BACKGROUND:It has been found that abnormal apoptosis of bone tissue cells induced by abnormal iron metabolism plays an important role in the progression of osteoporosis. OBJECTIVE:To investigate the effect of naringin on iron metabolism and cell apoptosis in bone tissue of rats with osteoporosis. METHODS:Fifty 2-month-old female Sprague-Dawley rats were randomly divided into five groups with 10 rats in each group:sham group,osteoporosis group,naringin low-dose group,naringin high-dose group,and naringin high-dose+DKK-1 group.Except for the sham group,rat models of osteoporosis were established by removing bilateral ovarian tissues in the other groups.At 8 weeks after modeling,rats in the naringin low-and high-dose groups were given 100 and 400 mg/kg/d naringenin by gavage,respectively,and rats in the naringenin high dose+DKK-1 group were given 400 mg/kg/d naringin by gavage and subcutaneous injection of 25 mg/kg/d DKK-1,an inhibitor of the Wnt1 signaling pathway,for 7 consecutive days.Relevant indexes were detected after administration. RESULTS AND CONCLUSION:Compared with the osteoporosis group,naringin could enhance the bone mineral density and serum calcium and superoxide dismutase levels in rats(P<0.05),and reduce the serum levels of osteocalcin,malondialdehyde,and phosphorus(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Micro-CT scanning,hematoxylin-eosin and TUNEL staining showed that compared with the osteoporosis group,naringin significantly improved bone microstructure and reduced the rate of cell apoptosis,while DKK-1 partially inhibited the interventional effect of naringin.Immunofluorescence staining results showed that compared with the osteoporosis group,naringin could reduce the oxygen content,anti-tartaric acid phosphatase expression,and elevate the expression of alkaline phosphatase in active tibia tissues(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Prussian blue staining and immunohistochemical staining showed that compared with the osteoporosis group,naringin reduced iron deposition in bone and liver tissues as well as the expression of transferrin receptor 1(P<0.05),and elevated the protein expression of ferroportin 1(P<0.05)in bone tissue,and DKK-1 partially inhibited the intervention of naringin(P<0.05).PCR and western blot assay of tibia specimens showed that compared with the osteoporosis group,naringin decreased the expression of anti-tartrate acid phosphatase,transferrin receptor 1 and Bax(P<0.05),and elevated the expression of alkaline phosphatase,ferroportin 1,Bcl-2,Wnt1 and β-catenin(P<0.05),while DKK-1 partially inhibited the interfering effect of naringin(P<0.05).To conclude,naringin inhibits the progression of osteoporosis by reducing iron deposition and apoptosis rate in bone tissue,which may be related to the activation of the Wnt1 signaling pathway.

Objective To formulate an expert consensus on the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound(hereinafter referred to as the consensus).To standardize the clinical practice of ultrasound-guided puncture of difficult autologous arteriovenous fistula.Methods We conducted a comprehensive literature review of domestic and international publications,integrated clinical nursing experts' practical experience,and followed evidence-based nursing principles to identify the best available evidence.Through expert panel discussions and 3 rounds of Delphi expert consultation,we systematically revised,refined and improved the initial draft of the consensus,ultimately developing the finalized version.Results The response rates of the 3 rounds of Delphi expert correspondence inquiries were all 100％;the authority coefficient of expert correspondence inquiries was 0.97;the mean importance assignment of the 3 rounds of correspondence inquiries was more than 3.50.The Kendall coordination coefficients of the 3 rounds of expert consultation were 0.127,0.120,and 0.201,respectively(P＜0.05),and the degree of coordination of expert opinions was good and the expert opinions were consistent.The consensus summarized 5 aspects,including relevant terms and definitions,indications for real-time ultrasound-guided arteriovenous fistula puncture,personnel qualifications and training,difficult arteriovenous fistula puncture procedures under real-time ultrasound-guided,and nursing quality control.Conclusion The consensus is scientific,which can provide a basis for hemodialysis practitioners to practice the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound.

The study was a prospective observational study. A total of 24 patients who underwent maintenance hemodialysis (MHD) at Haidian Hospital in Beijing from May 2024 to June 2024 were included as the study subjects. The safety and efficacy of a new single-needle dialysis in MHD patients were evaluated. The reasons for using single-needle dialysis included waiting for the maturity of internal fistula(7 cases, 29.17%), autogenous arteriovenous fistula thrombosis occurred (6 cases, 25.00%), puncture difficulty occurred (7 cases, 29.17%), and pain sensitivity or elderly (4 cases, 16.67%). The results showed that the average blood flow was (155.65±5.90) ml/min, total blood volume was (35.92±2.65) L during single-needle dialysis. One patient had slight puncture leakage, and the puncture success rate was 95.83%. Relevant indicators of dialysis adequacy showed that the average urea clearance (Kt/V) was 0.90±0.42, urea reduction ratio was 58.31%±7.93%, and online real-time Kt/V monitoring average value was 0.98±0.55. The results suggest that the application of the new improved single-needle dialysis mode in MHD patients is safe and effective.

Objective To formulate an expert consensus on the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound(hereinafter referred to as the consensus).To standardize the clinical practice of ultrasound-guided puncture of difficult autologous arteriovenous fistula.Methods We conducted a comprehensive literature review of domestic and international publications,integrated clinical nursing experts' practical experience,and followed evidence-based nursing principles to identify the best available evidence.Through expert panel discussions and 3 rounds of Delphi expert consultation,we systematically revised,refined and improved the initial draft of the consensus,ultimately developing the finalized version.Results The response rates of the 3 rounds of Delphi expert correspondence inquiries were all 100％;the authority coefficient of expert correspondence inquiries was 0.97;the mean importance assignment of the 3 rounds of correspondence inquiries was more than 3.50.The Kendall coordination coefficients of the 3 rounds of expert consultation were 0.127,0.120,and 0.201,respectively(P＜0.05),and the degree of coordination of expert opinions was good and the expert opinions were consistent.The consensus summarized 5 aspects,including relevant terms and definitions,indications for real-time ultrasound-guided arteriovenous fistula puncture,personnel qualifications and training,difficult arteriovenous fistula puncture procedures under real-time ultrasound-guided,and nursing quality control.Conclusion The consensus is scientific,which can provide a basis for hemodialysis practitioners to practice the puncture of difficult arteriovenous fistula under real-time guidance of ultrasound.

The study was a prospective observational study. A total of 24 patients who underwent maintenance hemodialysis (MHD) at Haidian Hospital in Beijing from May 2024 to June 2024 were included as the study subjects. The safety and efficacy of a new single-needle dialysis in MHD patients were evaluated. The reasons for using single-needle dialysis included waiting for the maturity of internal fistula(7 cases, 29.17%), autogenous arteriovenous fistula thrombosis occurred (6 cases, 25.00%), puncture difficulty occurred (7 cases, 29.17%), and pain sensitivity or elderly (4 cases, 16.67%). The results showed that the average blood flow was (155.65±5.90) ml/min, total blood volume was (35.92±2.65) L during single-needle dialysis. One patient had slight puncture leakage, and the puncture success rate was 95.83%. Relevant indicators of dialysis adequacy showed that the average urea clearance (Kt/V) was 0.90±0.42, urea reduction ratio was 58.31%±7.93%, and online real-time Kt/V monitoring average value was 0.98±0.55. The results suggest that the application of the new improved single-needle dialysis mode in MHD patients is safe and effective.

Objective Motortherapy and neck muscle resistance training are used to study the effects of resistance training on neck pain level and surface myoelectric activity of student pilots of carrier aircraft.Methods We conducted an intervention experiment on the neck pain of the carrier-based aircraft student pilots.The experiment period was 3 months.The experimental subjects were male carrier-based aircraft student pilots aged from 23 to 35.Questionnaires,including the Cervical Dysfunction Index and the Chinese Physical Activity Questionnaire,were issued,followed by cervical muscle function tests,including cervical maximum muscle strength,cervical range of motion,and surface electromyography tests.The experimental subjects were randomly divided into the control group and the resistance training group,with 8 in each.The subjects in the control group recieved usual military training.Those in the resistance training group recieved targeted training programs developed by using the self-developed cervical spondylosis prevention training device in addition to usual military training.The programs were carried out for resistance training three times a week for 20 minutes in each.Cervical maximum muscle strength,cervical range of motion,and surface electromyography were tested again before the end of the intervention experiment.The data were analyzed by SPSS 22.0.The results were expressed by mean±standard deviation((-x)±s).P<0.05 was considered statistically significant.Results(1)After 12-week intervention,resistance training had a significant effect on visual pain analog scale(VAS).(2)After the intervention,the comparison results of the subjects'cervical spine dysfunction index(NDI)before and after their own tests showed that the level of cervical spine dysfunction was significantly improved.(3)After the intervention,the results of inter-group comparison of the subjects'own joint motion showed that the self-variation difference of the subjects in the resistance training group was significantly different in forward flexion,backward extension,left flexion,right flexion,right rotation and left rotation.(4)After the intervention,the comparison results between the two groups of subjects'own neck muscle strength showed that there was no significant difference in the self-change of the six movements of subjects in the resistance training group.(5)The root mean square(RMS)values in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle.(6)The integrated electromyography(iEMG)in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle superior bundle.Conclusion After 12 weeks of resistance training,VAS scores and NDI scores of resistance training subjects are significantly reduced,indicating that resistance training can alleviate neck pain and improve cervical spine dysfunction.12-week resistance training can enhance the strength of neck muscles of carrier-based aircraft student pilots and improve the anti-fatigue ability of neck muscles.Meanwhile,it can enhance the range of motion of neck joints,improve the load of the deep and shallow muscle fibers of the four tested muscles in the neck and optimize the activation mode of the deep and shallow muscles in the neck.

Objective To explore the intervention effect of badminton exercise on neck pain in naval carrier-based aircraft flight trainees,and provide data support for the prevention and relief of neck pain in these trainees.Methods A total of 16 naval carrier-based aircraft flight trainees were selected as subjects based on inclusion and exclusion criteria,and randomly divided into the sports rehabilitation group and the control group,with eight participants in each group.The sports rehabilitation group engaged in badminton exercise three times a week for one hour each time,in addition to their regular military training.The control group received no other interventions apart from their regular military training.Neck Disability Index(NDI),Visual Analog Scale(VAS)for pain simulation,Cervical Range of Motion(CROM),maximum neck strength,Root Mean Square(RMS)value of surface electromyographic signals,and integrated electromyography(iEMG)values were used as evaluation indexes for the intervention effect of neck pain.Results There was a significant difference in NDI scores among members of the sports rehabilitation group before and after intervention(P<0.05).However,there was no significant difference observed in NDI scores among members of the control group before and after intervention(P>0.05).Furthermore,there was a significant difference in VAS scores among members of the sports rehabilitation group before and after intervention(P<0.01).The VAS scores of the control group members showed no significant difference compared to pre-intervention testing(P>0.05).The maximum range of motion in all directions increased for the exercise rehabilitation group,with significant differences observed in left and right flexion(P<0.05),but no significant differences were found in other directions(P>0.05)compared to pre-intervention levels.There was no significant change in maximum range of motion within the control group before and after intervention(P>0.05).The exercise rehabilitation group demonstrated a significant increase in neck muscle strength during forward flexion,backward extension,left flexion(P<0.01),and right flexion as well as left and right rotation values(P<0.05)compared to pre-intervention levels.There was no significant difference observed between RMS values on both sides of the sternocleidomastoid muscles during movement in four different directions for the exercise rehabilitation group(P>0.05).However,there was a significant difference observed on the left side of the upper trapezius muscle during forward and rightward movements(P<0.05),but not during backward or leftward movements(P>0.05).No statistically significant differences were found among any direction's iEMG values before or after intervention for four muscles tested except that iEMG value increased slightly without significance after intervention when performing forward bending,backward extension and rightward bending exercises within exercise rehabilitation groups(P>0.05).Conclusion After badminton training,neck pain among carrier-based fighter pilots is allivated while cervical dysfunction recovers somewhat.Furthermore,their neck flexibility increases along with their neck muscle strength while deep muscles are activated to maintain stability to effectively enhance fatigue resistance capacity within these muscle groups around their necks.

Objective:To explore the risk factors of hypomagnesemia in elderly patients with sepsis and the influence of hypomagnesemia on the prognosis of elderly patients with sepsis.Methods:In this retrospective study, 249 elderly patients with sepsis or septic shock were recruited between January 2018 and January 2021 from the Department of Geriatrics and the Department of Emergency Medicine, General Hospital of Tianjin Medical University, and relevant clinical data were collected.The Logistic regression analysis model was used to identify the relationship between risk factors and hypomagnesemia in patients with sepsis.The prognosis criteria such as hospitalization time in intensive care unit(ICU), 28-day mortality rate, mechanical ventilation time, double infection rate, shock reversal time, etc., were compared between the hypomagnesemia group and the normal magnesium group.Results:Among the 249 elderly patients with sepsis, 187 had normal blood magnesium, 43 had low blood magnesium and 19 had high blood magnesium, accounting for 75.10%, 17.27% and 7.63%, respectively.Compared with the normal blood magnesium group, elderly sepsis patients with hypomagnesemia had a longer hospitalization time in ICU[(16.21±3.68)d vs.(13.86±3.58)d, t=-4.845, P=0.036], and a significantly prolonged mechanical ventilation time[11(3, 18)d vs.3(1, 6)d, Z=-1.782, P=0.033]. There was no significant difference in mortality and double infection rate between the two groups(both P>0.05). The sequential organ failure assessment(SOFA)score of elderly sepsis patients in the low magnesium group was significantly higher than that in the normal magnesium group[(5.69±1.28)scores vs.(3.09±0.68)scores, t=-0.322, P=0.008], but there was no significant difference in acute physiology and chronic health evaluation(APACHE) Ⅱ score between the two groups( P>0.05). Multivariate Logistic regression analysis showed that high SOFA score( OR=1.111, 95% CI: 1.025-1.758, P=0.001)was an independent risk factor for hypomagnesemia. Conclusions:A high SOFA score is an independent risk factor for hypomagnesemia in elderly sepsis patients, and the clinical prognosis of elderly sepsis patients with hypomagnesemia is poor.

Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.

Objective:To investigate the correlation between mild cognitive impairment(MCI)and abnormal glucose metabolism and thus to provide a basis for MCI prevention.Methods:A total of 1 074 elderly outpatients with normal cognitive function and without confirmed diabetes mellitus, hyperlipoidemia or gout were enrolled.During a five-year follow-up period, 121 subjects were diagnosed with MCI based on the mini mental state examination(MMSE)and the Montreal cognitive assessment(MoCA). Furthermore, annual blood glucose and glycated hemoglobin monitoring was carried out to examine the long-term effects of abnormal glucose metabolism on MCI risk.Results:According to cognitive function, 1 074 subjects were divided into the MCI group and the non-MCI group.Compared with the non-MCI group, the mean values of fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), triglycerides(TG)and total cholesterol(TC)in the MCI group were elevated( P<0.05). The receiver operating characteristic(ROC)curve showed that the cut-off value of FBG was 6.2 mmol/L for the hyperglycemia group(sensitivity: 84.1%, specificity: 90.9%, area under curve: 0.875, P<0.001)and 4.5mmol/L for the hypoglycemic group(sensitivity: 77.4%, specificity: 87.3%, area under curve: 0.823, P<0.001); the cut-off value of HbA1c was 5.5%(sensitivity: 76.0%, specificity: 87.0%, area under curve: 0.815, P<0.001). Multiple Logistic regression analysis showed that increased risk of MCI was associated with the mean values of fasting blood glucose <4.5 mmol/L( RR: 1.69, 95% CI: 1.11-2.59)or ≥6.2 mmol/L( RR: 1.81, 95% CI: 1.15-2.86)and of glycosylated hemoglobin ≥ 5.5%( RR: 2.13, 95% CI: 1.51-2.99). Conclusions:Impaired fasting glucose tolerance and low fasting blood glucose are independent risk factors for MCI in the elderly.