Objective To analyze the current status of physical activity level and its influencing factors in parturients with advanced paternal age at 6 months postpartum,and to explore the correlation between physical activity level and the incidence of overweight/obesity.Methods A total of 399 par-turients with advanced paternal age were included as study subjects.Surveys were conducted using the International Physical Activity Questionnaire-Long Form,the Edinburgh Postnatal Depression Scale,the Pittsburgh Sleep Quality Index,and the Family Support Rating Scale.Univariate analysis and bina-ry Logistic regression analysis were used to investigate the influencing factors of physical activity level in parturients with advanced paternal age at 6 months postpartum.Spearman correlation analysis was used to explore the correlation between physical activity level and the incidence of overweight/obesity.Results Among the parturients with advanced paternal age at 6 months postpartum,134 cases(33.6％)and 265 cases(66.4％)were at low and moderate physical activity levels respectively,with no cases at a high physical activity level.The body mass at 6 months postpartum was(61.31±8.16)kg,and the body mass index(BMI)was(23.57±2.39)kg/m2.The incidence of over-weight/obesity was 42.9％.A negative correlation was observed between the physical activity level and the incidence of overweight/obesity in parturients with advanced paternal age at 6 months postpar-tum(r=-0.566,P＜0.001).There were significant differences in postpartum physical activity levels among with parturients with advanced paternal age at different pre-pregnancy BMI,sleep qualities,and family supports(P＜0.05).Conclusion A higher physical activity level at 6 months postpar-tum in parturients with advanced paternal age is associated with a lower incidence of overweight/obe-sity.The physical activity level is comprehensively influenced by pre-pregnancy BMI,sleep quality,and family support.

Objective To analyze the acupoint compatibility law and the application characteristics of acupuncture moxibustion treatment for depression based on complex network technology;To provide a basis and ideas for formulating prescriptions of acupuncture antidepressant therapy.Methods Related clinical literature about acupuncture for the treatment of depression was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Embase,Cochrane Library,and Web of Science from the establishment of the databases to 21st,Sep.2022.According to the inclusion and exclusion criteria,the literature was screened,and the clinical literature database of acupuncture in anti-depression was established.Excel 2010 was used for frequency analysis of acupoints.SPSS Modeler 18.0 was used for association rule analysis,and Gephi 0.9.5 was used for complex network analysis.Results Totally 579 articles were included,involving 172 acupoints,with a total frequency of 3 222.The results of descriptive analysis showed that the main meridians of acupoints were Governor Vessel,bladder meridian and liver meridian,and the specific acupoints such as Yuan-primary point,Shu-stream point,Back-shu point,Luo-connecting point,Eight confluence points,Front-mu point,He-sea point were frequently used.Association rules analysis showed that the combination of the highest correlation acupoints were"Yintang(GV29)-Baihui(GV20)".Through the complex network k-core analytic hierarchy process and community analysis,two core acupoint groups were finally obtained.The acupuncture angle,depth and direction were based on safety and meridian circulation direction,the tonifying and reducing method was based on syndrome differentiation,and the prescription was based on syndrome differentiation and symptomatic selection.Conclusion Acupuncture for depression has the following characteristics:the principle of acupoint selection is based on meridian selection and specific acupoints,the selection of core acupoints focuses on the treatment of spirit and the regulation of viscera,channels and functions,and the emphasis on syndrome differentiation and symptomatic acupoint selection in clinical treatment.While,it was important to pay more attention to the specificity of acupuncture and moxibustion.

Objective:To investigate the effects of regular yoga practice on pulmonary function and mechanical parameters of diaphragm.Methods:Eighty regular yoga practitioners, including 40 practicing for≤5 year (yoga≤5 years group) and 40 for>5 year (yoga>5 years group) were recruited in Shanxi Norman Bethune Hospital from January 2024 to April 2024; and 40 sedentary subjects were also recruited as the control group. The diaphragmatic motion was evaluated by two-dimensional ultrasound and speckle tracking ultrasound in all subjects, the parameters, including displacement, fractional thickening, strain and strain rate of diaphragm were observed at rest and deep breathing. At the same time, the pulmonary function tests were performed, the indexes including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1) and one-second rate (FEV 1/FVC) were measured in all subjects. The mechanical parameters of diaphragm and the pulmonary function were compared among three groups. Results:There were no significant differences in gender ( χ2= 0.346), age ( F=1.16), height ( F=0.45), weight ( F=0.11) and body mass index (BMI) ( F=0.07) among the three groups (all P>0.05).At the rest status, there was no significant difference in diaphragm displacement, thickening rate and strain among three groups ( F=1.21, 2.10 and 0.23,all P>0.05); the strain rate of yoga>5 years group was lower than that of other two groups ( t=-4.23、-4.10, all P<0.05); however, there was no significant difference between yoga≤5 years group and control group ( t=-0.06, P>0.05). During deep breathing, the increment of displacement, thickening rate, strain and strain rate of diaphragm in yoga>5 years group was larger than that in other tow groups, while the increment of yoga≤5 years group was larger than that in control group ( F=25.82, 60.99, 17.29 and 52.46, all P<0.05); the increment of FVC, FEV 1 and FEV 1/FVC in yoga>5 years group was larger than other two groups, whilc the increment of yoga≤5 years group was larger than that of sedentary group (F=4.49, 7.32 and 39.71, all P<0.05). The diaphragmatic displacement was positively correlated with FVC ( r=0.290, P<0.05), and diaphragmatic displacement and thickening rate were positively correlated with FEV 1 and FEV 1/FVC (0.333 and 0.448, 0.231 and 0.599, all P<0.05), the strain and strain rate of diaphragm were negatively correlated with FEV 1 and FEV 1/FVC ( r=-0.399 and -0.719, -0.355 and -0.796, all P<0.05). Conclusion:The regular yoga practice can improve the movement capacity and efficiency of diaphragm, improve the pulmonary function, and there is a negative correlation between the strain rate and the mechanical parameters of diaphragm and FEV 1, FEV 1/FVC.

Objective:To analyze the satisfaction of elderly outpatient experience, based on a satisfaction questionnaire survey of outpatients in public hospitals, for references to improve the medical experience of elderly patients.Methods:This study extracted the satisfaction survey questionnaires for outpatients in second level and above public hospitals nationwide from the National Health Commission′s satisfaction survey platform from 2019 to 2022. The questionnaire content included six dimensions: registration experience, doctor-patient communication, nurse-patient communication, environment and labeling, privacy protection, and medical staff response, as well as overall satisfaction. The satisfaction, relative satisfaction, and dissatisfaction rates of elderly outpatients were analyzed using standardized assignment of question options, etc; T-test was used for inter group comparison.Results:A total of 10.095 7 million outpatient satisfaction questionnaires were included in this study, including 0.576 3 million questionnaires for elderly outpatients. From 2019 to 2022, the overall satisfaction of outpatients had been increasing year by year, and the overall satisfaction scores of elderly patients were significantly higher than that of non-elderly patients( P<0.01). The satisfaction scores of elderly patients in the nurse communication dimension(86.55 to 91.03 points) and relative satisfaction(1.000) were the higher in each year, while the satisfaction scores in the environment and identification dimension(81.05 to 86.03 points) and relative satisfaction(0.935 to 0.955) were lower. In 2019 and 2022, elderly patients had higher dissatisfaction rates in the two dimensions of registration experience(2.26%, 1.91%) and doctor communication(0.80%, 0.53%). Conclusions:From 2019 to 2022, the overall satisfaction of elderly patients in secondary and above public hospitals in China was relatively higher with a steady increasing tendency. However, there was still room for further improvement in the environment and labeling, cultural construction, and registration experience for elderly patients.

OBJECTIVE To investigate the effects of individualized dosing regimen on blood trough concentration of vancomycin and renal function in critically ill patients. METHODS According to relevant guidelines and the results of Vancomycin Calculator， clinical pharmacists formulated an individualized dosing regimen of vancomycin including loading dose and maintenance dose for critically ill patients based on the two independent variables of body weight and creatinine clearance rate. Using the method of retrospective study， patients who were admitted to the department of intensive care unit （ICU） of the Second Affiliated Hospital of Guangzhou Medical University and used the regimen from July 2018 to December 2021 were selected as the trial group， and patients who were treated with vancomycin and received blood drug concentration monitoring in ICU from January 2015 to June 2018 were recruited in the control group. The difference in trough concentration distribution and the incidence of acute kidney injury （AKI） after medication were compared between the two groups， the change of serum creatinine before and after medication in the trial group was analyzed. RESULTS Totally 197 patients were included in the trial group and 144 patients were in the control group. There was no significant difference between the two groups in the clinical information （gender， age， body weight， acute physiology and chronic health evaluation Ⅱ score， the proportion of patients with renal insufficiency， etc.） （P＞0.05）. The proportions of major infection sites （including lung， urinary， abdominal， blood and central nervous system） and treatment type （target or empirical treatment） also had no significant difference between the two groups （P＞0.05）. There was no significant difference in the attainment rate of ideal trough concentration （15-20 μg/mL） and the proportion of patients with trough concentration　＞20 μg/mL between the two groups （P＞0.05）， while the attainment rate of target trough concentration （10-20 μg/mL） and the proportion of patients with trough concentration ＜10 μg/mL were significantly different between the two groups （P＜0.05）. The attainment rate of target trough concentration in patients with chronic renal insufficiency in trial group was significantly higher than that in control group （P＜0.05）. There was no significant difference in the incidence of AKI and vancomycin-associated AKI between the two groups （P＞0.05）. In the trial group with medication duration ≥7 days ， the level of serum creatinine on the 7th day of treatment was increased significantly， compared with that on the 3rd day of treatment （P＜0.05）. CONCLUSIONS This individualized dosing regimen can improve the attainment rate of target trough concentration of vancomycin in critically ill patients， especially those with chronic renal insufficiency， during the first standardized monitoring， and not increase the risk of renal injury compared with previous empirical medication.

Objective:To identify the clinical characteristics and pathogenic gene of a Chinese Han family with achromatopsia (ACHM).Methods:The method of pedigree investigation was adopted.A Chinese Han ACHM family was recruited in Peking Union Medical College Hospital form July 2010 to July 2019, including 5 members of 2 generations.There were 2 patients and 3 phenotypically normal individuals.The medical history was collected and comprehensive ophthalmic examinations were performed, including visual acuity, colour vision, color fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), visual field and electroretinogram (ERG).Genomic DNA was extracted from peripheral blood sample from the patients and family members.Pathogenic variant was screened by whole exome sequencing (WES) and verified by Sanger sequencing and co-segregation analysis.The variant was annotated with the 1000 Genomes, Human Gene Mutation Database (HGMD), ExAC, ClinVar and OMIM databases to detect the single nucleotide polymorphism and whether it had been reported previously.The pathogenicity of the variant was evaluated according to the standards and guidelines of the American College of Medical Genetics and Genomics (ACMG).This study adhered to the Declaration of Helsinki.The study protocol was approved by the Institutional Review Board of Peking Union Medical College Hospital (No.JS-2059).Written informed consent was obtained from the guardians of juvenile patients.Results:There was consanguinity between the proband's parents and this family was consistent with autosomal recessive inheritance.Both male patients presented the reduction of visual acuity accompanied with photophobia and color blindness since childhood.Barely visible foveal light reflex in fundus images, hypofluorescence of foveal areas in FAF images, foveal defect with disruption of ellipsoid zone and interdigitation zone in OCT images were found in both patients.Central scotoma with or without peripheral visual field defects was detected.Generally normal scotopic 0.01, 3.0 and 10.0 responses, decreased oscillatory potentials amplitudes, no photopic 3.0 and 30 Hz flicker responses were observed.No sign of progression was found during the 9-year follow-up.It was confirmed that both patients carried a novel homozygous disease-causing variant c. 947insA (p.Asn316Lysfs*46) in ATF6 gene.Their mother had the heterozygous variant.The unaffected brother did not carry the variant.This family was consistent with co-segregation.This variant was labeled as pathogenic according to the ACMG standards and guidelines. Conclusions:A novel variant c.947insA (p.Asn316Lysfs*46) in ATF6 gene is the pathogenic variant of this achromatopsia family.This is the first time that this variant has been reported.

Objective To investigate the disease progression and influencing factors of human immunodeficiency virus (HIV)-infected persons in Sanya area from 2010-2020. Methods Data of HIV infected cases reported in XX region from January 2014 to January 2020 were collected through the National AIDS Comprehensive Prevention and Control Information System. The incidence of AIDS was calculated by the life expectancy method, and the single factors influencing the progression of HIV infection were analyzed from the aspects of sex, age, BMI, nationality, marital status, educational level, highly active anti-retroviral therapy (HAART), anemia, route of transmission, CD4⁺ cell count, and co-infection of other viruses. Results A total of 761 HIV-infected cases were reported in Sanya areaFrom January 2010 to January 2020, of which 103 had progressed to AIDS (13.53%), the incidence of AIDS was 6.01/100 person-years, the average incubation period was 4.63 years; There were 31 death cases, and the all-cause mortality rate was 1.81/100 person years; Gender, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections were single factors that affect the disease progression of HIV-infected persons (χ²=16.803, 13.362, 15.954, 20.119, 16.039, 15.711, P<0.05), meanwhile, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections were independent risk factors that affect the disease progression of HIV-infected persons (P=0.014, 0.007, 0.017, 0.009, 0.001, 0.001). Conclusion The incubation period is an important stage of the disease progression of HIV-infected patients, moreover, age, HAART treatment status, anemia, CD4⁺ cell count, and other viral infections are all independent risk factors that affect the disease progression of HIV-infected patients.

Objective:To investigate the role of LncRNA-TUG1 in the injury of intestinal epithelial cells induced by lipopolysaccharide (LPS).Methods:LPS was used to treat HIEC-6 human intestinal epithelial cells for 24 h to construct a sepsis injury model. Whole transcriptome RNA sequencing was used to analyze the expression changes of mRNA, microRNA and lncRNA in HIEC-6 cells after LPS treatment. Real-time fluorescence quantitative (qRT-PCR) and Western blot was performed to detect the expression changes of lncRNA-TUG1, microRNA-132-3p (miR-132-3p), SIRT1 mRNA and SIRT1 protein in HIEC-6 cells after LPS treatment. The expression levels of LncRNA-TUG1, miR-132-3p and SIRT1 were artificially changed by in vitro transfection. qRT-PCR and Western blot were used to confirm the regulatory effect of lncRNA-TUG1 on microRNA-132-3p and SIRT1. CCK-8 and flow cytometry were used to analyze the effects of LncRNA-TUG1, miR-132-3p and SIRT1 on the proliferation and apoptosis of HIEC-6 cells. The dual luciferase report analysis was used to verify the targeting relationship between LncRNA-TUG1, miR-132-3p and SIRT1. Statistical analysis was performed using SPSS 17.0, and differences between the two groups were compared using independent sample t test. Results:RNA sequencing results showed that the expressions of lncRNA-TUG1 and SIRT1 were decreased in HIEC-6 cells after LPS treatment ( t=3.26, P<0.05 and t=2.55, P<0.05), but the expression of miR-132-3p was increased ( t=4.12, P<0.05). In vitro cell experiments, the expression of lncRNA-TUG1 and SIRT1 were decreased in HIEC-6 cells treated with LPS ( t=5.69, P<0.05 and t=5.712, P<0.05), while the expression of miR-132-3p was increased ( t=3.88, P<0.05). Overexpression of lncRNA-TUG1 increased the proliferation rate ( t=6.55, P<0.05) and decreased the apoptosis rate ( t=3.94, P<0.05) of LPS-treated cells. Upregulation of lncRNA-TUG1 decreased the expression of miR-132-3p ( t=4.66, P<0.05), and increased the mRNA and protein levels of SIRT1 ( t=3.91, P<0.05). Transfection of miR-132-3P mimic could inhibit the mRNA ( t=4.08, P<0.05) and protein levels of SIRT1. In LPS-treated cells, the cells co-transfected with miR-132-3pmimic and siRNA-SIRT1 had a lower proliferation rate ( t=4.55, P<0.05 and t=5.67, P<0.05) and a higher apoptosis rate ( t=3.90, P<0.05 and t=4.22, P<0.05) than those transfected with only pcDNA3.1-lncRNA-TUG. Conclusions:lncRNA-TUG1 may act as a ceRNA to regulate miR-132-3p/SIRT1, therefore alleviating HIEC-6 cell injury caused by LPS. Intervention of lncRNA-TUG1/miR-132-3p/SIRT1 regulatory pathway may become a potential strategy to prevent sepsis-induced intestinal mucosal damage.

Objective:To access the genetic defects and clinical characteristics of patients with KCNV2-associated cone dystrophy. Methods:Three pedigrees with KCNV2-associated cone dystrophy were recruited in Peking Union Medical College Hospital from August 2017 to December 2019.Peripheral blood from each patient and their parents was collected, and genomic DNA was extracted.Targeted exome capture plus next-generation sequencing (NGS) was used to detect the candidate variants.Suspected causative variants were validated by Sanger sequencing and segregation analysis.Comprehensive ocular examinations were performed, including vision acuity, colour vision, fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), visual field and electroretinogram (ERG). This study was approved by the Institutional Review Board of Peking Union Medical College Hospital and adhered to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination. Results:Three probands from three unrelated Chinese families were confirmed carrying biallelic KCNV2 disease-causing variants.Two patients harbored compound heterozygous variants and one patient with history of consanguinity was identified carrying homozygous variant.Five novel variants in the KCNV2 gene were identified, including p. T121M, p.R244C, p.C199Y, p.M250R and p. L171Pfs*201.All patients enrolled in this study were male with age of 25, 16 and 2 years old, respectively.Three affected individuals complained of vision loss and photophobia and two patients demonstrated reduced color perception and nystagmus.Macular discoloration (bull's eye maculopathy or gold foil macular reflex) was observed in fundus photographs.Macular hypofluorescence was illustrated in FAF imaging, which accompanying a broad hyperfluorescent ring surrounding the central atrophy or not.Macular thinning with loss of the inner segment ellipsoid zone was noted in OCT images, and the disruption was more profound in older patients.Central scotoma with or without peripheral visual field defects was observed in perimetry.Severe cone function loss and variable scotopic rod impairment were demonstrated in ERG, whereas a broad a-wave trough response to scotopic bright flash stimulation was noted. Conclusions:Patients with KCNV2-associated cone dystrophy show a characteristic ERG manifestation.ERG results and KCNV2 variants in Chinese patients differ from those in foreigners.

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.