Objective:To investigate the awareness of sarcopenia and knowledge about its prevention and control in elderly patients with cardiovascular disease and analyze potential influencing factors for the awareness rate of sarcopenia, in order to provide a theoretical foundation for further developing a precise health education program for elderly patients with cardiovascular disease and sarcopenia.Methods:In this multicenter cross-sectional study, the representative sampling method was used via a questionnaire to collect demographic data, awareness of sarcopenia, and knowledge about its prevention and control from 576 elderly patients aged 60 years and over receiving treatment between March and August 2022 at 12 hospitals including Zhejiang Hospital.Meanwhile, possible influencing factors on the awareness rate of sarcopenia in elderly cardiovascular disease patients were analyzed.Results:The overall awareness rate of sarcopenia in elderly patients with cardiovascular disease was 43.2%(249/576).The awareness rates for sarcopenia-related declines in grip strength and walking speed were 39.9%(230/576)and 39.8%(229/576), respectively.The rates of awareness that sarcopenia is more likely to occur in very elderly people was 37.8%(218/576)and the rate of awareness for its more likely occurrence in elderly people with chronic diseases was 29.3%(169/576).The rates of awareness that resistance exercise and protein supplementation could prevent or improve sarcopenia were 33.9%(195/576)and 37.0%(213/576), respectively.Multivariate Logistic regression analysis found that being female and being 70-89 years old were independent risk factors affecting the awareness of sarcopenia and related knowledge about its prevention and control, while high school education and above and living alone were independent protective factors.Conclusions:The awareness rate of sarcopenia and knowledge about its prevention and control in elderly patients with cardiovascular disease is low and is significantly correlated to the female gender, advanced age, high educational achievement, living alone and other factors.Therefore, when education about sarcopenia is conducted, a precise health education program for sarcopenia should be established to improve the awareness rate of sarcopenia in elderly patients with cardiovascular disease, thus minimizing or delaying the occurrence and development of sarcopenia as much as possible.

Objective:A one-day nutritional survey study was conducted on geriatric inpatients in the Zhejiang region to evaluate their nutritional and health status.The study aimed to assess the nutritional and health status of elderly patients in the hospital, as well as perform a correlation analysis on the factors influencing the nutritional status of geriatric inpatients.The findings aim to provide evidence to support clinical interventions.Methods:This multicenter cross-sectional study involved conducting a one-day nutritional survey among geriatric inpatients in 42 medical units across Zhejiang, China.Questionnaires were utilized to gather demographic information, record 24-hour dietary intake, calculate total calorie and protein intake, screen for nutrition-related geriatric syndromes, and collect laboratory data from inpatients in the geriatrics department of these medical facilities.Analysis of the data was performed using SPSS 25.0 software to compare groups with varying nutritional statuses and identify potential influencing factors on the nutritional status of elderly hospitalized patients.Results:A total of 325 valid surveys(97.9%)were collected from 332 senior inpatients.Among them, 30 individuals(9.2%)were classified in the malnutrition group, 120 individuals(36.9%)were in the group at risk for malnutrition, and 175 individuals(53.8%)were in the group with appropriate nutrition.Approximately 37.8%(123 out of 325)of elderly hospitalized patients met the recommended minimum daily protein intake of 1g/(kg·d).Following adjustment for confounding variables, the results of multifactorial logistic regression analysis revealed that shorter daily sedentary time(2-4h), independent ambulation, assisted ambulation, maintaining regular food intake before hospitalization, and good or fair self-perceived health were protective factors for the nutritional status of elderly hospitalized patients.Conversely, having fewer than 5 teeth was identified as a risk factor.Conclusions:The prehospital living status of elderly hospitalized patients is closely related to their nutritional status.It is important to prioritize nutritional assessment and provide intervention guidance for lifestyle improvements in this population.

Objective:To evaluate the role of autophagy in hydrogen-rich solution-induced reduction of remifentanil-induced hyperalgesia in rats.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 240-260 g, were divided into 4 groups ( n=8 each) by a random number table method: incisional pain group (group I), remifentanil+ incisional pain group (group RI), hydrogen-rich solution+ remifentanil+ incisional pain group (group HRI), and hydrogen-rich solution + autophagy inhibitor+ remifentanil+ incisional pain group (MHRI group). The tail vein was catheterized, the equal volume of normal saline was intravenously infused for 60 min while the incisional pain model was developed in group I, and remifentanil was intravenously infused at a rate of 1 μg·kg -1·min -1 for 60 min while the incisional pain model was developed in RI, HRI and MHRI groups, hydrogen-rich solution 10 ml/kg was intraperitoneally injected at 10 min before preparing the model in group HRI, and 3-MA 15 mg/kg was intraperitoneally injected at 1 h before preparing the model in MHRI group, and the other treatments were similar to those previously described in group HRI. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were determined at 24 h before and 2, 6, 24 and 48 h after the end of infusion. The rats were sacrificed under anesthesia after the behavioral testing, and the lumbar enlargement segment of the spinal cord was removed for determination of the expression of microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 by Western blot. Results:Compared with the baseline at T 0, the MWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with group I, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was up-regulated, and the expression of P62 was down-regulated in group RI and group HRI ( P<0.05). Compared with group RI, the MWT was significantly increased and TWL was prolonged at T 1-4 in group HRI and group MHRI, the expression of LC3 II and Beclin-1 was significantly up-regulated, and the expression of P62 was down-regulated in group HRI, and the expression of LC3 II and Beclin-1 was significantly down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Compared with group HRI, the MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 II and Beclin-1 was down-regulated, and the expression of P62 was up-regulated in group MHRI ( P<0.05). Conclusions:The mechanism by which hydrogen-rich solution alleviates hyperalgesia may be related to enhancing the level of autophagy in the spinal cord of rats with incisional pain induced by remifentanil.

Objective To observe the clinical efficacy of Wenyang Huayin Prescription(cooked Aconiti Lateralis Radix Praeparata,Cinnamomi Ramulus,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Poria,Descurainiae Semen Lepidii Semen,etc.)combined with conventional western medicine in the treatment of elderly patients with chronic heart failure(CHF).Methods A total of 120 elderly CHF patients with fluid retention due to yang deficiency syndrome who were treated in People's Hospital of Chenghai District from December 2021 to December 2022 were selected as the research objects.They were randomly divided into control group and observation group,with 60 cases in each group.The control group was given conventional western medicine treatment,and the observation group was treated with Wenyang Huayin Prescription on the basis of the treatment of the control group.The course of treatment was four weeks.The indexes of the two groups were observed before and after treatment:(1)TCM syndrome scores;(2)serum levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6);(3)left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD);(4)6-minute walking distance.The clinical efficacy and safety of the two groups were compared.Results After treatment,(1)the scores of TCM syndromes in the two groups were significantly lower than those before treatment(P＜0.05),and the scores in the observation group were significantly lower than those in the control group(P＜0.05).(2)The levels of serum hs-CRP,TNF-α,IL-6 and NT-proBNP in the two groups were significantly lower than those before treatment(P＜0.05),and the levels in the observation group were significantly lower than those in the control group(P＜0.05).(3)The levels of LVEF in the two groups were significantly higher than those before treatment(P＜0.05),and the levels of LVEDD were significantly lower than those before treatment(P＜0.05).The level of LVEF in the observation group was significantly higher than that in the control group(P＜0.05),and the level of LVEDD was significantly lower than that in the control group(P＜0.05).(4)The 6-minute walking distance in the two groups was significantly increased when compared with that before treatment(P＜0.05),and the increase in the observation group was significantly greater than that in the control group(P＜0.05).(5)The total effective rate of the observation group(96.67%)was significantly higher than that of the control group(86.67%)(P＜0.05);the total incidence of adverse reactions in the observation group(1.67%)was significantly lower than that in the control group(11.67%)(P＜0.05).Conclusion Wenyang Huayin Prescription combined with conventional western medicine treatment can effectively reduce the TCM syndrome score of elderly CHF patients with fluid retention due to yang deficiency syndrome,improve clinical symptoms and cardiac function,and reduce the body's inflammatory response.The clinical efficacy is superior to that of western medicine alone,and the safety is relatively high.

Bayesian statistics is an approach for learning from evidences as it accumulates, combining prior distribution with current information on a quantity of interest, in which posterior distribution and inferences are being updated each time new data become available using Bayes' Theorem. Though frequentist approach has dominated medical studies, Bayesian approach has been more and more widely recognized by its flexibility and efficiency. Research and development (R&D) on anti-cancer new drugs have been so hot globally in recent years in spite of relatively high failure rate. It is the common demand of pharmaceutical enterprises and researchers to identify the optimal dose, regime and right population in the early-phase R&D stage more accurately and efficiently, especially when the following three major changes have been observed. The R&D on anticancer drugs have transformed from chemical drugs to biological products, from monotherapy to combination therapy, and the study design has also gradually changed from traditional way to innovative and adaptive mode. This also raises a number of subsequent challenges on decision-making of early R&D, such as inability to determine MTD, flexibility to deal with delayed toxicity, delayed response and dose-response changing relationships. It is because of the above emerging changes and challenges that the Bayesian approach is getting more and more attention from the industry. At least, Bayesian approach has more information for decision-making, which could potentially help enterprises achieve higher efficiency, shorter period and lower investment. This study also expounds the application of Bayesian statistics in the early R&D on anticancer new drugs, and compares and analyzes its idea and application scenarios with frequentist statistics, aiming to provide macroscopic and systematic reference for all related stakeholders.
.
Humans ; Bayes Theorem ; Lung Neoplasms/drug therapy* ; Research Design ; Antineoplastic Agents/therapeutic use* ; Biological Products ; Pharmaceutical Preparations

Objective:To evaluate the relationship between autophagy and oxidative stress during remifentanil-induced hyperalgesia in the rats with incisional pain.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, weighing 230-250 g, aged 2-3 months, were divided into 4 groups ( n=8 each) using a random number table method: incisional pain group (I group), remifentanil + incisional pain group (RI group), autophagy inhibitor 3-methyladenine + remifentanil + incisional pain group (MRI group) and autophagy agonist rapamycin group + remifentanil + incisional pain group (RRI group). The model of incision pain was developed and the equal volume of normal saline was intravenously infused simultaneously for 60 min.In RI, MRI and RRI groups, the model of incision pain was developed and remifentanil 1 μg·kg -1·min -1 was simultaneously infused for 60 min.In MRI group, 3-methyladenine 15 mg/kg was intraperitoneally injected at 12 h before developing the model, and rapamycin 10 mg/kg was intraperitoneally injected at 12 h before developing the model in RRI group.Thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 24 h before infusion of remifentanil or normal saline (T 0) and at 2, 6, 24 and 48 h after the end of infusion (T 1-4). The rats were sacrificed after the end of behavioral testing, and the lumbar enlargement segments of the spinal cord were harvested for determination of the expression of autophagy microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 (by Western blot), activity of superoxide dismutase (SOD) (by xanthine oxidase method) and content of malondialdehyde (MDA) (by thiobarbital method). Results:Compared with the baseline at T 0, PWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with I group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was decreased, and MDA content was increased in RI group ( P<0.05). Compared with RI group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was down-regulated, the expression of P62 was up-regulated, SOD activity was decreased, and MDA content was increased in MRI group ( P<0.05), and MWT was significantly increased and TWL was prolonged at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was increased, and MDA content was decreased in RRI group ( P<0.05). Conclusions:Autophagy is involved in the process of remifentanil-induced incisional hyperalgesia through regulating the level of oxidative stress in rats.

Objective:To analyze the antigenicity and genetic characteristics of two strains of Eurasian avian H1N1 swine influenza virus (EAS-H1N1) isolated from 2 human cases found in Gansu province to provide scientific reference for disease prevention and control.Methods:Two cases of human infection with EAS-H1N1 discovered in Gansu province since February 2021 were analyzed for antigenicity and genome comparison, and their genome characteristics were analyzed using software such as Mega7.0.Results:Two human infections with EAS-H1N1 had related environmental exposure history. Two strains were obtained: A/Gansu-Xifeng/1143/2021 and A/Gansu-Xifeng/1194/2021. The two strains of HA, NA genes were all from the Eurasian avian H1N1 swine influenza virus, and are closely related to the human infection EAS-H1N1 virus in Hebei and Tianjin and the EAS-H1N1 virus isolated from the mink in Shandong; the HA receptor binding sites of 2 strains E190D and D225E mutations occurred in all spots, and there were no H274Y and N294S mutations in NA protein.Conclusions:Some important molecular mutations occurred in the genome of people infected with EAS-H1N1 virus in Gansu province, which may lead to increased virulence and potential human-to-human transmission. Strengthening the research and analysis of EAS-H1N1 gene characteristics will help to monitor the mutation and mutation of the virus at the molecular level and scientifically prevent and control the epidemic.

It is an inevitable trend for dental nurses to meet the requirements for becoming a well-qualified nurse specialist who should have professional skills, basic nursing skills and holistic nursing consciousness. Combined with the daily clinical works in large general hospital, a standardized training system for dental nurses was preliminarily constructed. The strategies and experience of the professional training, including personal career planning, emergency handling capacity improvement by multi-discipline training, core curriculum system construction, dental clinical techniques strengthening, customized training strategies implementation, as well as clinical examination and evaluation, were herein discussed. In conclusion, our experience provides useful references for standardized education of the dental nurses with qualified clinical competence.

Objective To investigate the effects of ferulic acid (FA) and adipose-derived mesenchymal stem cells(ADMSCs)on rat hepatic stellate cells (HSCs) by regulating TGF-β/smad signal transduction pathway.Methods HSCs were divided into 4 groups:blank control group,FA control group,ADMSCs control group and FA+ADMSCs group.The apoptosis rate of HSCs in each group was detected by flow cytometry.The expression levels of TGF-β1,Smad2,Smad3 and Smad7 mRNA in HSCs were detected by qRT-PCR.The TGF-β1 and Smad7 protein levels,and phosphorylated-Smad2/3 (p-Smad2/3)expression were detected by Western blot.Results Compared with the other 3 groups,the apoptosis rate of HSCs in the FA+ADMSCs group was significantly increased(P＜0.05),while the expression levels of TGF-β1,Smad2 and Smad3 mRNA were significantly decreased,and the Smad7 mRNA expression was increased;moreover,the expression levels of TGF-β1 protein and p-Smad2/3 were significantly decreased,while the Smad7 protein expression was significantly increased(P＜0.05).Conclusion FA can enhance the effect of ADMSCs for down-regulating the TGF-β1 expression in HSCs,and then leads to the decrease of downstream p-Smad2/3 activity and Smad7 expression increase,thus participates in promoting cellular apoptosis.

Objective To compare and analyze the genetic structure of NIH mice bred in Unites A and B, using microsatellite technology.Methods Thirty SPF 8-week old outbred NIH mice (half male and half female) of each population were randomly chosen from the Units A and B, respectively.PCR amplification and STR scan were performed to determine the genetic characteristics of two outbred populations using microsatellite loci, and the population genetic structure was analyzed with statistical software Popgene 1.32.Results In the NIH mouse population form the Unit A, 74 alleles were obtained, with an average heterozygosity of 0.3108 and polymorphism information content of 0.2637.In the NIH mouse population from the Unit B, 76 alleles were obtained, with an average heterozygosity of 0.3257 and polymorphism information content of 0.2777.The inter-population comparison showed that genetic differentiation coefficient Fst was 0.3932, the genetic identity was 0.3971, and the genetic distance was 0.9235.The population difference was significant.Conclusions There is serious genetic differentiation between the two NIH mice populations,resulting in the formation of two different closed populations.