Objective To investigate the correlation and lag effect between atmospheric particulate matter and the risk of hospitalization for chronic kidney disease(CKD).Methods The daily hospitalization data for CKD in 9 hospitals in Urumqi from Jan.1,2019,to Dec.31,2020,and the air pollution and meteorological data during the same period were collected.The relationship between PM2.5 and PM10 concentrations and CKD incidence was analyzed after controlling for long-term trends,meteorological factors,and potential confounding factors such as the"day of the week effect"by using the generalized additive model(GAM).The effects of single-day lag of 0-7 d(lag0-lag7)and cumulative lag of 0-7 d(lag01-lag07)were analyzed,and subgroup analyses were conducted for gender,age,and season.On the basis of the single pollutant model,other pollutants were included(at most 2 pollutants were included at a time),and a double pollutant model was constructed to evaluate the stability of the model.Results For every 10 μg/m3 increase in PM2.5 concentration,the highest risk of CKD hospitalization occured when lagged alone at lag2(relative risk[RR]=1.014,95％confidence interval[CI]1.006-1.023)and lagged cumulatively at lag04(RR=1.018,95％CI 1.007-1.029).For every 10 μg/m3 increase in PM10 concentration,the risk of CKD hospitalization was highest when lagged alone at lag0 and lagged cumulatively at lag07(RR=1.012,95％CI 1.007-1.017;RR=1.024,95％CI 1.016-1.032).In gender stratification,for every 10 μg/m3 increase in PM2.5 concentration,the cumulative lag at lag04 indicated that males had the highest risk of CKD hospitalization(RR=1.023,95％CI 1.008-1.038);for every 10 μg/m3 increase in PM10 concentration,the highest risk of CKD hospitalization was observed in males when lagged alone at lag0(RR=1.013,95％CI 1.006-1.020),and in females when lagged alone at lag1(RR=1.013,95％CI 1.006-1.020).In age stratification,for every 10 μg/m3 increase in PM2.5 concentration,the risk of CKD hospitalization was highest in people 65 years old with single-day lag at lag3 and cumulative lag at lag04(RR=1.016,95％CI 1.007-1.026;RR=1.022,95％CI 1.010-1.035);for every 10 μg/m3 increase in PM10 concentration,the cumulative lag at lag07 indicated that individuals aged＜65 years old and ≥65 years old had the highest risk of CKD hospitalization(RR=1.027,95％CI 1.017-1.037;RR=1.015,95％CI 1.001-1.028).In seasonal stratification,for every 10 μg/m3 increase in PM2.5 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag3 and lagged cumulatively at lag07(RR=1.020,95％CI 1.011-1.029;RR=1.025,95％CI 1.011-1.038).For every 10 μg/m3 increase in PM10 concentration during the cold season,the risk of CKD hospitalization was highest when lagged alone at lag2(RR=1.013,95％CI 1.007-1.019).For every 10 μg/m3 increase in PM10 concentration during the warm season,the risk of CKD hospitalization was highest when lagged alone at lag7(RR=1.015,95％CI 1.006-1.024).In the dual pollutant model,the effects of PM2.5 adjusting PM10,SO2,O3 and CO,and PM10 adjusting NO2,SO2,O3,and CO on the risk of CKD hospitalization were still significant(P＜0.05).Conclusion The increase in atmospheric particulate matter concentrations of PM2.5 and PM10 can lead to an increased risk of CKD,and there is a lag effect.Men,people under the age of 65 years old,and those in cold seasons(heating periods)are more sensitive to exposure to PM2.5 and PM10.

OBJECTIVE:Cognitive impairment is one of the most common non-motor symptoms of Parkinson's disease,which seriously affects patients'quality of life.Non-invasive brain stimulation,as a common non-pharmacological treatment,has good efficacy in improving cognitive impairment after Parkinson's disease,but how to choose the optimal stimulation modality of non-invasive brain stimulation in clinical practice is still unclear.This study assessed the effects of different stimulation modalities of non-invasive brain stimulation on cognitive function in patients with Parkinson's disease by means of the network Meta-analysis,which provides an evidence-based basis for the selection of non-invasive brain stimulation modalities in the clinic.METHODS:PubMed,EMbase,Web of Science,Cochrane Library,CNKI,CBM,and WanFang databases were searched for randomized controlled trials on the effects of non-invasive brain stimulation interventions on cognitive function in patients with Parkinson's disease from the inception to August 2024.The control group was treated with conventional therapy(rehabilitation training and conventional medication)or sham stimulation,and the experimental group was treated with non-invasive brain stimulation based on the treatment in the control group.The Cochrane Risk of Bias Assessment Tool for Randomized Controlled Trials RoB 2 was used to evaluate the quality of the included studies.Literature screening and data extraction were performed independently by two researchers and the risk of bias for the included studies was evaluated.Traditional Meta-analysis and network Meta-analysis of short-term cognitive functioning scale scores and long-term cognitive functioning scale scores were performed using RevMan 5.4 and Stata 16.0 software to draw network relationship,diagrams league table and cumulative probability ranking tables.GRADE was used to rate the level of evidence for the outcome indicators.RESULTS:(1)A total of 31 randomized controlled trials were included,of which 8 studies were rated as low-risk,23 studies were rated as medium-risk,and there were no high-risk studies,comprising 1 670 subjects and involving different stimulation modalities for 14 types of non-invasive brain stimulation.(2)Network Meta-analysis showed that compared with conventional treatment,high-frequency repetitive transcranial magnetic stimulation of the first motor cortex(standardized mean difference[SMD]=0.73,95％confidence interval[CI]=0.14-1.32,P＜0.05,the surface under the cumulative ranking curve[SUCRA]=66.2％)was the most effective in improving short-term cognitive functioning in Parkinson's patients,followed by transcranial direct current stimulation of the dorsolateral prefrontal cortex(SMD=0.56,95％CI=0.14-0.98,P＜0.05,SUCRA=54.4％)and high-frequency repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex(SMD=0.52,95％CI=0.11-0.93,P＜0.05,SUCRA=51.4％);and in terms of improvement of long-term cognitive functioning in patients with Parkinson's disease,high-frequency repetitive transcranial magnetic stimulation of the first motor cortex(SMD=1.17,95％CI=0.48-1.85,P＜0.05,SUCRA=91.2％)was the most effective.CONCLUSION:Low-level intensity clinical evidence suggests that high-frequency repetitive transcranial magnetic stimulation of the first motor cortex is the most effective in improving short-term cognitive function in patients with Parkinson's disease,followed by transcranial direct current stimulation of the dorsolateral prefrontal cortex and high-frequency repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex.Also high-frequency repetitive transcranial magnetic stimulation of the first motor cortex is the best stimulation modality in improving long-term cognitive function in patients with Parkinson's disease.

OBJECTIVE:Cognitive impairment is one of the most common non-motor symptoms of Parkinson's disease,which seriously affects patients'quality of life.Non-invasive brain stimulation,as a common non-pharmacological treatment,has good efficacy in improving cognitive impairment after Parkinson's disease,but how to choose the optimal stimulation modality of non-invasive brain stimulation in clinical practice is still unclear.This study assessed the effects of different stimulation modalities of non-invasive brain stimulation on cognitive function in patients with Parkinson's disease by means of the network Meta-analysis,which provides an evidence-based basis for the selection of non-invasive brain stimulation modalities in the clinic.METHODS:PubMed,EMbase,Web of Science,Cochrane Library,CNKI,CBM,and WanFang databases were searched for randomized controlled trials on the effects of non-invasive brain stimulation interventions on cognitive function in patients with Parkinson's disease from the inception to August 2024.The control group was treated with conventional therapy(rehabilitation training and conventional medication)or sham stimulation,and the experimental group was treated with non-invasive brain stimulation based on the treatment in the control group.The Cochrane Risk of Bias Assessment Tool for Randomized Controlled Trials RoB 2 was used to evaluate the quality of the included studies.Literature screening and data extraction were performed independently by two researchers and the risk of bias for the included studies was evaluated.Traditional Meta-analysis and network Meta-analysis of short-term cognitive functioning scale scores and long-term cognitive functioning scale scores were performed using RevMan 5.4 and Stata 16.0 software to draw network relationship,diagrams league table and cumulative probability ranking tables.GRADE was used to rate the level of evidence for the outcome indicators.RESULTS:(1)A total of 31 randomized controlled trials were included,of which 8 studies were rated as low-risk,23 studies were rated as medium-risk,and there were no high-risk studies,comprising 1 670 subjects and involving different stimulation modalities for 14 types of non-invasive brain stimulation.(2)Network Meta-analysis showed that compared with conventional treatment,high-frequency repetitive transcranial magnetic stimulation of the first motor cortex(standardized mean difference[SMD]=0.73,95％confidence interval[CI]=0.14-1.32,P＜0.05,the surface under the cumulative ranking curve[SUCRA]=66.2％)was the most effective in improving short-term cognitive functioning in Parkinson's patients,followed by transcranial direct current stimulation of the dorsolateral prefrontal cortex(SMD=0.56,95％CI=0.14-0.98,P＜0.05,SUCRA=54.4％)and high-frequency repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex(SMD=0.52,95％CI=0.11-0.93,P＜0.05,SUCRA=51.4％);and in terms of improvement of long-term cognitive functioning in patients with Parkinson's disease,high-frequency repetitive transcranial magnetic stimulation of the first motor cortex(SMD=1.17,95％CI=0.48-1.85,P＜0.05,SUCRA=91.2％)was the most effective.CONCLUSION:Low-level intensity clinical evidence suggests that high-frequency repetitive transcranial magnetic stimulation of the first motor cortex is the most effective in improving short-term cognitive function in patients with Parkinson's disease,followed by transcranial direct current stimulation of the dorsolateral prefrontal cortex and high-frequency repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex.Also high-frequency repetitive transcranial magnetic stimulation of the first motor cortex is the best stimulation modality in improving long-term cognitive function in patients with Parkinson's disease.

ObjectiveTo investigate the effects of Guizhi Jia Longgu Mulitang on the expression difference of interleukin-10 （IL-10） and tumor necrosis factor -α （TNF-α） in related organs of insomnia rats with sensory dysfunction dominated by lung and study the mechanism of Guizhi Jia Longgu Mulitang in improving insomnia. MethodSD rats were randomly divided into the blank group， model group， western medicine group， and traditional Chinese medicine （TCM） group， with 10 rats in each group. The rats were deprived of sleep by shallow water environment method in a long platform， and the modeling lasted for 42 d. The blank group and model group were given 0.05 mL·kg^-1 normal saline by gavage， and the western medicine group and TCM group were given drugs during modeling. To be specific， the western medicine group was given 0.105 mg·kg^-1 dexzopiclone tablet by gavage， while the TCM group was given 7 600 mg·kg^-1 Guizhi Jia Longgu Mulitang by gavage， both lasting for 28 days. After successful modeling， the Morris water maze experiment was performed on the 42nd day to detect the motion and spatial memory ability of rats. The levels of IL-10 and TNF-α in serum were detected by enzyme-linked immunosorbent assay （ELISA）. The protein expression of IL-10 and TNF-α in the lung and brain tissue of rats was detected by Western blot. The levels of IL-10 and TNF-α in the lung and brain tissue of rats were detected by immunohistochemistry. ResultCompared with the blank group， the sleep stages non-rapid eye movement ( NREM ) and rapid eye movement ( REM ) of the model group were significantly shortened （P<0.5， P<0.01）， and the wake stage was significantly increased （P<0.01）. The total time and distance of platform exploration were significantly increased （P<0.01）. In the target quadrant （the third quadrant）， the percentage of exploration time and the times of crossing the platform were significantly decreased （P<0.01）. ELISA results showed that the serum IL-10 level was significantly decreased （P<0.01）， and TNF-α level was significantly increased （P<0.01）. The results of Western blot showed that the protein expression of IL-10 in brain and lung tissue of rats was significantly decreased （P<0.01）， and the protein expression of TNF-α was significantly increased （P<0.01）. The results of immunohistochemistry showed that the expression of IL-10 in the brain and lung tissue of rats was significantly decreased （P<0.01）， and that of TNF-α was significantly increased （P<0.01）. Compared with the model group， the NREM stage and REM stage of the western medicine group and the TCM group were significantly increased （P<0.5， P<0.01）， and the wake stage was shortened （P<0.5）. The total time and distance of platform exploration were significantly decreased （P<0.01）. In the target quadrant （the third quadrant）， the percentage of exploration time and the times of crossing the platform were significantly increased （P<0.05， P<0.01）. The serum IL-10 level was significantly increased （P<0.01）， and the serum TNF-α level was significantly decreased according to the ELISA results （P<0.01）. The results of Western blot showed that the protein expression of IL-10 in brain tissue and lung tissue was significantly increased （P<0.01）， and the protein expression of TNF-α was significantly decreased （P<0.01）. The results of immunohistochemistry showed that the expression of IL-10 in brain tissue and lung tissue was significantly increased （P<0.05， P<0.01）， and the expression of TNF-α was significantly decreased （P<0.05， P<0.01）. ConclusionGuizhi Jia Longgu Mulitang can improve the expression of IL-10 and TNF-α in brain and lung tissue of insomnia rats with sensory dysfunction dominated by lung， prolong sleep time， and then improve insomnia. The mechanism may be related to improving the expression level of inflammatory factors.

Objective To investigate the effect of diurnal temperature difference on hospitalization volume of patients with cardiovascular and cerebrovascular diseases in Urumqi City. Methods The daily hospitalization data for cardiovascular and cerebrovascular diseases in Urumqi City from 2019-2021, and meteorological and pollutant data for the same period were collected. The relationship between diurnal temperature range and hospitalizations for cardiovascular and cerebrovascular diseases was analyzed using a distribution lag non-linear model (DLNM), controlling for the long-term trends, the day-of-week effects and other factors. Results The greater the diurnal temperature range, the longer the lag time, and the higher the risk of hospitalization for cardiovascular and cerebrovascular diseases. The lag effect increased significantly when the maximum diurnal temperature range reached 21.0°C. The risk effect appeared on the day of exposure and lasted until day 20, with a maximum RR of 1.266 (95% CI: 1.129-1.421) at a lag of 13 days. At very high diurnal temperature range, the risk of hospitalization for cardiovascular and cerebrovascular diseases was higher in the cold season than that in the warm season. Results after stratified analysis by sex and age showed that men and people aged ≥65 years were more susceptible to diurnal temperature range. Conclusion Extremely high diurnal temperature range is a potential trigger for hospitalization for cardiovascular and cerebrovascular diseases in Urumqi. Men and people aged ≥65 years are more vulnerable to the impact of diurnal temperature range. In the cold season, more attention should be paid to protecting vulnerable people from the impact of the extremely high diurnal temperature difference.

Objective To explore the effects of comprehensive rehabilitation on patients with stable chronic obstructive pulmonary disease (COPD) in rural communities.Methods Between June 2010 and June 2012,212 stable COPD patients were randomly divided into management group (n =107) and control group (n =105).All patients received conveutional treatment.In addition,107 stable COPD patients relying on new rural cooperative medical service station in management group underwent community comprehensive rehabilitation including training in respiratory function,exercise training,nutrition intervention and psychological care.Effect of lung function,symptoms (times of acute attack & hospitalization) and quality-of-life (QOL) rated by SF-36 questionnaire between two groups were recorded at Month 6.Results The score changes of QOL had significant inter-group differences between 2 groups for PCS (scores for physical component summary) and MCS (scores for mental component summary) (11.4 ±8.2 vs.1.6 ± 1.2,5.5 ±3.5 vs.2.2 ±0.9,all P ＜0.01).In the scores for physical component summary,the score change of physical function,physiological function,body pain and general health were significantly different between two groups (6.7 ±4.3 vs.1.2 ±0.8,10.9 ±6.3 vs.1.9 ± 1.5,6.4 ±4.7 vs.3.6 ±2.7,3.2 ±2.7 vs.1.6 ± 1.1,P ＜ 0.01).In the scores for mental component summary,the score change of vitality,emotional function,social function and mental health were significantly different between two groups (4.9±3.2 vs.1.9±1.4,2.7±2.1 vs.1.6±1.1,11.6 ±9.2 vs.3.6 ±2.3,6.7 ±4.3 vs.1.4±0.9,P＜0.01).The times of acute attack and hospitalization were obviously lower than those of the control group.No significant inter-group difference existed in lung function.Conclusion Comprehensive rehabilitation may improve the QOL in stable COPD patients in rural communities and reduce their times of acute attack.

Objective To evaluate the effectiveness of management for patients with chronic obstructive pulmonary disease (COPD) in stage Ⅰ at new rural cooperative medical facilities.Methods A quasi-experiment design was used for the evaluation of patients registering at Dongcun and Fangyuan subdistrict offices in Haiyang.And 79 COPD cases from Dongcun sub-district offices were selected into the management group while 76 cases from Fangyuan the control group.The measures at the new rural cooperative medical facilities included smoking-free publicity,avoiding a hazardous environment,application of influenza vaccines and training of patients and local general practitioners in essences of COPD prevention and treatment.Except for routine treatment,no special measures were taken for the control group.ResultsSixty-one patients in the management group and 60 in the control group completed a 3-year follow-up.Fifteen patients were smokers during their initial visits in the management group and 13 quitted smoking after a 3-year management.Meanwhile 19 patients were smokers during their initial visits in the control group and 3 of them quitted smoking within the same period.The decrement of BODE index between post-management at year 2&3 and between pre-management was higher in the management group versus the control group within the same period (P ＜ 0.01).The annual average frequencies of common cold,acute attack and physician consultation were obviously lower post-management at year 3 than those pre-management and the control group within the same period ( P ＜ 0.05 ).Lung functions of two groups deteriorated as compared with those 3 years before ( P ＜ 0.05).But no statistical difference existed between two groups (P ＞ 0.05).ConclusionThe management of COPD patients in stage Ⅰ at new rural cooperative medical facilities can improve their quality of life and reduce their frequencies of common cold,acute attack and physician consultation.

Objective To observe the effects of electroacupuncture combined with edaravone on the conduction velocity of sciatic nerve and oxidative stress in rats with diabetic peripheral neuropathy. Methods 60 Sprague Dawley (SD) rats were included. 10 of them were selected as normal group. The other rats were modeled as diabetic peripheral neuropathy with streptozotocin. 48 of them were randomly selected and divided into electroacupuncture group (n=12), edaravone group (n=12), electroacupuncture + edaravone group (n=12), and model group (n=12). The threshold temperature for wave tail was tested, the levels of superoxidase dismutase (SOD) and malonaldehyde (MDA) were determined, and the conduction velocity of sciatic nerve were measured, before, and 4 and 8 weeks after modeling. Results 8 weeks after modeling, the conduction velocity and SOD increased in the electroacupuncture group, edaravone group and electroacupuncture+edaravone group compared with the model group (P<0.01), with the MDA decrease (P<0.01), while it was improved more in the electroacupuncture+edaravone group than in the electroacupuncture group or the edaravone group (P<0.01). Conclusion Both electroacupuncture and edaravone can inhibit oxidative stress and improve nerve conduction velocity of the sciatic nerve in rats with diabetic peripheral neuropathy, and it is more effective of combination.

Objective To understand awareness of basic concepts, diagnosis, treatment and patient education for chronic obstructive pulmonary disease (COPD) among practitioners in rural new cooperative medical scheme (NCMS) and evaluate effectiveness of training for them in Haiyang, Shandong.Methods In total, 116 practitioners, two or three randomly selected from each of 43 NCMS service stations under the Third People's Hospital of Haiyang, were surveyed with questionnaire and then systematic training was provided for them. Another survey was conducted among them a half and two years after the first one with the same questionnaire. Results At the first survey, only 9.5 % (11/116) of the practitioners surveyed knew about "Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease",19. 8 % (23/116) knew clinical characteristics of COPD, 29. 3 % (34/116) knew that pulmonary function test is gold standard for COPD diagnosis, 62. 9 % (73/116) knew that smoking is major inductive factor for COPD and could persuade patients to quit smoking, only 2.6 % (3/116) could make registration for the patients and provide health education for them, 48. 3 % (56/116) knew that the patients should be immunized with influenza vaccine, and 7. 8 % (9/116) knew long-term oxygen therapy for the patients. At the second survey, 94. 8 % (110/116) of the practitioners surveyed knew about " Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease", all of them knew characteristics of COPD, that pulmonary function test is gold standard for COPD diagnosis, smoking is major inductive factor for COPD,could make registration for COPD patients and provide health education for them, 99. 1% (115/116) used influenza vaccine for COPD patients, and 99. 1% (115/116) knew long-term oxygen therapy for the patients. Conclusions Systematic training for COPD knowledge among practitioners in rural NCMS seems to be significantly beneficial for their awareness about the illness and to improve their abilities of prevention and treatment for it in rural areas.

Objective To evaluate and compare the results of different operative methods for different types of femoral neck fracture. Methods To assess the treatment effect of two methods. Some eases of femoral neck fracture of basal-neck type and via-neck type were treated with closed reduction internal fixation with two compression spiral screws(14 eases). Other eases(32 eases) of femoral neck fracture of sub-head type and head-neck type were treated with closed reduction internal fixation with two cannulated compression screws and bone graft flaped with quadrate muscle of thigh. Results 41 cases were followed up. The average healing time was 3 years and 10 months.The bone healing rate was 97.5% ,femoral head necrosis occurred in 2.4% ,excellent and good rate was 92.6%.Conclusion Cases of femoral neck fracture of sub-head type and head-neck type were treated with closed reduction internal fixation with two cannulated compression screws and bone graft flaped with quadrate muscle of thigh. This method has the advantage of reliable fixation, simple operation, less injury and little hemorrhage. It can improve the rate of fracture union and reduce the rate of avascular necrosis of femoral head. It is the optimal method for the treatment of femoral neck fractures.