Objective:To conduct a scoping review on gamified exercise interventions for elderly patients with cognitive impairment to provide insights for the application of gamification design in exercise programs for this population.Methods:Guided by the scoping review framework proposed by Arksey and O'Malley, a systematic search was conducted in databases including China National Knowledge Infrastructure, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest, and Wiley Online Library. The search covered the period from the establishment of the databases to June 12, 2024. An integrative analysis was performed on the included literature.Results:A total of 12 studies were included. The most commonly used gamification elements were achievement- and progress-oriented features, while the most frequently applied behavior change theories were behavior change techniques and social cognitive theory.Conclusions:Gamification-based exercise interventions can improve adherence to exercise programs in elderly patients with cognitive impairment, promote physical activity, and enhance cognitive function. Future research should focus on combining various theories with different gamification elements to encourage proactive exercise behavior in elderly individuals with cognitive impairment.

Objective To explore the effect of umbilical cord mesenchymal stem cells with positive human leukocyte antigen(HLA)-G on inducing the production of regulatory T cells(Treg) in vitro.Methods Umbilical cord mesenchymal stem cells were isolated from umbilical cord of neonates. PEGFP-N1-HLA-G plasmid was transfected into the human umbilical cord mesenchymal stem cells by liposome transfection, as PEGFP-N1-HLA-G group. PEGFP-N1 empty vector plasmid was transfected into the human umbilical cord mesenchymal stem cells, as PEGFP-N1 group. The human umbilical cord mesenchymal stem cells without empty vector under the same conditions were set as blank control group. Markers of the umbilical cord mesenchymal stem cells were detected using flow cytometry. The expression of HLA-G protein in each group of cells was identified by Western Blot. After mixed-culturing with CD4+T cells in peripheral blood of healthy subjects for 24 h and 48 h, the proportion of CD4+CD25+Foxp3+Treg in total T cells of each group was detected by flow cytometry. Results CD45, CD34 and HLA-DR presented negative expression on umbilical cord mesenchymal stem cells, while CD29, CD44 and CD105 presented positive expression. HLA-G protein could be expressed in the PEGFP-N1-HLA-G group, which had statistically significant difference compared with the blank control group and PEGFP-N1 group (both P<0.01). After PEGFP-N1-HLA-G group and CD4+T cells were mixed-cultured for 24 h and 48 h, CD4+CD25+Foxp3+Treg accounted for (15.3±1.9)% and (14.3±2.1)% of the total T cells respectively, both of which presented statistically significant difference compared with the blank control group and PEGFP-N1 group (all P<0.05). Conclusions Umbilical cord mesenchymal stem cells with HLA-G gene modified can effectively induce the production of CD4+CD25+Foxp3+Treg in vitro.

Objective: To investigate the current status of job burnout in clinical nurses in a grade A tertiary hospitalin Shaoxing,China and related influencing factors. Methods: In October 2016, the Nursing Burnout Scale (NBS)was used for the investigation of 304 clinical nurses in a grade A tertiary hospital.The contents of the investigation included general data(including age,education background,working years,marital status, frequency of night shifts,professional title, and way of employment), characteristics of working environment,burnout, personality characteristics,coping strategy,and psychosomatic symptoms.SPSS 18.0 was used to conduct Pearson correlation analysis of the scores of each dimension of NBS. A multivariate regression analysis was performed with the demographic features of clinical nurses as the independent variable and the scores of each dimension of NBS as the dependent variable. Results: Among the clinical nurses in this grade A tertiary hospital, the incidence rate of severe burnout was 74%.The Pearson correlation analysis showed that burnout,pessimistic personality,negative coping,and psychosomatic symptoms were positively correlated with working environment(r=0.530,0.316,0.116,and 0.502); pessimistic personality and psychosomatic symptoms were positively correlated with burnout(r=0.618 and 0.675); psychosomatic symptoms were positively correlated withpessimistic personality(r=0.540); negative coping was negatively correlated with pessimistic personality(r=-0.145).The multivariate linear regression analysis showed that department(Department of Internal Medicine or Department of Surgery,B=-0.364 and -0.428)and frequency of night shifts(<6 times/month and 6-10 times/month,B=0.199 and 0.256)were influencing factors for the score of working environment; department(Department of Internal Medicine or Department of Surgery, B=-0.350 and -0.360)was an influencing factor for the score of burnout; 1-3 working years(B=-0.238)was an influencing factor for the score of pessimistic personality; married state,1-3 working years,and department (Department of Internal Medicine or Department of Surgery)were influencing factors for the score of psychosomatic symptoms(B=0.263,-0.301,-0.322,and -0.391). Conclusion There is a high incidence rate of job burnout among clinical nurses in this grade A tertiary hospital,which is associated with burnout,working environment, pessimistic personality,and psychosomatic symptoms.Marital status,working years,department,and frequency of night shifts are major influencing factors for job burnout.

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data

A method was developed for the determination of four sulfa antibiotics in groundwater, soil and excreta using solid phase micro extraction disks coupled with high performance liquid chromatography. The influence of eluent, different solid phase micro extraction membranes on the recovery of sulfa antibiotics in groundwater was investigated and it was found that when using the mixture of methyl alcohol and 1 . 0% formic acid as eluent, HLB ( divinyl benzene-N-vinyl pyrrolidone polymer ) as extraction membranes, an optimal enrichment effect was obtained. Different pretreatment methods for the 3 kinds of samples abovementioned were also examined. It was found that the signal response values obtained by using mixture of methyl alcohol and 1 . 0% formic acid as base solution of standard or sample solution was higher 8-10 times than that by using methyl alcohol only. Under the optimal conditions, good linear relationships were obtained in the sulfa antibiotics concentrations of 0 . 005-10 . 0 mg/L with the correlation coefficients>0 . 9999;The detection limits of sulfathiazole ( ST ) , sulfadiazine ( SM ) , sulfamethazine ( SM2 ) , sulfamethoxazole ( SMX ) were 1 . 08 , 3. 56, 4. 63 and 1. 84 ng/L(S/N=3), respectively. The enrichment factors for four sulfa antibiotics were 4000 times with solid phase micro extraction disks. The RSD of matrix spiked samples were 0. 1%-0. 4%(n=7). The proposed method was applied to the determination of the four sulfa antibiotics in groundwater, soil and excreta with spiked recoveries of the four sulfa antibiotics in the range of 69 . 80%-117 . 60%.

OBJECTIVETo investigate the maturation of individual bones on the hand and wrist in children with central precocious puberty (CPP) and idiopathic short stature (ISS).

METHODSHand and wrist films of 25 children with CPP, 29 children with ISS and 21 normal controls were evaluated by conventional Greulich-Pyle (GP) atlas method and individual bone assessment method, in which all twenty bones of the hand and wrist were evaluated based on GP atlas, including 2 radius and ulna, 7 carpal bones, 11 metacarpal and phalangeal bones, the average bone age (BA) was calculated. The differences in groups were analyzed by independent samples t test. The differences between the two methods were analyzed by paired sample t test. The differences between BA and chronological age (CA) were analyzed by ROC with SPSS 17.0.

RESULTSCompared with the normal control group, the advance of BA in the CPP group was 0.70-2.26 y (1.48 ±0.78) by the GP atlas method, while that was 0.28-2.00 y(1.14 ±0.86) by the individual bone evaluation method. In all twenty bones, the advance of metacarpal and phalangeal BA was the greatest [0.34-2.06 y(1.2±0.86)]. In the ISS group,the delay of BA was 0.47-2.91 y(-1.69±1.22) by the GP atlas method, while that was 0.48-2.50 y (-1.49±1.01) by individual bone evaluation method.The delay of carpal BA was the greatest [0.59-2.73 y(-1.66±1.07)] in all twenty bones. In the ISS group and the normal control group, there were no statistic differences between the two methods. In the CPP group, statistic difference was found between two methods. There were no statistic differences for the areas under ROC curves between two methods.

CONCLUSIONThe advance of metacarpal and phalangeal BA is the greatest in CPP group and the delay of carpal BA is the greatest in ISS group.Both methods provide diagnostic information for bone age in CPP and ISS children.

Age Determination by Skeleton ; methods ; Carpal Bones ; diagnostic imaging ; Case-Control Studies ; Child ; Dwarfism ; diagnostic imaging ; Female ; Hand ; diagnostic imaging ; Humans ; Male ; Puberty, Precocious ; diagnostic imaging

Objective:The present study aimed to conduct a clinical analysis of nosocomial infections in hospitalized cancer pa-tients and propose effective precautionary measures. Methods:We retrospectively analyzed 56,430 cases of discharges from the Cancer Institute and Hospital of Tianjin Medical University between January and December 2012. Results:Among 825 cases, the rate of noso-comial infections was 1.46%;46.42%of the patients aged>60 years. The highest infection rate was observed in the Medical Depart-ment of Stomach Cancer. The highest composing rate was recorded in the Department of Hepatobiliary Cancer. The major pathogenic bacteria were Gram-negative bacilli;fungal infections were relatively rare. The most vulnerable body parts were the abdomen and diges-tive tract, which were mainly infected by pathogenic Escherichia coli. Conclusion:Healthcare workers should consider the importance of influencing factors and take precautionary measures to reduce the rate of nosocomial infections in cancer patients.

Objective To explore the clinical characteristics of poststroke epilepsy and to discuss the association with the type of stroke,the location of focus.Methods Clinical information of 64 patients with poststroke epilepsy taken from 932 patients with stroke were analyzed retrospectively.Results In the patients with first stroke,the incidence of poststroke epilepsy was 6.9％.Among them,47 cases belong to early seizure (73.4％) and 17 cases belong to late seizure (26.6％).The incidence of poststroke epilepsy was difference between ischemic stroke and hemorrhagic stroke.There were more cases of stroke in cortical focus than subcortial one.Onset seizures type was more cases of partal seizure than generalized tonic-seizure (GTS).The treatment on early seizure could be short-range treatment and the treatment on late seizure should be long-term standardized treatment and regular.Conclusions Occurrence of poststroke epilepsy were involved in the type of stroke,the location of focus (cortex / subcortex).It is helpful for guiding the clinical therapy of patients with stroke and improving the quality of their life to analyse the clinical characteristics of poststroke epilepsy.

Objective To detect the expression of inhibitor of apoptosis protein survivin and mdr1 gene protein P-gp in ovarian epithelial carcinoma,and analyze their functions of drug resistance in chemotherapy and the relationship with pathological characteristics.Methods We detected the expression of survivin and mdr1 proteins in 8 cases of normal ovarian tissues,16 cases of benign epithelial ovarian tumor tissues and 46 cases of epithelial ovarian cancerous tissues(28 cases of serous cystadenocarcinoma,12 cases of mucinous cystadenocarcinoma,and 6 cases of endometrioid carcinoma) with immunohistochemistry.Results The positive rate of survivin and mdr1 proteins in ovarian cancerous tissues was 60.9% and 34.8%,respectively,which was significantly higher than that in benign epithelial ovarian tumor tissues(31.3% and 0%) and normal ovarian tissues(negative)(P