Objective: To investigate the current status and influencing factors for cognitive frailty among the elderly in community, so as to provide the evidence for early identification and prevention of cognitive frailty among the elderly. Methods: Residents aged 60 years and above with local household registration from 11 counties (cities, districts) in Zhejiang Province from 2021 to 2023 were selected as study participants using a multistage random sampling method. Demographic information, lifestyle, and health status were collected through questionnaire surveys. Depressive symptoms were assessed using the Patient Health Questionnaire. Cognitive frailty was evaluated using the FRAIL Scale and the Mini-Mental State Examination. Factors affecting cognitive frailty among the elderly in community were identified using a multivariable logistic regression model. Results: A total of 16 613 individuals were surveyed, including 7 465 males (44.93%) and 9 148 females (55.07%). The average age was (70.97±7.29) years. A total of 784 individuals were detected with depressive symptoms, with a detection rate of 4.72%. A total of 724 individuals were detected with cognitive frailty, with a detection rate of 4.36%. Multivariable logistic regression analysis showed that females (OR=1.419, 95%CI: 1.179-1.708), aged ≥70 years (70-<80 years old, OR=1.869, 95%CI: 1.490-2.345; ≥80 years old, OR=5.017, 95%CI: 3.935-6.398), without a spouse (OR=1.495, 95%CI: 1.234-1.810), sedentary (OR=2.420, 95%CI: 1.829-3.202), chronic diseases (1 type, OR=1.456, 95%CI: 1.175-1.804; ≥2 types, OR=1.639, 95%CI: 1.314-2.045), and depressive symptoms (OR=4.191, 95%CI: 3.361-5.225) were associated with a higher risk of cognitive frailty among the elderly in community. Conversely, a lower risk of cognitive frailty was seen among the elderly in community who had primary school or above (primary school, OR=0.512, 95%CI: 0.389-0.676; junior high school or above, OR=0.464, 95%CI: 0.354-0.608), engaged in physical exercise (OR=0.396, 95%CI: 0.291-0.539), and were reported average or good self-rated health status (average, OR=0.641, 95%CI: 0.475-0.866; good, OR=0.150, 95%CI: 0.109-0.208). Conclusions The detection rate of cognitive frailty among the elderly in community is relatively low and is influenced by demographic factors such as gender, age, education level, as well as lifestyle like sedentary and physical exercise, and health status. It is recommended to reduce the risk of cognitive frailty among the elderly through multidimensional interventions, including health education, promotion of healthy lifestyles, and enhanced mental health support.

Objective:Analyzing the influence of morphological evaluation parameters of blastocysts, including days of blastocyst development [day 5 (D5) and day 6 (D6)], degree of blastocyst expansion (4, 5, 6), inner cell mass and trophectoderm grade, on the occurrence of chromosomal karyotype abnormalities of chorionic villi in missed abortion after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment and fresh/frozen-thawed single blastocyst transfer. Methods:The clinical data of patients with missed abortion after IVF/ICSI treatment and fresh/frozen-thawed single blastocyst transfer from February 2015 to February 2023 in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were included. Using a case-control study, the data were divided into two groups according to the detection results of chromosomal copy number variations (CNVs) in chorionic villi of missed abortion abnormal karyotype group ( n=139) and normal karyotype group ( n=82). The baseline data between the two groups were compared. Univariate logistic regression was used to investigate the effect of blastocyst morphological rating parameters on the occurrence of chromosomal karyotype abnormalities of chorionic villi in aborted tissues, and multivariate logistic regression was also used to adjust confounding factors. Results:Male age [(34.12±6.49) years], sperm morphology rate [5.00 (4.00,6.00)%] and female age [33.00 (30.00, 37.00) years] in abnormal karyotype group were higher than those in the normal karyotype group [(32.38±4.69) years, 4.00 (2.00,5.00)% and 31.50 (29.00,34.00) years], and the differences were statistically significant ( P=0.022, P=0.020, P=0.009). Univariate and multivariate logistic regression analyses showed that days of blastocyst development, degree of blastocyst expansion, inner cell mass and trophectoderm grade did not increase the risk of chromosomal karyotype abnormalities of chorionic villi (all P>0.05). Conclusion:There is no significant correlation between blastocyst morphological evaluation parameters and chromosomal karyotype abnormalities in chorionic villi of missed abortion after fresh/frozen-thawed single blastocyst transfer with IVF/ICSI treatment.

Objective:Analyzing the influence of morphological evaluation parameters of blastocysts, including days of blastocyst development [day 5 (D5) and day 6 (D6)], degree of blastocyst expansion (4, 5, 6), inner cell mass and trophectoderm grade, on the occurrence of chromosomal karyotype abnormalities of chorionic villi in missed abortion after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment and fresh/frozen-thawed single blastocyst transfer. Methods:The clinical data of patients with missed abortion after IVF/ICSI treatment and fresh/frozen-thawed single blastocyst transfer from February 2015 to February 2023 in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were included. Using a case-control study, the data were divided into two groups according to the detection results of chromosomal copy number variations (CNVs) in chorionic villi of missed abortion abnormal karyotype group ( n=139) and normal karyotype group ( n=82). The baseline data between the two groups were compared. Univariate logistic regression was used to investigate the effect of blastocyst morphological rating parameters on the occurrence of chromosomal karyotype abnormalities of chorionic villi in aborted tissues, and multivariate logistic regression was also used to adjust confounding factors. Results:Male age [(34.12±6.49) years], sperm morphology rate [5.00 (4.00,6.00)%] and female age [33.00 (30.00, 37.00) years] in abnormal karyotype group were higher than those in the normal karyotype group [(32.38±4.69) years, 4.00 (2.00,5.00)% and 31.50 (29.00,34.00) years], and the differences were statistically significant ( P=0.022, P=0.020, P=0.009). Univariate and multivariate logistic regression analyses showed that days of blastocyst development, degree of blastocyst expansion, inner cell mass and trophectoderm grade did not increase the risk of chromosomal karyotype abnormalities of chorionic villi (all P>0.05). Conclusion:There is no significant correlation between blastocyst morphological evaluation parameters and chromosomal karyotype abnormalities in chorionic villi of missed abortion after fresh/frozen-thawed single blastocyst transfer with IVF/ICSI treatment.

Objective To observe the effect of preoperative muscle strength training combined with postoperative BIODEX balance function training in improving the motor function of patients with total hip arthroplasty (THA). Methods A total of 110 patients with THA from January 2021 to December 2022 were selected as research objects, and were divided into observation group and control group by the simple randomization method, with 55 cases in each group. The control group received conventional postoperative rehabilitation training, while the observation group was treated with muscle strength training and BIODEX balance function training. Imaging indicators (acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone, and centering rate of femoral prosthesis) at 5 days after surgery were compared between two groups; the joint motor function (Harris score for hip joint), balance ability [Berg Balance Scale (BBS)] and daily activity ability [Activities of Daily Life Scale (ADL)] before treatment and one month after treatment were compared between the two groups. Results There were no significant differences in acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone and centering rate of femoral prosthesis between the two groups at 5 days after surgery (P>0.05); after one month of treatment, the Harris score for hip joint, the BBS score and ADL score in both group increased significantly, and the scores in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion Preoperative muscle strength training combined with postoperative BIODEX balance function training shows a significant therapeutic effect, which can effectively improve the hip motor function and enhance the balance control ability in patients with THA.

Based upon the experiences of planning and implementation of "Dynamic changes of Torque Teno virus load in Chinese renal transplant recipients with immunosuppressive therapy: A multi-center prospective observational double-blind cohort study", this article explored the current status and major difficulties of investigator-initiated multi-center prospective clinical trials of kidney transplantation in China. Various issues of organization design and implementation process management were discussed for enhancing the quality of implementing the relevant trials.

Objective:To investigate the perinatal outcome of selective fetal reduction of dizygotic twins pregnancies after double embryo transferred assisted by in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Methods:The clinical data of patients with single birth who underwent IVF/ICSI after double embryo transferred from September 1, 2005 to July 31, 2020 in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into three groups according to the occurrence of fetal reduction: 80 cases of dizygotic twins to singleton by selective fetal reduction (group A), 832 cases of dizygotic twins to singleton by spontaneous fetal reduction (group B), and 6 178 cases of singleton (group C). Using group A as the reference, after approximately propensity score matching (PSM) with 1∶4 ratio, 289 cases in group B and 271 cases in group C were obtained. The differences in baseline data and perinatal outcomes between group A and group B or group C were analyzed.Results:1) Before PSM, there were statistically significant differences in patients' age, previous fertility history, type of infertility, and stage of embryo transferred between group A and group B or group C (all P<0.05); after PSM, there were no statistically significant differences in baseline data between group A and group B or group C (all P>0.05). 2) After PSM, the premature birth rate was higher in group A than in group B [17.5% (14/80) vs. 8.7% (25/289), P=0.023] and the gestational weeks [(38.18±1.98) weeks vs. (38.64±1.83) weeks, P=0.034] were lower; group A had higher incidence rates of premature birth [17.5% (14/80) vs. 7.7% (21/271), P=0.011] and premature rupture of membranes [5.0% (4/80) vs. 0.4% (1/271), P=0.002] than those in group C, but gestational weeks [(38.18±1.98) weeks vs. (38.85±1.47) weeks, P=0.002] and birth weight [(3 253.07±475.73) g vs. (3 384.89±479.54) g, P=0.029] were lower. Conclusion:Perinatal outcomes of selective fetal reduction of dizygotic twins pregnancies after assisted by IVF/ICSI were poor. Selective fetal reduction in multiple pregnancies is not the best remedy. The strategy of selective single embryo transfer should be adopted to effectively reduce the rate of multiple pregnancies and improve maternal and infant outcomes.

Objective:To investigate the perinatal outcome of selective fetal reduction of dizygotic twins pregnancies after double embryo transferred assisted by in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Methods:The clinical data of patients with single birth who underwent IVF/ICSI after double embryo transferred from September 1, 2005 to July 31, 2020 in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into three groups according to the occurrence of fetal reduction: 80 cases of dizygotic twins to singleton by selective fetal reduction (group A), 832 cases of dizygotic twins to singleton by spontaneous fetal reduction (group B), and 6 178 cases of singleton (group C). Using group A as the reference, after approximately propensity score matching (PSM) with 1∶4 ratio, 289 cases in group B and 271 cases in group C were obtained. The differences in baseline data and perinatal outcomes between group A and group B or group C were analyzed.Results:1) Before PSM, there were statistically significant differences in patients' age, previous fertility history, type of infertility, and stage of embryo transferred between group A and group B or group C (all P<0.05); after PSM, there were no statistically significant differences in baseline data between group A and group B or group C (all P>0.05). 2) After PSM, the premature birth rate was higher in group A than in group B [17.5% (14/80) vs. 8.7% (25/289), P=0.023] and the gestational weeks [(38.18±1.98) weeks vs. (38.64±1.83) weeks, P=0.034] were lower; group A had higher incidence rates of premature birth [17.5% (14/80) vs. 7.7% (21/271), P=0.011] and premature rupture of membranes [5.0% (4/80) vs. 0.4% (1/271), P=0.002] than those in group C, but gestational weeks [(38.18±1.98) weeks vs. (38.85±1.47) weeks, P=0.002] and birth weight [(3 253.07±475.73) g vs. (3 384.89±479.54) g, P=0.029] were lower. Conclusion:Perinatal outcomes of selective fetal reduction of dizygotic twins pregnancies after assisted by IVF/ICSI were poor. Selective fetal reduction in multiple pregnancies is not the best remedy. The strategy of selective single embryo transfer should be adopted to effectively reduce the rate of multiple pregnancies and improve maternal and infant outcomes.

Objective:To investigate the factors predictive of heart failure developing during hospital stay after undergoing percutaneous coronary intervention (PCI).Methods:A retrospective analysis was performed on 534 patients with coronary heart disease who underwent PCI treatment at Hangzhou Ninth People′s Hospital from January 2017 to September 2022. The patients were divided into two groups according to whether heart failure occurred after the operation: a heart failure group consisting of 51 patients and a control group consisting of 483 patients. Univariate comparison and multivariate analysis were performed on factors that could lead to heart failure between the two groups, and a prediction model was established.Results:Univariate analysis showed that there were significant differences in age at admission, presence of cerebral infarction, presence of hypertension, New York Heart Association (NYHA) heart function classification, left ventricular ejection fraction (LVEF), serum albumin, neutrophil-to-lymphocyte ratio (dNLR), D-dimer, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels between the PCI postoperative heart failure group and the control group (all P<0.05). Multivariate analysis showed that age ≥60 years, LVEF<40%, presence of cerebral infarction, NYHA heart function classification Ⅱ/Ⅲ, serum albumin<40.15 g/L, and dNLR≥2.30 were independent risk factors for the development of heart failure during hospitalization after PCI (all P<0.05). Conclusions:Age, LVEF, presence of cerebral infarction, NYHA heart function classification, serum albumin, and dNLR can all affect the occurrence of heart failure during hospitalization after PCI for coronary heart disease. Establishing a prediction model based on these indicators can provide guidance for clinical practice.

OBJECTIVE To establish a method for the determination of fourteen fluorescent whitening agents in cosmetics by HPLC-MS/MS. METHODS Samples were extracted on a Waters ACQUITY UPLC ®BEH C18(2.1 mm×50 mm, 1.7 μm) column after ultrasonic extracted by DMF with the mobile phase consisted of methanol-0.1% ammonia water solution by gradient elution. The flow rate was 0.3 mL·min-1. The column temperature was 40 ℃. MS was performed using triple quadrupole mass spectrometry. Electrospray ionization source was operated in the positive/negative mode using multiple reaction monitoring scanning mode. RESULTS The results showed that there were good linear relationships for the fluorescent whitening agents in a certain concentration range with correlation coefficients(r) greater than 0.99. The limits of quantification were 0.01-20 μg·g-1 and the limits of detection were 0.004-8 μg·g-1. The average recoveries at three spiked levels were in the range of 85.4%-108.9%, and the relative standard deviation were in the range of 0.3%-7.2%. CONCLUSION The method has high sensitivity, strong specificity, simple and convenient operation, and is suitable for the detection of fourteen fluorescent whitening agents in cosmetics.

Objective: To understand the incidence and mortality of drowning and secular trend among children aged 0-14 from 1990 to 2019 in China, so as to provide reference for drowning intervention among children in China. Methods: Based on data of drowning incidence and death in 0-14 years old children in China in 1990-2019 years Global Burden of Disease (GBD 2019) database, the standardized rate was calculated by the world standard population, and the trend of incidence rate and mortality rate was fitted by Joinpoint regression model respectively. Results: From 1990 to 2019, the overall incidence of drowning among children aged 0-14 years in China decreased from 37.17/100 000 to 12.54/100 000, a relative decrease of 66.26%; the standardized incidence rate decreased from 21.78/100 000 to 14.98/100 000, a relative decrease of 31.22%. The incidence rate and standardized incidence rate of drowning in children showed an increasing after decreasing trend, with decreasing mortality and standardized mortality rate. Joinpoint regression showed that the incidence rate of standardized AAPC for child drowning was -1.3, -2.5 for males and 0 for females. The overall standardized mortality rate of drowning was -3.9, male was -3.6, female was about -4.5 , the trend changes were statistically significant ( P <0.05). The incidence rate and mortality rate of male were higher than that of female, and there was significant difference between male and female groups ( P <0.05). Conclusion Significant progress has been made in child drowning prevention and control, with substantial decreasing in the incidence rate of child drowning. However, considering recent slight increase in drowning incidence, effective measures should be developmed including risk factors, vulnerable population to further control the incidence and mortality of child drowning.