Objective To explore the risk factors and possible preventive measures of delayed postoperative intestinal paralysis(PPOI)in elderly(aged ≥75 years)patients with colorectal cancer.Methods This retrospective study included 333 patients with CRC who underwent laporascopic resection in General Department of Beijing Chaoyang Hospital from June 2016 to August 2023.There were 126 patients were enrolled in PPOI group and 207 patients were enrolled in non-PPOI group.The perioperative clinical characteristics of the patients were compared between PPOI group and non-PPOI group,and the risk factors of PPOI and potential preventive measures for them were investigated usingLogisticregression.Results The incidence of PPOI after laparoscopic surgery in elderly patients with colorectal cancer was 37.84％.The ages of the PPOI group and the non-PPOI group were(82.60±3.587)years and(80.38±3.847)years respectively.The rates of primary enterostomy during the operation were 20.63％and 9.66％,respectively,and the preoperative combined nutritional risks were 53.97％and 20.77％,respectively.The preoperative serum albumin levels were lower,which were(35.32±3.77)g/L and(38.36±3.91)g/L,respectively,and the preoperative hemoglobin levels were(104.47±20.31)g/L and(110.33±20.27)g/L,respectively.The intraoperative blood loss was(140.48±130.65)mland(98.26±56.45)ml,respectively.The patients who received enhanced recovery after surgery(ERAS)measures during the perioperative period were 14.29％and 75.85％,respectively.There was a statistically significant difference between the two groups(P＜0.05).The Logistic analysis showed that the risk factors for elderly patients with PPOI including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.Moreover,the implementation of ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be the protective factors of PPOI.Conclusion The risk factors of PPOI for colorectal patients older than 75 years including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.The ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be useful to prevent the occurrence of PPOI for elderly patients with colorectal cancer.

Objective To explore the risk factors and possible preventive measures of delayed postoperative intestinal paralysis(PPOI)in elderly(aged ≥75 years)patients with colorectal cancer.Methods This retrospective study included 333 patients with CRC who underwent laporascopic resection in General Department of Beijing Chaoyang Hospital from June 2016 to August 2023.There were 126 patients were enrolled in PPOI group and 207 patients were enrolled in non-PPOI group.The perioperative clinical characteristics of the patients were compared between PPOI group and non-PPOI group,and the risk factors of PPOI and potential preventive measures for them were investigated usingLogisticregression.Results The incidence of PPOI after laparoscopic surgery in elderly patients with colorectal cancer was 37.84％.The ages of the PPOI group and the non-PPOI group were(82.60±3.587)years and(80.38±3.847)years respectively.The rates of primary enterostomy during the operation were 20.63％and 9.66％,respectively,and the preoperative combined nutritional risks were 53.97％and 20.77％,respectively.The preoperative serum albumin levels were lower,which were(35.32±3.77)g/L and(38.36±3.91)g/L,respectively,and the preoperative hemoglobin levels were(104.47±20.31)g/L and(110.33±20.27)g/L,respectively.The intraoperative blood loss was(140.48±130.65)mland(98.26±56.45)ml,respectively.The patients who received enhanced recovery after surgery(ERAS)measures during the perioperative period were 14.29％and 75.85％,respectively.There was a statistically significant difference between the two groups(P＜0.05).The Logistic analysis showed that the risk factors for elderly patients with PPOI including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.Moreover,the implementation of ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be the protective factors of PPOI.Conclusion The risk factors of PPOI for colorectal patients older than 75 years including increased age,preoperative nutritional risk,low preoperative albumin,increased intraoperative blood loss.The ERAS protocols including preoperative nutritional support,multimodal low-opioid anesthesia,gastric tube removal and ground activity early after surgery may be useful to prevent the occurrence of PPOI for elderly patients with colorectal cancer.

Objective This study aimed to explore the current status of home-based fatigue among patients after cardiac surgery and analyze its influencing factors.Methods From January 2023 to December 2023,we retrospectively collected data from 200 patients who underwent cardiac surgery and were discharged for more than 3 months from Guangdong Provincial People's Hospital.The Multidimensional Fatigue Inventory-20,Overall Pain Assessment Scale,Cardiac Rehabilitation Inventory and Self-efficacy for Managing Chronic Disease 6-Item Scale were used to assess the patients.Results Overall fatigue of patients at home after cardiac surgery was at a moderate level.A stepwise multiple linear regression analysis revealed that anxiety during cardiac rehabilitation(β=7.476,P=0.001),severe pain(β=11.939,P=0.001),and frequency of discomfort symptoms(P＜0.001)significantly positively predicted post-cardiac surgery fatigue,whereas self-efficacy in chronic disease management(β=-6.974,P＜0.001)significantly negatively predicted it.Conclusions Fatigue among home-based patients after cardiac surgery requires further improvement and is associated with cardiac rehabilitation anxiety,pain severity,self-efficacy,and frequency of discomfort symptoms.Healthcare providers could develop targeted continuity interven-tions based on these influencing factors to reduce fatigue levels and promote recovery among home-based patients after cardiac surgery.

Objective This study aimed to explore the current status of home-based fatigue among patients after cardiac surgery and analyze its influencing factors.Methods From January 2023 to December 2023,we retrospectively collected data from 200 patients who underwent cardiac surgery and were discharged for more than 3 months from Guangdong Provincial People's Hospital.The Multidimensional Fatigue Inventory-20,Overall Pain Assessment Scale,Cardiac Rehabilitation Inventory and Self-efficacy for Managing Chronic Disease 6-Item Scale were used to assess the patients.Results Overall fatigue of patients at home after cardiac surgery was at a moderate level.A stepwise multiple linear regression analysis revealed that anxiety during cardiac rehabilitation(β=7.476,P=0.001),severe pain(β=11.939,P=0.001),and frequency of discomfort symptoms(P＜0.001)significantly positively predicted post-cardiac surgery fatigue,whereas self-efficacy in chronic disease management(β=-6.974,P＜0.001)significantly negatively predicted it.Conclusions Fatigue among home-based patients after cardiac surgery requires further improvement and is associated with cardiac rehabilitation anxiety,pain severity,self-efficacy,and frequency of discomfort symptoms.Healthcare providers could develop targeted continuity interven-tions based on these influencing factors to reduce fatigue levels and promote recovery among home-based patients after cardiac surgery.

Objective To analyze the characteristics of work-related musculoskeletal disorders (WMSDs) among sonographers in Guangdong Province, and to explore the disease pattern of the cases. Methods A total of 512 sonographers from 31 hospitals in Guangdong Province were selected as the research subjects using stratified cluster sampling method. The prevalence of WMSDs in the past year was investigated using the Musculoskeletal Disorders Questionnaire, and the characteristics of WMSDs were analyzed. Latent class analysis was used to identify the disease pattern of WMSDs. Results The overall prevalence of WMSDs was 94.3%. The top five affected body parts were right shoulder, neck, right hand/wrist, lower back and right forearm/elbow, with the prevalence of 80.3%, 75.4%, 61.1%, 55.5% and 45.3%, respectively. The prevalence of WMSDs was higher on the right side for the shoulder, hand/wrist, forearm/elbow, hip/leg and knee compared with the left side (80.3% vs 31.3%, 61.1% vs 13.9%, 45.3% vs 10.0%, 17.4% vs 8.6%, 13.1% vs 8.4%, all P<0.05). The prevalence of WMSDs increased with work years, as well the prevalence of WMSDs in the top five affected body parts among the sonographers (all P<0.05). However, there were no statistical differences in prevalence of WMSDs between general hospitals and maternal and child health hospitals, tertiary hospitals and non-tertiary hospitals, Pearl River Delta hospitals and non-Pearl River Delta hospitals; there was also no statistical difference between different genders and age groups of the sonographers (all P>0.05). The best-fit latent disease pattern for sonographers WMSDs comprised three categories： symptom of neck-right shoulder, symptom of neck-lower back-right shoulder-right elbow-right hand/wrist, and symptom of multi-parts above the knees, with the latent probabilities of 0.438, 0.427 and 0.135, respectively. Conclusion The prevalence of WMSDs in sonographers is extremely high, with a dose-effect relationship with work years. The most common affected parts are neck, lower back and right shoulder, right hand/wrist, and right forearm/elbow. The prevalence of WMSDs in the right side of limb was higher than that in the left. WMSDs primarily occur in multiple parts simultaneously. The most common symptoms occur in the neck-right shoulder and neck-lower back-right shoulder-right elbow-right hand/wrist.

【Objective】 To explore the establishment methods of transgenic human umbilical cord mesenchymal stem cells (hUC-MSCs) overexpressing tumor necrosis factor(TNF)-related apoptosis-inducing ligand (TRAIL) based on the transposons, and attempt to apply it on the nude mice mode with glioma. 【Methods】 PiggyBac transposon system specially designed by us was used to prepare non-targeting and Her2-targeting hUC-MSCs that can stably express TRAIL through puromycin screening. The glioma cells expressing firefly luciferase (U87MG-LUC) were injected into the skull of the immunodeficient mice (BALB/c-nu/nu) with 1×10⁶ cells per mouse. After 7 days of injection, the mice transplanted with U87MG were detected with a small animal living imager to determine the size and location of the tumors in skull. Then we injected the glioma-transplantation nude mouse with two kinds of transgenic hUC-MSCs expressing TRAIL (named as untarget-TRAIL and target-TRAIL, respectively), or the non-transgenic hUC-MSCs (all 1×10⁶ cells per mouse) or PBS (named as WT-MSCs and PBS for negative control) respectively, and then monitored the changes of tumor signals by a small animal living imager every week for 3~4 weeks. 【Results】 After six passages to expand the cells, the both transgenic cell lines can stably express TRAIL gene. Their ratio of green fluorescent protein (GFP) positive cells can reach 93%-97%, and the positive ratio of their MSC-specific surface markers still maintained normal (CD34⁺, CD45⁺, and HLA-DR⁺ all <0.1%, CD90>99%, CD73>88%, and CD105 >60%). The median survival time (d) of U87MG-transplanted nude mice in the groups of untarget-TRAIL, target-TRAIL, WT-MSCs, and PBS was 41 vs 39 vs 24 vs 23(P<0.05). 【Conclusion】 The transgenic hUC-MSCs overexpressing TRAIL gene can significantly prolong the survival time of nude mice with brain glioma.

Background and Objectives: p21, an important member of the Cip/Kip family, is involved in inhibitory effects of RUNX1b overexpression during the early stage of human hematopoiesis. Methods: and Results: We established a human embryonic stem cell (hESC) line with inducible expression of p21 (p21/hESCs). Overexpression of p21 did not influence either mesoderm induction or emergence of CD34＋ cells, but it significantly decreased the production of CD43＋ cells and changed the expression profile of hematopoiesis-related factors, leading to the negative effects of p21 on hematopoiesis. Conclusions In RUNX1b/hESC co-cultures when RUNX1b was induced from D0, perturbation of the cell cycle caused by upregulation of p21 probably prevented the appearance of CD43＋ cells, but not CD34＋ cells. The mechanisms via which CD34＋ cells are blocked by RUNX1b overexpression remain to be elucidated.