Objective: To investigate the effect of different volumes of isotonic washing solution (0.9% NaCl) on the quality of intraoperative autologous blood salvage in craniocerebral surgery. Methods: Thirty patients who underwent neurosurgical procedures with intraoperative salvaged blood volumes exceeding 800 mL between August 2022 and July 2024 were enrolled as study subjects. The salvaged blood was divided into four groups: group A, group B, group C, and group D. Group A was washed with 500 mL of isotonic solution (blood-to-washing solution ratio of 1∶2), group B with 1000 mL (ratio of 1∶4), and group C with 1 500 mL (ratio of 1∶6). After centrifugation, the washed blood was stored in designated blood bags (A, B, and C, respectively). Blood gas analysis was performed on 5 mL samples obtained from the centrifuged blood in groups A, B, and C, and from the unwashed blood in the reservoir of the control group (group D). Parameters including red blood cell (RBC) count, pH, hemoglobin (Hb), hematocrit (HCT), potassium ion (K ), sodium ion (Na ), and lactate levels were also measured using these samples. Additionally, blood samples from each group were examined microscopically to assess red blood cell morphology. Results: No significant differences were observed among groups A, B, and C in terms of RBC recovery rate, HCT, Na concentration, or lactate clearance rate (P>0.05). All three groups exhibited a reduction in pH, with group C showing a more pronounced decrease compared to groups A and B. Similarly, K clearance was achieved in all groups, with group C demonstrating superior efficiency. Microscopic analysis revealed a reduction in spiculated red blood cells across all groups, with group C achieving the highest clearance rate. Conclusion: Group C (washed with 1 500 mL solution) demonstrated optimal performance in reducing pH levels, clearing K , and removing spherocytes, while maintaining red blood cell recovery rate. Additionally, it did not significantly increase the risk of hypernatremia in critically ill neurosurgical patients, making it more suitable for craniocerebral surgeries.

Objective To investigate the status quo of health literacy among military personnel stationing on plateau and analyze its influencing factors.Methods National Health Literacy Monitoring Questionnaire(2015),self-made questionnaire for demographic data based on literature,Connor-Davidson Resilience Scale,Simplified Coping Style Questionnaire,and Positive and Negative Affect Scale were employed to survey 2 516 officers and soldiers stationing on plateau with aid of a WeChat APP Questionnaire Star.Their current status of health literacy and its influencing factors were analyzed.Results The survey results showed that the overall health literacy level was 20.03％among the 2 516 participants.The literacy levels of basic knowledge and concepts,healthy lifestyles and behaviors,and health skills were 31.08％,26.23％,and 26.63％,respectively,and the health literacy levels of scientific health concepts,infectious disease prevention and treatment,chronic disease prevention and treatment,safety and first aid,basic medical care,and health information were 40.58％,19.36％,9.62％,82.75％,29.61％,and 45.03％,respectively.Multivariate unconditional logistic regression analysis indicated that the influencing factors of health literacy level were years of working(OR=1.857,95％CI:1.391～2.479;OR=4.657,95％CI:3.297～6.578),ethnicity(OR=0.394,95％CI:0.251～0.620),marriage(OR=0.609,95％CI:0.430～0.861),only-child family(OR=0.759,95％CI:0.585～0.985),home location(OR=0.545,95％CI:0.359～0.827),smoking(OR=1.579,95％CI:1.254～1.988),education level(OR=3.638,95％CI:1.500～8.822),weekly online game time(OR=0.517,95％CI:0.365～0.731;OR=0.351,95％CI:0.172～0.716),number of physical checkups per year(OR=3.251,95％CI:1.359～7.778;OR=4.545,95％CI:1.841～11.221),father's occupation(OR=5.185,95％CI:1.800～14.933;OR=3.229,95％CI:1.261～8.270),mother's occupation(OR=0.221,95％CI:0.086～0.568;OR=0.218,95％CI:0.081～0.587;OR=0.046,95％CI:0.018～0.118),positive coping(OR=1.052,95％CI:1.033～1.072),and negative coping(OR=0.950,95％CI:0.929～0.972).Conclusion The overall health literacy level is quite low among the plateau military personnel in this ministry,and the relevant departments should actively explore effective interventions to comprehensively improve their health literacy based on the influencing factors.

OBJECTIVE: To explore prevalence, risk factors and treatment of ankle sprain of young college student , in order to obtain accurate epidemiological data. METHODS: From March 2019 to May 2019, 552 college students(1 104 sides of anke joints) from Xi'an Physical Education university were enrolled in study according to inclusion and excludion standard, including 309 males and 243 females aged from 16 to 24 years old with an average of (20.9±3.7) years old. Age, gender, and body mass indes(BMI) etc were recorded. Morbidity of acute and chronic ankle sprains of physical students, treatment after the first sprain (cold compress, cast or plaster bracing and medicine), visual analogue scale (VAS) during walking were assessed through ankle sprain questionnaire;Cumberland ankle instability tool (CAIT), Maryland foot score were applied to assess ankle function. Lateral ankle ligament injury was objectively assessed by musculoskeletal ultrasonography. RESULTS: The prevalence of acute ankle sprain(AAS) was 96.20% (531/552), and the incidence of AAS was 59.96% (622/1 104). The prevalence of chronic ankle joint instability(CAI) was 16.85% (93/552), and the incidence of CAI was 8.97% (99/1 104). In the four categories of sports, college student suffered from multiple sprains in performance majors group was 22.20% (14/63), including of aerobicsand dance performance. The incidence of AAS of ball sports was 8.60%(14/163). After the first sprain, most college students(94.4%) were received cold compression, about 60% of them went to hospital;however, only 44.7% students were received standard treatmens(cast or plaster), only 35.3% of them were received hard ankle orthosis. In 552 college students, 44 students were suffered from more than 4 times of ankle sprain, and the total incidence was 7.97% (44/552). Cumberland score was 26.6±2.4, Cumberland score of students sprained ankle joint more than 4 times was (29.2±1.1), suggested it was a risk factor for ankle joint instability. VAS of students sprained ankle joint more than 4 times was higher than that of less than 4 times(P<0.05), Maryland foot score was significantly lower than that of that of <4 times(P<0.05). Musculoskeletal ultrasonography measured the thickness of anterior tibiofibular ligament(ATFL) was (2.41±0.41) mm, and the thickness of calcaneofibular ligament(CFL) was (1.92±0.21) mm, and had no statistical difference(P>0.05). CONCLUSION Ninty-four percent college students had at least once ankle sprain, ankle sprains were more common in erobics and ball sports. After the first sprain, the proportion of cast or plaster treatment was less than 50%. Sprained ankle joint more than 4 times is a risk factor, and musculoskeletal ultrasonography showed thickening of both ATFL and CFL, while no statstical difference.
Female ; Male ; Humans ; Adolescent ; Young Adult ; Adult ; Cross-Sectional Studies ; Joint Instability/epidemiology* ; Physical Education and Training ; Universities ; Ankle Injuries/therapy*

Military vocational education has become one of the strategies to strengthen the military in the new era. The army urgently needs to build a number of featured online courses of military vocational education. Therefore, taking the course "Knowledge and Skills of Health Education for the Army" as an example, this paper discusses the overall construction objectives, construction ideas, teaching content, curriculum and test question bank construction of the course. In addition, this paper analyzes and summarizes the problems existing in the teaching organization, implementation, and preliminary application, so as to provide ideas and construction strategies for the construction of online open courses in other military vocational education.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

The modern surgical treatment of cervical degenerative disc disease can be traced back to the advent of anterior cervical decompression and fusion.With the emergence of fusion-related complications,different scholars have promoted the gradual transformation of cervical degenerative disc diseases from "fusion fixation" to "non-fusion reconstruction" through in-depth fusion with materials science,engineering mechanics and other disciplines.The innovation of this treatment concept is consistent with the original intention of "structural remodeling,functional reconstruction,maximum repair and reconstruction of the morphology and function of skeletal muscle system" in orthopedic bionic treatment,which is essentially in line with the "bionic alternative therapy" in orthopedic bionic therapy.This paper focuses on the surgical treatment of cervical degenerative disc diseases,reviews the development history of artificial cervical disc replacement,analyzes the evolution from orthopedic biomimetic therapy,and explores a new direction for the design of artificial cervical disc prostheses and the treatment of cervical degenerative disc diseases in the future.
Bionics ; Cervical Vertebrae/surgery* ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration/surgery* ; Spinal Fusion ; Total Disc Replacement ; Treatment Outcome

Objective: To learn the activities of daily living（ADL）of the elderly in Chongqing and its influencing factors,so as to provide basis for developing ADL intervention measures for the elderly. Methods: Multi-stage sampling method was used to select the elderly aged 65 years or over from 2-3 communities each in 11 districts or counties of Chongqing. They were surveyed by ADL scale including physical activities of daily living（PADL）and instrumental activities of daily living（IADL）. The influencing factors for ADL disability were analyzed by multivariate logistic regression models. Results: Totally 1 341 valid questionnaires out of 1 400 distributed were recovered,with a response rate of 95.79%. There were 596（44.44%）people with ADL disability,among whom 321（53.86%）cases were mild and 275（46.14%）cases were apparently impaired. There were 385（28.71%）suffered from PADL and 575（42.88%）suffered from IADL. The results of multivariate logistic regression analysis showed that age of 70 years old and over（OR：2.858-7.507,95%CI：2.119-11.816）,not living in downtown（OR=2.073-3.709,95%CI：1.434-5.613）,having commercial insurance（OR=3.202,95%CI：1.419-7.223）and suffering from at least one chronic disease（OR：2.909-5.629,95%CI：1.562-10.681）were the risk factors for ADL disability in the elderly,while having a diploma or above（OR=0.236,95%CI：0.090-0.621）,employing a caregiver（OR=0.466,95%CI：0.260-0.835）and monthly income of 1 000 to less than 4 000 yuan（OR：0.480-0.664,95%CI：0.274-0.923）were the protective factors. Conclusions The rate of ADL impairment is 44.44% in the elderly aged 65 years or over,and is associated with old age,living away from downtown,participation in commercial insurance and suffering from chronic diseases.

Objective: To compare the effect of two different methods of "3-PR" participatory health education and traditional distribution of publicity materials on health literacy improvement of medical students, to provide a reference for making more effective measure to improve health literacy. Methods: 173 Second-grade students in nursing major were selected in a secondary vocational school in Datong City. Two different intervention methods were used to intervene for 8 weeks. The experimental group (92 students) received "3-PR" participatory health education; the traditional health education intervention in the control group(81 students). The "National Residents’ Health Literacy Monitoring Questionnaire 2015" was used to conduct a questionnaire survey on the experimental group and the control group before and after the intervention, and to compare the effects before and after the intervention. Results: The average score of health literacy was (36.04±9.43) points and (36.01±10.17) points before and after intervention in the control group; (35.78±8.91) points and (49.53±13.53) points before and after intervention in the experimental group; No statistical difference between experimental and control group was found before intervention(t=0.18, P=0.86); There was no significant difference in health literacy score before and after intervention for the control group(t=0.03, P=0.98); Health literacy significantly increased in the experimental group after intervention(t=-11.36, P=0.00). Adequate health literacy accounted for 3.70% and 4.94% before and after intervention in the control group and 4.35% and 45.65% in the experimental group before and after intervention. No significant difference was found in adequate health literacy proportion between the two groups before intervention(χ2=0.00, P=1.00). However, the difference showed statistically significant after intervention(χ2=36.58, P=0.00). The change of health literacy score in the control group and the experimental group was (-0.02±7.52) and (12.75±10.77), respectively, accounting for 1.24% decrement and 41.30% increment. The difference between the two groups was statistically significant (t=-8.93, P=0.00). The dimension-and type-specific score of health literacy showed similar pattern. Conclusion The "3-PR" participatory health education model is more effective than the traditional health education method in improving health literacy, and it could be carried out by multi-disciplinary students.

Objective To explore the blood lead level and its relationship with behavior in school?age children from rural areas of Chongqing. Methods A total of 697 students from grades 3 to 6 in the fall semester of 2014 from 14 rural townships in one district of Chongqing was selected by using the random cluster sampling method. Blood were sampled to analyze the lead level. Neurobehavioral tests were performed to determine their personal cognitive and memory ability. Questionnaires and physical examinations were administered to obtain the information of confounding factors. All students were divided into Q1-Q4 groups according to the quartile of their blood lead level. The relationship between the blood lead level and behavior was analyzed by multivariate logistic regression model and restricted spline regression model. Results The mean age of 697 students was (10.07±1.36) years old, and the median (interquartile range) of their blood lead level was 44.31 (35.42) μg/L. Multivariate logistic regression model showed that after adjusting for age, gender, body mass index and maternal culture level, compared with Q1 group, the OR (95%CI ) values of high digit symbol substitution test (DSST) scores and high overall memory quotient (MQ) scores in Q 3 group were 1.65 (1.01-2.70) and 2.10 (1.21-3.62), and the OR (95%CI ) value of high long term memory (LTM) scores in Q4 group was 0.53 (0.31-0.92). The results of the restricted spline regression model showed that the dose?response curves between the blood lead level and MQ/LTM test scores were both parabolic (P<0.05). Conclusion The blood lead level of school?age children from rural areas of Chongqing is the same as that from other areas of China, but slightly higher than that from other areas of Chongqing. Children with higher blood lead level have poor long?term memory ability.

Objective To explore the blood lead level and its relationship with behavior in school?age children from rural areas of Chongqing. Methods A total of 697 students from grades 3 to 6 in the fall semester of 2014 from 14 rural townships in one district of Chongqing was selected by using the random cluster sampling method. Blood were sampled to analyze the lead level. Neurobehavioral tests were performed to determine their personal cognitive and memory ability. Questionnaires and physical examinations were administered to obtain the information of confounding factors. All students were divided into Q1-Q4 groups according to the quartile of their blood lead level. The relationship between the blood lead level and behavior was analyzed by multivariate logistic regression model and restricted spline regression model. Results The mean age of 697 students was (10.07±1.36) years old, and the median (interquartile range) of their blood lead level was 44.31 (35.42) μg/L. Multivariate logistic regression model showed that after adjusting for age, gender, body mass index and maternal culture level, compared with Q1 group, the OR (95%CI ) values of high digit symbol substitution test (DSST) scores and high overall memory quotient (MQ) scores in Q 3 group were 1.65 (1.01-2.70) and 2.10 (1.21-3.62), and the OR (95%CI ) value of high long term memory (LTM) scores in Q4 group was 0.53 (0.31-0.92). The results of the restricted spline regression model showed that the dose?response curves between the blood lead level and MQ/LTM test scores were both parabolic (P<0.05). Conclusion The blood lead level of school?age children from rural areas of Chongqing is the same as that from other areas of China, but slightly higher than that from other areas of Chongqing. Children with higher blood lead level have poor long?term memory ability.