Objective:To understand the current situation and influencing factors of functional constipation among elderly people in nursing homes, and construct a risk prediction model.Methods:Conveniently select 542 elderly people from 8 nursing homes in Tangshan urban area from July to November 2023 as the research subjects, use binary logistic regression analysis to construct a risk prediction model, and conduct internal validation of the model.Results:Among the 542 elderly people who were included in the study, there were 250 males and 292 females with an average age of 78.00 (70.00, 86.00) years. The incidence of functional constipation among elderly people in nursing homes was 54.06%(293/542). The predictive model includes six predictive factors: age, Barthel index, water intake, daily vegetable intake, insomnia, and perianal disease. The model AUC was 0.885 (95% CI 0.858-0.913), the Youden index was 0.628, the best critical value was 0.585, sensitivity was 0.819, specificity was 0.809. The Hosmer-Lemeshow test χ2=6.38, P=0.605. The internal validation results of the Bootstrap method showed that the AUC of the model was 0.876, the calibration curve was close to the standard line, and the Brier score was 0.135. The DCA results showed that the threshold was 0.1-0.9, and the model had good clinical net benefits. Conclusions:The incidence of functional constipation in elderly care institutions is relatively high. The functional constipation risk prediction model constructed in this study has good predictive efficacy and applicability, which can provide reference for nursing home staff.

Objective:To understand the current situation and influencing factors of functional constipation among elderly people in nursing homes, and construct a risk prediction model.Methods:Conveniently select 542 elderly people from 8 nursing homes in Tangshan urban area from July to November 2023 as the research subjects, use binary logistic regression analysis to construct a risk prediction model, and conduct internal validation of the model.Results:Among the 542 elderly people who were included in the study, there were 250 males and 292 females with an average age of 78.00 (70.00, 86.00) years. The incidence of functional constipation among elderly people in nursing homes was 54.06%(293/542). The predictive model includes six predictive factors: age, Barthel index, water intake, daily vegetable intake, insomnia, and perianal disease. The model AUC was 0.885 (95% CI 0.858-0.913), the Youden index was 0.628, the best critical value was 0.585, sensitivity was 0.819, specificity was 0.809. The Hosmer-Lemeshow test χ2=6.38, P=0.605. The internal validation results of the Bootstrap method showed that the AUC of the model was 0.876, the calibration curve was close to the standard line, and the Brier score was 0.135. The DCA results showed that the threshold was 0.1-0.9, and the model had good clinical net benefits. Conclusions:The incidence of functional constipation in elderly care institutions is relatively high. The functional constipation risk prediction model constructed in this study has good predictive efficacy and applicability, which can provide reference for nursing home staff.

A system for achieving two-dimensional(2D)visualization and three-dimensional(3D)reconstruction of lung images using CT data is designed.After DICOM image processing,and lung nodule segmentation and labeling,the multi-view and multi-resolution 3D display of lung parenchyma and nodules is realized using techniques such as resampling of CT sequences,3D reconstruction based on surface rendering,and morphological processing.Finally,the interactive interface is designed for implementing the functions of image enhancement,2D visualization,nodule delineation,3D reconstructions of lung parenchyma and nodules,rotation,zooming and switching the viewpoint.Experimental results show that the system provides clear and accurate 2D image visualization and lesion delineation,while reconstructing nodules in the generated 3D images completely and smoothly.Compared with the existing similar medical processing software,the developed system substantially improves the reconstruction and visualization efficiencies,enabling doctors to observe 3D images more quickly and accurately,and assisting in disease diagnosis and surgical planning.

Objective:To observe the clinical outcomes of living related kidney transplantation (LRKT) recipients with hyperuricemia.Methods:A retrospective analysis was conducted on the medical records of 212 cases of LRKTs performed between Jan. 2015 and Dec. 2021. All cases involved children who received a kidney transplant donated by their parents. Based on the average blood uric acid levels (>420 μmol/L) between 1 to 12 months postoperatively, the patients were divided into two groups: the hyperuricemia group (HUA, n=43) and the non-hyperuricemia group (non-HUA, n=169) . Demographic information, the incidence of adverse events within one year after the operation, serum creatinine (Scr) levels, and the survival rate of the transplanted kidney at 1, 3, and 5 years after the operation were compared between the groups. Results:The non-HUA group had a significantly shorter preoperative dialysis duration compared to the HUA group (median 350 days vs 484 days) . The incidence of delayed graft function and acute rejection within 1 year postoperatively was significantly higher in the HUA group compared to the non-HUA group (14.0% vs 4.7% and 11.6% vs 2.4%) . At 1, 3, and 5 years after surgery, the serum creatinine levels in the HUA group were significantly higher than those in the Non HUA group, which were (131.1±31.2) vs (116.3±32.1) mmol, (133.6±34.7) vs (119.9±31.9) mmol/L, and (137.3±32.4) vs (115.4±30.3) mmol/L. The survival rate of kidney transplantation was slightly lower in the HUA group compared to the non-HUA group, but the difference was not statistically significant.Conclusions:Hyperuricemia in kidney transplant recipients who received a donor kidney from their parents is associated with increased incidences of delayed graft function and acute rejection, as well as compromised graft kidney function.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To understand the oral health and frailty status of the elderly in the community in Beijing and analyze the correlation between the two, so as to provide a reference for the frailty management of the elderly in the community.Methods:This study was a cross-sectional study. Using the multi-stage stratified sampling method, a total of 241 community elderly people in 9 communities in Beijing from July to December 2021 were selected as the research objects. They were investigated using the general information questionnaire, Mini-Nutritional Assessment (MNA) and the Fried Frailty Phenotype. Univariate analysis and ordinal logistic regression analysis were used to explore the influencing factors of frailty among the elderly in the community. A total of 260 questionnaires were distributed in this study and 241 valid questionnaires were recovered, with an effective recovery rate of 92.6%.Results:Among the 241 community elders, 115 (47.7%) were not frail, 92 (38.2%) were pre-frail and 34 (14.1%) were frail. Ordinal Logistic regression analysis showed that the number of teeth of 0-9, 10-19, dry mouth and incomplete or unrepaired restoration of missing teeth were risk factors for frailty among the elderly in the community ( P<0.05) . Conclusions:From the perspective of oral health, this study further analyzes the risk factors of frailty in the elderly in the community. Medical institutions and elderly care institutions at all levels can use oral health status as a screening item for the frailty risk of the elderly in the community, providing new ideas for the prevention and intervention of frailty in the community.

Objective:To evaluate the efficacy by using domestic recombinant human thyroid-stimulating hormone (rhTSH) in patients with differentiated thyroid cancer (DTC) before or after 131I therapy. Methods:From May 2019 to November 2020, a total of 24 patients with DTC (5 males, 19 females, median age 41 years) in Peking Union Medical College Hospital and Affiliated Tumor Hospital of Zhengzhou University were enrolled into the open-label, dose escalation phase Ⅰ study. All patients were divided into 4 domestic rhTSH dose groups: 0.9 mg×1 d (group A), 0.9 mg×2 d (group B), 1.8 mg×1 d (group C), 1.8 mg×2 d (group D) in succession, with 6 patients in each group. Each patient underwent rhTSH phase and thyroid hormone withdrawal (THW) phase. The end point included safety, tolerability, the quality of life (hypothyroidism symptom and sign score (Billewicz score), profile of mood states (POMS)), effectiveness (thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels, diagnostic whole-body scan (Dx-WBS)) and pharmacokinetic characteristics (peak time, peak concentration) of rhTSH. Paired t test and Wilcoxon signed rank test were used for statistical analysis. Results:There were no dose-limiting toxicities, serious adverse events, or no grade ≥3 adverse events reported. The quality of life in rhTSH phase was significantly better than those in THW phase, including the lower Billewicz score (-53.00(-53.00, -53.00) vs -39.50(-47.00, -23.00); S=119.50, P<0.001) and the lower POMS score (91.92±12.06 vs 99.67±19.13; t=0.95, P=0.025). Serum TSH level was increased from 0.04(0.02, 0.11) mU/L (baseline) to 150.00(105.20, 173.31) mU/L 24 h after the last rhTSH administration, which was increased along with the elevation of rhTSH doses. In the THW phase, patients′ TSH levels were≥30 mU/L after 23 d (median) of THW, with the median of 73.51(57.22, 106.22) mU/L. Median Tg level of baseline was 0.10(0.10, 0.41) μg/L, which reached a peak of 0.85(0.12, 3.01) μg/L at 48 h after rhTSH administration. The peak Tg level in the THW phase was 0.88(0.15, 8.04) μg/L. The Dx-WBS consistency rate between rhTSH and THW phase was 95.8%(23/24). Conclusion:rhTSH is a safe and effective method to stimulate the serum Tg level and radioiodine uptake in patients undergoing post-operation or post- 131I assessment for DTC, as well as maintain a higher quality of life in comparison to THW phase.

Objective:To analyze the association between thyroglobulin antibody (TgAb) and differentiated thyroid cancer (DTC) metastases detected by post-radioactive iodine (RAI) therapy scan, when stimulated thyroglobulin (sTg) <1 μg/L.Methods:A total of 314 (68 males, 246 females, age (44.5±12.5) years) post-thyroidectomy DTC patients whose sTg <1 μg/L between March 2013 and May 2017 in Henan Cancer Hospital were enrolled retrospectively. Patients underwent 131I whole-body planar imaging ( 131I-WBS) and SPECT/CT imaging 5 d after 131I administration. Iodine avid metastases were compared between TgAb-positive group and TgAb-negative (TgAb<4 kU/L) group. Logistic regression analysis was conducted to assess odds ratio ( OR) for iodine avid metastases in each subgroup (Q1: 4 kU/L≤TgAb≤9.27 kU/L; Q2: 9.27 kU/L101.43 kU/L) of TgAb-positive patients, with the TgAb-negative patients as the reference. χ2 test was used to analyze the data. Results:Iodine avid metastases were found in 16.9% (53/314) of DTC patients and were more frequently in TgAb-positive group with TgAb>26.75 kU/L than TgAb-negative group (26.0%(19/73) vs 13.7%(23/168); χ2=5.382, P=0.02). Most metastases (92.5%, 49/53) occurred in cervical and mediastinal lymph nodes. The OR for iodine avid metastases was obviously high in TgAb-positive patients with 26.75 kU/L

Objective To compare the effect of ultrasound measurements of the distance from skin to vocal folds (DSV), neck diameter (d) and the ratio among the two measurements (R) used to predict difficult laryngoscopy. Methods Seventy-two toddelers scheduled to undergo general anesthesia, aged ≤ 3 years, falling into ASA physical status Ⅰ or Ⅱ, were included and categorized as having easy (n = 48, grades Ⅰ and Ⅱ) or difficult (n = 24, grades Ⅲ and Ⅳ) laryngoscopy based on the criteria of Cormack and Lehane. When children were ventilated by mask, we measured DSV by ultrasound; obtained d and R. Receiver operating characteristic (ROC) curve analysis was used to determine the DSV, d and R in predicting difficult laryngoscopy. The value of cutoff was obtained by maximizing the Youden's index. Results DSV was significantly shorter in difficult laryngoscopy group (P ＜ 0.05). The areas under the ROC curve of R was 0.807, and the cutoff value was 0.090. the sensitivity was 70.83％, the specificity was 83.33％ Conclusion The ratio of distance from skin to vocal folds to neck diameter is a good predictor of difficult laryngoscopy in children under 3 years old.

Objective To explore the feasibility and effectiveness of peer-assisted learning (PAL) in the clinical probation teaching of orthopaedics in excellent doctors classes. Methods Forty students in the 2014 excellent doctors class in Inner Mongolia Medical University were selected and randomly divided into the experimental group and the control group. The experimental group adopted the PAL teaching mode, and the control group received the ordinary teaching mode . At the end of the internship , theoretical knowledge and practical skills tests were conducted, and self-evaluation and course evaluation were completed in the form of questionnaires. Results The scores of the experimental group in theoretical knowledge and practical skills were higher than those of the control group, and the differences are statistically significant [theoretical scores (97.2±0.7) vs. (90.2±1.3); practical operation scores (98.5±2.4) vs. (89.2±1.5); case analysis (98.1 ±0.8) vs. (92.3 ±2.8), P<0.05]. Students in the experimental group were generally satisfied with their mastering of the basic theoretical knowledges and clinical practice skills of orthopaedics. Conclusion The application of the PAL model in clinical probation teaching not only stimulates students' enthusiasm for learning, but also enhances their eagerness in self-learning;it helps students master the basic theoretical knowledge and clinical skills better in clinical probation.