Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Objective By comparing with arthroscopic rotator cuff repair alone,to explore the efficacy and difference of leukocyte poor platelet-rich plasma(LP-PRP)and leukocyte rich platelet-rich plasma(LR-PRP)in arthroscopic rotator cuff repair.Methods Sixty patients with total rotator cuff tear accompanied by arthroscopic rotator cuff repair admitted to the Affiliated Hospital of North China University of Science and Technology from October 2021 to September 2022 were included and randomly divided into control group(n=20),LP-PRP group(n=20)and LR-PRP group(n=20).The control group only received arthroscopic rotator cuff repair.The LP-PRP group was injected with leukocyte poor platelet-rich plasma(LP-PRP)into the sutured torn tendon after the same operation,and the LR-PRP group was injected with leukocyte rich platelet-rich plasma(LR-PRP)into the sutured torn tendon after the same operation.The postoperative rehabilitation training plan of the three groups was the same,and the postoperative follow-up and evaluation were conducted for 1 year.It included pain score(VAS score),shoulder joint function score(CMS,UCLA,ASES score),retear rate and related complications.Results All patients were followed up.(1)VAS score:Compared with the LR-PRP group and the control group,the results were statistically significant only at 1,3 and 6 weeks after surgery(P<0.05);There was no statistical significance between the LR-PRP group and the control group at 1 week,3 weeks,6 weeks,3 months,6 months and 12 months after surgery(P>0.05).(2)CMS,UCLA and ASES scores:There were no significant differences between the LP-PRP group and the LR-PRP group at 3 months,6 months and 12 months after surgery(P>0.05);Compared with LP-PRP group and LR-PRP group,there were significant differences in each follow-up time point of control group(P<0.05).(3)Retear rate:In the LP-PRP group,there was 1 retear in the LR-PRP group(tear rate 5%),and 3 in the control group(tear rate 15%).There was no statistically significant difference between the three groups(P>0.05).(4)There were no postoperative complications in 60 patients.Conclusions Compared with arthroscopic rotator cuff repair alone,although the application of LP-PRP and LR-PRP could not reduce the rate of retear,it could significantly improve the shoulder joint function of patients,and LP-PRP could significantly reduce the pain of patients with rotator cuff injury in the early postoperative period(within 6 weeks),with no postoperative complications,and the short-term clinical results of patients were satisfactory.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To explore the current situation of the intrinsic capacity of elderly people in the community and analyze its influencing factors.Methods:From September 2022 to March 2023, convenience sampling was used to select 360 elderly community residents from Xicheng District, Beijing, and Xingtai City, Hebei Province, as the research subjects. The subjects were surveyed using the Intrinsic Capacity Assessment Questionnaire, Intrinsic Capacity Influencing Factors Questionnaire, Barthel Index, and Lawton Instrumental Activities of Daily Living Scale.Results:A total of 360 questionnaires were distributed, and 360 valid questionnaires were collected, with an effective response rate of 100.0% (360/360). The overall impairment rate of intrinsic capacity among 360 elderly people in the community was 90.3% (325/360), and the impairment rates in various fields from high to low were sensation, psychology, vitality, cognition, and exercise. Multiple linear regression analysis showed that age, gender, residential pattern, education level, work status, grip strength, number of geriatric syndrome, self-rated health status, adverse life events, number of social activities, transportation conditions, and social security were the influencing factors of the intrinsic capacity of elderly people in the community, and the difference was statistically significant ( P<0.05) . Conclusions:The impairment rate of intrinsic capacity among elderly people in the community is relatively high. Grassroots medical and nursing staff should assess the intrinsic capacity of elderly people in the community in health promotion work, identify elderly people with decreased intrinsic capacity early and carry out effective interventions to prevent elderly people from becoming disabled and dependent on care.

Objective: To investigate an acute gastroenteritis outbreak caused by Norovirus, and to provide evidence for effective school infectious outbreak prevention and control. Methods: In March 2019, basic information of Huzhou Normal University and related data of cases were collected. Epidemiological characteristics were analyzed. Anal swabs of the 10 cases were collected for laboratory detection. Case definitions, specific detection criteria and procedures were based on the Diagnostic Criteria for Infectious Diarrhea (WS 271-2007) and the Technical Guidelines for the Investigation, Prevention and Control of Outbreaks of Norovirus Infection (2015 edition). Results: During March 15 to March 20, a total of 13 (12 girls and 1 boy) confirmed cases were reported, all of them were from the same class, with the incidence rate being 25.00% (1/4) and 37.50% (12/32) in boys and girls, respectively. No significant sex difference was found ( χ 2=2.05， P >0.05). Anal swab specimens of 10 students were collected from laboratory were positive for Norovirus GII and have an identity of 100%. Conclusion The gastroenteritis outbreak was deduced to be attributed to GII Norovirus infection, which are likely caused by fecal contamination through person to person contact. It is suggested that schools should strengthen knowledge education on the prevention and control of infectious diseases and improve the protection awareness and ability of teachers and students to protect them.

[摘 要] 目的：探讨番茄红素通过沉默信息调节因子1（SIRT1）/核因子-κB（NF-κB）轴对肾癌786-O细胞增殖、凋亡的影响。方法：常规培养人正常肾细胞HK-2和人肾癌细胞786-O，实验分为对照组（0.1% DMSO）、顺铂组（40 μg/mL）、番茄红素低质量浓度（2.5 μg/mL）组、番茄红素高质量浓度（5 μg/mL）组、番茄红素（5 μg/mL）+EX527（SIRT1抑制剂）（3 µmol/L）组。CCK-8法、克隆形成实验检测各组HK-2、786-O细胞的增殖能力，流式细胞术检测各组786-O细胞的凋亡，RH123、DCFH-DA染色分别检测各组786-O细胞的线粒体膜电位（MMP）、活性氧（ROS）水平，WB法检测各组786-O细胞中凋亡相关蛋白BAX、Bcl-2、C-casp3和SIRT1/NF-κB轴相关蛋白SIRT1、p-NF-κB蛋白的表达。786-O细胞移植瘤实验检测番茄红素低（5 mg/kg）、高质量浓度（20 mg/Kg）、顺铂（2 mg/kg）、番茄红素（20 mg/kg）+EX527（10 mg/kg）对移植瘤生长的影响，TUNEL法检测各组移植瘤组织中的细胞凋亡。结果：番茄红素呈剂量依赖性地抑制786-O细胞的增殖活性，番茄红素、顺铂均明显抑制786-O细胞的克隆形成能力且促进其凋亡，细胞中MMP损伤率升高而ROS水平降低，凋亡相关蛋白BAX、C-casp3表达均显著升高（均P<0.05）而Bcl-2表达下调（P<0.05），SIRT1表达显著升高（P<0.05）而p-NF-κB的表达显著降低（P<0.05），上述作用均可被EX527逆转；番茄红素、顺铂抑制786-O细胞移植瘤的生长且促进其细胞凋亡，其作用也能被EX527逆转。结论：番茄红素通过上调SIRT1、抑制NF-κB通路的激活进而抑制786-O细胞增殖且诱导其凋亡。

Objective:To evaluate the effect of inhaled medication compliance intervention in elderly patients with chronic obstructive pulmonary disease (COPD) based on integrated theory of health behavior change.Methods:A total of 117 elderly COPD patients who visited Respiratory Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from July to December 2021 were selected by the convenient sampling method. According to the random number table method, they were divided into the experimental group and the control group. 7 cases fell off during follow-up, and a total of 110 cases were finally included in the study, of which 55 cases were in the experimental group and 55 cases in the control group. The control group adopted the conventional health education method, while the experimental group adopted the intervention plan of inhalation medication compliance of elderly COPD patients based on the integrated theory of health behavior change. The accuracy of inhalation device use, inhalant medication compliance, forced expiratory volume in the first second (FEV 1) and Chronic Obstructive Pulmonary Diseases Assessment Test (CAT) scores were compared between the two groups before intervention and 3 months after intervention. Results:After 3 months of intervention, the inhalation device use accuracy, inhalation medication compliance in experimental group were higher than those in the control group, the score of CAT in experimental group was lower than that in the control group, the differences were statistically significant ( P<0.05). There was no statistically significant difference in FEV 1 between two groups ( P>0.05) . Conclusions:The intervention plan for inhalation medication compliance in elderly patients with chronic obstructive pulmonary disease based on the integrated theory of health behavior changes can improve their inhalation medication compliance and improve their quality of life.

Object:To conduct a scoping review of maternal readiness for hospital discharge, so as to provide references for future clinical research and practice on maternal and infant care.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as the methodological framework, the relevant studies on maternal readiness for hospital discharge were searched by computer on PubMed, Web of Science, Scopus, CNKI, Wanfang Database, Chinese Science and Technology Journal Database and China Biology Medicine disc. The search period was from the establishment of the databases to October 20, 2022.Results:A total of 24 artiles were included. The influencing factors of maternal readiness for hospital discharge included sociodemographic factors, maternity factors, psychological factors, children factors, family social factors, medical staff related factors and other factors. The intervention measures of maternal readiness for hospital discharge included the establishment of discharge preparation team, the measures from hospital admission to prenatal period, the measures from postpartum to the day of discharge and the measures after discharge. There were many kinds of scales for maternal readiness for hospital discharge, and there was no unified assessment standard.Conclusions:The level of maternal readiness for hospital discharge is different, and its influencing factors should be paid attention to. In the future, further research can be conducted on intervention measures and evaluation standards for maternal discharge readiness, providing references for improving the level of maternal discharge readiness.

Objective    To investigate the feasibility of magnamosis rings designed based on magnetic compression technique in esophageal anastomosis reconstruction. Methods    According to the anatomical characteristics of esophagus in SD rats, the esophageal magnamosis rings were designed. SD rats were used as animal models (n=10, 5 males and 5 females) to complete the magnetic anastomosis reconstruction of the cervical esophagus using magnamosis rings, and the operation time, animal survival, postoperative complications, magnetic rings excretion time were recorded. Two weeks after operation, the rats were killed, and the esophageal anastomotic specimens were obtained. The blasting pressure of the anastomotic site was measured and the formation of the anastomotic site was observed with naked eyes. Results    Esophageal magnamosis was successfully performed in 10 SD rats, and the median operation time was 11 (8-13) min. All rats survived without anastomotic leakage, anastomotic stenosis, or magnetic rings incarceration. The magnetic rings were discharged after 8 (5-10) days and the burst pressure was higher than 300 mm Hg. Visual observation showed that the anastomotic muscle healed well and the mucosa was smooth. Conclusion    The magnetic compression technique  can be used for anastomosis reconstruction of esophagus, which has the advantages of simple operation and reliable anastomosis effect, and has clinical application prospect.