To develop a traditional Chinese medicine （TCM） diagnostic scale for type 2 diabetes mellitus with turbid-toxin accumulation syndrome and to validate the performance of the scale. A candidate pool was established through literature review and expert consultation， and a clinical case information collection form was developed accordingly. Patients with type 2 diabetes mellitus admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from July 2021 to January 2022 were investigated， and 312 valid clinical case information collection forms were obtained， which were randomly divided into 235 cases in the study group and 77 cases in the validation group. Four statistical methods， namely， differentiation analysis， Cronbach's coefficient， correlation coefficient， and stepwise regression， were used to screen out the candidate items， and Logistic regression analysis and factor analysis were used to assign weights to the items， and the final diagnostic model was determined by the receiver operating characteristic （ROC） curve， and the diagnostic thresholds were calculated for the Yoden index. The final TCM diagnostic scale for type 2 diabetes mellitus was composed of 8 items： turbid dirt coating （with a weight value of 23， the same below）， sticky stools （16）， fullness in the epigastrium and abdomen （12）， dark complexion （12）， irritability （11）， brown spots on the skin （11）， heaviness of head （10）， and chest stuffiness （5）， and the degree score was 0， 0.5， 1.0， and 1.5 points corresponding to no， mild， moderate and severe symptoms， respectively. The total score was the sum of the degree score multiplied by the weighted value of each item， and when the total score reached 33 points， it is diagnosed as the turbid-toxin accumulation syndrome. The established scale was tested and evaluated in the study group and the validation group， and the results showed that the sensitivity of the study group and the validation group was 89.38% and 89.47%， with the specificity of 95.90% and 89.74%， the Yoden index of 0.85 and 0.79， the positive predictive value of 95.28% and 89.47%， the negative predictive value of 90.70% and 89.74%， the diagnostic advantage ratios of 198.18 and 72.67， and the Kappa values of 0.86 and 0.79， which indicated that the TCM diagnostic scale for turbid-toxin accumulation syndrome of type 2 diabetes mellitus showed good diagnostic ability.

Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.

OBJECTIVE: To delineate a small supernumerary marker chromosome (sSMC) derived from chromosome 9 with combined cytogenetic and molecular methods. METHODS: For a pregnant woman with fetal ultrasound revealing left ventricular punctate hyperechoic echo, and a high risk for monosomy or partial deletion of chromosome 8, chromosome 9 trisomy, monosomy or partial deletion of chromosome 11 by non-invasive prenatal testing, and an abnormal MOM value revealed by mid-term serum screening, amniocentesis was performed for G banded chromosomal analysis and single nucleotide polymorphism array (SNP-array) assay. Peripheral blood samples of the woman and her spouse were also collected for the above tests. In addition, the woman was further subjected to C banding karyotyping analysis and fluorescence in situ hybridization (FISH) assay. RESULTS: The G-banded karyotype of the pregnant women was 47,XX,+mar[20]/46,XX[80], whilst C-banding analysis showed a deep stain in the middle of the sSMC (suggestive of centromeric region) and light stain at both ends (suggestive of euchromatism). FISH combined with DAPI banding analysis using 9pter/9qter probes revealed a karyotype of 47,XX,+mar.ish i(9)(9p10)(9p++)[2]/46,XX[18], whilst SNP-array has revealed a 68.1 Mb duplication in the 9p24.3q13 region. A database search has suggested the duplication to be likely pathogenic. No abnormality was found in her fetus and spouse by karyotyping and SNP-array analysis. CONCLUSION Through combined cytogenetic and molecular genetic analysis, a sSMC derived from chromosome 9 was delineated, which has enabled genetic counseling for the couple.
Female ; Humans ; Pregnancy ; Biomarkers ; Chromosomes, Human, Pair 9/genetics* ; Genetic Testing ; In Situ Hybridization, Fluorescence ; Monosomy

Objective To examine the effects of ankle brace on biomechanics of the lower extremity during landing, so as to provide a theoretic support to choose ankle brace for people with different sports levels. Methods The key words (ankle brace OR ankle braces OR ankle bracing OR ankle support) AND (landing OR land OR jump OR hopped OR hopping) AND (biomechanics OR kinematics OR kinetics OR electromyography OR neuromuscular) in Chinese and English were searched from different electronic databases (CNKI, Web of Science, EBSCO, PubMed and other databases), for a period of Jan. 2000 to Dec. 2020. Cochrane was used to evaluate the quality of eligible studies. For meta analysis, subgroup analysis was used to assess the impact of ankle braces on ankle biomechanics.Results Thirteen studies with a total of 222 participants were included for mata analysis in this study. The semi-rigid ankle brace reduced the peak of ankle inversion by 25.8% compared with the elastic ankle brace (SMD=-0.562, P<0.001). Moreover, the elastic ankle brace reduced ankle plant flexion during landing among athletes (SMD=-3.42, P=-0.021). As for collagiate students, both elastic ankle and semi-rigid ankle decreased the ankle inversion (elastic ankle brace: 35.4%, SMD=-1.000, P=-0.013; semi-rigid ankle brace: 31.11%, SMD=-0.881, P<0.001) and ankle plant flexion (elastic ankle brace:23.30%, SMD=-1.381, P<0.001;semi-rigid ankle brace: 36.33%, SMD=-1.605, P<0.001).Conclusions Both ankle braces can prevent ankle sprain for athletes (basketball, volleyball, running) who experience training more than 5 years. The elastic ankle brace can limit the inversion and plantar flexion, while the semi-rigid ankle brace can merely decrease the ankle inversion. Therefore, athletes are more suitable for the elastic ankle brace. As for collegiate students without training history, both ankle brace can decrease the ankle inversion and plantar flexion. The elastic ankle brace has greater restriction on inversion, while the semi-rigid ankle brace has more restriction on plantar flexion. Therefore, the elastic ankle brace should be utilized if collegiate students have calcaneofibular ligament injury, while the semi-rigid ankle brace is more suitable for collegiate students who have a history of anterior talofibular ligament injury.

Objective To study the effect of gender and maneuvers on anterior cruciate ligament (ACL) injury risk factors for volleyball players. Methods Sports biomechanics data of volleyball players during stop-jump, drop landing and sidestep cutting were collected. The ACL injury rate and biomechanical parameters of simulated injured jumps were obtained with Monte Carlo simulation. The influence of gender and maneuvers on ACL injury risk factors was validated by 2×3 mixed designed two-way ANOVA. Results Sidestep cutting was the highest risk maneuver of ACL injury for both genders (P＜0.001). Compared with male players, female players had a greater risk of ACL injury during sidestep cutting and stop-jump (P＜0.001), while male players were more prone to have ACL injury than female players during drop landing (P＜0.001). The risk factors of ACL injury obtained by simulation were significantly influenced by gender and maneuvers (P＜0.001). Conclusions Male players were more likely to increase ACL load due to smaller knee flexion, forward leg tilt and heel landing than female players during sidestep cutting, while female players owned larger ground reaction force (GRF) and knee extension moment. Smaller knee flexion angle during stop jump was the major risk factor for both genders, however more characteristics contributed to the males. Female players with large GRF, knee valgus and extension moment, and heel-landing were likely to have ACL injury, while the small knee flexion angle was the key risk factor for male players. The results can provide evidences for evaluation of volleyball players’ ACL injury risk, individualized injury prevention protocols, and clinical treatment and rehabilitation directions.

OBJECTIVE: To establish a method of determination of difluorochloromethane in workplace air by direct sampling gas chromatography. METHODS: Difluorochloromethane in workplace air was collected with aluminum plastic composite film airbag and then directly injected. Difluorochloromethane was separated by DB-1 capillary column and detected with hydrogen flame ionization detector. RESULTS: Good linearity was obtained in the range of 1.50-15 042.90 mg/m~3 with the correlation coefficient of 0.999 96. The limit of detection was 1.26 mg/m~3 and the limit of quantitation was 3.78 mg/m~3. The minimum detection concentration was 1.26 mg/m~3 and the minimum quantification concentration was 3.78 mg/m~3. The standard recovery was 98.34%-99.19%. The within-run relative standard deviation(RSD) and the between-run RSD were 1.82%-3.72% and 2.17%-4.17%, respectively. The samples can be stored at room temperature for at least 7 days. CONCLUSION: This method is suitable for difluorochloromethane detection in workplace air.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Objective : To investigate the behavior problems and influencing factors of school-age students from the third to the sixth grade in Zhongshan,and to provide evidence for early intervention of behavior problems in children. Methods : According to the proportion of population in urban area and township in Zhongshan,students of Grade Three to Six from eight primary schools（three in urban area and five in township）were recruited by stratified sampling method. The behavior problems in children were assessed by the Conners Parent Symptom Questionnaire（PSQ）. Sociodemographic information,family discipline and so on was investigated by a general questionnaire. The influencing factors for behavior problems were analyzed by a logistic regression model. Results : A total of 2 292 questionnaires were issued,and 2 236 valid questionnaires were recycled,with an effective rate of 97.56%. The positive rate of behavioral problems was 11.72%. The results of multivariate logistic regression analysis showed that the risk factors for behavior problems were females（OR=1.594,95%CI：1.170-2.171）,birth asphyxia（OR=2.372,95%CI：1.320-4.261）,main family discipline（laissez-faire：OR=3.326,95%CI：1.450-7.630;doting：OR=3.244,95%CI：1.867-5.638;autocratic：OR=2.609,95%CI：1.584-4.296,mixed：OR=2.313,95%CI：1.669- 3.207）,less than four hours per week for father-child communication（OR=1.551,95%CI：1.052-2.286）,negative life events（OR=2.188,95%CI：1.448-3.308）,living in township（OR=2.031,95%CI：1.330-3.102）,academic performance （average：OR=2.786,95%CI：1.868-4.156;poor：OR=6.665,95%CI：3.236-13.727;very poor：OR=25.068,95%CI：5.786-108.617）;the protective factors were occupation of mother as civil servants or professional personnel（OR=0.449,95%CI：0.238-0.844）and higher grades（Grade Five：OR=0.496,95%CI：0.339-0.727;Grade Six：OR=0.468,95%CI：0.309-0.710）. Conclusion Females,birth asphyxia,main family discipline,less communication between father and child,occupation of mother,negative life events,place of residence,academic performance and grade were the influencing factors for behavior problems.

Objective : To learn the preference and determinants for institute-based care of the elderly in Zhejiang Province. Methods : By multi-stage sampling and convenient sampling methods,three communities and three villages from Hangzhou,Jinhua and Yongkang as investigation spots,respondents who aged 60 years or above and lived for one year or more were selected for a questionnaire survey to learn their preference for institute-based care. Logistic regression analysis was used to explore the influencing factors for preference of institute-based care among the elderly. Results : A total of 390 valid questionnaires were collected,accounting for 91.76%. Among them,there were 219 men and 171 women, accounting for 56.15% and 43.85; 155 old people chose institute-based care,accounting for 39.74%. The results of multivariate logistic regression analysis illustrated that the elderly who had three children or more had less preference for institute-based care（OR=0.072,95%CI：0.007-0.742）;the elderly who lived with spouse（OR=0.395,95%CI：0.188-0.833）,with children（OR=0.323,95%CI：0.132-0.791）,with spouse and children（OR=0.305,95%CI：0.139-0.673）,compared with the elderly who lived alone,had less preference for institute-based care;the elderly who lived in rural areas,compard with the elderly who lived in urban areas had less preference for institute-based care（OR=0.404,95%CI：0.224-0.730）;the elderly without chronic diseases had less preference for institute-based care（OR=0.485,95%CI：0.292-0.805）. Conclusion Having three or more children,living with spouse,living with children,living with spouse and children,living in rural areas and living without chronic diseases are determinants for choosing institute-based care among the elderly.