Objective To investigate the current status of frailty in patients on maintenance hemodialysis(MHD),and explore the correlation of frailty with anxiety and depression.Methods General information,clinical data and blood biochemical data of 101 cases who underwent MHD in Department of Nephrology,Shunde Hospital Affiliated to Jinan University from January 2023 to January 2024 were collected.FRAIL scale was applied to evaluate the frailty of the patients,and they were accordingly classified into frailty group and non-frailty group(including pre-frail and non-frail participants).Anxiety and depression were evaluated by GAD-7 and PHQ-9 scale.Univariate analysis and logistic regression were used to explore the association of frailty with anxiety,depression and other possible influencing factors.Results Among the 101 cases,29 cases(28.71%)were includedin frailty group and 72 cases(71.29%)in non-frailty group.There were 42 patients with depression(41.58%)and 25 with anxiety(24.75%).In the frailty group,the prevalence of depression was 65.52%and that of anxiety 55.17%.There were significant differences in age,grip strength,exercise,stroke and coronary heart disease,anxiety and depression,ferritin and CRP between the two groups(P＜0.01).Multivariate regression analysis showed that depression,anxi-ety,no exercise,stroke and high ferritin concentration were independent risk factors for frailty in MHD patients(P＜0.05).Conclusion In patients on MHD,frailty is closely associated with depression,anxiety,and lack of exercise,and stroke as well as high ferritin concentration are independent risk factors for frailty.

Objective:To optimize the strategy of Nuss procedure with open approach via median sternotomy for pectus excavatum(PE) with congenital heart disease(CHD).Methods:25 PE patients with CHD treated in our center from January 2017 to November 2021 were reviewed and divided into two groups. The CHD surgery and open Nuss procedure with median sternotomy were performed concomitantly in 9 cases(group A), whose height of(121.7±28.0)cm, weight of(22.2±14.0)kg, age of(7.65±4.08) years old, and Haller index of 3.99±1.37. 16 cases underwent open Nuss procedure via median re-sternotomy after congenital heart surgery(group B), whose height of(130.9±27.2)cm, weight of(26.5±14.3)kg, age of(8.82±4.09) years old, and Haller index of 4.18 ± 0.97. The cardiac anatomy, cardiac function and the severity of PE of all patients were evaluated by echocardiography and computed tomography preoperatively. The preoperative gender, appearance of PE, types of associated CHD, retrosternal adhesion and the interval between open Nuss procedure and CHD surgery were collected. The details of operation, hospital stay, intraoperative adverse events, postoperative complications and follow-up were collected.Results:All the operations were accomplished successfully in 25 children. No intraoperative complications occurred. One had a postoperative wound infection in group A. The operation time of group A was significantly longer than that of group B[(3.78±1.54) h vs.(2.19±0.94) h, P<0.05]. There was no significant difference in the mechanical ventilation time between the two groups[(22.50±45.64) h vs.(4.18±1.41) h, P=0.263]. The ICU stay of group A was significantly longer than that of group B[(4.00±6.42) days vs.(1.13±0.34) days, P<0.05]. There was no significant difference in the length of hospital stay between the two groups[(16.00±15.18) days vs.(9.19±2.31) days, P=0.419]. The Nuss bar was removed in 14 cases of the two groups, with a interval of(27.9±11.25) months after open Nuss procedure, the postoperative Haller Index was 2.48±0.49. There was no difference of LVEF in postoperative and preoperative echocardiography(0.663±0.028 vs. 0.659±0.038, P=0.533). The FVC and FEV1 were significantly improved compared with before operation[(87.2±3.9)% vs.(84.1±8.2)%]. The outcome was good. Conclusion:For PE patients with CHD, one-stage or staged individualized Nuss procedure with open approach via median sternotomy can be performed after careful preoperative evaluation. A skillful median re-sternotomy and widely dissecting retrosternal adhesion between sternum and anterior wall of heart are necessary to avoid serious intraoperative complications such as massive heart bleeding and ensure good sternal elevation.

Objective:To analyze the dynamic characteristics of rodents population density distribution in plague foci of Yinchuan City, Ningxia, and to provide reference for early warning of the plague.Methods:The plague surveillance results and epidemic reports of Yinchuan City from 2015 to 2018 were collected retrospectively, and the data were obtained from the database of Yinchuan City Center for Disease Control and Prevention. Descriptive method was used to analyze the species, number, density, fleas, vector index, etiology and serology results of rodents in the plague foci.Results:From 2015 to 2018, 4 families, 8 genera, 13 species, and 8 843 rodents were captured in the plague foci of Yinchuan City, and Meriones unguiculatus (4 557 rodents) was the dominant species. The survey area of host animal density was 1 459 hm 2, 3 805 rodents were captured, and the average density was 2.61/hm 2, of which the Meriones unguiculatus density was 1.98/hm 2. A total of 41 488 traps of nocturnal rodents were investigated, and 2 660 rodents were captured, with an average capture rate of 6.41%. A total of 6 952 fleas were obtained, belonging to 4 families, 7 genera, and 8 species; Xenopsylla conformis conformis (4 597 fleas) and Nosopsyllus laeviceps kuzenkovi (1 761 fleas) were the dominant species. Among them, there were 2 286 flea-infected rodents, the body flea-infected rate was 25.85% (2 286/8 843), and the body flea-infected index was 0.76. A total of 220 gerbils nests were investigated, and the nest flea-infected rate was 34.55% (76/220), and the nest flea-infected index was 0.98. No plague bacterium was isolated by pathogen detection of rodents and fleas. The results of indirect hemagglutination test were all negative. Conclusion:The Meriones unguiculatus is the dominant species in the plague foci of Yinchuan City, the average density is still high, attention should be paid to the occurrence of plague outbreaks.

Myelodysplastic syndrome (MDS) is a heterogeneous group of myeloid clonal disease deriving from hematopoietic stem cells, which is mainly characterized with bone marrow failure and abnormal cloning. Trisomy 8 is the most common chromosomal abnormality in MDS. Current studies have found that gene amplification, gene mutation, abnormal expression of microRNA, high expression of Wilms tumor 1 protein, Survivin and miR-661 are related to trisomy 8, which play roles in the abnormality of clone and apoptosis of MDS. This article summarizes the molecular biology transformation and clinical treatment progress of MDS with trisomy 8.

Objective? To explore the effects of strengthening out-of-hospital health beliefs on perceived well-being and behavioral change in elderly patients with colon cancer. Methods? Totally 112 elderly patients with colon cancer admitted in Nanyang City Center Hospital from August 2015 to August 2017 were selected by convenient sampling and divided into two groups (n=56) based on the time of admission. Patients in the control group received conventional nursing care, while patients in the observation group received out-of-hospital health beliefs. Both interventions lasted for 6 months. The knowledge needs scale for cancer patients and the Health Promoting Lifestyle Profile-Ⅱ (HPLPⅡ) were used to evaluate the perceived well-being and healthy behaviors in the two groups before and after intervention. Results? The scores of psychological needs, technical needs, medication needs and rehabilitation needs and the total score of the knowledge needs scale for cancer patients in the observation group were higher than those before intervention and those of the control group after intervention. The scores of self-fulfillments, exercise, health responsibility, nutrition, pressure handling and interpersonal support and the total score of HPLP Ⅱ of the observation group were higher than those before intervention and those of the control group after intervention (P＜ 0.05). Conclusions? Strengthening out-of-hospital health beliefs can effectively improve the perceived well-being of elderly patients with colon cancer and enable them to develop healthy behaviors.

Objective To develop the clinical practice guidelines for the management of medication adherence to highly active antiretroviral therapy (HAART) in China. Methods The development methods included qualitative interview of 31 stakeholders, questionnaire survey of 423 PLHIV, adaptation of 30 clinical practice guidelines related to AIDS care, and overviews of reviews of 44 systematic reviews/Meta-analysis. Results 10 clinical practice guidelines and 10 systematic reviews/Meta-analysis were included. The clinical practice guidelines for the management of HAART were formed. Conclusions The formed clinical practice guidelines showed better applicability and higher general quality. It is recommended to use the guidelines in AIDS care.

Objective To analyze the changes of gopher density and epidemic situations of animal plague in the natural plague foci of Yinchuan from 2004-2014,to sum up the epidemic regularity of the epidemic situation,and to provide a scientific basis for prevention and treatment of the plague.Methods Retrospective analysis was used in the study.The plague monitoring data were collected;the number of host animals,density of rat,media index,aetiological and serological test results were analyzed.Results From 2004 to 2014,a total of 15 664 rats in 14 species,4 families and 9 genera were captured.The dominant populations were Meriones unguiculatus and Meriones meridianus.The density of rats was 4 919 km2,the number of rats was 6 196,the density of each rat was 0.21 to 3.85/hm2,and the average density was 1.26/hm2.A total of 15 664 rats were examined,the number of positive rats was 33,and the positive rate was 0.21％ (33/15 664).Among them,gerbils were 29,accounted for 87.88％ (29/33);18 strains of Yersiniapestis were detected in dead rats,which accounted for 54.54％ (18/33).A total of 5 810 groups of 22 070 fleas were cultured,the number of positive fleas was 42,and the positive rate was 0.12％ (7/5 810).Plague fleas were 2 kinds,the same type cheopis subspecies in 6 groups of 37 fleas,Nosopsyllus laeviceps vole subspecies in 1 group of 5 fleas.The positive number of F1 antibody was 3,and the positive rate was 0.12％ (3/ 2 446).Conclusions Yinchuan City,the natural foci of plague epidemic,is in the active state.We should pay attention to the density changes of Meriones unguiculatus and strengthen the monitoring work to pick up the dead rats,and found the epidemic of animal plague as soon as possible,in order to prevent the occurrence of human plague.

Objective To investigate the effect of thrombospondin 1(TSP-1) on the cell proliferation of cultured rat pulmonary artery smooth cell (PASMCs) in vitro .Methods Rat PASMCs were cultured in vitro ,and treated with different concentrations (10-12 、10-11 、10-10 mol/L) of TSP-1 for 12 ,24 ,48 h .The cell proliferation was quantified by MTT assay .The cell cycle of PASMCs was measured by flow cytometric(FCM) analysis .Results MTT assay showed that TSP-1 promoted the proliferation of PASMCs significantly ,and the effect was concentration-dependent and time-dependent .FCM analysis indicated that TSP-1 increased the percentage of S phase .The percentage of S phase of PASMCs were increased after treated with thrombospondin-1 for 12 h , slight down after 24 h ,while reached a maximal level at 48 h .Conclusion The TSP-1 promotes rat PASMCs proliferation in a con-centration-dependent and time-dependent manner .

Objective To study the effect of early enteral nutrition (EEN) with ω-3 polyunsaturated fatty acid on nutritional status and body immunity of postoperative patients with colorectal cancer.Methods Forty patients with colorectal cancer were randomly divided into EEN group and parenteral nutrition (PN) group by systematic sampling method with 20 cases of each.The patients in EEN group were given complete enteral nutrition with ω-3 polyunsaturated fatty acid 1-7 d after operation,while the patients in PN group only were given nutrient by regular PN.Nutritional status,body immunity before operation and 1-7 d after operation,and intestinal function recovery time,untoward reaction were determined.Results The postoperative anus first exhaust time and defecate time of patients in EEN group were significantly shorter than those in PN group [(48.0±5.6) hvs.(51.0±6.7) h,(53.0±4.8) h vs.(72.0±3.6) h,P＜0.05].Serum albumin and prealbumin 1 d after operation in 2 groups were significantly lower than before operation (P ＜0.05),but 7 d after operation were significantly higher than 1 d after operation (P ＜0.05).Serum albumin and prealbumin 7 d after operation in EEN group were significantly higher than PN group(P ＜ 0.05).IgG,IgA,IgM,CD3,CD4,CD8,CD4/CD8 1 d after operation in 2 groups were significantly lower than before operation (P ＜ 0.05).IgG,IgA,CD4,CD4/CD8 7 d after operation in EEN group were significantly higher than PN group (P＜ 0.05).Conclusions Compared with the PN,EEN with ω-3 polyunsaturated fatty acid can remarkably improve nutritional status and body immunity in postoperative patients with colorectal cancer.It can accelerate the recovery of intestine function and worthy of recommending.

Objective To summarize the experiences of extracorporeal membrane oxygenation (ECMO) technique in human lung transplantation. MethodsECMO was used in 45 patients undergoing lung transplantation.There were 32 cases of dilated pulmonary fibrosis and pulmonary hypertension,4 cases of chronic obstructive pulmonary disease,2 cases of pneumosilicosis,2 cases of phthisis,one case of diffuse panbronchiolitis,2 cases of bronchiectasis and 2 cases of primary pulmonary hypertension. In 3 patients, ECMO conduit was used as a bridge to the lung transplantation for 13,19 and 6 days respectively before operation,and ECMO support was done after the operation.In 40 patients ECMO support was done during operation.In 2 patients without using cardiopulmonary bypass, ECMO support was done after operation because of primary graft dysfunction.Results In 40 patients undergoing ECMO support during operation,the ECMO conduit was removed in 37 patients immediately after the operation.ECMO mean blood flow was (2.8 ± 0.6)L/min,running time was (7.7 ± 0.9) h,and 31 patients survived. In 3 patients undergoing postoperative ECMO support,ECMO was removed in 2 cases at 36th h and 6th day after the operation respectively,and the remaining one died from acute renal failure 2 weeks after the operation though the continuing hemofiltration was applied through ECMO conduit. In 2 patients without using cardiopulmonary bypass and 3 patients using ECMO during operation,ECMO support was used initially or again after operation because of PGD or acute heart failure.Three patients were cured,and 2 patients were died from multiple system organ failure.Conclusion ECMO is an important auxiliary tool in lung transplantation for preoperative,intraoperative and postoperative supports. As the transition bridge to recipients,ECMO can be used for preoperative supports; during operation,it can stabilize the haemodynamics,and postoperation,it can improve severe pulmonary function dysfunction and PGD.