before treatment.Conclusion Endoscopic irrigation has a useful diagnostic and therapeutic value for uncomplicated acute diverticulitis of the colon.It is worthy of further clinical study.

Objective:To investigate the effect of core strength training based on total resistance exercise (TRX) for the flying personnel with nonspecific low back pain (NLBP).Methods:Flying personnel with NLBP who recuperated in Air Force Healthcare Center for Special Services Hangzhou from October of 2019 to June of 2021 were selected. They were divided into test group and control group by simple random sampling. The test group received 4 weeks of TRX core strength training, and the control group received 4 weeks of traditional core strength training. The isokinetic muscle strength testing instrument was used to measure the muscle strength characteristics of lumbar and abdominal flexor and extensor muscle groups of the subjects. The differences in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared between 2 groups before and after training.Results:A total of 40 subjects were included with 20 cases in the test group and 20 cases in the control group, all of them were helicopter flying personnel. After training, the scores of VAS in both groups were lower than those before training ( t=22.01, 17.15, both P<0.001), and the VAS score of the test group was lower than that of the control group, with a significant difference ( t=6.55, P<0.001). After training, the ODI scores of subjects in both groups were lower than those before training ( t=32.05, 27.45, both P<0.001), and the score of the test group was lower than that of the control group, with a significant difference ( t=4.85, P<0.001). After training, the relative peak moment of lumbar and abdominal flexor and extensor muscle groups of the test group were higher than those of control group, and the differences were significant ( t=2.65, 2.41, 2.04, 3.31, P=0.026, 0.037, 0.047, 0.005). Conclusions:TRX core strength training can significantly improve the muscle strength of the lumbar and abdominal flexor and extensor muscle groups of flying personnel with NLBP, which can be used as a training program to prevent NLBP for flying personnel.

Objective:To investigate the effect of core strength training based on total resistance exercise (TRX) for the flying personnel with nonspecific low back pain (NLBP).Methods:Flying personnel with NLBP who recuperated in Air Force Healthcare Center for Special Services Hangzhou from October of 2019 to June of 2021 were selected. They were divided into test group and control group by simple random sampling. The test group received 4 weeks of TRX core strength training, and the control group received 4 weeks of traditional core strength training. The isokinetic muscle strength testing instrument was used to measure the muscle strength characteristics of lumbar and abdominal flexor and extensor muscle groups of the subjects. The differences in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared between 2 groups before and after training.Results:A total of 40 subjects were included with 20 cases in the test group and 20 cases in the control group, all of them were helicopter flying personnel. After training, the scores of VAS in both groups were lower than those before training ( t=22.01, 17.15, both P<0.001), and the VAS score of the test group was lower than that of the control group, with a significant difference ( t=6.55, P<0.001). After training, the ODI scores of subjects in both groups were lower than those before training ( t=32.05, 27.45, both P<0.001), and the score of the test group was lower than that of the control group, with a significant difference ( t=4.85, P<0.001). After training, the relative peak moment of lumbar and abdominal flexor and extensor muscle groups of the test group were higher than those of control group, and the differences were significant ( t=2.65, 2.41, 2.04, 3.31, P=0.026, 0.037, 0.047, 0.005). Conclusions:TRX core strength training can significantly improve the muscle strength of the lumbar and abdominal flexor and extensor muscle groups of flying personnel with NLBP, which can be used as a training program to prevent NLBP for flying personnel.

Objective:To explore the relationship between non-alcoholic fatty liver disease and sarcopenia in patients with type 2 diabetes mellitus.Methods:792 cases with type 2 diabetes mellitus who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University from June 2013 to December 2015 were enrolled in this cross-sectional study. Liver ultrasound examination and dual-energy X-ray absorptiometry (DXA) were used to examine the body composition. Patients were grouped according to gender and whether or not they had combined NAFLD, and indicators such as age, duration of diabetes, body mass index (BMI), waist circumference, biochemical indicators, skeletal muscle mass index (SMI), prevalence of sarcopenia, and medication status were collected. An independent-sample t-test, two-sample Kolmogorov-Smirnov test or χ2 test were performed on the data. Logistic regression model was used to analyze the correlation between NAFLD, sarcopenia and SMI in diabetic patients of different genders. Results:The average age of 792 cases were (64.54 ± 9.61) years, and there were 301 (38%) patients with NAFLD. The prevalence of sarcopenia in male and female NAFLD patients was significantly higher than non-NAFLD patients (male 20.2% and 9.9%, χ 2 = 9.67, P = 0.002; female 12.2% and 5.1%, χ 2 = 5.64, P = 0.018). Male SMI (30.92 ± 2.31 and 31.81 ± 2.17, P < 0.001) and female SMI (25.48 ± 2.14 and 26.34 ± 2.28, P < 0.001) in NAFLD patients were significantly lower than non-NAFLD patients. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for NAFLD in male patients with type 2 diabetes mellitus ( OR = 2.006, 95% CI: 1.012 ~ 3.976, P = 0.046). There was no correlation between sarcopenia and NAFLD in female patients after adjusting for clinical risk factors. Conclusion:There is an independent correlation between sarcopenia and NAFLD in male patients with type 2 diabetes, and sarcopenia may be an independent risk factor for male patients with NAFLD.

Objective:To study the strength characteristics of waist and abdominal flexor and extensor muscles of helicopter pilots in order to provide the basis for waist and abdominal strength training, endurance training and prevention of the lumbar injury.Methods:Seventy-eight male helicopter pilots, whose average age was 38.9±7.5 yrs, height was 173.3±3.0 cm, weight was 72.7±7.7 kg and BMI was 24.2±2.2 kg/m 2, were selected as subjects. Strength characteristics and work of waist and abdominal flexor and extensor muscles of helicopter pilots were detected with 2 angular velocities of 60°/s and 180°/s by using Isomed 2 000 Isokinetic Test System. The peak torques and the relative peak torques of flexor and extensor muscles were compared under same angular velocity and between different angular velocities. The difference of peak torques of flexor and extensor and the relative peak torques of flexor and extensor were compared between age groups (20-39 yrs and 40-59 yrs). Results:At the same angular velocity, the peak torque and relative peak torque of the waist and abdominal extensor muscles of helicopter pilots were higher than those of the flexor muscles ( t=5.43-8.90, P<0.01). The peak torque and relative peak torque of the waist and abdominal extensor and flexor muscles reduced with the increasing of angular velocity ( t=11.36-12.19, P<0.01). The peak torque of the waist and abdominal extensor and flexor muscles in significantly reduced with the increasing of age, but the relative peak torque of the waist and abdominal flexor and extensor muscles reduced, and the difference was statistically significant ( P<0.05 or 0.01). The qualification rate of peak moment ratio was very low, and the balance of flexor and extensor muscles was weakened. Waist and abdominal extensor muscle endurance was weaker than flexor muscle endurance, but the differences was not significant. Conclusion:It is suggested that we should scientifically strengthen the strength training of flexor muscles and the endurance training of extensor muscles, so as to improve the balance of flexor and extensor muscles, and to slow down the decline of lumbar and abdominal muscle strength with age growing.

Objective:To study the strength characteristics of waist and abdominal flexor and extensor muscles of helicopter pilots in order to provide the basis for waist and abdominal strength training, endurance training and prevention of the lumbar injury.Methods:Seventy-eight male helicopter pilots, whose average age was 38.9±7.5 yrs, height was 173.3±3.0 cm, weight was 72.7±7.7 kg and BMI was 24.2±2.2 kg/m 2, were selected as subjects. Strength characteristics and work of waist and abdominal flexor and extensor muscles of helicopter pilots were detected with 2 angular velocities of 60°/s and 180°/s by using Isomed 2 000 Isokinetic Test System. The peak torques and the relative peak torques of flexor and extensor muscles were compared under same angular velocity and between different angular velocities. The difference of peak torques of flexor and extensor and the relative peak torques of flexor and extensor were compared between age groups (20-39 yrs and 40-59 yrs). Results:At the same angular velocity, the peak torque and relative peak torque of the waist and abdominal extensor muscles of helicopter pilots were higher than those of the flexor muscles ( t=5.43-8.90, P<0.01). The peak torque and relative peak torque of the waist and abdominal extensor and flexor muscles reduced with the increasing of angular velocity ( t=11.36-12.19, P<0.01). The peak torque of the waist and abdominal extensor and flexor muscles in significantly reduced with the increasing of age, but the relative peak torque of the waist and abdominal flexor and extensor muscles reduced, and the difference was statistically significant ( P<0.05 or 0.01). The qualification rate of peak moment ratio was very low, and the balance of flexor and extensor muscles was weakened. Waist and abdominal extensor muscle endurance was weaker than flexor muscle endurance, but the differences was not significant. Conclusion:It is suggested that we should scientifically strengthen the strength training of flexor muscles and the endurance training of extensor muscles, so as to improve the balance of flexor and extensor muscles, and to slow down the decline of lumbar and abdominal muscle strength with age growing.

Maternal immunization is an immune strategy that protects both mothers and early-life infants from disease by the vaccination of pregnant women. The effect of maternal immunization is influenced by the types of vaccines, the timing of vaccination, the subtypes of antibodies induced by vaccines, and the health status of mothers themselves. Inactivated influenza vaccination during pregnancy and DPT vaccination during the third trimester of pregnancy have been widely used in the world, while Hepatitis B vaccine, pneumococcal and meningococcal vaccines also show good efficacy and safety in pregnant women. This article reviews the research progress of Maternal Immunization in order to provide a reference for Maternal Immunization planning and policymaking in China.

Maternal immunization is an immune strategy that protects both mothers and early?life infants from disease by the vaccination of pregnant women. The effect of maternal immunization is influenced by the types of vaccines, the timing of vaccination, the subtypes of antibodies induced by vaccines, and the health status of mothers themselves. Inactivated influenza vaccination during pregnancy and DPT vaccination during the third trimester of pregnancy have been widely used in the world, while Hepatitis B vaccine, pneumococcal and meningococcal vaccines also show good efficacy and safety in pregnant women. This article reviews the research progress of Maternal Immunization in order to provide a reference for Maternal Immunization planning and policymaking in China.