Objective To understand the current situation and influencing factors of the quality of life(QOL)of elderly people in Xinjiang,explore the relationship between the quality of life of elderly people,chronic disease comorbidities,and daily living activities,and provide new ideas and reference research for improving the quality of life of elderly people.Methods Stratified cluster random sampling was used,and 2610 permanent elderly population in Urumqi,Aksu,Karamay and Changji of Xinjiang Uygur Autonomous Region were selected in 2023 for questionnaire survey.Results The quality of life score of the elderly was(68.38±20.76),and the comorbidity rate of chronic diseases was 53.1%.Multiple chronic conditions(MCC)had a significant predictive effect on QOL score(β=-4.3497,P<0.001),and activities of daily living(ADL)grading had a significant predictive effect on QOL score(β=0.5534,P<0.001).MCC can affect QOL score through the mediating effect of ADL directly or indirectly.The direct effect(-6.2894)and indirect effect(-1.7820)account for 70.18%and 29.82%of the total effect,respectively.There is a certain mediating effect of ADL between QOL and MCC status in elderly people.Conclusion Chronic comorbidities are significantly negatively correlated with QOL and ADL scores for the elderly.The more chronic diseases,the lower the QOL score and ADL score in the elderly,and the more severe the impairment of daily living ability.

Objective To examine and compare the effect of personalized progressive aerobic-exercise and resistance-training prescriptions on anxiety of undergraduates.Methods This was a randomized controlled trial.Sixty-six undergraduates with anxiety were recruited and randomized into an aerobic ex-ercise(AE)group,a resistance exercise(RE)group and a control group,each of 22.The aerobic and resistance exercise groups underwent 12-week aerobic and resistance exercise respectively,while the control group only received health education.Before as well as after 4-,8-and 12-week interven-tion,and 4 weeks after the intervention,all groups were evaluated using Self-Rating Anxiety Scale(SAS)and Chinese College Students Mental Health Scale--Anxiety Subscale(CCSMHS-AS).More-over,before and 16 weeks after the intervention,all groups were assessed physical activity(PA)us-ing the International Physical Activity Questionnaire-Short Form(IPAQ-SF).Results The average SAS scores of the AE and RE groups decreased significantly from 6.95±6.32 and 56.41±5.45 before the intervention to 38.29±5.82 and 41.18±7.51 after 12-week exercise,while the average CC-SMHS-AS score decreased significantly from 20.00±5.66 and 19.41±3.70,to 13.18±4.81 and 14.32±4.16 during the same period of time(P<0.01 for all).Four weeks after the intervention,the SAS score of the AE group was significantly higher than 4 weeks earlier(49.18±11.84 vs.38.29±5.82,P<0.01),while that of the RE group increased without significant differences compared with 4 weeks earlier(42.50±9.57 vs.41.18±7.51,P>0.05),with the value of both groups significantly lower than right after the intervention(P<0.01,P<0.05).In the control group,the SAS score de-creased significantly from 55.73±5.27 before the intervention to 47.09±5.55 right after the interven-tion,and further to 46.95±9.70 4 weeks later(P<0.05),but no significant differences were ob-served in the CCSMHS-AS score(P>0.05).Meanwhile,right after the intervention,the average SAS scores of the AE and RE groups were significantly lower than the control group(P<0.01,P<0.05),without significant differences among the three groups 4 weeks after the intervention(P>0.05).The CC-SMHS-AS scores of AE group right after and 4 weeks after the intervention were significantly higher than the control group(P<0.01),but no significant differences were found in it between either the AE and RE group,or the RE and control group(P>0.05).Besides,the PA levels of the AE and RE groups 4 weeks after the intervention were significantly higher than before the intervention,while no significant changes were observed in the PA level of the control group(P>0.05).Conclusion Twelve-week personalized progressive aerobic-exercise and resistance-training prescriptions both result in a similar effect on relieving anxiety and improving spontaneous PA of college students.However,the prognosis of aerobic exercise is poorer than the other.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objectives:To calculate the age-standardized incidence rate, disability-adjusted life years (DALY) rate, and mortality rate of chronic obstructive pulmonary disease (COPD) among individuals aged ≥60 years globally from 1990 to 2019, and analyze their trends. To assess the impact of population growth, changes in age structure, and epidemiological changes on global changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years.Methods:The data were derived from the 2019 Global Burden of Disease study. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) and its 95% uncertainty interval ( UI). Through decomposition analysis, the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years globally were attributed to three main factors: population growth, changes in age structure, and epidemiological changes. The contributions of these different factors were analyzed to identify the important factor driving the changes. Results:From 1990 to 2019, the age-standardized incidence rate, DALY rate, and mortality rate of COPD in the global population aged ≥60 years all showed a decreasing trend, with AAPCs of -0.12% (95% UI: -0.13%--0.11%), -1.69% (95% UI: -1.80%--1.58%), and -1.77% (95% UI: -1.89%--1.64%), respectively. The overall contributions of population growth, changes in age structure, and epidemiological changes to the changes in the number of COPD cases, DALYs, and deaths in the global population aged ≥60 years were 5.631 million (112.55%), 14.315 million person-years (33.08%), and 799 400 (35.76%), respectively. Specifically, the contributions of population growth were 5.643 million (112.80%), 39.774 million person-years (91.92%), and 2.078 million (92.93%) for incidence, DALYs, and deaths, respectively. The contributions of changes in age structure were 3.228 million (6.45%), 2.231 million person-years (5.15%), and 265 600 (11.88%) for incidence, DALYs, and deaths, respectively. The contributions of epidemiological changes were -335 200 (-6.70%), -27.690 million person-years (-64.00%), and -1.544 million (-69.05%) for incidence, DALYs and deaths, respectively. Conclusions:Globally, from 1990 to 2019, the age-standardized incidence, DALY rate, and mortality of COPD in individuals aged ≥60 years showed a general downward trend while the combined factors, including contribution of population growth, age structure, and epidemiological features, showed positive impacts on the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years. The largest impact was on the number of cases. Specifically, population growth had the highest contribution ratio to the changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years, while epidemiological changes had a negative contribution.

Objective:To measure pancreatic fat deposition by magnetic resonance chemical shift imaging (CSI), and analyze the correlation between pancreatic fat deposition and pancreatic fistula after pancreaticoduodenectomy (PD).Methods:A retrospective analysis was conducted on the data of 55 patients who underwent PD in the Affiliated Hospital of Xuzhou Medical University from September 2021 to April 2024. Among them, 34 were male (61.8%) and 21 were female (38.2%), with the age of (63.5±12.0) years. The 55 patients included 17 cases (30.9%) of pancreatic ductal adenocarcinoma, 1 case (1.8%) of pancreatic serous cystadenoma, 2 cases (3.6%) of pancreatic mucinous cystadenoma, 1 case (1.8%) of pancreatic solid pseudopapillary tumor, 11 cases (20.0%) of ampullary carcinoma, 10 cases (18.2%) of common bile duct carcinoma, and 13 cases of other pathological types (such as high-grade intraepithelial neoplasia of the ampullary gland, duodenal adenocarcinoma, etc.) (23.6%). Before the operation, pancreatic fat deposition was measured by CSI and the fat fraction was calculated. With a fat fraction of 6.2% as the cut-off value, 55 patients were divided into the normal pancreas group (fat fraction ≤ 6.2%, n=29) and the fat pancreas group (fat fraction > 6.2%, n=26). The total hospitalization cost, postoperative hospital stay, biochemical leakage, grade B pancreatic fistula of the two groups were compared, and the correlation between pancreatic fat fraction and pancreatic fistula was analyzed. Result:The total hospitalization cost in the normal pancreas group was (91 527.3±19 118.4) yuan, and the postoperative hospital stay was 9.0 (8.0, 13.0) days, both of which were lower than those in the fatty pancreas group (107 772.4 ± 27 055.6) yuan and 11.0 (8.0, 22.0) days, and the differences were statistically significant ( t=-2.59, P=0.012; Z=-2.08, P=0.038). In the normal pancreas group, 8 cases (27.6%) of biochemical leakage and 1 case (3.4%) of grade B pancreatic fistula occurred after the operation. In the fat pancreas group, 10 cases (38.5%) of biochemical leakage and 8 cases (30.8%) of grade B pancreatic fistula occurred after the operation. There was no statistically significant difference in the incidence of biochemical leakage between the two groups ( χ2=0.74, P=0.391). The incidence of grade B pancreatic fistula after surgery in the adipose pancreas group was significantly higher than that in the normal pancreas group, and the difference was statistically significant ( χ2=5.61, P=0.018). The relationship between pancreatic body fat fraction and the occurrence of pancreatic fistula is correlated (the correlation coefficient was 0.334, 95% CI: 0.127-0.515, P=0.013) The relationship between the overall fat fraction of the pancreas and the occurrence of pancreatic fistula is correlated (the correlation coefficient was 0.472, 95% CI: 0.235-0.689, P<0.001). Conclusions:The incidence of grade B pancreatic fistula after PD in patients with a low fat fraction of the pancreas measured by CSI was lower than that in patients with a high fat fraction. Fat deposition in the pancreatic body and the pancreas as a whole is associated with the incidence of pancreatic fistula.

Objective To investigate the effect of lidocaine medicated plaster （LMP） combined with pregabalin （PGB） on patients with postherpetic neuralgia （PHN）, and the impact on serum pain mediators. Methods 108 PHN patients admitted in our hospital from January 2024 to December 2024 were selected and grouped according to the time point of receiving treatment, 54 PHN patients treated with PGB from January 2024 to June 2024 were included in the PGB group, and 54 PHN patients treated with LMP on top of the PGB group from July 2024 to December 2024 were included in the PGB+LMP group. Comparisons were made between the two groups in terms of pain score, serum pain mediator levels, dosage of PGB, and incidence of adverse reactions. Results After 4 weeks of treatment, both groups showed a decrease in Pain Rating Index scores （sensory score and affective score）, Present Pain Intensity score, Visual Analog Scale score, and total score. Meanwhile, above scores of the PGB+LMP group were lower than those of the PGB group （P<0.05）. After 4 weeks of treatment, the levels of substance P（SP） and neuropeptide Y （NPY） in both groups were lower than those before treatment, while serum 5-hydroxytryptamine （5-HT） levels were higher than those before treatment. Moreover, the levels of SP and NPY were lower, and 5-HT level was higher in the PGB+LMP group than in the PGB group （P<0.05）. The dosages of PGB in the PGB+LMP group at T1, T, T3 and T4 were significantly lower than those in the PGB group （P<0.05）. The incidence of adverse reactions was 1.85%（1/54） in the PGB+LMP group. Compared to 5.56%（3/54） in the PGB group, and the difference was not statistically significant （P>0.05）. Conclusion LMP combined with PGB was effective in the treatment of patients with PHN, which could effectively alleviate pain and lower the levels of serum pain mediators, with good safety.

Objective To understand the current situation and influencing factors of the quality of life(QOL)of elderly people in Xinjiang,explore the relationship between the quality of life of elderly people,chronic disease comorbidities,and daily living activities,and provide new ideas and reference research for improving the quality of life of elderly people.Methods Stratified cluster random sampling was used,and 2610 permanent elderly population in Urumqi,Aksu,Karamay and Changji of Xinjiang Uygur Autonomous Region were selected in 2023 for questionnaire survey.Results The quality of life score of the elderly was(68.38±20.76),and the comorbidity rate of chronic diseases was 53.1%.Multiple chronic conditions(MCC)had a significant predictive effect on QOL score(β=-4.3497,P<0.001),and activities of daily living(ADL)grading had a significant predictive effect on QOL score(β=0.5534,P<0.001).MCC can affect QOL score through the mediating effect of ADL directly or indirectly.The direct effect(-6.2894)and indirect effect(-1.7820)account for 70.18%and 29.82%of the total effect,respectively.There is a certain mediating effect of ADL between QOL and MCC status in elderly people.Conclusion Chronic comorbidities are significantly negatively correlated with QOL and ADL scores for the elderly.The more chronic diseases,the lower the QOL score and ADL score in the elderly,and the more severe the impairment of daily living ability.

Objective:To design an assisted management system for medical consumables that integrated management logic of diagnosis related groups(DRG)for disease,so as to standardize the use for medical consumables and to strengthen regulatory efficiency.Methods:The system was designed by a microservices architecture,and the data fusion of business data,data of diagnosis and treatment,and DRG data was realized through constructed data lake.A knowledge graph of associated rule for medical consumables was established,and the intelligent analysis function included prediction for demand,usage optimization,and anomaly detection was provided to assist management decision-making on the basis of inference for historical data and knowledge,and multi-dimensional data queries.A rule engine was deployed at key clinical nodes for real-time compliance review and intelligent alerts.A DRG-based business management process was constructed to cover full lifecycle of consumables,including admission,procurement,warehousing,storage,requisition,usage billing,and traceability,so as to realize real-time monitoring and early warning for consumable costs at the DRG level.Six clinical doctors with 2-3 years of experience in using medical consumable were selected as test users from Tangdu Hospital of the Air Force Medical University,and they were randomly assigned into a system group and a control group,with 3 subjects in each group.The system group utilized the auxiliary management system for medical consumable to perform prediction for the demand of monthly procurement,and rationality verification of consumable.The control group relied on individual experience of doctors.The predicted monthly procurement demand for medical consumables,the accuracy of verifying rationality of using medical consumables between two groups were compared,and the efficiencies of two kinds of management modes also were compared.Results:The accuracy rate of system group was 89.17%in predicting the monthly procurement demand for medical consumables,and the rate of checking accuracy and the rate of checking comprehensiveness of system group were respectively 87.50%and 91.67%in verifying rationality of using medical consumables,which were significantly higher than those of control group,and the differences were significant(x2=6.62,1.96,16.73,P<0.05).The durations of predicting the demand for procurement,and verifying and testing the rationality of consumables in system group were significantly shorter than these in control group[(3.54±0.45)s,(2.23±0.15)s],and the differences were statistically significant(t=1.97,1.65,P<0.05).Conclusion:The medical consumables auxiliary management system integrated with DRG management logic can significantly enhance the accuracy of monthly demand prediction for consumables and the recall rate and precision rate of rationality verification for consumables usage,while greatly improving work efficiency.It is conducive to enhancing the standardized and refined supervision level of consumables usage.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objectives:To calculate the age-standardized incidence rate, disability-adjusted life years (DALY) rate, and mortality rate of chronic obstructive pulmonary disease (COPD) among individuals aged ≥60 years globally from 1990 to 2019, and analyze their trends. To assess the impact of population growth, changes in age structure, and epidemiological changes on global changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years.Methods:The data were derived from the 2019 Global Burden of Disease study. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) and its 95% uncertainty interval ( UI). Through decomposition analysis, the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years globally were attributed to three main factors: population growth, changes in age structure, and epidemiological changes. The contributions of these different factors were analyzed to identify the important factor driving the changes. Results:From 1990 to 2019, the age-standardized incidence rate, DALY rate, and mortality rate of COPD in the global population aged ≥60 years all showed a decreasing trend, with AAPCs of -0.12% (95% UI: -0.13%--0.11%), -1.69% (95% UI: -1.80%--1.58%), and -1.77% (95% UI: -1.89%--1.64%), respectively. The overall contributions of population growth, changes in age structure, and epidemiological changes to the changes in the number of COPD cases, DALYs, and deaths in the global population aged ≥60 years were 5.631 million (112.55%), 14.315 million person-years (33.08%), and 799 400 (35.76%), respectively. Specifically, the contributions of population growth were 5.643 million (112.80%), 39.774 million person-years (91.92%), and 2.078 million (92.93%) for incidence, DALYs, and deaths, respectively. The contributions of changes in age structure were 3.228 million (6.45%), 2.231 million person-years (5.15%), and 265 600 (11.88%) for incidence, DALYs, and deaths, respectively. The contributions of epidemiological changes were -335 200 (-6.70%), -27.690 million person-years (-64.00%), and -1.544 million (-69.05%) for incidence, DALYs and deaths, respectively. Conclusions:Globally, from 1990 to 2019, the age-standardized incidence, DALY rate, and mortality of COPD in individuals aged ≥60 years showed a general downward trend while the combined factors, including contribution of population growth, age structure, and epidemiological features, showed positive impacts on the changes in the number of COPD cases, DALYs, and deaths among individuals aged ≥60 years. The largest impact was on the number of cases. Specifically, population growth had the highest contribution ratio to the changes in COPD incidence, DALYs, and deaths among individuals aged ≥60 years, while epidemiological changes had a negative contribution.