Objective To clarify the evidence of the frequency and risk factors for falls in knee osteoarthritis(KOA)of adults by meta-analysis.Methods Computerized searches of the CNKI,VIP,Wanfang data,CBM,PubMed,Cochrane Library,Embase,Web of Science were conducted for literature on risk factors for falls in adults with KOA from the inception of the databases to August 2024.After literature screening,data extraction,and quality evaluation,RevMan 5.4 software was used for Meta-analysis.Results A total of 26 articles were involved.Meta-analysis result showed that the rate of falls was 29.0％.Factors associated with increased risk of falls included being female(OR=1.35),decreased lower limb muscle strength(OR=1.72),decreased knee flexion muscle strength(OR=7.05),decreased static posture stability(OR=1.28),opioid use(OR=1.79),antidepressant use(OR=1.69),frequent stair climbing(OR=7.58),combined neurological disease(OR=1.77),history of falls(OR=3.29)and fear of falling(OR=2.54).Conclusion The rate of falls of patients with KOA is high.The adults with KOA who are women,have lower muscle strength of lower limbs and knee flexion muscle strength,poorer static posture stability,use opioids,antidepressant,frequent stair climbing,combined neurological disorders,previous falls in the past year and fear of falls are at higher risk of falls.Healthcare professionals should dynamically assess and detect the risk of falls in the patients with KOA and adopt targeted,individualized interventions to prevent falls.

Objective To clarify the evidence of the frequency and risk factors for falls in knee osteoarthritis(KOA)of adults by meta-analysis.Methods Computerized searches of the CNKI,VIP,Wanfang data,CBM,PubMed,Cochrane Library,Embase,Web of Science were conducted for literature on risk factors for falls in adults with KOA from the inception of the databases to August 2024.After literature screening,data extraction,and quality evaluation,RevMan 5.4 software was used for Meta-analysis.Results A total of 26 articles were involved.Meta-analysis result showed that the rate of falls was 29.0％.Factors associated with increased risk of falls included being female(OR=1.35),decreased lower limb muscle strength(OR=1.72),decreased knee flexion muscle strength(OR=7.05),decreased static posture stability(OR=1.28),opioid use(OR=1.79),antidepressant use(OR=1.69),frequent stair climbing(OR=7.58),combined neurological disease(OR=1.77),history of falls(OR=3.29)and fear of falling(OR=2.54).Conclusion The rate of falls of patients with KOA is high.The adults with KOA who are women,have lower muscle strength of lower limbs and knee flexion muscle strength,poorer static posture stability,use opioids,antidepressant,frequent stair climbing,combined neurological disorders,previous falls in the past year and fear of falls are at higher risk of falls.Healthcare professionals should dynamically assess and detect the risk of falls in the patients with KOA and adopt targeted,individualized interventions to prevent falls.

Objective To develop and test the reliability and validity of the Intrinsic Capacity Assessment Scale for the Older People,so as to provide an effective tool for the assessment of the intrinsic capacity of the aged.Methods Based on the International Classification of Functioning,Disability and Health(ICF)as the theoretical framework,the initial version of The Intrinsic Capacity Assessment Scale for the Older People was developed through literature analysis,Delphi expert consultation and pre-survey.From July to September 2023,650 old people were selected by convenience sampling method to conduct a survey,and 20 old people were surveyed after 2 weeks again to test the reliability and validity of the scale.Results The effective questionnaire recovery rates of the 2 rounds of expert correspondence were 92.3％and 91.7％;the expert authority coefficients were 0.83 and 0.86;the mean importance scores of items were 2.04-3.79 and 3.50-3.82,and the full score ratios were 4.2％-83.3％and 54.6％-86.4％,respectively.The coefficients of variation were 0.11-0.42 and 0.11-0.23,respectively.A total of 5 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 68.327％.The results of confirmatory factor analysis showed that the fit indexes were x2/df=1.908,RMSEA=0.054,CFI=0.931,IFI=0.932,TLI=0.922,indicating a good fit.The Cronbach's α coefficient of the scale was 0.944;the split half reliability was 0.806;the retest reliability was 0.933.The content validity index of item level was 0.82-1.00,and the content validity index of scale level was 0.91.The Intrinsic Capacity Assessment Scale for the Older People included 35 items in 5 dimensions:movement,vitality,sensation,cognition and psychology.Conclusion The Intrinsic Capacity Assessment Scale for the Older People has good reliability and validity,and it can be used as a reliable tool to evaluate the intrinsic capacity level of the aged.

Objective:To systematically evaluate the risk factors of sarcopenia in patients with chronic heart failure, and to provide a basis for delaying the occurrence of sarcopenia and preventing the adverse outcome of sarcopenia.Methods:Cross-sectional studies, cohort studies and case-control studies of sarcopenia in PubMed, Cochrane Library, Web of Science, EMBase, China National Knowledge Infrastructure, China biomedical database (Sinomed), VIP database, Wanfang medical database were searched from database establishment to November 30, 2023. Meta-analysis was performed using RevMan 5.4 and Stata18.0 software.Results:In total, 16 articles were included, including 11 risk factors. The results showed that the incidence of chronic heart failure was 31.00%. The age of sarcopenia in chronic heart failure ( OR = 1.09, 95% CI 1.06-1.11), other chronic diseases ( OR = 6.57, 95% CI 3.29-13.10), cardiac function grade ( OR = 3.24, 95% CI 1.48-7.08), left ventricular ejection fraction ( OR = 0.96, 95% CI 0.94-0.97). Conclusions:Advancedage, comorbididy with other chronic diseases, and high cardiac function class are the risk factors for the development of sarcopenia in patients with chronic heart failure, and high left ventricular ejection fraction is a protective factor. Medical staff should screen early, identify high-risk groups early, strengthen health education, and give targeted interventions to slow down the development of sarcopenia to improve the quality of life of patients.

Objective:To systematically evaluate the risk factors of sarcopenia in patients with chronic heart failure, and to provide a basis for delaying the occurrence of sarcopenia and preventing the adverse outcome of sarcopenia.Methods:Cross-sectional studies, cohort studies and case-control studies of sarcopenia in PubMed, Cochrane Library, Web of Science, EMBase, China National Knowledge Infrastructure, China biomedical database (Sinomed), VIP database, Wanfang medical database were searched from database establishment to November 30, 2023. Meta-analysis was performed using RevMan 5.4 and Stata18.0 software.Results:In total, 16 articles were included, including 11 risk factors. The results showed that the incidence of chronic heart failure was 31.00%. The age of sarcopenia in chronic heart failure ( OR = 1.09, 95% CI 1.06-1.11), other chronic diseases ( OR = 6.57, 95% CI 3.29-13.10), cardiac function grade ( OR = 3.24, 95% CI 1.48-7.08), left ventricular ejection fraction ( OR = 0.96, 95% CI 0.94-0.97). Conclusions:Advancedage, comorbididy with other chronic diseases, and high cardiac function class are the risk factors for the development of sarcopenia in patients with chronic heart failure, and high left ventricular ejection fraction is a protective factor. Medical staff should screen early, identify high-risk groups early, strengthen health education, and give targeted interventions to slow down the development of sarcopenia to improve the quality of life of patients.

Objective:To observe the effects of acupuncture at Houxi(SI3)and Huantiao(GB30)on the expression levels of nuclear factor kappa B(NF-κB),inducible nitric oxide synthase(iNOS),and nitric oxide(NO)of NF-κB inflammatory signaling pathway in L5 spinal nerve root of lumbar disc herniation(LDH)model rats and explore the mechanism of acupuncture in LDH treatment.Methods:Forty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into a sham operation group,a model group,acupuncture group 1,and acupuncture group 2,with 10 rats in each group.The non-compression nucleus protrusion model was made by puncturing L4-L5 spinous process space and injecting autologous nucleus suspension.Acupuncture at bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)was carried out in acupuncture group 1,and acupuncture at bilateral Houxi(SI3)and Huantiao(GB30)in acupuncture group 2.All rats were treated with balanced reinforcing and reducing needling manipulations,and the needles were retained for 30 min/time with one episode of needling manipulation every 10 min,once a day,14 times in total.The threshold value of paw withdrawal pain was measured by a thermal stimulation pain instrument;the serum NF-κB,iNOS,and NO levels were measured by enzyme-linked immunosorbent assay.The pathomorphological changes of spinal nerve roots were observed by hematoxylin-eosin(HE)staining;quantitative reverse transcription polymerase chain reaction was used to detect iNOS mRNA expression in spinal nerve roots;the NF-κB and iNOS protein expression in spinal nerve roots was detected by the immunofluorescence method.Results:Compared with the sham operation group,the threshold of paw withdrawal pain in the model group was decreased,and the expression levels of serum NF-κB,iNOS,and NO were increased;HE staining showed many degenerated and dissolved Schwann cells in spinal nerve roots with vacuolar changes;meanwhile,the expression levels of NF-κB and iNOS proteins,and the iNOS mRNA in spinal nerve roots were increased.Compared with the model group,the paw withdrawal pain thresholds in acupuncture group 1 and acupuncture group 2 were increased,and the increase in acupuncture group 2 was greater(P<0.05);the expression levels of serum NF-κB,iNOS,and NO in acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01);the vacuolar changes of spinal nerve roots,and the degeneration and lysis of Schwann cells in acupuncture group 1 and acupuncture group 2 were decreased,which were more obvious in acupuncture group 2;the NF-κB and iNOS protein expression and the iNOS mRNA expression levels in spinal nerve roots of acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01).Conclusion:Acupuncture at Houxi(SI3)and Huantiao(GB30)can improve the morphology of spinal nerve roots,inhibit the NF-κB and iNOS protein expression levels in spinal nerve roots and the serum NO level,and relieve the pain caused by inflammation of spinal nerve roots,which may be one of the mechanisms of acupuncture in LDH treatment.

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Objective:To understand the status of young nurses' turnover intentions in the ClassⅢ Grade A hospitals of our country, and explore its influencing factors from personal factors and organizational factors, and so as to provide a reference for reducing the turnover of young nurses and stabilizing the team of young nurses.Methods:This study is a cross-sectional study. From December 2016 to June 2018, stratified sampling and cluster sampling were used to select young nurses from 10 hospitals in 7 administrative regions of China as the research subject. The Intent to Leave Questionnaire, General Information Questionnaire, Career Growth Scale of Nurses, General Self-Efficacy Scale, Work-Family Support Scale and Organizational Commitment Scale were used to understand young nurses' turnover intentions and organizational factors. Logistic regression was used to explore the influencing factors of turnover intention. A total of 11 466 questionnaires were returned, and 10 781 young nurses were surveyed.Results:Among the 10 781 young nurses in ClassⅢ Grade A hospitals across our country, 3 612 nurses (33.5%, 3612/10 781) had intention to leave, of which 413 nurses (3.8%, 413/10 781) had very strong intention to leave. Logistic regression analysis showed that male ( OR=1.268) , only child ( OR=1.177) , high self-efficacy ( OR=1.671) were risk factors for turnover intention ( P<0.05) , having children ( OR=0.845) , have changed work place ( OR=0.788) , formal authorized strength ( OR=0.852) , higher interest in nursing ( OR=2.161) , high level of career growth ( OR=0.517) , high level of work-family support ( OR=0.523) , and high level of organizational commitment ( OR=0.633) were protective factors for turnover intention ( P<0.05) . Conclusions:The turnover intention of young nurses in ClassⅢ Grade A hospitals across our country is at a high level. Medical institutions need to focus on creating a good environment, providing good work-family support, and increasing nurses' organizational commitment and professional interest, so as to reduce the turnover of young nurses.

Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.

Objective:To stablish a transitional nursing model for patients with chronic diseases under the hierarchical diagnosis and treatment system and clarify the structure and functions, so as to provide a chronic disease management model with practical operation, promotion and reference.Methods:In April 2019, a research group was established. Based on a large amount of literature and policy analysis, guided by the three-dimensional quality theory model of structure-process-results, the transitional nursing model was constructed and the index system letter consultation questionnaire was initially prepared. After the preliminary survey, it was revised to form the first-round consultation questionnaire. Delphi method was used to conduct 2 rounds of letter consultation among 19 experts. The positive coefficient of experts, the authoritative coefficient of experts and Kendall 's coordination coefficient were calculated. Analytic hierarchy process (AHP) was used to determine the weight coefficient of each index and quantify the importance degree of the index. Results:The effective recovery rates of the two rounds of letter consultation questionnaires of expert were both 100%. The authoritative coefficients of experts were respectively 0.80 and 0.84, Kendall 's coordination coefficient was 0.137 to 0.253 ( P<0.001) , and the coefficients of variation were all less than 0.25. The index system for the transitional nursing model of patients with chronic diseases finally established included 6 first-level indicators, 38 second-level indicators and 32 third-level indicators of "transitional nursing procedures", and the structural and functional diagram was generated. Conclusions:The established transitional nursing model for patients with chronic diseases is scientifically reliable and comprehensive in content, which has practical significance for promoting the deep integration of mobile Internet and medical and health fields, guiding the subsidence of advantageous resources and promoting the implementation of hierarchical diagnosis and treatment.