Objective:To explore the alteration of irisin in chronic obstructive pulmonary disease(COPD)patients before and after pulmonary rehabilitation(PR)treatment and to analyze the prognostic value of irisin in COPD pa-tients with acute exacerbations.Method:A total of 68 COPD outpatients from department of respiratory and critical care medicine in the Sec-ond Hospital of Hebei Medical University from February 2022 to August 2022 were enrolled and 35 healthy participants were admitted as controls.ELISA was applied to detect the expression of irisin in the serum of the patients.The difference between the COPD group and the health control group and the difference between before and after PR treatment were compared.The correlation analysis was used to analyze the relationship be-tween irisin and 6MWD(6 minutes walking distance)and IL-6(interleukin-6).In addition,K-M survival curve was used to differ the one-year cumulative risk of acute exacerbation-free risk ratio between the low irisin and the high irisin expression group.Result:①The expression of irisin in serum of the COPD patients and the health control group were(16.79±5.83)ng/ml and(34.89±8.68)ng/ml,respectively(P<0.05,t=12.55).②The concentration of irisin in the COPD patients before and after 8 weeks of PR treatment were(17.72±4.56)ng/ml and(19.55±4.25)ng/ml(P<0.05,t=4.43),respectively.③The level of Irisin in the COPD patients was positively correlated with the 6MWD(R=0.475,P<0.05)and negatively related with IL-16 level(R=﹣0.39,P<0.05).④K-M survival curve demonstrated that the median time without AECOPD(acute exacerbations of chronic obstructive pulmo-nary disease)in the low-level irisin and high-level irisin groups were(6.17±0.68)month and(9.58±0.82)month,respectively.Moreover,the cumulative acute exacerbation-free rate in 1 year was 30.0%and 68.12%,respectively(F=11.1 P<0.05).Conclusion:The expression of irisin in serum of the COPD patients was lower than that in the health control group and its level increased after PR treatment.The reduction of irisin might be a poor prognostic indicator for acute exacerbation in patients with COPD.

Objective:To explore the alteration of irisin in chronic obstructive pulmonary disease(COPD)patients before and after pulmonary rehabilitation(PR)treatment and to analyze the prognostic value of irisin in COPD pa-tients with acute exacerbations.Method:A total of 68 COPD outpatients from department of respiratory and critical care medicine in the Sec-ond Hospital of Hebei Medical University from February 2022 to August 2022 were enrolled and 35 healthy participants were admitted as controls.ELISA was applied to detect the expression of irisin in the serum of the patients.The difference between the COPD group and the health control group and the difference between before and after PR treatment were compared.The correlation analysis was used to analyze the relationship be-tween irisin and 6MWD(6 minutes walking distance)and IL-6(interleukin-6).In addition,K-M survival curve was used to differ the one-year cumulative risk of acute exacerbation-free risk ratio between the low irisin and the high irisin expression group.Result:①The expression of irisin in serum of the COPD patients and the health control group were(16.79±5.83)ng/ml and(34.89±8.68)ng/ml,respectively(P<0.05,t=12.55).②The concentration of irisin in the COPD patients before and after 8 weeks of PR treatment were(17.72±4.56)ng/ml and(19.55±4.25)ng/ml(P<0.05,t=4.43),respectively.③The level of Irisin in the COPD patients was positively correlated with the 6MWD(R=0.475,P<0.05)and negatively related with IL-16 level(R=﹣0.39,P<0.05).④K-M survival curve demonstrated that the median time without AECOPD(acute exacerbations of chronic obstructive pulmo-nary disease)in the low-level irisin and high-level irisin groups were(6.17±0.68)month and(9.58±0.82)month,respectively.Moreover,the cumulative acute exacerbation-free rate in 1 year was 30.0%and 68.12%,respectively(F=11.1 P<0.05).Conclusion:The expression of irisin in serum of the COPD patients was lower than that in the health control group and its level increased after PR treatment.The reduction of irisin might be a poor prognostic indicator for acute exacerbation in patients with COPD.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To investigate the current status and longitudinal development trajectory of postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip replacement surgery and analyze the relationship between POCD and postoperative hip joint function recovery.Methods:Using the convenient sampling method, elderly patients who underwent hip replacement surgery in Department of Orthopedics in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2022 were selected as the research objects. The cognitive function at 1 week, 1 month, 2 months and 3 months after surgery was assessed using Mini-Mental State Examination (MMSE), and the longitudinal development trajectory of postoperative POCD was fitted using latent class growth model (LCGM). The differences between cognitive function categories and Oxford Hip Score (OHS) score at 3 months after surgery were compared by ANOVA.Results:A total of 307 elderly patients with hip replacement completed full follow-up and data collection. The incidence of POCD (MMSE<8 points) in patients at four postoperative time points was 30.29% (93/307), 29.97% (92/307), 28.66% (88/307) and 21.17% (65/307), respectively. The MMSE score was lowest at 1 week after surgery. Three potential categories of cognitive function longitudinal development tracks were identified by LCGM, including 208 cases (67.75%) with no cognitive dysfunction, 32 cases (10.42%) with improved cognitive dysfunction, and 67 cases (21.82%) with continuous cognitive dysfunction. Three months after surgery, patients with no cognitive impairment had the lowest OHS score, while patients with persistent cognitive impairment had the highest OHS score. There were statistically significant differences in OHS scores among patients with three longitudinal potential categories of cognitive function ( P<0.05) . Conclusions:The incidence of POCD in elderly patients with hip replacement varies at different postoperative times, with the most significant difference occurring at 1 week after surgery. Medical staff must dynamically evaluate the postoperative cognitive function of elderly patients and adopt targeted nursing strategies for different types of cognitive impairments, to promote the patient's recovery of hip function.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province.. Methods In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents’ demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis. Results A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ² = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ² = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey. Conclusions The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.

Objective:To investigate the application effect of preoperative prerehabilitation in elderly patients with knee arthroplasty combined with sarcopenia.Methods:A total of 164 elderly patients who were hospitalized and underwent artificial knee arthroplasty combined with sarcopenia in Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from July 2020 to December 2021 were included by the convenient sampling method. According to random number table method, they were divided into the control group and the observation group, with 82 cases in each group. The control group received routine preoperative nursing, and the observation group received preoperative pre-rehabilitation intervention on the basis of the control group. Knee range of motion, Hospital for Special Surgery Knee Score (HSS) , skeletal muscle mass index and grip strength were evaluated before intervention and 1 month after operation. Length of stay and postoperative complications were recorded and compared between the two groups.Results:Knee range of motion, HSS of two groups at 1 month after operation were higher than those before intervention, and the differences were statistically significant ( P<0.05) . One month after surgery, the knee range of motion, HSS and grip strength of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The skeletal muscle mass index of the observation group was higher one month after surgery than before intervention, but the difference was not statistically significant ( P>0.05) . The hospitalization time of observation group was shorter than control group, and the difference was statistically significant ( P<0.05) . The incidence of complications in the observation group and control group was respectively 15.85% (13/82) and 39.02% (32/82) , and the difference was statistically significant ( P<0.05) . Conclusions:Preoperative rehabilitation can effectively improve the knee range of motion and joint function of elderly patients with sarcopenia after knee rarthroplasty, alleviate sarcopenia, shorten the length of hospital stay and reduce postoperative complications.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

Objective: To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS. Methods: Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software. Results: A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ²=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ²=14.47, P<0.001 in stool specimen; χ²=31.99, P<0.001 in throat swab; χ²=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases. Conclusions Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.