Objective:To explore the effect of "Internet plus" exercise prescription intervention on upper limb dysfunction and quality of life of breast cancer patients at home after surgery, so as to provide reference for health management of breast cancer patients after surgery.Methods:Adopting a prospective randomized controlled trial research method. From November 2021 to January 2023, 124 breast cancer patients in the breast and thyroid surgery department of Xiang′an Hospital Affiliated to Xiamen University were selected for the study. According to the random number table method, they were randomly divided into an intervention group (62 cases) and a control group (62 cases). The control group patients were given routine training, and the intervention group patients received routine training in the first four weeks after operation, and "Internet plus" exercise prescription intervention in the fifth week after operation. The upper limb dysfunction, quality of life before and after the intervention and motor compliance after the intervention between the two groups were compared.Results:A total of 117 patients were ultimately included, and they were all female, with 58 patients in the intervention group aged (51.01 ± 9.77) years old and 59 patients in the control group aged (51.47 ± 9.85) years old. There was no statistically significant difference in upper limb dysfunction and quality of life between the two groups of patients before intervention ( P>0.05). After the intervention, the degree of upper limb dysfunction in the intervention group was (63.55 ± 7.02) points, which were lower than that in the control group (67.13 ± 7.25) points, and the difference was statistically significant ( t = 2.71, P<0.01). After the intervention, the total score of quality of life and the scores of physiological status, social/family status, emotional status, functional status and additional attention of breast cancer patients in the intervention group were (115.27 ± 17.35), (22.65 ± 4.53), (22.79 ± 4.36), (20.96 ± 3.95), (19.56 ± 4.22), (29.31 ± 5.24) points, which were higher than those in the control group (104.28 ± 17.04), (20.57 ± 4.48), (20.85 ± 4.23), (18.75 ± 4.04), (17.18 ± 4.06), (26.93 ± 5.21) points, the differences were statistically significant ( t values were 2.44-3.46, all P<0.05). In terms of exercise compliance of breast cancer patients in the intervention group, the aerobic exercise completion rate was 91.38% (53/58), muscle strength training completion rate was 77.59% (45/58), stretching exercise completion rate was 86.21% (50/58), exercise frequency was (3.96 ± 1.13) times/week, exercise duration was (29.51 ± 7.64) min/time, which was superior to 77.97% (46/59), 57.63% (34/59), 69.49% (41/59), (3.38 ± 0.94) times/week, (23.96 ± 7.33) min/time in the control group, the differences were statistically significant ( χ2 = 4.04, 5.31, 4.73, t = 3.02, 4.01, all P<0.05). Conclusions:"Internet plus" exercise prescription intervention has the characteristics of convenience, intuition and strong operability, which is conducive to improving the upper limb dysfunction, quality of life and exercise compliance of breast cancer patients at home after surgery. It is recommended to be popularized and applied clinically.

Objective:To explore the application effect of "Internet plus" exercise program in patients with chronic heart failure, and provide reference for health management of patients with chronic heart failure.Methods:This was a prospective randomized controlled trial study. A total of 130 patients with chronic heart failure who received treatment in the Cardiology Department of Xiang ′an Hospital Affiliated to Xiamen University from January 2022 to February 2023 were selected by convenient sampling method. According to the random number table method, they were divided into the control group and the intervention group with 65 cases in each group. The control group adopted routine nursing methods, and the intervention group implemented 12 week "Internet plus" exercise program intervention on the basis of routine nursing. The exercise compliance after intervention as well as cardiac function (6-minute walking distance) and quality of life of two groups of patients before and after intervention were compared between two groups. Results:Ultimately, there were 63 cases in the control group and 61 cases in the intervention group. In the control group, there were 45 males and 18 females, aged (61.77 ± 9.56) years old, in the intervention group, there were 49 males and 12 females, aged (61.08 ± 9.72) years old. After intervention, the ratio and frequency of completing aerobic exercise, resistance exercise, exercise frequency, exercise duration in the intervention group were 95.08%(58/61), 77.05%(47/61), (3.94 ± 1.18) times/week, (4.08 ± 1.33) times/week, (29.65 ± 7.83) min/time, which were better than 84.13%(53/63), 47.62%(30/63), (3.15 ± 0.94) times/week, (3.37 ± 0.99) times/week and (23.37 ± 6.79) min/time in the control group. The results showed statistically significant differences ( χ2=3.96, 11.41, t=4.13, 3.38, 4.78, all P<0.05). After intervention, the 6-minute walking distance in the intervention group was (351.22 ± 33.06) m, which was higher than (323.64 ± 31.85) m in the control group, with a statistically significant difference ( t=4.73, P<0.01). After intervention, the total quality of life scores and scores in various dimensions (physical, emotional, and other fields) in the intervention group were (44.45 ± 10.46), (19.19 ± 4.28), (9.95 ± 2.44), and (15.31 ± 4.75) points, which were lower than those in the control group (53.57 ± 11.02), (22.17 ± 4.51), (12.31 ± 2.69), and (19.09 ± 4.96) points, with statistically significant differences ( t values were 3.77 to 5.11, all P<0.01). Conclusions:The "Internet plus" exercise program is convenient, intuitive and operable, which is conducive to improving the exercise compliance, cardiac function and quality of life of patients with chronic heart failure.

Objective:To design and fabricate a new open-window customized tray by newly developed digital software,and to eval-uate its accuracy and fitness.Methods:A matte metal model of a standard mandibular Ken's class Ⅱ dental defect was selected as the initial model,scanned by a desktop scanner and saved in STL format.The model inverted concave filling,tray edge line and support bracket were completed in tray design software;handles,overflow holes and occlusal dike structures were added to complete the tray design.3D printing technology was used to produce 10 pairs of new open-window customized pallets made of polyacrylic acid.The pal-lets were scanned and the data were imported into Geomagic software,the pallet tissue surface was taken as a common area,the pallet CAD data were aligned with the 3D scanning data,and the deviation between the two was mesured by 3D deviation analysis.The"pal-let-model"data was obtained by repositioning the pallet on the initial model and imported into Geomagic software,and the"initial model"and"pallet"data were aligned to the"pallet-model"and"pallet"data respectively.The"initial model"and"pallet"data were aligned to the"pallet-model"data,and the distance deviation between the pallet inner surface data and the initial model data was measured and analyzed.Results:The average deviation of the inner surface printing accuracy of the new windowed customized pallet from the overall RMS estimate(mm)of the design data was 0.140±0.021,that of the support bracket area 0.115±0.024,and that of the free end saddle base area 0.185±0.036,respectively.The average deviation of the average gap size(mm)between the in-ner surface of the pallet and the outer surface of the initial model was 0.998±0.042,that of the support bracket area 0.1 1 9±0.048,and that of the saddle-base area of the free end 0.989±0.082,respectively.Conclusion:The new pallet made by the newly developed software has good accuracy and suitability,and can be used for the fabrication of corrective impressions for free-end dental defects.

Objective:To design and manufacture removable partial dentures with a new configuration,and to evaluate their accuracy and suitability.Method:A structure with abutment tooth preparation was designed in the mesh structure of the bracket.The resin substrate of buccal and tissue surfaces was designed using a layered method.Selective laser melting(SLM),digital light processing(DLP)and CNC cutting techniques were used to produce a pure titanium new configuration removable local denture bracket,base res-in part and crown,respectively,followed by splicing and assembling the new removable partial denture configuration(Test group).The samples in control group was a traditional design removable partial denture bracket made by SLM technology,and the final denture was completed by conventional tooth placement and filling with glue.10 samples were included in each group.The accuracy and suita-bility of the sample were examined,data were statistically analyzed.Results:The accuracy(3D deviation,mm)of the test and control group was 0.153±0.019 and 0.153±0.011(P=0.978),the overall suitability(3D deviation,mm)of the 2 groups was 0.191±0.006 and 0.187±0.007(P=0.218),respectively.Conclusion:The configurtion is simplified and more feassible to design and manufac-ture removable partial denture with proper accuracy and suitability.

The prevalence of hyperuricemia and gout is continuously increasing on a global scale,leading to increased social burden through complications such as chronic kidney disease,cardiovascular diseases,and joint disorders.Several studies have reported gender differences in the onset of gout,but the relationship between sex hormones as biologic markers and hyperurice-mia or gout has just gained attention in recent years,with ongoing debates on its authenticity and mechanisms.This article com-prehensively elaborates on the research progress in the impact of estrogen,androgen,progesterone,and sex hormone-binding globulin(SHBG)on hyperuricemia and gout,as well as underlying mechanisms.It will provide a basis for further understanding of uric acid metabolism and early prevention and treatment of gout.

Objective:To investigate the indication, effectiveness, tolerance, and safety of levosimendan in patients with acute heart failure (AHF) in 20 hospitals in Beijing, China.Methods:This prospective, observational, and multicenter study consecutively enrolled AHF patients who were treated with levosimendan at 20 hospitals in Beijing from April 2020 to March 2022. Baseline demographics, laboratory parameters, clinical presentation, concomitant diseases and medications were collected. After initiation of levosimendan, levosimendan administration, laboratory parameter pre- and post-administration, symptoms improvement, and adverse events were also collected.Results:Totally 800 AHF patients were included, 67% of whom were male, aged (65 ±17) years, 50% of whom had ischemic heart disease, and the left ventricular ejection fraction (LVEF) was (36±11)%. The dose of levosimendan was (11.84 ±2.11) mg and the mean infusion time was (1 450±307) min. Dyspnea was improved in 83.4% of AHF patients at 24 h after treatment. The level of B-type natriuretic peptide (BNP) significantly decreased from 689 (406-1509) pg/mL to 410 (156-697) pg/mL in all patients at 24-72 h after treatment ( P<0.001), and the level of N-terminal pro-brain natriuretic peptide (NT-pro BNP) decreased from 6910 (3 715-13 914) pg/mL to 2 851 (1 288-6 191) pg/mL ( P<0.001). Meanwhile, LVEF level also improved significantly [(40±11)% vs. (36±11)%, P<0.001]. During levosimendan administration, adverse events occurred in 74 (9.3%) patients, including hypotension (5.9%), arrhythmia (1.9%), and other symptoms (1.1%). Among them, 7 patients ( 2 patients with hypotension and 5 patients with ventricular tachycardia) interrupted levosimendan administration. Conclusions:The use of levosimendan is safe, and can improve symptoms reduce BNP or NT-pro BNP levels and increase LVEF level in AHF patients.

Objective:To translate the English version of the Modified Atrial Fibrillation Information Overload Scale into Chinese,and to preliminarily test its reliability and validity.Methods:According to the Brislin translation model,the English version of the Modified Atrial Fibrillation Information Overload Scale was translated into Chinese, and then was back-translated and modified for cultural adaptation followed by the guidelines. From December 2021 to May 2022,200 patients with atrial fibrillation in the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital Affiliated to Qingdao University were included by a convenience sampling method for a questionnaire survey, in order to evaluate its reliability and validity.Results:The Chinese version of the Modified Information Atrial Fibrillation Overload Scale contained 8 items. The Cronbach α coefficient of the Chinese version of the Modified Atrial Fibrillation Information Overload Scale was 0.884. The test-retest reliability was 0.653. The split-half reliability was 0.794. The scale-content validity index was 0.98, and the item-content validity index ranged from 0.83 to 1.00. Confirmatory factor analysis showed that the two-factor model fitted well, χ2/ df was 3.958, root mean square error was 0.026, comparative fit index was 0.936, goodness of fit index was 0.918, normal of fit index was 0.917, Tucker-Lewis index was 0.900, root mean square error of approximation was 0.08. Conclusions:The Chinese version of the Modified Atrial Fibrillation Information Overload Scale has good reliability and validity. It provides a reliable research tool for the patients to measure information overload in China, and provides a basis for health education for medical staff.

Objective:To explore the effect of Toll-like receptor 9 (TLR9) signaling pathway activation on the transcriptome in the renal tubular cells.Methods:Mouse primary renal tubular epithelial cells were extracted and cultured. When the degree of cell fusion reached 80%, they were divided into two groups, which were added with 10 μL phosphate buffered saline (PBS, PBS control group) and TLR9 activator cytosine phosphate guanidine oligodeoxynucleotide (CpG-ODN) with a final concentration of 5 μmol/L (CpG-ODN treatment group). The RNA sequencing was performed on the Illumina platform after extraction. DEGseq software was used to analyze the differential expression of genes between the two groups. Goatools and KOBAS online software were used to analyze the differential genes involved signal pathways. Homer software was used to predict transcription factors.Results:Compared with the PBS control group, there were a total of 584 differentially expressed genes in the CpG-ODN treatment group, of which 102 were up-regulated and 482 were down-regulated. The most significantly enriched gene ontology (GO) terms of differentially expressed genes included response to interferon-β, defense response to virus and other inflammatory pathway. The most significantly enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways included 2'-5'-oligoadenylate synthase activity, regulation of ribonuclease activity, negative regulation of virus life cycle, cellular response to interferon-βand defense response to protozoan. The results of transcription factor prediction showed that interferon regulatory factor 3 (IRF3) was the most significantly enriched transcription factor in the promoter sequence of differential genes; the most significant transcription factor downstream of TLR9 was IRF3, and other predicted transcription factors such as transcription factor 21 (TCF21), zinc finger protein 135 (ZNF135), and PR domain containing 4 (PRDM4) might be new candidates for TLR9 signaling pathway.Conclusion:CpG-ODN activates TLR9 signaling pathway, and primary renal tubular epithelial cells can directly respond to CpG-ODN stimulation and undergo transcriptome changes, which provides a basis for further research on the molecular mechanism of TLR9 pathway in sepsis induced acute kidney injury.

Objective:To assess the effectiveness and safety of adalimumab in Crohn′s disease (CD) patients.Methods:We retrospectively reviewed the charts of 41 CD patients who received adalimumab in Zhongda Hospital Southeast University from January 2020 to August 2021. General clinical data, laboratory results, endoscopy and radiologic findings were collected, meanwhile, disease activity and safety events were evaluated at baseline and at 12, 24 and 48 weeks of administration. Adalimumab was given subcutaneously once every 2 weeks in doses of 160 mg for the first time, 80 mg for the second time, and 40 mg for each subsequent time.Results:The clinical remission rates at 12, 24, and 48 weeks of treatment were 43.9% (18/41), 60.6% (20/33), 60.9% (14/23), and the clinical response rates were 75.6% (31/41), 69.7% (23/33), and 56.5%( 13/23), respectively. The proportion of endoscopic remission at 12, 24 and 48 weeks were 4/14, 2/6, 1/4 in patients undergoing endoscopy, and 1/14 patients achieved mucosal healing at 24 weeks. Primary nonresponse rate (PNR) was 17.1% (7/41), loss of response (LOR) rate was 14.6% (6/41). The incidence of adverse reactions was 9.8%(4/41).Conclusion:Adalimumab can effectively relieve the clinical symptoms and intestinal disease activities of Crohn′s disease, and deserves to be popularized clinically. Patients with disease course <2 years, first-line biologics, low baseline HBI score, and longer duration of medication may have better results.

Objective: To analyze the correlation between parental involvement and the formation of good eye use behavior in children,and to provide theoretical basis for more accurate prevention and control of myopia. Methods: A total of 2 726 children and their parents from 3 primary schools were selected from April to May 2021 by clustering sampling method. Children s ocular parameters, eye use behavior, general characteristics of parents, and parental involvement were collected through ocular measurements and questionnaires, respectively. Results: Parental involvement was associated with family economic, parental education level, and parental myopic status( P <0.05). Children s myopia risk was associated with parental involvement: lower myopia risk was associated with frequent parental involvement in behavioral management of child sleep and child outdoor activities( P <0.01). Parents who always/frequently participate in the management of children s eye behavior have an average daily screen time of <2 h ( OR= 1.95 , 95%CI =1.31-2.90), and daily outdoor activity time>2 h ( OR=0.78, 95%CI =0.65-0.93), daily sleep time >8 h ( OR= 0.52 , 95%CI =0.40-0.68), daily continuous reading and writing time <1 h ( OR=1.33, 95%CI =1.30-1.56), reading and writing The distance from the desktop > 30 cm ( OR=0.57, 95%CI =0.34-0.95) had a statistically significant effect ( P <0.05). Conclusion High parental involvement may help school age children develop good eye habits and reduce the risk of childhood myopia. Parental involvement is higher among those who had myopia themselves, and parental involvement is positively associated with total household income and parental literacy.