Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

OBJECTIVES: To compare the efficacy of toric implantable collamer lens (Toric-ICL) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia correction in patients with moderate to high myopia complicated with astigmatism. METHODS: We retrospectively collected data from 64 patients (aged 18-42 years) with moderate to high myopia complicated with astigmatism (128 eyes) undergoing either Toric-ICL (28 patients/56 eyes) or FS-LASIK (36 patients/72 eyes) at our department between January, 2019 and December, 2020. The changes of uncorrected distance visual acuity (UCVA), spherical equivalent (SE), mean astigmatism correction index (CI), corneal endothelial cell density (ECD) and intraocular pressure (IOP) following the procedures were compared between the two groups. RESULTS: In FS-LASIK group, all the eyes (72/72) achieved an UCVA≥1.0, similar to the rate in Toric-ICL group (55/56 eyes; P=0.2374). The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups [0.43±0.06 D (range: -1.0 to 1.50 D) vs 0.38±0.05 D (range: -0.75 to 1.00 D); P=0.56]. The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group (0.8561 vs 0.7176; P<0.0001), and 88.89% of the eyes in FS-LASIK group and 69.64% in Toric-ICL group had postoperative astigmatism ≤0.50 D. No significant changes were observed in postoperative corneal ECD in FS-LASIK group, whereas ECD decreased significantly after the procedure in Toric-ICL group (P=0.0057). The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP, but the patients receiving FS-LASIK had significantly reduced IOP after the procedure (P<0.001). CONCLUSIONS Although the patients included in Toric-ICL group had higher myopia and astigmatism, Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group. Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
Humans ; Astigmatism/complications* ; Myopia/complications* ; Keratomileusis, Laser In Situ/methods* ; Retrospective Studies ; Adult ; Visual Acuity ; Adolescent ; Young Adult ; Treatment Outcome ; Male ; Lens Implantation, Intraocular/methods* ; Female ; Phakic Intraocular Lenses ; Intraocular Pressure

Objective To investigate the current status of hypertension in the old adults living in urban city and rural areas in Qinghai Plateau and analyze the related influencing factors in order to provide data and evidence for targeted formulation of preventive and control measures for the pop-ulation.Methods Cluster-random sampling was used to subject 1372 elderly people(aged ≥60 years)from 8 urban areas and 25 natural villages in Xining City,Qinghai Province.Questionnaires were used to collect their demographic data,body mass index(BMI),history of chronic diseases,and lipid-related indicators.According to complicated with hypertension or not,they were divided into a hypertension group(615 cases)and a non-hypertension group(757 cases).SPSS 26.0 soft-ware was employed to perform statistical analyses with descriptive analysis and multivarlate un-conditional logistic regression analysis.Results Among the 1372 elderly persons,615 participants had hypertension,and the overall prevalence was 44.8％,and that in urban area and rural area was 50.1％and 38.5％,respectively,with significant difference(P＜0.01).Statistical differences were observed between those with and without hypertension in terms of age,BMI,and proportions of coronary heart disease(CHD),diabetes and stroke(P＜0.05,P＜0.01).In the urban populations,there were obvious differences in marital status,BMI,and proportions of CHD and diabetes be-tween those with and without hypertension(P＜0.01).For the rural populations,notable differ-ences were observed in age and proportions of CHD and diabetes between those with and without hypertension(P＜0.05,P＜0.01).Multivariate unconditional logistic regression analysis revealed that urban areas,obesity,CHD and diabetes were risk factors for hypertension in the elderly living in the urban and rural areas(OR=1.622,95％CI:1.299-2.026,P=0.000;OR=0.564,95％CI:0.315-1.006,P=0.042;OR=0.604,95％CI:0.417-0.874,P=0.008;OR=0.472,95％CI:0.328-0.678,P=0.000;OR=0.474,95％CI:0.334-0.673,P=0.000).Obesity,CHD and diabetes were risk factors for hypertension in those in the urban areas(OR=0.553,95％CI:0.317-0.963,P=0.036;OR=0.506,95％CI:0.320-0.800,P=0.004;OR=0.458,95％CI:0.303-0.692,P=0.000),and CHD and diabetes were risk factors in those in the rural areas(OR=0.382,95％CI:0.219-0.666,P=0.001;OR=0.452,95％CI:0.253-0.807,P=0.007).Conclusion There is sig-nificant difference in the prevalence of hypertension between the elderly living in the urban city and rural areas in Qinghai Plateau.The old adults with overweight,obesity,and complication of CHD and diabetes are prone to developing hypertension.

BACKGROUND:Spleen has the functions of blood storage,hematopoiesis,and immunity.With the increase of age,the structural degeneration and functional decline of spleen lead to the impairment of immune system function,thus accelerating the aging process of the body.The treatment of spleen aging in tree shrews with highly active umbilical cord mesenchymal stem cells has not been reported. OBJECTIVE:To explore the intervention effect and mechanism of highly active umbilical cord mesenchymal stem cells on spleen aging in tree shrews. METHODS:Highly active umbilical cord mesenchymal stem cells were isolated,cultured,and obtained from the umbilical cord tissue of newborn tree shrews by caesarean section.The differentiation abilities of adipogenesis,osteogenesis,and chondrogenesis were detected by three-line differentiation kit.Cell cycle and surface markers were detected by flow cytometry.The second generation of highly active umbilical cord mesenchymal stem cells were transfected with Genechem Green Fluorescent Protein with infection complex values of 100,120,140,160,180,and 200,respectively,to screen the best transfection conditions.After transfection,the fourth generation of highly active umbilical cord mesenchymal stem cells was injected into the tail vein of tree shrews in the elderly treatment group.The young control group and the aged model group were not given special treatment.After 4 months of treatment,the spleen tissue was taken and the structure of the spleen was observed by hematoxylin-eosin staining.β-Galactosidase staining was used to detect the activity of aging-related galactosidase.Immunohistochemical staining was used to detect the expression levels of p21 and p53 proteins.Ki67 and PCNA immunofluorescence staining was used to detect cell proliferation activity.Immunofluorescence staining was used to detect the expression levels of spleen autophagy protein molecules Beclin 1 and APG5L/ATG5.Reactive oxygen species fluorescence staining was used to detect the content of reactive oxygen species in spleen tissue.CD3 immunofluorescence staining was used to detect the change of the proportion of total T lymphocytes.The secretion levels of interleukin 1β and transforming growth factor β1 in spleen were detected by enzyme linked immunosorbent assay.The distribution of highly active umbilical cord mesenchymal stem cells labeled with green fluorescent protein in spleen tissue was observed by DAPI double staining of nucleus. RESULTS AND CONCLUSION:(1)Highly active umbilical cord mesenchymal stem cells grew in a short spindle shape with fish-like growth,with a large proportion of G0/G1 phase,and had the potential to differentiate into adipogenesis,osteogenesis,and chondrogenesis.(2)Multiplicity of infection=140 and transfection for 72 hours were the best conditions for labeling tree shrews highly active umbilical cord mesenchymal stem cells with Genechem Green Fluorescent Protein.(3)Compared with the aged model group,in the aged treatment group,the spleen tissue cells of tree shrews were arranged closely,and the area of white pulp was increased(P<0.01);the boundary between red pulp and white pulp was clear;the proportion of germinal centers did not show statistically significant difference(P>0.05).The activity level of galactosidase related to spleen tissue aging was decreased(P<0.001),and the expression levels of aging protein molecules p21 and p53 were down-regulated(P<0.001).The expression levels of proliferation-related molecules Ki67 and PCNA were up-regulated(P<0.001,P<0.05);expression levels of autophagy-related molecules Beclin 1 and APG5L/ATG5 were up-regulated(P<0.001),and the content of reactive oxygen species decreased(P<0.001),and the proportion of CD3+T cells increased(P<0.05).The secretion level of interleukin 1β in the aging-related secretion phenotype decreased(P<0.001);no significant difference was found in transforming growth factor β1 level(P>0.05).Compared with the young control group,the above indexes were significantly different in the elderly treatment group(P<0.05).(4)Green fluorescent cells labeled with green fluorescent protein were observed in spleen tissue of tree shrews the elderly treatment group by frozen tissue section observation.The results show that intravenous infusion of highly active umbilical cord mesenchymal stem cells can migrate to spleen tissue,inhibit the production of reactive oxygen species,down-regulate the expression of aging-related proteins,induce autophagy,promote cell proliferation,reduce chronic inflammation,and then improve the structure and function of spleen tissue.

Objective:To investigate the efficacy of phloroglucinol combined with ballon dilation in promoting cervical ripening and shortening labor duration in full-term primiparas and its effects on maternal and neonatal outcomes.Methods:A randomized controlled study was conducted on 60 full-term primiparas who delivered at the First People's Hospital of Longnan from January 2022 to December 2023. The subjects were randomly divided into a control group and an observation group ( n = 30/group) using the random number table method. The control group underwent ballon dilation for cervical ripening, while the observation group received intravenous injection of 80 mg phloroglucinol in addition to ballon dilation. Cervical ripening effect, labor duration, delivery mode, and the incidence of adverse pregnancy outcomes were observed in both groups. Results:The score of cervical ripening in the observation group was significantly higher than that in the control group [(8.31 ± 0.93) vs. (7.83 ± 0.85), t = 2.09, P = 0.041]. The duration of the first stage of labor, the duration of the second stage of labor, and the total duration of labor were (482.7 ± 18.2) minutes, (38.3 ± 10.7) minutes, and (526.6 ± 21.2) minutes, respectively. All these durations were significantly shorter than those in the control group [(521.3 ± 16.4) minutes, (45.7 ± 8.3) minutes, (573.4 ± 18.5) minutes, t = 2.62, 4.32, 12.80, all P<0.05]. The amount of postpartum bleeding in the observation group was significantly lower than that in the control group [(322.5 ± 21.2) mL vs. (341.9 ± 32.5) mL, t = -3.87, P<0.001]. There were no statistically significant differences in the Apgar scores and neonatal behavioral neurological assessment scores between the two groups (both P>0.05). Conclusions:The use of phloroglucinol combined with ballon dilation can effectively promote cervical ripening in full-term primiparas, shorten labor duration, improve induction success rates, and reduce postpartum hemorrhage. Therefore, this combined treatment significantly enhances maternal and neonatal outcomes while demonstrating high safety.

Objective:To study the relationship between serum levels of angiopoietin-2 (Ang-2), insulin-like growth factor 1 (IGF-1), immune factors, and prognosis in patients with uterine fibroids.Methods:A case-control study was conducted involving 93 patients with uterine fibroids who underwent laparoscopic myomectomy at The First People's Hospital of Longnan City between June 2021 and June 2023. These patients constituted the study group. Additionally, 104 healthy women undergoing routine health check-ups during the same period were selected as the control group. Based on the prognosis of the patients in the study group, they were further divided into two subgroups: a good prognosis group ( n = 42) and a poor prognosis group ( n = 46). The correlations among serum levels of Ang-2, IGF-1, immune factors, and prognosis were analyzed in the study group compared to the control group, as well as between the good prognosis and poor prognosis groups. Results:Four cases from the control group and five cases from the study group were excluded from the analysis. In the study group, serum levels of Ang-2 and IGF-1 were found to be (303.18 ± 42.39) mg/L and (1377.11 ± 84.78) mg/L, respectively. Both levels were significantly higher than those in the control group [(231.25 ± 34.18) mg/L, (438.09 ± 52.15) mg/L, t = 12.87, 19.63, both P < 0.001]. Additionally, CD 8+ levels in the study group were higher than those in the control group ( t = -15.79, P < 0.001). Conversely, CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the study group compared to the control group ( t = 7.92, 8.41, 5.21, all P < 0.001). In the poor prognosis group, the levels of Ang-2 and IGF-1 were (335.16 ± 42.67) mg/L and (1406.18 ± 83.77) mg/L, respectively, both of which were significantly higher than those in the good prognosis group [(284.63 ± 36.19) mg/L, (434.91 ± 53.28) mg/L, t = 5.96, 64.1, both P < 0.001]. The CD 8+ levels in the poor prognosis group were also higher than those in the good prognosis group ( t = -10.27, P < 0.001), while CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the poor prognosis group ( t = 5.31, 7.03, 3.15, all P < 0.001). Correlation analysis revealed that Ang-2 was negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.623, -0.578, -0.662). In contrast, Ang-2 was positively correlated with CD 8+ levels, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.593, 0.452, 0.446, 0.419, 0.422). IGF-1 levels were also negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.720, -0.751, -0.712), while positively correlated with CD 8+, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.631, 0.503, 0.444, 0.501, 0.451). Furthermore, multivariate logistic regression analysis indicated that a family history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding were all significant risk factors affecting the prognosis of patients with uterine fibroids (all P < 0.05). Conclusions:Patients with uterine fibroids have higher levels of Ang-2, IGF-1 and CD 8+, while the levels of CD 3+, CD 4+, and CD 4+/CD 8+ are lower. Additionally, the expression levels of Ang-2 and IGF-1 are associated with the patients' immune factors and prognosis.

Objective:To investigate the efficacy of phloroglucinol combined with ballon dilation in promoting cervical ripening and shortening labor duration in full-term primiparas and its effects on maternal and neonatal outcomes.Methods:A randomized controlled study was conducted on 60 full-term primiparas who delivered at the First People's Hospital of Longnan from January 2022 to December 2023. The subjects were randomly divided into a control group and an observation group ( n = 30/group) using the random number table method. The control group underwent ballon dilation for cervical ripening, while the observation group received intravenous injection of 80 mg phloroglucinol in addition to ballon dilation. Cervical ripening effect, labor duration, delivery mode, and the incidence of adverse pregnancy outcomes were observed in both groups. Results:The score of cervical ripening in the observation group was significantly higher than that in the control group [(8.31 ± 0.93) vs. (7.83 ± 0.85), t = 2.09, P = 0.041]. The duration of the first stage of labor, the duration of the second stage of labor, and the total duration of labor were (482.7 ± 18.2) minutes, (38.3 ± 10.7) minutes, and (526.6 ± 21.2) minutes, respectively. All these durations were significantly shorter than those in the control group [(521.3 ± 16.4) minutes, (45.7 ± 8.3) minutes, (573.4 ± 18.5) minutes, t = 2.62, 4.32, 12.80, all P<0.05]. The amount of postpartum bleeding in the observation group was significantly lower than that in the control group [(322.5 ± 21.2) mL vs. (341.9 ± 32.5) mL, t = -3.87, P<0.001]. There were no statistically significant differences in the Apgar scores and neonatal behavioral neurological assessment scores between the two groups (both P>0.05). Conclusions:The use of phloroglucinol combined with ballon dilation can effectively promote cervical ripening in full-term primiparas, shorten labor duration, improve induction success rates, and reduce postpartum hemorrhage. Therefore, this combined treatment significantly enhances maternal and neonatal outcomes while demonstrating high safety.

Objective:To study the relationship between serum levels of angiopoietin-2 (Ang-2), insulin-like growth factor 1 (IGF-1), immune factors, and prognosis in patients with uterine fibroids.Methods:A case-control study was conducted involving 93 patients with uterine fibroids who underwent laparoscopic myomectomy at The First People's Hospital of Longnan City between June 2021 and June 2023. These patients constituted the study group. Additionally, 104 healthy women undergoing routine health check-ups during the same period were selected as the control group. Based on the prognosis of the patients in the study group, they were further divided into two subgroups: a good prognosis group ( n = 42) and a poor prognosis group ( n = 46). The correlations among serum levels of Ang-2, IGF-1, immune factors, and prognosis were analyzed in the study group compared to the control group, as well as between the good prognosis and poor prognosis groups. Results:Four cases from the control group and five cases from the study group were excluded from the analysis. In the study group, serum levels of Ang-2 and IGF-1 were found to be (303.18 ± 42.39) mg/L and (1377.11 ± 84.78) mg/L, respectively. Both levels were significantly higher than those in the control group [(231.25 ± 34.18) mg/L, (438.09 ± 52.15) mg/L, t = 12.87, 19.63, both P < 0.001]. Additionally, CD 8+ levels in the study group were higher than those in the control group ( t = -15.79, P < 0.001). Conversely, CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the study group compared to the control group ( t = 7.92, 8.41, 5.21, all P < 0.001). In the poor prognosis group, the levels of Ang-2 and IGF-1 were (335.16 ± 42.67) mg/L and (1406.18 ± 83.77) mg/L, respectively, both of which were significantly higher than those in the good prognosis group [(284.63 ± 36.19) mg/L, (434.91 ± 53.28) mg/L, t = 5.96, 64.1, both P < 0.001]. The CD 8+ levels in the poor prognosis group were also higher than those in the good prognosis group ( t = -10.27, P < 0.001), while CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the poor prognosis group ( t = 5.31, 7.03, 3.15, all P < 0.001). Correlation analysis revealed that Ang-2 was negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.623, -0.578, -0.662). In contrast, Ang-2 was positively correlated with CD 8+ levels, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.593, 0.452, 0.446, 0.419, 0.422). IGF-1 levels were also negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.720, -0.751, -0.712), while positively correlated with CD 8+, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.631, 0.503, 0.444, 0.501, 0.451). Furthermore, multivariate logistic regression analysis indicated that a family history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding were all significant risk factors affecting the prognosis of patients with uterine fibroids (all P < 0.05). Conclusions:Patients with uterine fibroids have higher levels of Ang-2, IGF-1 and CD 8+, while the levels of CD 3+, CD 4+, and CD 4+/CD 8+ are lower. Additionally, the expression levels of Ang-2 and IGF-1 are associated with the patients' immune factors and prognosis.

Objective To investigate the current status of hypertension in the old adults living in urban city and rural areas in Qinghai Plateau and analyze the related influencing factors in order to provide data and evidence for targeted formulation of preventive and control measures for the pop-ulation.Methods Cluster-random sampling was used to subject 1372 elderly people(aged ≥60 years)from 8 urban areas and 25 natural villages in Xining City,Qinghai Province.Questionnaires were used to collect their demographic data,body mass index(BMI),history of chronic diseases,and lipid-related indicators.According to complicated with hypertension or not,they were divided into a hypertension group(615 cases)and a non-hypertension group(757 cases).SPSS 26.0 soft-ware was employed to perform statistical analyses with descriptive analysis and multivarlate un-conditional logistic regression analysis.Results Among the 1372 elderly persons,615 participants had hypertension,and the overall prevalence was 44.8％,and that in urban area and rural area was 50.1％and 38.5％,respectively,with significant difference(P＜0.01).Statistical differences were observed between those with and without hypertension in terms of age,BMI,and proportions of coronary heart disease(CHD),diabetes and stroke(P＜0.05,P＜0.01).In the urban populations,there were obvious differences in marital status,BMI,and proportions of CHD and diabetes be-tween those with and without hypertension(P＜0.01).For the rural populations,notable differ-ences were observed in age and proportions of CHD and diabetes between those with and without hypertension(P＜0.05,P＜0.01).Multivariate unconditional logistic regression analysis revealed that urban areas,obesity,CHD and diabetes were risk factors for hypertension in the elderly living in the urban and rural areas(OR=1.622,95％CI:1.299-2.026,P=0.000;OR=0.564,95％CI:0.315-1.006,P=0.042;OR=0.604,95％CI:0.417-0.874,P=0.008;OR=0.472,95％CI:0.328-0.678,P=0.000;OR=0.474,95％CI:0.334-0.673,P=0.000).Obesity,CHD and diabetes were risk factors for hypertension in those in the urban areas(OR=0.553,95％CI:0.317-0.963,P=0.036;OR=0.506,95％CI:0.320-0.800,P=0.004;OR=0.458,95％CI:0.303-0.692,P=0.000),and CHD and diabetes were risk factors in those in the rural areas(OR=0.382,95％CI:0.219-0.666,P=0.001;OR=0.452,95％CI:0.253-0.807,P=0.007).Conclusion There is sig-nificant difference in the prevalence of hypertension between the elderly living in the urban city and rural areas in Qinghai Plateau.The old adults with overweight,obesity,and complication of CHD and diabetes are prone to developing hypertension.