AIM: To explore the efficacy of bilateral lateral rectus recession in the treatment of basic intermittent exotropia. METHODS: A prospective study was conducted on 104 patients with basic intermittent strabismus admitted to our hospital from October 2022 to October 2023, patients were randomly divided into a study group of 52 cases and a control group of 52 cases using a random number ranking method. The control group received unilateral recess-resect, while the study group received bilateral lateral rectus recession, the differences in surgical success rate, postoperative strabismus, and postoperative exotropia drift were compared between two groups.RESULTS: There was no statistically significant difference between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05). The strabismus in the 6 m and 33 cm eye positions at 1, 3, and 6 mo after surgery were lower than those at 1 d after surgery(all P<0.05). However, there was no statistically significant difference in the strabismus in the 6 m and 33 cm eye positions between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05), and there was statistical significant difference between the two groups in exotropia drift at different postoperative time points(all P<0.05). The exotropia drift of both groups increased at 3 and 6 mo after surgery compared to 1 mo after surgery, and the exotropia drift at 6 mo after surgery was greater than that at 3 mo after surgery(all P<0.05). However, the exotropia drift of the study group at 3 and 6 mo after surgery was lower than that of the control group(all P<0.001). CONCLUSION: Bilateral lateral rectus recession for the treatment of basic-type intermittent exotropia effectively reduces the amount of postoperative exotropia drift, and it has better long-term stability.

Objective To explore the correlation between serum homocysteine(Hcy),25-hydroxyvitamin D[25(OH)D]and frailty with type 2 diabites mellitus(T2DM)complicated with sarcopenia.Methods From September 2021 to March 2023,210 elderly T2DM patients were selected from the Department of Geriatrics of The First People's Hospital of Yunnan Province,and divided into simple T2DM(n=99)group,mild sarcopenia(M-Sar,n=59)group and severe sarcopenia(S-Sar,n=52)group.The"Elderly Comprehensive Assessment System"was used to evaluate subjects.The influencing factors of T2DM complicated with sarcopenia were analyzed by Logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of Hcy,25(OH)D combined with frailty in evaluating T2DM with sarcopenia.Results In T2DM,M-Sar and S-Sar groups,the age,Hcy,the risk rate of balance gait work falling and the rate of weakness increased in turn(P<0.05),while BMI,hemoglobin,25(OH)D,the rate of good nutrition,the normal rate of basic daily living,the low risk rate of falling,the rate of good balance gait function and the rate of no weakness decreased in turn(P<0.05).Logistic regression analysis showed that serum Hcy,frailty and 25(OH)D were the influencing factors of senile T2DM complicated with sarcopenia.Hcy,25(OH)D and frailty combined to predict T2DM with sarcopenia had an area under ROC carve of 0.815,with a sensitivity of 0.811 and a specificity of 0.717.Conclusions Serum Hcy,25(OH)D and frailty are closely related to T2DM combined with sarcopenia.Detection of Hcy and 25(OH)D combined with frailty score is helpful for early diagnosis of sarcopenia in primary hospitals.

Objective To explore the correlation between serum homocysteine(Hcy),25-hydroxyvitamin D[25(OH)D]and frailty with type 2 diabites mellitus(T2DM)complicated with sarcopenia.Methods From September 2021 to March 2023,210 elderly T2DM patients were selected from the Department of Geriatrics of The First People's Hospital of Yunnan Province,and divided into simple T2DM(n=99)group,mild sarcopenia(M-Sar,n=59)group and severe sarcopenia(S-Sar,n=52)group.The"Elderly Comprehensive Assessment System"was used to evaluate subjects.The influencing factors of T2DM complicated with sarcopenia were analyzed by Logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of Hcy,25(OH)D combined with frailty in evaluating T2DM with sarcopenia.Results In T2DM,M-Sar and S-Sar groups,the age,Hcy,the risk rate of balance gait work falling and the rate of weakness increased in turn(P<0.05),while BMI,hemoglobin,25(OH)D,the rate of good nutrition,the normal rate of basic daily living,the low risk rate of falling,the rate of good balance gait function and the rate of no weakness decreased in turn(P<0.05).Logistic regression analysis showed that serum Hcy,frailty and 25(OH)D were the influencing factors of senile T2DM complicated with sarcopenia.Hcy,25(OH)D and frailty combined to predict T2DM with sarcopenia had an area under ROC carve of 0.815,with a sensitivity of 0.811 and a specificity of 0.717.Conclusions Serum Hcy,25(OH)D and frailty are closely related to T2DM combined with sarcopenia.Detection of Hcy and 25(OH)D combined with frailty score is helpful for early diagnosis of sarcopenia in primary hospitals.

In order to understand the status quo of ethical review of clinical research on the defecation function of patients with rectal cancer after sphincter-preserving surgery, analyze its causes and put forward corresponding suggestions, to arouse researchers’ attention to ethical review in subsequent relevant clinical studies. The ethical review of literatures related to the defecation function of patients with rectal cancer after sphincter-preserving surgery published on CNKI in recent 10 years was sorted out and summarized. The results showed that the ethical review of clinical research papers on defecation function of patients with rectal cancer after sphincter-preserving surgery was not optimistic. We should strengthen the ethical training of researchers, improve the ethical awareness of researchers, strictly implement the ethical norms of paper publication, strengthen the ethical requirements of manuscript contracts, perfect the ethical review system, and pay attention to the examination and supervision of informed consent, so as to promote the construction of ethical examination and approval norms of clinical research documents.

Objective To study the factors affecting hospital death in elderly patients with novel coronavirus infec-tion/disease 2019(COVID-19),and to build a risk prediction model.Methods According to the diagnostic criteria of Diagnosis and Treatment Protocol for COVID-19 Infection(Trial 10th Edition).Totally 775 elderly patients(≥60 years old)diagnosed as COVID-19 infection in the emergency department and fever clinic of the First Hospital of Changsha were selected as the research objects.General data and serum biomarkers of patients were collected.After treatment,the patients'data were divided into survival group and hospital death group.Binary Logistic regres-sion was used to screen the independent influencing factors of death,and ROC curve was used to analyze the pre-dictive value of related indicators on hospital death.Results After treatment,712 patients(91.9%)survived and 63 patients(8.3%)died in hospital.Binary Logistic regression analysis showed that:≥90 years old[OR=5.065,95%CI(1.427,17.974)],type 2 diabetes mellitus[OR= 3.757,95%CI(1.649,8.559)],COPD[OR= 5.625,95%CI(2.357,13.421)],monocyte ratio[OR=0.908,95%CI(0.857,0.963)],plasma fibringen[OR=1.376,95%CI(1.053,1.800)]and lactate dehydrogenase[OR=1.005,95%CI(1.001,o1.008)]were independent factors of in-hospital death(P＜0.05).The predictive value of diabetes mellitus+COPD+age+monocyte ratio+plasma fibrinogen+lactate dehydrogenase was proved in hospital death from COVID-19 infected patients:the area under the curve(AUC)was 0.883(95%CI:0.827,0.940,P＜0.001),the critical value≥0.710 suggested the risk of death in hospital,the specificity was 0.851,the sensitivity was 0.857.Conclusions The hospital mortality of the elderly after COVID-19 infection is higher and closely related to type 2 diabetes,COPD,monocyte ratio,plasma fibrinogen and lactate dehydrogenase.

Objective:To explore the effects of different health education methods on patients with enterostomy using a network Meta-analysis, so as to provide a theoretical basis for patients with enterostomy to choose the health education method.Methods:Randomized controlled trials (RCTs) on the effects of different health education methods in patients with enterostomy were electronically searched in PubMed, Web of Science, Embase, Cochrane Library, Medline, CINAHL, China National Knowledge Infrastructure, China Biology Medicine disc, VIP, and WanFang Data, supplemented by other manual search methods. The search period was from database establishment to May 31, 2023. This study extracted data, conducted methodological quality evaluation, and used Stata 15.0 software for network Meta-analysis.Results:A total of 30 RCTs were included, involving 7 health education methods. The probability ranking of the network Meta-analysis showed that in terms of enhancing self-care ability, the effects were ranked from high to low as personalized education, internet platform education, nursing pathway education, visual education, mind mapping education, peer support education, and routine health education. In terms of promoting the level of stoma adaptation, the order of effects from high to low was visual education, internet platform education, peer support education, and routine health education. In terms of improving quality of life, the order of effects from high to low was internet platform education, personalized education, peer support education, and routine health education.Conclusions:Personalized education has certain advantages in enhancing the self-care ability of patients with enterostomy, visual education is advantageous in promoting the social adaptation of patients, and internet platform education has certain advantages in improving the quality of life. This study can effectively guide clinical nurses to choose appropriate health education methods based on the purpose of health education, in order to heighten the effectiveness of patient health education.

OBJECTIVES: To investigate the inhibitory effect of GSK484, a PAD4 inhibitor, on H3Cit expression following sepsis and its effects for improving sepsis-induced endothelial dysfunction. METHODS: Eighteen C57BL/6 mice were randomized into sham-operated group, sepsis model group and GSK484 treatment group (n=6), and in the latter two groups, models of sepsis were established by cecal ligation and puncture (CLP). The mice in GSK484 treatment group were given an intraperitoneal injection of GSK484 (4 mg/kg) on the second day following the surgery. Twenty-four hours after the injection, the mice were euthanized for measurement of serum levels of VEGF, ESM-1, IL-6 and IL-1β using ELISA. Lung tissue pathology was observed with HE staining, and pulmonary expressions of F-actin, VE-cadherin, ZO-1 and H3Cit proteins were detected using immunofluorescence staining and Western blotting. In primary cultured of mouse lung microvascular endothelial cells, the effect of stimulation with LPS (10 μg/mL) for 24 h on tube formation, proliferation, apoptosis and expressions of VEGF, ESM-1, IL-6 and IL-1β were assessed using CCK-8 assay, flow cytometry and ELISA. RESULTS: Compared to the sham-operated mice, the septic mice exhibited significant lung tissue pathologies characterized by vascular congestion, alveolar rupture, edema, and neutrophil infiltration. Serum levels of IL-6, IL-1β, VEGF, and ESM-1 were elevated, pulmonary expressions of F-actin, VE-cadherin, and ZO-1 were decreased, and H3Cit expression was increased significantly in the septic mice. GSK484 treatment effectively mitigated these changes in the septic mice. The LPS-stimulated endothelial cells showed increased productions of IL-6, IL-1β, VEGF and ESM-1, which were significantly reduced after treatment with 2.5 μmol/L GSK484. CONCLUSIONS GSK484 treatment effectively suppresses H3Cit expression in septic mice to ameliorate sepsis-induced endothelial dysfunction.
Animals ; Sepsis/drug therapy* ; Mice ; Mice, Inbred C57BL ; Lung Injury/drug therapy* ; Endothelial Cells/drug effects* ; Interleukin-6/metabolism* ; Protein-Arginine Deiminase Type 4/metabolism* ; Lung/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Interleukin-1beta/metabolism* ; Disease Models, Animal ; Cadherins/metabolism* ; Apoptosis/drug effects* ; Imidazoles ; Antigens, CD

The primary cause of injury and death in the elderly has been reflected in fall the elderly, so the application of reasonable and effective prevention strategies has great significance in reducing the risk of fall in the elderly. The research progress of virtual reality technology applied in preventing fall in the elderly at home and abroad over the years was systematically reviewed in this study. The mechanism of the technology in preventing fall in the elderly was mainly elaborated from five aspects of improving balance ability, gait disturbance, cognitive impairment, muscle strength and the fear psychology of falling. The purpose of this thesis is to broaden the research ideas of medical personnel on the prevention of fall of the elderly, provide more effective clinical practice plans, reduce the occurrence of fall, and guarantee the safety of the elderly.
Aged ; Humans ; Gait ; Muscle Strength ; Technology ; Virtual Reality

Objective:To explore the pathogenesis of major depressive disorder(MDD) by comparing the serum glucose and lipid metabolism indicators, levels of glucagon-like peptide-1(GLP-1) in plasma and feces, and the content of specific intestinal flora ( Lactobacillus, Bifidobacterium) between patients with MDD who were diagnosed for the first time and healthy controls. Methods:Totally 80 MDD patients hospitalized from January 1, 2020 to March 30, 2021 and 80 healthy volunteers with normal physical examination in the same period were selected. Blood and fecal samples of patients with MDD and healthy controls were collected respectively. The indicators of serum glucose and lipid metabolism were detected by automatic biochemical analyzer, the concentrations of GLP-1 in plasma and feces were detected by ELISA, and the relative contents of Lactobacillus and Bifidobacterium in feces were detected by real-time PCR. The differences between two groups of glucose and lipid metabolism indicators, GLP-1 levels and the relative contents of Lactobacillus and Bifidobacterium in feces were analyzed. SPSS 22.0 software was used for statistical analysis. Independent sample t-test and analysis of variance were used for inter group comparison, and Pearson correlation analysis was used for correlation analysis. Results:Compared with the control group, the levels of serum TC, HDL, and LDL in the MDD group decreased ((3.99±0.85)mmol/L , (4.78±0.86)mmol/L; (1.18±0.29)mmol/L, (1.30±0.28)mmol/L; (2.64±0.70)mmol/L, (3.19±0.69)mmol/L; t=5.559, 2.371, 4.695, all P<0.05). The plasma and fecal GLP-1 levels of the MDD group were lower than those of the control group (plasma: (0.81±0.22)pmol/mL, (1.05±0.26)pmol/mL , t=4.509, P<0.01; feces: (2.23±0.46)pmol/mL , (2.47±0.37)pmol/mL, t=2.533, P<0.05). Compared with the control group, the relative contents of Lactobacillus(2.56±1.59, 3.51±2.21) and Bifidobacterium(2.24±1.89 , 3.17±2.08) in the MDD group decreased ( t=2.218, 2.082, both P<0.05). The level of plasma GLP-1 in the MDD group was negatively correlated with FPG, TG, and disease severity ( r=-0.281, -0.221, -0.437, P<0.05). The level of plasma GLP-1 in the control group was negatively correlated with FPG ( r=-0.580, P<0.01). The fecal GLP-1 level of the MDD group was negatively correlated with the severity of the disease ( r=-0.298, P<0.01), and the fecal GLP-1 level of the control group was positively correlated with fecal Lactobacillus and Bifidobacterium ( r=0.685, 0.428, P<0.01). Conclusion:MDD patients have abnormal glucose and lipid metabolism, decreased GLP-1 level and decreased relative content of intestinal Lactobacillus and Bifidobacterium. Changes in intestinal flora affect GLP-1 levels. GLP-1 can affect glucose and lipid metabolism and depressive symptoms in patients with MDD by binding to specific receptors in intestinal tract and central nervous system.

Objective:To explore the status and influencing factors of positive feelings of caregivers of patients with enterostomy, so as to provide a reference for targeted interventions.Methods:From May to October 2021, convenience sampling was used to select 130 caregivers of patients with enterostomy who received follow-up visits in the Stoma Clinic of the First Affiliated Hospital of Xi'an Jiaotong University as the research subject. The survey was carried out using the General Information Questionnaire, the Positive Aspects of Caregiving (PAC) , and the Care Preparedness Scale (CPS) . A total of 130 questionnaires were distributed, and 127 valid questionnaires were recovered, with a valid recovery rate of 97.69%.Results:Among 127 caregivers of patients with enterostomy, the total score of PAC was (32.69±4.99) , and the self-affirmation dimension score was (18.39±2.84) , and the life outlook dimension score was (14.36±2.53) , and the total score of CPS was (17.76±4.36) . Multiple linear regression analysis showed that caregiver gender, education level, work status, and readiness were the influencing factors of positive feelings of caregivers of patients with enterostomy ( P<0.05) , which explained 43.7% of the total variance. Conclusions:The positive perception of caregivers of patients with enterostomy is at an upper-middle level. Nurses should formulate targeted humanistic care strategies according to the influencing factors, increase the positive feelings of caregivers, help patients adapt to the stoma as soon as possible, and then improve the quality of life of patients.