Objective:To explore the application effect of lower limb strength training based on "Internet +" in the home rehabilitation of knee osteoarthritis (KOA) patients.Methods:Using the convenient sampling method, a total of 80 KOA patients who visited Pain Outpatient Department of Beijing Friendship Hospital, Capital Medical University from May 2021 to December 2022 were selected. They were randomly divided into the observation group and the control group by the random number table method, with 40 cases in each group. The control group adopted routine home rehabilitation nursing, and the observation group implemented lower limb strength training based on "Internet +" on the basis of the control group. Both groups were intervened for 3 months, and the knee joint pain degree (VAS score), knee joint function (KOOS score) and exercise compliance of the two groups were compared.Results:After intervention, the VAS score of the observation group was lower than that of the control group and the KOOS score was higher than that of the control group, and the differences were statistically significant ( P<0.05). There were 26 cases of high compliance, 11 cases of partial compliance and 3 cases of low compliance in the observation group, and 19, 10 and 11 cases in the control group, respectively. The exercise compliance of the observation group was better than that of the control group, and the difference was statistically significant ( Z=1.997, P=0.046) . Conclusions:The implementation of lower limb strength training rehabilitation management based on "Internet +" can effectively alleviate knee pain in knee osteoarthritis patients, improve knee function, and improve their compliance with home exercise.

Objective:To evaluate the clinical effect of the position pillows for neuraxial anesthesia.Methods:This was a prospective randomized controlled trial. Four hundred and twelve patients regardless of gender, aged ≥18 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, who underwent elective surgery under neuraxial anesthesia at Peking University Third Hospital from February to October 2023, were selected and divided into 2 groups ( n=206 each) using a random number table method: pillow group (P group) and control group (C group). Group C underwent the conventional procedure for neuraxial anesthesia. The patients were placed in a position using the position pillow on the basis of oral education before routine anesthesia in group P. The success rate of puncture at first attempt, puncture time and position placement time were recorded. The adjustment of position, body movement and occurrence of discomfort during the puncture were also recorded. The visual analogue scale score was used to evaluate the level of anxiety before positioning, after positioning and after anesthesia. The visual analogue scale score was used to evaluate the patient′s comfort and the operator′s satisfaction with position after the anesthesia was completed. Results:Compared with group C, the time for positioning was significantly shortened, the anxiety level was decreased after positioning and after anesthesia, the rate of improvement in anxiety was increased, the scores for the patient′s comfort and the operator′s satisfaction with position were increased ( P<0.05), and no significant changes were found in the success rate of puncture at first attempt, puncture time and incidence of body movement during the puncture and incidence of the adjustment of position ( P>0.05). No discomfort was observed in either group during the puncture. Conclusions:This new type of position pillows for the neuraxial anesthesia can not only optimize the effect of position placement, but also improve the patients′ comfort.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Objective To investigate the value of 4D-CTA combined with SDF-1a/CXCR4 signaling pathway in evaluating the risk of intracranial aneurysm rupture.Methods Fifty patients with unruptured intracranial posterior communicating aneurysms and 50 patients with ruptured intracranial posterior communicating aneurysms were divided into unruptured group 1 and ruptured group 1.All patients underwent 4D-CTA examination and serumSDF-1alevel was detected.Non-ruptured group 1 was followed up for 12 months(After conservative treatment),on this basis,patients with ruptured posterior communicating aneurysms were included in ruptured group 2,and patients with unruptured posterior communicating aneurysms were included in non-ruptured group 2.Results The AUC values of Wn,AR,L,SR,SDF-1a and their combinations in diagnosing ruptured intracranial posterior communicating aneurysms were all greater than 0.70.The AUC values of Wn,AR,L,SR,SDF-1a and their combinations in predicting ruptured intracranial posterior communicating aneurysms in ruptured group 2 were all greater than 0.70.Conclusion 4D-CTA combined with SDF-1acan effectively distinguish ruptured intracranial posterior communicating aneurysms and predict the risk of rupture.

Objective:To evaluate the development of hypothermia after spinal anesthesia and risk factors.Methods:Patients undergoing spinal anesthesia in the anesthesia preparation room of our hospital from April 2020 to April 2021 were included. The temperature of the tympanic membrane was measured before spinal anesthesia and immediately after anesthesia and at 5, 10 and 15 min after anesthesia. Patients with tympanic membrane temperature<36 ℃ at any time point were considered as having hypothermia and included in hypothermia group and patients with membrane temperature ≥ 36 ℃ were considered as having no hypothermia and included in non-hypothermia group. The patients′ demographic data, highest anesthesia plane, puncture space of spinal anesthesia, types of anesthetics, preoperative fasting time, and surgical sites were recorded. The multivariate logistic regression analysis was performed to identify the risk factors for hypothermia.Results:A total of 196 patients were finally enrolled. The body temperature was significantly decreased at 5 and 10 min after anesthesia compared with the baseline body temperature before anesthesia and immediately after anesthesia ( P<0.001), and the incidence of hypothermia was 10.2%. The multivariate logistic regression analysis showed that female and high anesthesia plane were independent risk factors for hypothermia, and higher baseline body temperature was an independent protective factor for hypothermia ( P<0.05). Conclusions:Body temperature decreases at 5-10 min after spinal anesthesia, and the occurrence of hypothermia is not a small probability event in the patients undergoing spinal anesthesia; female and higher anesthesia plane are risk factors and higher baseline body temperature is the protective factor.

Objective To explore the correlation between 4D-CTA imaging and the risk factors for the rupture of anterior communicating aneurysms.Methods A total of 100 patients with anterior communicating aneurysms in the Department of Radiology of Yan'an Hospital of Kunming City from June 2020 to March 2023 were selected as the study objects.The patients were divided into ruptured group and unruptured group based on whether the aneurysm had ruptured(with 50 cases in each group).The unruptured group(50 cases)received conservative treatment and follow-up observation for 1-12 months.The measurements included the aneurysm neck width(Wn),aneurysm height(H),average diameter of the carrying artery(DA),aneurysm length(L),aneurysm neck ratio(AR),the ratio of aneurysm height to carrying artery diameter(SR),aneurysm volume to aneurysm base area(VOR),and the search for the pulsation point of the aneurysm,analyzing the correlation between these measurements and aneurysm rupture.Results Wn,AR,L and SR in ruptured group 1 were higher than those in non-ruptured group 1(P<0.05).Wn,AR,L and SR in fracture group 2 were higher than those in non-fracture group 2(P<0.05).The CT values of internal carotid artery and middle cerebral artery,and the CT values and noise of brain parenchyma in 4D-CTA were higher than those in 3D-CTA(P<0.05).Conclusion The use of 4D-CTA imaging for quantitative analysis of anterior communicating aneurysms can not only predict the risk of rupture,but also provide better image quality compared to 3D imaging while reducing radiation dosage.4D-CTA imaging has a positive impact on the diagnosis and treatment of clinical aneurysms.

ObjectiveTo explore the effects of phillygenin （PHI） on the inflammation in L02 cells induced by lipopolysaccharide （LPS） and adenosine triphosphate （ATP） and the expression of purinergic 2X7 receptor （P2X7R）， NOD-like receptor family pyrin domain containing 3 （NLRP3）， and nuclear factor kappa B （NF-κB） expression. MethodIn this study， the inflammation model was induced in L02 cells by 100 μg·L^-1 LPS treatment for 24 h and 5 mmoL·L^-1 ATP treatment for 5 h. The cells in the PHI groups were cultured with PHI （100， 50， 25 mg·L^-1） for 6 h in the LPS treatment period， followed by LPS treatment for another 18 h. After ATP treatment for 5 h， the mRNA and protein expression of interleukin-1β （IL-1β）， interleukin-18 （IL-18）， P2X7R， NLRP3， Caspase-1 precursor （pro-Caspase-1）， cleaved Caspase-1， NF-κB， and NF-κB inhibitor protein α （IκBα） in L02 cells was detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. Molecular docking was used to predict whether P2X7R could bind to PHI， and DCFH-DA was employed to detect the accumulation of reactive oxygen species （ROS） in cells. P2X7R was silenced by small interfering ribonucleic acid （siRNA）， and then the mRNA expression of IL-1β， IL-18， P2X7R， NLRP3， Caspase-1， NF-κB， and IκBα was detected by Real-time PCR. ResultReal-time PCR and Western blot showed that compared with the normal group， the model group showed increased expression of IL-1β and IL-18 （P<0.05）， and compared with the model group， the PHI groups showed down-regulated IL-1β， IL-18 mRNA and protein expression （P<0.05）. Molecular docking suggested a good binding effect of PHI to P2X7R. Real-time PCR and Western blot analysis showed that the expression of P2X7R in the model group was significantly up-regulated compared with that in the normal group （P<0.05）， and compared with the model group， the PHI groups showed down-regulated mRNA and protein expression of P2X7R （P<0.05）. DCFH-DA results showed that compared with the normal group， the model group showed increased content of ROS （P<0.05）， and compared with the model group， the PHI groups decreased the accumulation of ROS （P<0.05）. As demonstrated by Real-time PCR and Western blot， compared with the normal group， the model group showed increased expression of NLRP3 inflammasome and NF-κB （P<0.05）， and compared with the model group， the PHI groups significantly decreased the mRNA and protein expression of NLRP3 and cleaved Caspase-1， and up-regulated the mRNA and protein expression of NF-κB and IκBα （P<0.05）. Real-time PCR analysis showed that compared with the results in the model group， after silencing P2X7R by siRNA， the mRNA expression of IL-1β， IL-18， P2X7R， NLRP3， Caspase-1， NF-κB， and IκBα was decreased （P<0.05）. PHI exerted the same effect， and the mRNA expression was further reduced after the combination of them. ConclusionPHI is presumed to suppress the expression of the NLRP3/NF-κB signaling pathway by down-regulating upstream P2X7R to alleviate the LPS/ATP-induced inflammation in L02 cells， suggesting that P2X7R may be the target of PHI against inflammation.

Objective:To investigate the current situation of core competence of anesthesiology nurses in China, and to provide basis for formulating and perfecting the training curriculum of anesthesiology nurses.Methods:The cluster sampling method was used, and 231 nurses in the department of anesthesiology were investigated by using the general data questionnaire and the self-assessment form of core competence of specialized nurses in the department of anesthesiology.Results:Anesthesiology nurses scored (3.7±0.5) points in their core competencies, of which 43.2% and 36.4% had complete mastery of humanistic literacy, and communication and coordination skills, respectively, and only 4.3% of them had mastered scientific research ability.The core competence scores of anesthesiology nurses with the title of head nurse or above positions and deputy chief nurse or above titles were significantly higher than those of other positions and titles ( P<0.05). Conclusions:The self-evaluation of core competence of specialized nurses in anesthesiology department is at a medium level.There are differences in core competencies among nurses in the department of anesthesiology with different positions and titles.It is suggested that the training of specialized nurses should be guided by core competence.

Objective: To provide a largescale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion. Methods: This crosssectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals. Results: The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)( χ 2=68 944.95, P <0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67 (0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups. Conclusion Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.