BACKGROUND:The proximal femoral nail antirotation is the preferred treatment for reverse osteoporotic intertrochanteric fractures.Bone cement enhancement can reduce the probability of proximal femoral nail antirotation cut-out and cut-through,but there are no relevant biomechanical studies demonstrating the effect of bone cement content and location on the stress and displacement of the fracture end. OBJECTIVE:To investigate the effects of different contents and locations of bone cement in cement-reinforced proximal femoral nail antirotation on stress,strain,and displacement of reverse osteoporotic femoral intertrochanteric fractures in the elderly by finite element analysis. METHODS:A healthy adult female right femur model was extracted by Mimics software and smoothed in Geometric software.Five types of internal fixation methods of proximal femoral nail antirotation(cementless,cephalic spherical 1 mL,cephalic spherical 2 mL,cephalic spherical 3.4 mL,and cylindrical 5 mL around spiral blade)and femoral intertrochanteric fracture(AO subtype 31-A3.1 type)model were established in Solidworks software.After assembly,the total stress distribution,peak stress and displacement of the five models of implants with the femur were compared in Ansys software. RESULTS AND CONCLUSION:(1)The peak stresses of proximal femoral nail antirotation with head-end spherical 1 mL,head-end spherical 2 mL,head-end spherical 3.4 mL,and cylindrical 5 mL enhanced proximal femoral nail antirotation around the spiral blade respectively were 571.07 MPa(located at the junction of the spiral blade and the main nail),495.45 MPa(located at the junction of the spiral blade and the main nail),467.20 MPa(located at the junction of the main nail and the distal screw connection),642.70 MPa(located at the junction of the main nail and distal screw connection),and 458.58 MPa(located at the junction of the spiral blade and the main nail).(2)The maximum displacements of proximal femoral nail antirotation with head end sphere 1 mL,head end sphere 2 mL,head end sphere 3.4 mL,and with cylindrical 5 mL enhancement around the spiral blade were 9.260 5,7.589 1,7.316 8,6.790 7,and 6.615 7 mm,respectively,all of which were located at the proximal end of the femoral head.(3)These findings revealed that for reverse femoral intertrochanteric fractures treated with proximal femoral nail antirotation,the bone cement enhancement had significant mechanical stability compared with no enhancement,and the enhancement of the spiral blade 5 mL around the perimeter was the best,which is more preferable for aged unstable intertrochanteric fractures.

Objective:To explore the effect and safety of endoscopic tubular musculoskeletal tumor surgery (ETMS) technology in spinal tumors.Methods:Clinical data were retrospectively collected from 18 spinal tumor patients who were treated with ETMS technology at Tianjin Medical University Cancer Institute and Hospital ( n=16) or the Affiliated Hospital of Qingdao University ( n=2) from November 2022 to December 2023. The total cohort included 11 males and 7 females, with the age at 60.3±8.6 years (range of 41-76). Two cases were diagnosed with benign tumors, four patients were diagnosed with spinal hematologic malignancies while other 12 cases were patients with spinal metastases. After localization under the C-arm X-ray machine, the spinal endoscopic channel is established using dilators. Soft tissue is dissected under endoscopic guidance to create an artificial cavity. Subsequently, the saline medium relied upon by the spinal endoscopic technique is removed, and posterior decompression and tumor curettage are performed using tubular techniques. Frankel grade classification and paraplegia index were used to evaluate the improvement of postoperative function and the VAS score was performed in pain scoring. The surgical complications and tumor evaluation were observed by postoperative outpatient and telephone follow-up. Results:The ETMS technology was successfully completed in all 18 patients with the mean operation time of 240.3±80.2 min. The median of intraoperative bleeding was 200.0(172.5, 350.0) ml and the mean postoperative drainage was 131.4±69.5 ml. The median value of postoperative hospitalization days was 6.0(4.0, 10.25) d. The paraplegia index decreased from 1.5(0, 3.0) preoperatively to 0(0, 1.25) postoperatively ( Z=-2.599, P=0.009). All the patients presented an improvement in Frankel grading after surgery except for one patient (downgrading from grade E to grade D). There was significantly difference in Frankel grading between preoperative and postoperative groups ( Z=2.812, P=0.005). The median value of preoperative VAS score was up to 5.5(4.0, 7.0) while the median value at postoperative, one month after surgery and three months after surgery were 1.5(1.0, 2.25), 1.0(0, 1.0) and 0(0, 1.0), respectively (χ 2=44.641, P<0.001). The 3-month postoperative VAS improvement rate was 91.2% (range 75%-100%). During a mean follow-up period of 7.6±6.2 months, none of the 18 patients presented surgical complications or tumor recurrence at surgical region. Only one patient died at 3.2 months after surgery until the last follow-up due to respiratory failure after lung tumor progression. The mean survival of the total cohort was up to 13.3 [95% CI (11.5, 15.0)] months. The 16 cases with spinal metastases or spinal hematological malignancies had a mean survival of 13.2 [95% CI (11.3, 15.0)] months. Conclusion:The ETMS technology presented good efficacy and safety in treatment of spinal tumors with low blood supply and with diameter less than 5cm.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

Objective:To explore the willingness to use mobile healthcare in patients with gout and explore its influencing factors, and provide theoretical guidance for optimizing the gout mobile healthcare platform and improving patients' willingness to use it.Methods:This study was a cross-sectional study. Totally 234 patients with gout who attended the outpatient service in Shandong Provincial Gout Clinic Medical Center from November 2019 to January 2020 were selected by convenient sampling, and investigated with a self-designed general information questionnaire and questionnaire of gout patients' willingness to use mobile healthcare and its influencing factors. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of gout patients' willingness to use mobile healthcare.Results:A total of 53.85% (126/234) of patients with gout mainly used gout WeChat official account as a form of mobile healthcare, and the commonly used functions were diet guidance (64.96%, 152/234) , disease knowledge (60.26%, 141/234) , exercise guidance (54.27%, 127/234) ; 47.01% (110/234) of patients were not satisfied with mobile healthcare. The gout patients' willingness score to use mobile healthcare was (10.91±3.28) . Univariate analysis showed that there were statistically significant differences in the willingness scores of patients with different personal monthly income, education level, and whether have comorbid diseases ( F/t=12.511, 6.343, -2.229; P< 0.05) . Regression analysis showed that the influencing factors of gout patients' willingness to use mobile healthcare included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, information quality and system quality (adjust R2=0.446, P<0.01) . Conclusions:The willingness of gout patients to use mobile healthcare services is at a moderately high level, and there are differences between different individuals. The willingness to use mobile healthcare is affected by patients' health beliefs and the quality of mobile healthcare information systems.

Objective Based on lung cancer center database,we analyzed the clinical characteristics of lung patients with bone metastases.The relationship between bone metastases,skeletal-related events,survival time and different pathological subtypes of lung cancer were also evaluated in this study.Methods A total of 861 patients with lung cancer were studied from May 2010 to April 2012 at Tianjin Medical University Cancer Institute and Hospital.As to follow-up situation,patients' survival status and treatment information were collected by telephone follow-up and (or) examinationsin outpatient.The clinical characteristics,skeletal-related events and survival of bone metastaticpatients with different pathological types of lung cancer were analyzed.Logistic regression analysis was used to identify risk factors for bone metastases.The relationship between histological subtypes and the incidence of bone metastases was evaluated using Odds Ratios (ORs).The chi-square test was used to compare the proportion of bone metastases,synchronous bone metastases and SREs among different histological subtypes patients.The overall survivals was evaluated using the Kaplan Meier.Results A total of 861 patients with lung cancerwere enrolled in this study,including 293 cases with bone metastases.The average follow-up of our population was 14.2 months and the last follow-up time was September 2017.Among different pathological types of lung cancer,adenocarcinoma (39.14％,173/442) has the highest incidence of bone metastases,followed by other types (29.91％,35/117),squamous cell carcinoma (29.47％,56/190) and SCLC (25.89％,29/112).Spine (59.73％,175/293) was the most common location site of the bone metastases,followed by the ribs (49.15％,144/293),pelvis (20.48％,60/293),femur (16.38％,48/293) and sternal (16.38％,48/293).Lung adenocarcinoma was a risk factor for bonemetastases (P=0.002).In ORs analyze,adenocarcinoma patients were more likely to develop bone metastases [OR=1.60,95％CI (1.21～2.13)].In our cohort,58.36％of patients with lung cancer had skeletal related events.Among various types of skeletal related events of patients with bone metastases,the most common one was radiotherapy for bone metastases (51.88％,152/293),followed by pathological fractures (15.02％,44/293),spinal cord compression (6.48％,19/293),bone instability requiring surgery (4.78％,14/293) and hypercalcemia (1.71％,5/293).There was no significant difference between different types of skeletal related events.The median survival time of the patients with bone metastases was 11.5 months.There was no significant difference in survival between adenocarcinoma patients and non-adenocarcinoma patients (P=0.111).Conclusion This study suggested that the incidence of bone metastasis in lung adenocarcinoma was 39.14％ and lung adenocarcinoma was a risk factor for bone metastases,which supported early screening and monitoring of bone metastasis in the patients.

Objective To investigate the current status of learning burnout on Basic Nursing Science practical course among five-year higher vocational nursing students and to analyze the reasons for burnout from nursing students' perspectives.Methods We selected 285 nursing students in a five-year higher vocational college by convenience sampling. The higher vocational nursing students practical training learning burnout questionnaire was used to investigate them. Among 285 nursing students, a total of 12 of them were selected to carry out focus group interview to explore the reasons for learning burnout of nursing students.Results A total of 285 questionnaires were sent out and 278 valid questionnaires were collected. Among 278 nursing students, the total score of higher vocational nursing students practical training learning burnout questionnaire was (2.78±0.52) with 93.9％ for the detection rate of learning burnout. There were statistical differences in the scores of the learning burnout questionnaire among nursing students with different sexes, places of birth, academic record and whether like nursing specialty (P<0.05).Conclusions The learning burnout of five-year higher vocational nursing students is common in nursing practical training. Many factors lead to practical training learning burnout of nursing students, such as individual, teachers, companions and vocational perspective.

Objective To systematically review the application effects of bundles nursing on pressure ulcer nursing intervention of elderly patients. Methods Clinical control trails of the application effect of bundles nursing on pressure ulcer nursing of elderly patients were searched using computer in cooperation with manual retrieval from SinoMed,VIP,CNKI,and WanFang database. Two reviewers independently searched and extracted data, screened captured citations,and assessed methodological quality of all included studies. RevMan 5.3 software was used for Meta-analysis. Results Twenty-nine literatures were included for systematic review with 3 020 cases. Meta-analysis showed that,bundles nursing significantly increased the effective rate of pressure ulcer treatment of elderly patients [RR=1.26,95%CI (1.22,1.31)],and improved the degree of nursing satisfaction [RR=1.18, 95%CI (1.12,1.25)] when compared with the usual care group. The differences were statistically significant (P< 0.05). Conclusions Bundles nursing can significantly increase the effective rate of pressure ulcer treatment of elderly patients,and improve the nursing satisfaction,so it is worthy of promotion.

Immunoglobulin (Ig) is considered a part of the innate immune system and cooperates with the complementary system as the first line of defense. In this study, a monoclonal antibody (MAb) direct against the light chain of goose Ig (GoIgCL) was generated, characterized and identified in various immunoassays to detect goose Ig. An immunoaffinity chromatography column prepared with this MAb was used to separate the goose Ig from sera. After being conjugated with horseradish peroxidase (HRP), this MAb was used as the secondary antibody to evaluate the goose-specific antibody. In addition, this MAb distinguished and localized the SIg+ lymphocytes from peripheral blood lymphocytes. MAb against GoIgCL may be good candidate to detect or purify goose Ig under various conditions and as a powerful tool for humoral immunity research on goose.

BACKGROUND:With the development of AO, the treatment of intercondylar humeral fractures with open reduction has been a trend. However, the methods of fixation become many. There is no conclusion of which method is optimal.
OBJECTIVE:To investigate the clinical effect of two kinds of different fixation methods (Y-type steel plate and double steel plate) for intercondylar humeral fractures via different surgical approaches.
METHODA retrospective analysis of clinical data of 86 cases of fresh intercondylar humeral fractures in the Department of Orthopedics, Sixth Affiliated Hospital, Xinjiang Medical University, between December 2003
and May 2014 were conducted in this study. According to the different fixation materials, patients were divided into two groupdouble steel group (n=44, including the surgical approach of ulna olecranon osteotomy which had 22 cases and the surgical approach of triceps V shaped severance which had 22 cases), Y-type steel group (n=42, including the surgical approach of ulna olecranon osteotomy which had 21 cases and the surgical approach of triceps V shaped severance which had 21 cases). The clinical curative effect and related complications of the two groups after operation were analyzed. During fol ow-up, modified Cassebaum elbow scoring system was used to evaluate the excellent and good rate of therapy.
RESULTS AND CONCLUSION:After fol owed up for 12-36 months, the total excellent and good rate of Y-type steel plate was 76%and the total excellent and good rate of double steel plate was 77%. There were no significant differences between the two groups (P>0.05). But interestingly, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance and the difference was statistical y significant (P<0.05). Above data suggested that Y-type steel plate and double steel plate were effective ways in the repair of intercondylar humeral fractures. However, for different surgical approaches, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance.

Nowadays, the research performance evaluation in Traditional Chinese Medicine (TCM) is basically exploring the principles and rules. What become the problems are that what index system can fully reflect the TCM performance evaluation, and what method can reflect the characteristics of TCM performance evaluation. Analyzing the status of the Korean research performance evaluation, we briefly disseminated how to establish the TCM performance evaluation.