Objective To systematically evaluate and integrate qualitative studies on perception of exercise behaviors in community-dwelling older adults with frailty,and to provide references for clinical development of targeted exercise intervention strategies.Methods A systematic search of PubMed,Medline,Embase,PsycINFO,the Cochrane Library,SinoMed,Wanfang Database,CNKI,and VIP Database for qualitative studies on perception of exercise behaviors in older adults with frailty in the community was conducted from the inception of the databases to June 2024.Literature quality was evaluated using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016 edition),and Meta-synthesis was performed using the theme synthesis method.Results A total of 10 papers were included,grouped into 10 categories and integrated into the 3 domains of the capability,opportunity,and motivation-behavior model(COM-B model),i.e.Preparation for exercise behavior is influenced by capability factors(physical reserve,knowledge reserve,psychological preparation);stage-specific motivational evolution promotes the internalization of exercise behavior(guiding,focusing,stimulating,and maintaining);external conditions provide opportunities for exercise behavior(individual interaction,community environment,and social support).Conclusion Perceptions of exercise behavior among community-dwelling older adults with frailty or are complex and influenced by a variety of factors.Future exercise intervention strategies should consider modifiable factors,enhance knowledge education,stimulate intrinsic motivation,and solidify external conditions,while also accommodating individual differences and preferences,so as to promote exercise participation and health enhancement in this group.

Objective:To investigate the risk factors for aggravation of type 2 diabetic foot ulcer and the correlation between the level of infection and the severity of the disease,as well as the association of the detection rate of bacteria and the types of bacteria with disease severity in patients with type 2 diabetic foot ulcer,and to provide individualized guidance for the prevention,diagnosis,and treatment of type 2 diabetic foot.Methods:A retrospective analysis was performed for the data of 150 patients with type 2 diabetic foot who were treated in Department of Endocrinology,The First Affiliated Hospital of Kunming Medical University,from October 2021 to June 2023,and according to the Wagner grade of diabetic foot,these patients were divided into mild group A(35 patients with Wagner grade 2),moderate group B(58 patients with Wagner grade 3),and severe group C(57 patients with Wagner grade 4).The clinical data of the three groups were analyzed.Results:The severity of type 2 diabetic foot ulcer was correlated with white blood cell count,neutrophil count,platelet count,monocyte count,globulin,alkaline phosphatase,neutrophil-lymphocyte ratio,monocyte-lymphocyte ratio,platelet-lymphocyte ratio,high-sensitivity C-reactive protein,procalcitonin,interleukin-6,erythrocyte sedimentation rate,hemoglo-bin,albumin/globulin ratio,lymphocyte count,cholinesterase,albumin,fasting blood glucose,gamma-glutamyl transferase,glycated he-moglobin,blood uric acid,high-density lipoprotein cholesterol,total cholesterol,triglycerides,and low-density lipoprotein cholesterol(P<0.05).The multivariate ordinal logistic regression analysis showed that the neutrophil-lymphocyte ratio and erythrocyte sedi-mentation rate were independent risk factors for the progression of Wagner grade of diabetic foot(P<0.05).For groups A,B,and C,the detection rate of bacteria in foot ulcer secretion tended to increase with the severity of diabetic foot,with the highest detection rate in group C,followed by groups B and A.A total of 31 types of bacteria were detected in the three groups,and the proportion of Gram-positive bacteria was higher than that of Gram-negative bacteria,with Staphylococcus aureus accounting for the highest proportion of 27.72%in all samples.Conclusion:High-sensitivity C-reactive pro-tein,procalcitonin,interleukin-6,and erythrocyte sedimentation rate increase with the progression of the Wagner grade of diabetic foot,and neutrophil-lymphocyte ratio and erythrocyte sedimentation rate are independent risk factors for the progression of the Wagner grade of diabetic foot.The detection rate of bacteria in foot ulcer secretion tends to increase with the Wagner grade of diabetic foot,and Gram-positive bacteria account for a higher proportion than Gram-negative bacteria,with Staphylococcus aureus accounting for the highest proportion.

Objective:To analyze the prevalence of chronic kidney disease (CKD) and influencing factors of adults in Hebei Province, and provide scientific evidence for the development of comprehensive CKD prevention and control strategies.Methods:In China Adult Chronic Disease and Nutrition Surveillance in Hebei in 2018, a total of 7 562 permanent residents aged ≥18 years were selected by multi-stage stratified cluster random sampling from 13 surveillance points in Hebei for questionnaire survey, medical examination and laboratory test.Results:A total of 1 067 CKD patients were detected in the adults aged ≥18 years in this survey, with a weighted prevalence rate of 12.10%. The results of multivariate analysis showed that the daily total static behavior time ( OR=1.07, 95% CI: 1.04-1.09), living in rural area ( OR=1.50, 95% CI: 1.14-1.97), coal use ( OR=1.37, 95% CI: 1.16-1.61), coal gas/liquefied gas/natural gas/biogas use ( OR=2.92, 95% CI: 2.40-3.54) and solar energy/electricity use ( OR=1.75, 95% CI: 1.36-2.25), insufficient fruit intake ( OR=1.39, 95% CI: 1.06-1.83), insufficient physical activity ( OR=1.35, 95% CI: 1.11-1.64), suffering from hypertension ( OR=1.80, 95% CI: 1.44-2.24) and suffering from diabetes ( OR=1.77, 95% CI: 1.27-2.45) were risk factors for CKD in adults in Hebei. High education level ( OR=0.41, 95% CI: 0.19-0.91), excessive drinking ( OR=0.53, 95% CI: 0.28-0.99), central obesity ( OR=0.75, 95% CI: 0.58-0.97), history of allergic diseases ( OR=0.44, 95% CI: 0.27-0.72) were protective factors for CKD. Conclusions:The prevalence of CKD in adults in Hebei was relatively high, especially in those who had too long average daily static behavior, lived in rural area, used coal, gas/liquefied gas/natural gas/biogas, solar energy/electricity, had inadequate intake of fruits, lacked physical activity and suffered from hypertension and diabetes. It is necessary to pay attention to the early prevention and treatment of CKD, strengthen the health education about healthy lifestyle and improve the management of patients with chronic disease, such as hypertension and diabetes, to further reduce the risk for CKD.

Prescription evaluation is an important innovative medication supervision mode in China,which is an impor-tant means to ensure rational drug use.The Pharmaceutical Specialized Committee of the Chinese Hospital Association had led the formulation of the Pharmacy Administration and Pharmacy Practice in Healthcare Institutions—Part 4-9:Pharmacy Administra-tion—Prescription Evaluation.The standard regulated 11 key elements in the three aspects of basic requirements,evaluation re-quirements,and quality management and evaluation improvement,which can be used as the basis for guiding medical institutions to standardize prescription evaluation work.This paper introduced the formulation process of the prescription evaluation standard and interpreted the key contents of the standard,which was helpful for peers to deeply understand the standard,promote the imple-mentation of the standard,and further improve the quality of prescription evaluation work.

Objective To investigate correlations of peripheral blood inflammatory and immune-related indices with clinicopathological features and prognosis in breast cancer patients.Methods A total of 144 breast cancer patients admitted to the Breast Surgery Department of Maternity and Child Healthcare Hospital of Tongzhou District of Beijing were included in cancer group,44 patients with a-typical breast hyperplasia were included in precancerous lesion group,and 131 patients with breast hyperplasia were included in breast hyperplasia group.The neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and lymphocyte-to-monocyte ratio(LMR)were compared among the three groups.A three-year follow-up was conducted for prognosis assessment.Based on different NLR,PLR,and LMR levels,the cancer group was divided into low NLR group(＜2.12,67 pa-tients),high NLR group(≥2.12,77 patients),low PLR group(＜133.21,65 patients),high PLR group(≥ 133.21,79 patients),low LMR group(＜5.05,80 patients),and high LMR group(≥5.05,64 patients).The correlations of NLR,PLR,and LMR with clinicopathological features and prognosis in breast cancer patients were analyzed.Results NLR in the cancer group was higher than that in the precancerous lesion group and breast hyperplasia group,the PLR was higher than that in the breast hyperplasia group,and the LMR was lower than that in the breast hyperplasia group(P＜0.05).NLR and PLR in the precancerous lesion group were higher and LMR was lower than those in the breast hyperplasia group(P＜0.05).PLR between patients with different menopa-usal statuses and Ki-67 levels showed statistically significant differences(P＜0.05).LMR between patients with different menopausal status also showed a statistically significant difference(P＜0.05).After a three-year follow-up,5 patients in the cancer group had a poor prognosis and 139 had a good prognosis.Poor prognosis rates between the low NLR and high NLR groups,low PLR and high PLR groups,and low LMR and high LMR groups showed statistically significant differences(P＜0.05).Logistic regression analysis results indicated that increased NLR and PLR were risk factors for poor prognosis in cancer patients,while increased LMR was a protective factor.Conclu-sion Peripheral blood inflammatory and immune-related indicators in breast cancer patients exhibit abnormal changes.Increased NLR and PLR are risk factors for poor prognosis,while increased LMR is a protective factor.

Objective To establish an optimized diagnostic model for hepatocellular carcinoma(HCC),designated as G-GADA,in chronic hepatitis B(CHB)patients based on the parameters of age,sex,alpha-fetoprotein(AFP),des-γ-carboxy prothrombin(DCP),and Golgi protein 73(GP73),to address the problems of low sensitivity and specificity in the early diagnosis of hepatitis B virus(HBV)-related liver cancer,and to assess the value of this model in the diagnosis of HCC.Methods A retrospective analysis was performed for 201 CHB patients(CHB group),137 patients with HBV-related liver cirrhosis(LC group),and 111 treatment-na?ve patients with newly diagnosed HCC(HCC group)who were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University from June 2015 to June 2020.Serological markers(AFP,DCP,alpha-fetoprotein L3%[AFP-L3%],and GP73)were compared between groups and were analyzed in terms of their differences from the clinical and tumor characteristics of HCC patients,and the Spearman correlation analysis was used to assess the correlation between different markers.A Logistic regression analysis was used to establish a diagnostic model for liver cancer,and the receiver operating characteristic(ROC)curve was used to assess the diagnostic performance of each marker.Results Comparison of clinical features between CHB,LC,and HCC patients showed that HCC patients had significantly higher age,proportion of male patients,and serum levels of DCP,AFP,GP73,and AFP-L3%(all P<0.05).In HCC patients,DCP levels are associated with tumor size and microvascular invasion;AFP levels are related to patient age,tumor size,tumor number,distant metastasis,and microvascular invasion;AFP-L3%levels are associated with patient age,tumor size,tumor number,distant metastasis,Milan staging,and microvascular invasion;GP73 levels are linked to tumor number,distant metastasis,and microvascular invasion(all P<0.05).The correlation analysis of the serum markers showed a strong positive correlation between AFP and AFP-L3%(r=0.71,P<0.05)and a moderate positive correlation between AFP and GP73(r=0.33,P<0.05)and between AFP-L3%and GP73(r=0.41,P<0.05).Based on the features of age,sex,DCP,AFP,and GP73,the multivariate Logistic regression analysis was used to establish a G-GADA diagnostic model for HCC,and for all patients,the G-GADA model had an area under the ROC curve(AUC)of 0.915(95%confidence interval[CI]:0.875-0.945)in the derivation cohort and 0.913(95%CI:0.862-0.950)in the validation cohort for the diagnosis of HCC.In the AFP-negative patients,the G-GADA model achieved an AUC of 0.884(95%CI:0.833-0.924)in the derivation cohort and 0.851(95%CI:0.779-0.907)in the validation cohort,and in the patients with liver cirrhosis,the G-GADA model achieved an AUC of 0.901(95%CI:0.841-0.944)in the derivation cohort and 0.885(95%CI:0.806-0.940)in the validation cohort.Conclusion The G-GADA diagnostic model based on multiple variables significantly improves the detection rate of HCC,and demonstrates superior diagnostic performance in patients with low AFP expression and those with liver cirrhosis.The G-GADA model has a better clinical application value in the noninvasive diagnosis of HCC.

Objective:To analyze the prevalence of chronic kidney disease (CKD) and influencing factors of adults in Hebei Province, and provide scientific evidence for the development of comprehensive CKD prevention and control strategies.Methods:In China Adult Chronic Disease and Nutrition Surveillance in Hebei in 2018, a total of 7 562 permanent residents aged ≥18 years were selected by multi-stage stratified cluster random sampling from 13 surveillance points in Hebei for questionnaire survey, medical examination and laboratory test.Results:A total of 1 067 CKD patients were detected in the adults aged ≥18 years in this survey, with a weighted prevalence rate of 12.10%. The results of multivariate analysis showed that the daily total static behavior time ( OR=1.07, 95% CI: 1.04-1.09), living in rural area ( OR=1.50, 95% CI: 1.14-1.97), coal use ( OR=1.37, 95% CI: 1.16-1.61), coal gas/liquefied gas/natural gas/biogas use ( OR=2.92, 95% CI: 2.40-3.54) and solar energy/electricity use ( OR=1.75, 95% CI: 1.36-2.25), insufficient fruit intake ( OR=1.39, 95% CI: 1.06-1.83), insufficient physical activity ( OR=1.35, 95% CI: 1.11-1.64), suffering from hypertension ( OR=1.80, 95% CI: 1.44-2.24) and suffering from diabetes ( OR=1.77, 95% CI: 1.27-2.45) were risk factors for CKD in adults in Hebei. High education level ( OR=0.41, 95% CI: 0.19-0.91), excessive drinking ( OR=0.53, 95% CI: 0.28-0.99), central obesity ( OR=0.75, 95% CI: 0.58-0.97), history of allergic diseases ( OR=0.44, 95% CI: 0.27-0.72) were protective factors for CKD. Conclusions:The prevalence of CKD in adults in Hebei was relatively high, especially in those who had too long average daily static behavior, lived in rural area, used coal, gas/liquefied gas/natural gas/biogas, solar energy/electricity, had inadequate intake of fruits, lacked physical activity and suffered from hypertension and diabetes. It is necessary to pay attention to the early prevention and treatment of CKD, strengthen the health education about healthy lifestyle and improve the management of patients with chronic disease, such as hypertension and diabetes, to further reduce the risk for CKD.

Aim To analyze the correlation between N6-methyladenosine(m6 A)and ferroptosis in acute myo-cardial infarction(AMI).Methods Two microarray datasets GSE34198 and GSE59867 was explored from GEO data-base.Both AMI and control samples were analyzed for differentially expressed genes.GO,KEGG,and GSVA analysis of the screened differential genes was performed using R.Machine learning was used to screen ferroptosis associated genes for DRA,GBM,LASSO and randomForest characteristic genes.The expression data of the core ferroptosis gene and m6A-related genes were analyzed by Pearson correlation analysis,and the m6A modified genes and ferroptosis associated genes with strong correlation were screened.Finally,10 cases of AMI and 10 control whole blood samples from the Fifth Affiliated Hospital of Xinjiang Medical University were collected,and the expression of related genes was verified by RT-qPCR and Western blot.Results 431 common differentially expressed genes were extracted from two datasets,GO and KEGG analysis showed that these genes were mainly enriched in TNF signaling pathway,FoxO signaling pathway and B cell receptor signaling pathway.The enrichment pathways of differentially expressed genes by GSVA were cuproptosis,netotic cell death,entotic cell death,alkaliptosis and ferroptosis.The characteristic genes of ferroptosis associated genes were screened by machine learning,and 19 core ferroptosis associated genes were screened from them.The expression data of ferroptosis associated genes and m6A-related genes were analyzed by Pearson correlation analysis.LRPPRC-IREB2,LRPPRC-ATG5,YTHDC2-IREB2,HNRNPA2B1-IREB2 and YTHDC2-ATG5 were the most correlated top five genes.The results of RT-qPCR and Western blot showed that the gene expression levels of LRPPRC,YTHDC2,HNRN-PA2B1,IREB2 and ATG5 were significantly lower than those of the control group(P＜0.001),which was consistent with the gene expression in the database.Conclusion m6A methylation is associated with ferroptosis in AMI.By regula-ting m6A methylation-related genes,ferroptosis in AMI can be regulated.It provides a new idea for the further study of the pathogenesis of the disease.

Objective:To retrieve and obtain relevant evidence at home and abroad on the prevention and management of chylous leakage after thyroid cancer surgery, and provide reference for clinical practice.Methods:Based on the 6S pyramid model system, evidence related to the prevention and management of chylous leakage after thyroid cancer surgery in the databases of UpToDate, BMJ best practice, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), PubMed, EMbase, Wanfang Database, China National Knowledge Infrastructure (CNKI) and other databases, including guidelines, expert consensus, systematic reviews, evidence summary, clinical decisions, and position statements. The retrieval time was from database establishment to June 1st 2024.Results:A total of 16 articles were included, including 5 guidelines, 9 expert consensus, and 2 systematic reviews. The 30 best pieces of evidence were summarized from 6 aspects: preoperative evaluation and preparation, intraoperative prevention, diagnosis, diet and nutrition management, monitoring and treatment, and health education.Conclusions:This study summarized relevant evidence and provides reference for medical staff to formulate intervention measures and management plans for chyle leakage after thyroid cancer surgery.