Objective To explore the relationship between body mass index(BMI)and blood pressure(BP),blood lipids,waist-to-hip ratio(WHR),and hemoglobin(Hb)in the elderly.Methods A total of 10 978 elderly individuals aged≥65 years old in a community in Baoshan District,Shanghai from February 2023 to October 2023 were selected as the research subjects.Height,body mass,waist circumference(WC),hip circumference(HC),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),Hb were measured,and BMI and WHR were calculated.According to the Chinese BMI reference standard,the elderly were divided into a lean group(BMI＜18.5 kg/m2,n= 310),a normal body mass group(18.5 kg/m2≤BMI＜24 kg/m2,n=4 692),a overweight group(24 kg/m2≤BMI＜28 kg/m2,n= 4 615),and an obese group(BMI≥28 kg/m2,n=1 361).The levels of BP,blood lipids,WHR,and Hb in the four groups were compared and correlation analysis was conducted.Results The levels of BMI,WC,HC,WHR,SBP,DBP,and Hb in elderly men were higher than those in elderly women(all P＜0.01),while the levels of TC,HDL,and LDL were lower than those in elderly women(all P＜0.01).The differences in SBP,DBP,TC,HDL,LDL,WHR,and Hb among the four groups were statistically significant(all P＜0.05),and BMI was positively correlated with SBP,DBP,TC,LDL,WHR,and Hb(r=0.109,0.064,0.041,0.042,0.108,0.089,all P＜0.01),and negatively correlated with HDL(r=﹣0.106,P＜0.01).The BMI of elderly men in the normal body mass group was higher than that of elderly women,while the BMI of elderly women in the obesity group was higher than that of elderly men(both P＜0.01).In the normal body mass group,the BMI of elderly people aged＜75 years old was higher than that of elderly people aged≥75 years old(P＜0.05).Conclusions BMI is closely related to the health of the elderly,and maintaining an ideal BMI is the foundation for health management and prevention of chronic diseases in the elderly.

Cognitive impairment is a kind of senile disease that leads to the decline of personality and behavior ability of the elderly,which seriously affects the quality of daily life of patients.The prevalence rate of the disease increases year by year with the acceleration of the aging process of the society,and its incidence is affected by many risk factors.At this stage,the curative effect for middle and advanced patients is poor.So early identification and intervention to delay the progression of cognitive impairment have become the focus of relevant research.Blood pressure variability can lead to damage of target organs such as heart,brain tissue and kidney,which is closely related to cognitive impairment.In order to expand a new perspective of early intervention in cognitive impairment,this paper reviews the effects of blood pressure variability on different cognitive impairment and its possible pathogenic mechanism.

Objective:To investigate the clinical efficacy of the bone-forming channel technique combined with double plates in the treatment of postoperative aseptic nonunion of the humeral shaft. Methods:A retrospective study was conducted to analyze the data of 39 patients with postoperative aseptic nonunion of the humeral shaft who had been treated by bone-forming channel technique combined with double plates from March 2018 to December 2022. There were 20 males and 19 females, with an age of (46.5±1.6) years. The bone nonunion was atrophic in 18 cases and hypertrophic in 21 cases. The operation time, intraoperative bleeding, fracture healing time and complications were recorded. The shoulder and elbow functions were evaluated before operation and at the final follow-up using the Disabilities of the Arm, Shoulder and Hand (DASH) score, Neer's shoulder function score, and Mayo's elbow performance score (MEPS). Results:All the 39 patients were followed up for an average duration of (13.8±3.5) months. The operation time was (84.3±7.3) minutes, the intraoperative bleeding (127.5±4.5) mL, the fracture healing time (24.4±1.3) weeks, and the fracture healing rate 100% (39/39). None of the patients had such postoperative complications as infection, neurovascular injury, or re-rupture of internal fixation. At the final follow-up, the patients' DASH score [(7.4±1.2) points], Neer's shoulder function score [(93.4±5.2) points], and MEPS [(94.6±3.3) points] were significantly improved compared respectively with the preoperative values [(26.6±8.4) points, (74.3±6.5) points, and (73.8±5.3) points] ( P<0.05). At the final follow-up, the patients' forward flexion and upward mobility was 168.5°±3.4°, abduction and upward mobility was 167.5°±5.2°, and horizontal forward flexion was 129.5°±11.8°. Conclusion:In the treatment of postoperative aseptic nonunion of the humeral shaft, since the bone-forming channel technique combined with double plates can achieve satisfactory clinical outcomes, it is worthy of clinical application.

Classical swine fever(CSF),caused by classical swine fever virus(CSFV),is a severe in-fectious disease characterized by high fever and extensive bleeding,which is listed as a mandatory report disease by WOAH.As a single-stranded RNA envelope virus,CSFV has evolved a strategy for attachment and entry to the cell in the process of adapting to external environmental pressure.H owever,the underlying molecular mechanism remains largely unknown.Studies have shown that CSFV is mainly internalized through clathrin-mediated cross-membrane internalization and exists in the form of endosomes in the cytoplasm.Under certain conditions,the endosomal membrane fu-sion releases the genome for viral proliferation.At the same time,CSFV also depends on the inter-action with host proteins to inhibit the synthesis and secretion of host interferon,regulate host cell apoptosis,autophagy,pyroptosis and inflammatory response,and other life activities to evade the host's natural immunity,thus promoting the further replication of the virus in the host.However,the underlying specific mechanism needs further studying.Here,we summarize the molecular mechanism of CSFV internalization across cell membranes and the challenges of CSF prevention and control,with a view to providing theoretical assistance for CSF purification.

Objective:To explore the influence factors for futile recanalization following endovascular treatment(EVT)in patients with acute basilar artery occlusion(BAO).Methods:Clinical data of patients with acute BAO,who underwent endovascular treatment within 24 h of onset from January 2017 to November 2022,were retrospectively analyzed.The futile recanalization was defined as modified thrombolysis in cerebral infarction(mTICI)grade≥2b or 3 after successful reperfusion,but the modified Rankin Scale score>2 at 3 months after EVT.Binary logistic regression model was used to analyze the influencing factors of futile recanalization.Results:A total of 471 patients with a median age of 68(57,74)years were included and 68.9%were males,among whom 298(63.27%)experienced futile recanalization.Multivariate analysis revealed that concomitant atrial fibrillation(OR=0.456,95%CI:0.282-0.737,P<0.01),bridging thrombolysis(OR= 0.640,95%CI:0.416-0.985,P<0.05),achieving mTICI grade 3(OR=0.554,95%CI:0.334-0.918,P<0.05),arterial occlusive lesion(AOL)grade 3(OR=0.521,95%CI:0.326-0.834,P<0.01),and early postoperative statin therapy(OR=0.509,95%CI:0.273-0.948,P<0.05)were protective factors for futile recanalization after EVT in acute BAO patients.High baseline National Institutes of Health Stroke Scale(NIHSS)score(OR=1.068,95%CI:1.049-1.087,P<0.01),coexisting hypertension(OR=1.571,95%CI:1.017-2.427,P<0.05),multiple retrieval attempts(OR=1.237,95%CI:1.029-1.488,P<0.05)and postoperative hemorrhagic transformation(OR=8.497,95%CI:2.879-25.076,P<0.01)were risk factors.For trial of ORG 10172 in acute stroke treatment(TOAST)classification,cardiogenic embolism(OR=0.321,95%CI:0.193-0.534,P<0.01)and other types(OR=0.499,95%CI:0.260-0.961,P<0.05)were related to lower incidence of futile recanalization.Conclusions:The incidence of futile recanalization after EVT in patients with acute BAO is high.Bridging venous thrombolysis before operation and an early postoperative statin therapy may reduce the incidence of futile recanalization.

From June 16 to 30, 2023, men who have sex with men (MSM) who had visited Voluntary Counseling Testing (VCT) clinics in the Luohu, Futian and Nanshan districts of Shenzhen were included in this study to analyze their awareness of Mpox and the influencing factors. The mean age of the 262 MSM was (34.78±8.94) years, with the majority being unmarried (75.2%) and 79.0% confirmed to be infected with HIV. The awareness rates for five primary indicators, current status of Mpox, pathogen and source of infection, mode of transmission, population susceptibility, clinical manifestations and treatment were 68.4%, 84.7%, 60.3%, 87.8%, and 52.5%, respectively. The awareness rates for five secondary indicators, earliest transmission location (44.7%), main mode of transmission (54.2%), role of masks (46.9%), drug accessibility (46.6%), and self-limiting nature (38.2%) were all below 60%. The MSM population in Shenzhen perceived their likelihood of being infected (2.76±1.32) and discriminated against (3.87±1.26) as relatively low. The logistic analysis showed that the high school or vocational school education ( OR:3.094, 95 %CI:1.180-9.299), college or above education ( OR:5.360, 95% CI:2.159-15.501), and higher scores on questions affecting learning or work ( OR:2.196, 95% CI:1.409-3.599) were promoting factors for Mpox awareness, while higher scores on questions concerning the possibility of Mpox mortality ( OR:0.591, 95% CI:0.432-0.791) was the hindering factor for Mpox awareness.

Objective:To investigate the clinical application value of the new tracer mitoxantrone hydrochloride in imaging of cervical lymph nodes and identifying of parathyroid, recurrent laryngeal nerve during thyroid cancer radical surgery.Methods:A prospective controlled study was conducted between January 2022 and April 2024 at Tianjin First Central Hospital, recruiting 180 patients with thyroid cancer, including 54 males and 126 females, aged from 26 to 69 years. The patients were randomly divided into three groups: the mitoxantrone hydrochloride lymph node tracing group (MHI group), the nanocarbon lymph node tracing group (nanocarbon group), and the control group without lymph node tracers, with 60 cases in each group. All patients underwent total thyroid resection and regional lymph node dissection. The number of detected lymph nodes and positive metastatic lymph nodes and surgical field clarity scores and the identification rate of parathyroid glands and the instances of inadvertent excision were compared between the groups. Serum calcium and parathyroid hormone (PTH) levels at different perioperative time points and treatment-related complications were analyzed. One-way ANOVA, chi-square test and two independent sample non-parametric tests, were employed for statistical analyses.Results:The mean operation time, neck drainage volume and hospital stay in the MHI group and the nanocarbon group were respectively significantly lower than those in the control group ( P<0.05). The mean staining intensity score, tracer success rate and surgical field clarity score in MHI group were respectively significantly higher than those in nanocarbon group ( P<0.05). The mean numbers of dissected lymph nodes positive metastatic nodes and identification rates of parathyroid glands in MHI group were respectively significantly higher than those in both the nanocarbon and control groups ( P<0.05). The rates of inadvertent parathyroid excision in both MHI group and nanocarbon group were significantly lower than those in control group ( P<0.05). On postoperative day 1 and day 5, mean serum calcium and PTH levels in MHI group were respectively significantly higher than those in nanocarbon group and control groups. However, on postoperative day 1, there was no difference in mean serum calcium levels between the nanocarbon group and the control group ( P>0.05), though PTH level in the nanocarbon group was higher than that in the control group. By postoperative day 5, both serum calcium and PTH levels were higher in the nanocarbon group compared to the control group ( P<0.05). On postoperative days 30, there were no differences in serum calcium and PTH levels between the MHI group and the nanocarbon group ( P>0.05). The risks of facial numbness, hand and foot tetany and choking during drinking were lower in both the MHI and nanocarbon groups compared to the control group ( P<0.05). Conclusion:MHI demonstrates advantages in rapid targeted delivery and clear staining of the surgical field during regional lymph node dissection in radical thyroidectomy for thyroid cancer, effectively reducing the risk of collateral damage to the recurrent laryngeal nerve and parathyroid glands.

From June 16 to 30, 2023, men who have sex with men (MSM) who had visited Voluntary Counseling Testing (VCT) clinics in the Luohu, Futian and Nanshan districts of Shenzhen were included in this study to analyze their awareness of Mpox and the influencing factors. The mean age of the 262 MSM was (34.78±8.94) years, with the majority being unmarried (75.2%) and 79.0% confirmed to be infected with HIV. The awareness rates for five primary indicators, current status of Mpox, pathogen and source of infection, mode of transmission, population susceptibility, clinical manifestations and treatment were 68.4%, 84.7%, 60.3%, 87.8%, and 52.5%, respectively. The awareness rates for five secondary indicators, earliest transmission location (44.7%), main mode of transmission (54.2%), role of masks (46.9%), drug accessibility (46.6%), and self-limiting nature (38.2%) were all below 60%. The MSM population in Shenzhen perceived their likelihood of being infected (2.76±1.32) and discriminated against (3.87±1.26) as relatively low. The logistic analysis showed that the high school or vocational school education ( OR:3.094, 95 %CI:1.180-9.299), college or above education ( OR:5.360, 95% CI:2.159-15.501), and higher scores on questions affecting learning or work ( OR:2.196, 95% CI:1.409-3.599) were promoting factors for Mpox awareness, while higher scores on questions concerning the possibility of Mpox mortality ( OR:0.591, 95% CI:0.432-0.791) was the hindering factor for Mpox awareness.

Objective:To explore the challenges in the implementation of drug centralized volume-based procurement policies in hospitals and propose corresponding optimization suggestions.Methods:From August to December 2023, a purposive sampling was conducted to select 11 pharmaceutical experts from tertiary hospitals in China for Delphi method. The survey content included " policy recommendations for promoting the acceleration and expansion of national drug centralized procurement and retaining surplus medical insurance funds for centralized procurement" .Results:Survey participants gave feedback on a set of existing problems found in the implementation of drug centralized procurement policies and proposed corresponding optimization methods. Kendall′s W coefficient of the specialist consultation was 0.332( P<0.05), demonstrating good consistency and concentration of the expert opinions. Among the problems, the score of drug supply guarantee was the highest(mean value of importance was 4.45). At the same time, the recommendation of strengthening monitoring and early warning, coordination and dispatch, and effectively ensuring the supply of centralized drug procurement had the highest score and concentration(mean value of importance was 4.91, coefficient of variation was 0.06). Conclusions:Through Delphi method, this study revealed issues and optimization methods in the implementation of drug centralized procurement policies in hospitals. The findings could provide valuable insights for improvements in the pharmaceutical sector and future policy adjustments.

Objective:To investigate the clinical characteristics and significance of supraspinatus fragments in proximal humerus fractures.Methods:A total of 210 patients with proximal humerus fractures who underwent surgical treatment in the Department of Orthopaedic and Trauma Surgery, Affiliated Hospital of Yunnan University from July 2016 to December 2020 were retrospectively analyzed. There were 91 males and 119 females, aged 52.4±11.3 years (range, 18-87 years). Preoperatively, the shoulder joint X-ray, CT and 3D reconstruction, and MRI were evaluated for the presence of a small fracture mass on the lateral side of the interarticular sulcus and an "M" shaped fracture mass at the interarticular sulcus. Intraoperative observation, management, postoperative functional exercise and follow-up were performed by the same group of doctors. Postoperative outpatient review was performed at 2, 4, 6, 12, and 24 weeks, shoulder joint X-ray and CT were taken at 2, 6, and 24 weeks to observe the presence of subacromial displaced bone mass. Constant-Murley scale was used to assess shoulder joint function.Results:All 210 patients completed the surgery successfully, and none of them had vascular, nerve or ligament injuries during the operation. According to Neer's classification: 59 cases of two-part humeral greater tuberosity fractures, 36 cases of two-part humeral surgical neck fractures, 50 cases of three-part humeral greater tuberosity fractures, and 65 cases of four-part proximal humeral fractures. 61.0% (128/210) of the patients showed the presence of a supraspinatus fragment on preoperative imaging, including 42 two-part humeral greater tuberosity fractures, 1 two-part humeral surgical neck fracture, and 31 three-part humeral greater tuberosity fractures with a small lateral fracture mass over the intertubular groove; 54 four-part proximal humeral fractures had an "M" shaped fracture mass containing the intertubular groove. All patients were followed up for 11.8±2.4 months (range, 6-20 months). Postoperative X-ray showed that all fractures healed, and the healing time was 3.4±0.3 months (range, 3-5 months). The Constant-Murley scale of the shoulder joint was 86.3±11.5 (range, 61-100).Conclusion:Supraspinatus fragments are more common in proximal humerus fractures. Proper recognition and management of supraspinatus fragments can help understand the mechanism of proximal humeral fracture occurrence, the relationship between fracture displacement and rotator cuff injury, reduce the incidence of postoperative complications, and improve the shoulder joint function.