Objective To explore the peak moment characteristics of lower limb joints,as well as the contribution rate and compensation mechanism of lower limb joints when older adults with a history of falls cross obstacles at different paces.Methods Thirty healthy older adults and 30 eldely fallers were recruited.The Qualisys infrared high-speed motion capture system and the Kistler three-dimensional force platform were used to collect the biomechanical data of the older adults when they crossed an obstacle with a height of 15％of their height at three walking speeds(1.05,1.41,1.74 m/s).The data were then modeled and analyzed using Visual 3D software.Results As walking speed increased,the peak knee extension moment,peak ankle plantar flexion moment,and double peak value of hip flexion moment in healthy group all increased significantly(P＜0.05).Compared with healthy group,the double peak values of hip flexion moment in faller group were significantly smaller than those in healthy group(P＜0.05).During walking at moderate speed,the contribution rate of the left hip joint in faller group was significantly higher than that of healthy group(P=0.025),while the contribution rate of the ankle joint was significantly lower(P=0.044).The margin of stability in the anterior-posterior direction at the moment of ground contact of the stance leg and the stride leg increased with walking speed(P=0.007,P=0.002).Conclusions Compared with healthy older adults,the elderly fallers have lower peak torque,peak ground reaction force,and dynamic stability in the anterior-posterior direction.As the walking speed increases,the mechanical parameters and the margin of stability of older adults increase significantly,and walking stability is improved.Compared with healthy older adults,elderly fallers usually rely more on the contribution of hip joint movements and reduce the involvement of ankle joints.It is recommended to incorporate fast walking exercises into the daily fall prevention exercise program for older adults,with combination of coordinated training of the hip,knee,and ankle joints.

ObjectiveTo analyze the influencing factors of pulmonary dysfunction among community-based population at high-risk for chronic obstructive pulmonary disease (COPD), and to establish a risk assessment model to provide a reference basis for accelerating the beforehand prevention and control of COPD and promoting the respiratory health of community-based residents. MethodsIndividuals aged >35 years old, with at least one risk factor except age illustrated in the Guidelines for Primary Diagnosis and Treatment of Chronic Obstructive Lung Disease (2018), and participated in the early screening for COPD from July 2022 to December 2023 were selected as the research subjects, and their lung function was assessed by the forceful expiratory volume in the first second after inhalation of bronchodilator (FEV₁)/ forced vital capacity (FVC) <70% and/or the ratio of FEV₁ to predicted value (FEV₁%Pred) <80% as the diagnostic criteria. In addition, risk factors related to pulmonary dysfunction were analyzed for the establishment of risk assessment model. ResultsA total of 823 individuals aged between 35‒76 years were included, among which 298 (36.21%) were diagnosed with pulmonary dysfunction, 167 (20.29%) with COPD, and 131 (15.92%) with preserved ratio but impaired spirometry. Logistic regression analysis revealed that male gender, increasing age, more frequent smoking, insufficient physical activity, recurrent wheezing, the presence of post-exercise wheezing or coughing, insensitive to airborne allergens, and history of chronic bronchitis or bronchial asthma were correlated with pulmonary dysfunction. The incidence rate of pulmonary dysfunction was 1.99 times higher in males than that in females, 1.81 times more common in those aged between 70‒76 years than those aged <60 years, 2.42 times more common in those who smoked 50‒200 pack-years than in those who smoked 0‒14 pack-years, 1.78 times higher in those who underwent physical activity <600 MET‑min·week^-1 than in those who underwent physical activity ≥600 MET‑min·week^-1, 2.61 times higher in those suffered recurrent wheezing than in those did not, 1.53 times higher in those with symptoms of post-exercise wheezing or coughing than in those without, 1.61 times higher in those insensitive to airborne allergens than those sensitive, 2.02 times higher in patients with chronic bronchitis than in those without, and 2.41 times higher in patients with bronchial asthma than in those without. The risk assessment model for pulmonary dysfunction constructed on this basis had a total score of 28 points, and the area under the subject operating characteristic (ROC) curve was 0.72, reaching the cut-off point of ROC curve while taking scores ≥10 points as the cut-off value for pulmonary dysfunction. ConclusionIn community-based high-risk COPD population, the incidence rate of pulmonary dysfunction is higher in males than that in females, in addition, which increases with the advancement of age. Smoking,insufficient physical activity,recurrent wheezing,post-exercise wheezing or coughing,insensitive to airborne allergens,and history of chronic bronchitis or bronchial asthma are high risk factors for pulmonary dysfunction. The risk assessment model constructed based on these factors has a good predictive effect in screening high-risk population of COPD, but its effectiveness in screening people at general risk needs to be further validated.

Objective To explore the peak moment characteristics of lower limb joints,as well as the contribution rate and compensation mechanism of lower limb joints when older adults with a history of falls cross obstacles at different paces.Methods Thirty healthy older adults and 30 eldely fallers were recruited.The Qualisys infrared high-speed motion capture system and the Kistler three-dimensional force platform were used to collect the biomechanical data of the older adults when they crossed an obstacle with a height of 15％of their height at three walking speeds(1.05,1.41,1.74 m/s).The data were then modeled and analyzed using Visual 3D software.Results As walking speed increased,the peak knee extension moment,peak ankle plantar flexion moment,and double peak value of hip flexion moment in healthy group all increased significantly(P＜0.05).Compared with healthy group,the double peak values of hip flexion moment in faller group were significantly smaller than those in healthy group(P＜0.05).During walking at moderate speed,the contribution rate of the left hip joint in faller group was significantly higher than that of healthy group(P=0.025),while the contribution rate of the ankle joint was significantly lower(P=0.044).The margin of stability in the anterior-posterior direction at the moment of ground contact of the stance leg and the stride leg increased with walking speed(P=0.007,P=0.002).Conclusions Compared with healthy older adults,the elderly fallers have lower peak torque,peak ground reaction force,and dynamic stability in the anterior-posterior direction.As the walking speed increases,the mechanical parameters and the margin of stability of older adults increase significantly,and walking stability is improved.Compared with healthy older adults,elderly fallers usually rely more on the contribution of hip joint movements and reduce the involvement of ankle joints.It is recommended to incorporate fast walking exercises into the daily fall prevention exercise program for older adults,with combination of coordinated training of the hip,knee,and ankle joints.

To summarize key points of nursing care of 25 patients with secondary hyperparathyroidism underwent parathyroid autotransplantation with forearm (tPTX+AT).The integrated mode was adopted during the perioperative period,focusing on the following key points:perioperative management of environment,nursing of vascular access,intro-operative management of sample,nursing management during anesthesia and recovery,management of drawing blood,treatment and nursing care of postoperative hypocalcemia,prevention and nursing care of infection and hemorrhage,wound care in the forearm and monitoring of graft.Compared with the preoperative period,levels of intact parathyroid hormone(iPTH),calcium and phosphorus were significantly decreased during the postoperative period (P＜0.01);symptoms were significantly improved after surgery included bone and joint pain,muscular weakness,and insomnia.

Objective To investigate the relationship between phosphatidylinositol 3-kinase catalytic subunit α(PIK3CA) expression and the incidence and different pathological grade of gastric cancer, and the mechanism thereof. Meth-ods The expressions of PIK3CA, serine/threonine protein kinase (pAkt) and cell proliferation associated nuclear antigen (ki-67) in gastric carcinoma and adjacent tissues and normal gastric mucosa were detected by immunohistochemical method. The relationship between expressions of PIK3CA, pAkt and ki-67 and tumorigenesis was analyzed. The expressions of PIK3CA, pAkt and ki-67 in different pathological conditions of gastric tissues were analyzed. The relationship between tu-mor pathologic classification and differentiation were analyzed too. Results There were significantly higher expressions of PIK3CA, pAkt and ki-67 in gastric cancer (P＜0.05), which were the highest in the poorly differentiated gastric adenocarci-noma (P＜0.05). There were a positive correlation between expressions of PIK3CA, pAkt and ki-67 and different pathologi-cal levels of gastric carcinoma and adjacent tissues and normal gastric tissues (P＜0.05). Conclusion PIK3CA may be the initiating factor of PI3K/Akt signaling pathway, which induced phosphorylation of Akt and activation PI3K/Akt signaling pathway, promoting the proliferation, invasion and metastasis of gastric adenocarcinoma.

Objective To study the value and feasibility of temporary emergency bedside cardiac pacing. Method Two hundred patients with severe witnessed bradycardia were treated with temporary emergency cardiac pacing. We treated 130 patients with emergency bedside pacing and 70 patients with x-ray-guided pacing. Results Emergency bedside pacing was successful in 127 patients except three patients and no postoperative complications occurred. X-ray-guided pacing was successful in all 70 patients but three patients experienced complications: one deep venous thrombosis and two cardiac tamponades due to myocardial perforation. The pacing electrodes were more likely to be displaced in X-ray-guided pacing than in emergency bedside pacing (six cases versus three cases) . The door-to-operation time was 30-90 min for x-ray-guided cardiac pacing and 5-15 min for emergency bedside pacing. Needle-to-pacing times were similar for both procedures (3.5 ± 1.5 min for x-ray guided pacing versus 4± 2.5 min for bedside pacing). Conclusions Temporary emergency bedside cardiac pacing is a rapid, efficient and safe procedure for treating severe witnessed bradycardia. The technique is easily mastered and may prove lifesaving in an emergency.

Objective To observe the effect of berberine on glucose transport in 3T3-L1 adipocytes and to investigate its mechanism. Methods The glucose consumption of the cells was determined by the glucose oxidase method. The glucose transportation rate of the cells was assayed by the uptake of 2-deoxy-〔 3H〕-D-glucose. Protein kinase B (Akt) activity was detected by immunoprecipitation and Western blot. The gene expression of c-Cbl-associated protein (CAP) was detected by Northern blot. Results 0.1～200 ?mol/L berberine significantly increased glucose consumption in 3T3-L1 adipocytes with a dose-dependent effect, which was independent of insulin. The glucose transportation was significantly increased in adipocytes incubated with 0.1～10 ?mol/L berberine; the action began at 2 h and reached a peak value at 12 h. The results of immunoprecipitation and Western blot showed that berberine did not enhance Akt activity. The result of Northern blot indicated that berberine significantly decreased CAP mRNA expression. Conclusion Adipocytes are the important target cells of berberine. Berberine significantly increases glucose transportation and consumption in adipocytes, the action appeares to be independent of insulin signal pathway.

Objective To explore the significance of the expression of p53 and bcl- 2 in different cutaneous tumors. Methods The expression of p53 and bcl- 2 were quantitatively detected by Flow Cytometry(FCM) and immunofluorescence in 10 cases of normal skin, 20 cases of squamous cell carcinoma(SCC), 22 cases of basal cell carcinoma(BCC), 18 cases of malignant melanoma(MM) and 18 cases of pigmented nevus (PN). Fluorescence Index(FI) was defined as the expression index of bcl- 2 and p53 protein. Results The FI for bcl- 2 in SCC and BCC was higher than that in normal skin tissues(P

Objective To observe expression of resistin gene in adipose tissue of SD rats fed with high-fat diet and its correlation to insulin resistance, diabetes mellitus and leptin. Methods Using RT-PCR to mRNA from adipose tissue, the products were obtained, purified, constructed and squenced. Once its squence was verified, semi-quantitative RT-PCR and Northern Blot were employed to study its expressions in adipose tissues of rats with different diets. Oral glucose tolerance test and insulin release test were performed in 2 groups of rats. Results (1) The resistin gene was successfully constructed and sequenced, which was in accordance with the data of genbank. (2) Compared with the control, the expression of resistin in adipose tissue of high-fat diet rats was significantly enhanced, and blood glucose, serum insulin and leptin levels were also elevated in high-fat diet rats (P