ObjectiveTo investigate the relationship between lower limb muscle strength and walking speed in older adults, and to analyze the mediating role of flexibility and dynamic balance. MethodsFrom November to December, 2021, a total of 155 older adults at the Shanghai Senior Sports and Health Home were included. Their basic health information was collected, and the lower limb muscle strength, flexibility, dynamic balance and walking speed were tested. A mediated effects analysis was conducted. ResultsThere was a pairwise correlation among lower limb muscle strength, flexibility, dynamic balance and walking speed in older adults (r > 0.210, P < 0.01). In the mediated effects model, after controlling for age and gender, lower limb muscle strength did not directly predict walking speed in older adults (β = 0.029, P = 0.699), however, lower limb muscle strength could influence walking speed through the partial mediation of dynamic balance (effect = 0.0130, 95% CI 0.0073~0.0197) and the chain mediation of lower flexibility and dynamic balance (effect = 0.0019, 95% CI 0.0003~0.0043). ConclusionLower limb muscle strength can indirectly affect walking speed in older adults through the mediators of flexibility and dynamic balance, or the dynamic balance alone.

Objective? To investigate the application of information-motivation-behavior (IMB) model in nursing care for patients with long-term indwelling bladder stoma. Methods? Totally 86 patients receiving long-term indwelling bladder stoma in the Department of Urinary Surgery, the Seventh Medical Center of Chinese PLA General Hospital from October 2015 to September 2017 were selected and divided into the control group (n=43) and the observation group (n=43) according to the random number table. Patients in the control group received conventional nursing care, while patients in the observation group received IMB-based health education on this basis. The self-care ability and quality of life of the two groups were assessed, and the incidence of complications during the follow-up was compared between the two groups after 12 months. Results? The scores of self-care ability, self-responsibility, self-conception and health knowledge as well as the total score after 12 months' nursing care were higher than those before treatment. The scores of the observation group were (43.18±4.32), (24.21±2.24), (26.04±2.63), (49.79±3.89), and (143.22±6.82), higher than those of the control group, which were (31.26±3.58), (16.74±1.55), (22.71±1.68), (38.67±1.92), and (109.38±5.04), and there were statistically differences between the two groups (P＜0.05). The total incidence rate of complications of the observation group was lower than that of the control group (6.98% vs. 37.21%,P＜0.05). Conclusions? The IMB model can enhance the self-care ability of patients with long-term indwelling bladder stoma, reduce the incidence of complications, and improve their quality of life effectively, which is worth promoting in clinical practice.

Objective: To develop a method of quantitative analysis of multi-components by single marker for nine effective constituents in Chenxiang-Huaqi tablets. Methods: Using HPLC method, the mobile phase was acetonitrile -0.2% physcion acid in gradient elution program, the flow rate was 1.0 ml/min. The detection wavelength was set at 230 nm for liquiritin, ammonium glycyrrhizinate, costunolide and dehydrocostus lactone, and 283 nm for narirutin, naringin, hesperidin and neohesperidin, and 310 nm for pogostone. The column temperature was 30 ℃ and the injection volume was 10 μl. Using Hesperidin as the internal standard, the relative correction factors among liquiritin, ammonium glycyrrhizinate, costunolide, dehydrocostus lactone, narirutin, naringin, neohesperidin, pogostone were detected by QAMS and their contents were calculated. The content difference of the above nine components with the external standard method were compared. Results: The calculated values of hesperidin, liquiritin, ammonium glycyrrhizinate, costunolide, dehydrocostus lactone, narirutin, naringin, neohesperidin, pogostone were not statistical significance from those measured by external standard method (P>0.05). Conclusions The method offered reference for quality standard of Chenxiang-Huaqi tablets.

Objective To explore the effects of comfort nursing interventions on clinical effects and negative emotions in patients receiving transurethral plasmakinetic resection of the prostate(PKRP).Methods A total of 94 patients with benign prostatic hyperplasia(BPH)were selected and randomized into a control group(n=47)and an observation group(n=47)from May 2013 to June 2015.All the patients received PKRP.Patients in the control group received conventional nursing care,while patients in the observation group received perioperative comfort nursing interventions in addition to conventional nursing.The changes in the patients' blood pressure and heart rate were detected;SAS and SDS were used to evaluate their anxiety and depression levels post operation;relevant clinical indicators were measured and compared between the two groups to evaluate their short-and long-term clinical effects;and the incidence of complications and satisfaction were compared between the two groups.Results Compared with control group,the systolic pressure,diastolic pressure,average arterial pressure and heart rate of the oberservation group were lower,and SAS and SDS scores in the patients of the oberservation group were lower postoperatively(P < 0.05).The time of bladder irrigation,catheter indwelling,operation and hospital stay was shortened in the patients in the observation group as compared to the control group(P < 0.01).International prostate symptom score(IPSS)and residual urine volume decreased 3 months post operation,while the maximum urine flow rate and quality of life score(QLS)increased compared with preoperative conditions(P<0.05).The satisfaction and the incidence of complications following nursing interventions were 95.74％and 12.77％for the patients in the observation group and 78.72％and 40.43％for the patients in the control group,respectively(P < 0.05).Conclusions Comfort nursing interventions can improve the psychological state of PKRP patients,enhance their short-and long-term effectsand satisfaction,and reduce the incidence of related complications.

Objective To summarize the methods of diagnosing and treating solid-pseudopapillary neoplasm of pancreas SPN so as to provide reference for its early clinical diagnosis.Methods We collected the clinical data of 62 patients with pathologically confirmed diagnosis of SPN treated in the First Affiliated Hospital of Xi'an Jiaotong University between Feb.2004 and Sep.2014.Then we retroactively analyzed and summarized the clinical characteristics,diagnosis and treatment of the disease.Results Among the 62 patients,55 were female and 7 were male;the mean age was (31.58±12.67) years old.The clinical features showed no specificity and the tumor was mostly detected upon physical check-up.The tumor was seen to be located mostly in the body and tail of the pancreas,and the average maximum diameter was (7.81±3.54)cm.We did not find obvious abnormality in routine pre-operative blood test results or liver and kidney functions.The imageological examination indicated tumor occupation in the pancreas.All the patients underwent surgical resection with no complications or death and had a good recovery after operation.Pathological diagnosis after operation was SPN without metastasis in lymph modes.Until the last time we followed up all the patients,we found relapse in two patients (3.2％).Conclusion SPN is a tumor that tends to affect young and middle-aged females.The malignancy grade of SPN is low,and patients with this disease show no specificity in clinical manifestation.The imageological examination is of vital importance in diagnosing SPN and surgical resection is an effective way to treat SPN.

Objective To observe the effects and safety of oxycodone hydrochloride combined with parecoxib sodium in preventing postoperative hyperalgesia induced by remifentanil. Methods Eighty-eight ASA Ⅰ or Ⅱ patients undergoing elective laparoscopic myomectomy surgery were randomly divided into four groups (C,O,P,PO) with 22 cases in each group. Patients in group C,O,P,PO were given with 10 mL saline, 0.1 mg?kg-1 oxycodone hydrochloride, 40 mg parecoxib sodium, 0.1 mg?kg-1 oxycodone hydrochloride and 40 mg parecoxib sodium 30 min before the end of the surgery, respectively. The VAS scores were recorded at the end of surgery 30 min, 1 h, 2 h, 4 h, 8 h, and the cases of agitation, rigor, vomiting and increasing of analgesics were recorded. Results Compared with group C, the VAS scores in group O, P,PO were significantly lower(P<0.05). The VAS scores in group PO were lower than those in group O,P(P<0.05). The cases of agitation and rigor in group PO (0.0%, 5.0%) were less than those in group C (45.0%,23.0%) (P<0.05). The increased doses of analgesics in group PO(0) were less than those in groups C (12), group P (5), and group O (5)(P<0.05). Conclusion Oxycodone hydrochloride combined with parecoxib sodium can effectively prevent postoperative hyperalgesia induced by remifentanil, and reduce the incidence of postoperative agitation.

Objective To evaluate the effects of dexmedetomidine on the activity of nuclear factor kappa B (NF-κB) in neutrophil granulocytes during one-lung ventilation in the patients undergoing pulmonary lobectomy.Methods Thirty-eight ASA physical status Ⅰ or Ⅱ patients,aged 40-64 yr,weighing 50-75 kg,scheduled for elective pulmonary lobectomy,were randomized into 2 groups (n =19 each) using a random number table:control group (group C) and dexmedetomidine group (group D).In group D,dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min before induction of anesthesia,followed by infusion at a rate of 0.5 μg· kg-1 · h-1 until 30 min before the end of operation.The equal volume of normal saline was given in group C.At 5 min after intubation,0,30 and 60 min of one-lung ventilation,0 and 30 min of two-lung ventilation,and 30 min after operation,blood samples were taken from the radial artery for blood gas analysis and for measurement of plasma concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).The oxygenation index and respiratory index were calculated.The nuclear protein of neutrophil granulocytes was extracted for measurement of NF-κB DNA-binding activity.Results Compared with group C,the respiratory index,plasma concentrations of TNF-α and IL-6 and NF-κB DNA-binding activity were significantly decreased,and no significant difference was found in the oxygenation index in group D.Conclusion Dexmedetomidine can inhibit the activation of NF-κB in neutrophil granulocytes and is helpful in reducing the systemic inflammatory responses during one-lung ventilation in the patients undergoing pulmonary lobectomy.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.

OBJECTIVE[corrected] To assess the specificity and applicability of direct PCR sequencing in the detection of point mutations in hepatitis B virus (HBV) associated with drug resistance.

METHODSSerum samples were obtained from 120 patients with hepatitis B treated with nucleoside analogus for at least 2 years to detect the point mutations in HBV genome in association with drug resistance using nested PCR and direct DNA sequencing.

RESULTSForty out of the 120 patients were found to have one or two point mutations associated with drug resistance, including 17 with L180M and M204V/I mutations (42.5%), 10 with M204V/I mutation (25%), 8 with N236T mutation (20%), 3 with L180M mutation (7.5%), and 1 with both A181V/T and N236T mutations (2.5%), and 1 with A181V/T mutation(2.5%).

CONCLUSIONDNA sequencing is a good method to detect all known point mutations associated with HBV drug resistance.

Adolescent ; Adult ; Aged ; Child ; Drug Resistance, Viral ; genetics ; Female ; Hepatitis B virus ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Point Mutation ; genetics ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Young Adult

Objective:To investigate the common reasons for the failure of radical mastoidectomy in order to improve the result of treatment and obtain a dry ear.Method:Twenty-eight cases,who achieved no dry ear after radical mastoidectomy,underwent secondary surgery.Result:All cases obtained dry ear without vertigo or facial paralysis after operation and postoperative dressing.Conclusion:The reasons for the failure of radical mastoidectomy result from the incomplete clearance of lesions, the insufficient ventilation of mastoid cavities, the inappropriate postoperative dressings or the residual foreign bodies in surgical cavity.It is the key points to achieve skeletonization adequately, to eliminate the pathological tissues thoroughly under microscope, and to ensure unobstructed drainage of surgical cavities for preventing secondary surgery.