ObjectiveTo explore the effect of nutrition combined with exercise intervention on stroke patients with sarcopenia. MethodsFrom January to June, 2022, 60 stroke patients with sarcopenia were randomly divided into control group (n = 15), nutrition group (n = 15), exercise group (n = 15) and combined group (n = 15). All the groups received routine rehabilitation training, while the nutrition group received nutrition intervention, the exercise group received exercise intervention, and the combined group received both the nutrition and exercise intervention, for four weeks. Before and after intervention, the muscle index was measured with bioelectrical impedance analysis, gripping strength of the healthy and the affected side was measured with gripping strength meter, and the patients were assessed with modified Barthel Index (MBI) and Berg Balance Scale (BBS). ResultsFour cases in the control group, two in the nutrition group, one in the exercise group, and three in the combined group dropped down. The muscle index, gripping strength, and the scores of MBI and BBS improved in all the groups after intervention (|t| > 3.004, P < 0.05), while all improved more in the combined group than in the other three groups (P < 0.05), and the grip strength of the healthy side was more in the exercise group than in the nutrition group (P < 0.05). ConclusionNutrition or exercise intervention alone can improve the muscle quality, grip strength, activities of daily living and balance of stroke patients with sarcopenia, while the combination is more effective.

Objective:To investigate the characteristics of primary catheter malposition (PCM) following totally implantable venous access port (TIVAP) implantation via the internal jugular vein (IJV) and management strategies.Methods:Clinical data of 587 consecutive breast cancer patients undergoing TIVAP implantation via the IJV performed by single team at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University from Aug 2017 to Aug 2022 was retrospectively analyzed.Results:A total of 593 TIVAP were implanted and PCM was found in 18 cases (3.0%). Four hundred and twenty five TIVAP were implanted via the right IJV with one PCM case (0.2%). One hundred and sixty eight TIVAP implantations were performed via the left IJV and PCM occurred in 17 cases (10.1%). The interventional management with a pigtail catheter was performed as a first-line strategy in 11 of the 18 PCM cases, with a success in 10 cases and failure in one. Three cases were successfully managed with the digital subtraction angiography (DSA)-guided open approach. Four cases underwent blind open procedure firstly and 2 suffered a failure.Conclusions:A higher incidence of PCM is found in TIVAP implantations via the left IJV than the right one. The interventional management with a pigtail catheter or the DSA-guided open procedure proves to be feasible for the correction of PCM.

【Objective】 Coronary no-reflow during percutaneous conranary intervention (PCI) often results in the failure of ischemic myocardial reperfusion and major adverse cardiovascular events (MACE). The present study sought to evaluate whether the GRACE risk score can predict coronary no-reflow in STEMI patients undergoing PCI. 【Methods】 We consecutively recruited 1 118 patients with STEMI who were admitted to Gansu Provincial People’s Hospital and The First Affiliated Hospital of Xi’an Jiaotong University from January 2009 to December 2011. Main demographic data, cardiovascular risk factors, blood lipid and other biochemical indicators were recorded. Coronary angiography was performed by a radial artery approach using the standard Judkins technique. Coronary no-reflow was evaluated by at least two independent experienced cardiologists. The GRACE risk score was calculated with a computer program. All the cases were followed up by medical records, face-to-face interviews or telephone calls. Finally, we analyzed the predictive value of the GRACE risk score for coronary non-reflow and MACE in STEMI patients undergoing PCI. 【Results】 During a median period of 36 months, 58 of the 1 118 patients (5.2%) were lost to follow-up. Of the remaining 1 060 patients, 118 (11.1%) had no-reflow and 147 (13.9%) had MACE. The GRACE score was higher in patients with no-reflow than those without no-reflow. Multivariate logistic regression established that the GRACE score was an independent predictor for coronary no-reflow (OR=1.034; P=0.002). And multivariate Cox analysis showed the GRACE score was an independent predictor of MACE. The area under the ROC curve for coronary no-reflow and MACE was 0.719 and 0.697, respectively. Kaplan-Meier analysis showed that the probability of rehospitalization for heart failure, reinfarction, all-cause death and cumulative cardiovascular events increased with the increase of the GRACE risk score. 【Conclusion】 The GRACE risk score is a readily available predictive scoring system for coronary no-reflow and MACE in STEMI patients.

ObjectiveTo explore the effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia. MethodsFrom September, 2022 to February, 2023, 124 elderly people with sarcopenia were conveniently sampled from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City, Hebei Province. According to the coin toss, 62 elderly people from Shuxiangyuan Community were designated as control group, and 62 elderly people from Lishuiwan Community were as intervention group. The intervention group implemented the intervention based on the theory of planned behavior, including behavior attitude, behavior, subjective norms, perceived behavior control and behavior awareness; the control group maintained their original lifestyle, for twelve weeks. Before and after intervention, the grip strength, time of Five-Times-Sit-to-Stand Test, relative appendicular skeletal muscle index (RASM), 6-minute walking speed and the score of Berg Balance Scale (BBS) were compared. ResultsAfter intervention, the grip strength, RASM, 6-minute walking speed, and the score of BBS significantly increased, and the time of Five-Times-Sit-to-Stand Test shortened in the intervention group (|Z| > 6.257, |t| > 28.643, P < 0.001), and they were better in the intervention group than in the control group (|Z| > 2.288, |t| > 3.177, P < 0.05). ConclusionThe intervention based on theory of planned behavior can effectively relieve the muscle attenuation of the elderly with sarcopenia, and improve their balance ability.

Objective:To investigate preliminary results of chest wall reconstruction with local kiss flap following mastectomy for locally advanced breast cancer (LABC).Methods:Clinical data of the LABC patients receiving treatment at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between June 2020 and July 2021 was retrospectively analyzed. All patients underwent modified radical mastectomy after neoadjuvant chemotherapy. And the local kiss flap was used for reconstruction of the secondary chest wall soft tissue defects. Two small local flaps were designed intraoperatively and harvested from inferior (flap A) and lateral (flap B) to the defect, respectively, resurfacing a large chest wall soft tissue defect side by side with primary closure of both two donor sites. The flap perfusion was routinely monitored postoperatively. Adjuvant systemic therapies were implemented based on both pre- and post-operative pathological results. And the adjuvant radiotherapy was started immediately after wound healed completely. All cases were followed up regularly.Results:A total of five female patients were included, with an average age of 53.4 (ranging from 41 to 71). Stage Ⅲ (T 3-4N 2-3M 0) breast cancer was diagnosed in all cases. After mastectomy, chest wall soft tissue defect was presented in all cases, ranging from 12.0 cm × 12.0 cm to 22.0 cm × 20.0 cm. The flap A measured from 7.0 cm × 7.0 cm to 14.0 cm × 13.0 cm and the flap B from 5.0 cm × 4.0 cm to 11.0 cm × 7.0 cm. Only 1 flap A suffered tip necrosis and the remnant flaps survived totally. All donor sites recovered uneventfully and no donor-site morbidity was noted. The mean post-operative follow-up period was 15.8 months (ranging from 13 to 20 months). No tumor recurrence or metastasis was noted in all patients, except one patient, who did not receive radiotherapy, suffered local recurrence 4 months after surgery. Conclusion:Given its simplicity and satisfying results, the local kiss flap is a feasible and reliable reconstructive option for chest wall soft tissue defect reconstruction after mastectomy in selected LABC patients.

Objective:To investigate preliminary results of chest wall reconstruction with local kiss flap following mastectomy for locally advanced breast cancer (LABC).Methods:Clinical data of the LABC patients receiving treatment at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between June 2020 and July 2021 was retrospectively analyzed. All patients underwent modified radical mastectomy after neoadjuvant chemotherapy. And the local kiss flap was used for reconstruction of the secondary chest wall soft tissue defects. Two small local flaps were designed intraoperatively and harvested from inferior (flap A) and lateral (flap B) to the defect, respectively, resurfacing a large chest wall soft tissue defect side by side with primary closure of both two donor sites. The flap perfusion was routinely monitored postoperatively. Adjuvant systemic therapies were implemented based on both pre- and post-operative pathological results. And the adjuvant radiotherapy was started immediately after wound healed completely. All cases were followed up regularly.Results:A total of five female patients were included, with an average age of 53.4 (ranging from 41 to 71). Stage Ⅲ (T 3-4N 2-3M 0) breast cancer was diagnosed in all cases. After mastectomy, chest wall soft tissue defect was presented in all cases, ranging from 12.0 cm × 12.0 cm to 22.0 cm × 20.0 cm. The flap A measured from 7.0 cm × 7.0 cm to 14.0 cm × 13.0 cm and the flap B from 5.0 cm × 4.0 cm to 11.0 cm × 7.0 cm. Only 1 flap A suffered tip necrosis and the remnant flaps survived totally. All donor sites recovered uneventfully and no donor-site morbidity was noted. The mean post-operative follow-up period was 15.8 months (ranging from 13 to 20 months). No tumor recurrence or metastasis was noted in all patients, except one patient, who did not receive radiotherapy, suffered local recurrence 4 months after surgery. Conclusion:Given its simplicity and satisfying results, the local kiss flap is a feasible and reliable reconstructive option for chest wall soft tissue defect reconstruction after mastectomy in selected LABC patients.

Objective:To fabricate tAu@glutathione(GSH)@Gd nanoprobe for tumor angiogenesis bimodal (MR/CT) imaging, and evaluate its characteristics and potential for MR/CT imaging in vivo. Methods:The tAu@GSH@Gd nanoprobes were constructed by encapsulating Au and Gd atoms into the GSH shell with cyclic asparagine-glycine-arginine (cNGR) peptide conjugation. EMT-6 BALB/c mice subcutaneous transplantation tumor models were established ( n=30) and divided into blank control group (saline), control group (Au@GSH@Gd nanoparticles) and experimental group (tAu@GSH@Gd nanoprobes) ( n=10 in each group). In vivo MR/CT imaging and distribution study were performed at different time points after tail intravenously injection. Relative MR signal value and relative CT value of tumor site and main organs in mice were used to evaluate MR/CT imaging property and biological distribution. After that, tumor tissues were collected for silver staining to study the accumulation of Au@GSH@Gd nanoparticles and tAu@GSH@Gd nanoprobes. Independent-sample t test was used for data analysis. Results:The tAu@GSH@Gd nanoprobes were (6.40±0.22) nm with high T 1 relaxation efficiency ((36.91±0.07) mmol·L -1·s -1). MR/CT imaging of tAu@GSH@Gd nanoprobes showed good performance in vitro. In vivo MR/CT imaging demonstrated MR/CT imaging of tumor was significantly enhanced by tAu@GSH@Gd nanoprobes after 2 h post injection. The strongest enhancement was observed at 24 h, with an increased relative MR signal value from 1.04±0.12 (before injection) to 1.84±0.26 ( t=12.61, P=0.006), and increased relative CT value from 1.01±0.04 (before injection) to 1.95±0.05 ( t=15.34, P=0.004). The highest MR/CT effect in control group appeared at 16 h, with the relative MR signal value of 1.50±0.06 and the relative CT value of 1.53±0.10, which were significantly lower than those in experimental group (1.84±0.26 and 1.95±0.05; t values: 5.35 and 16.46, both P<0.05). Distribution in normal tissues showed that most of tAu@GSH@Gd nanoprobes were metabolized through the kidneys. Tissue silver staining experiment verified the tumor angiogenesis targeting effect. Conclusion:The tAu@GSH@Gd nanoprobes exhibit favorable tumor angiogenesis target MR/CT imaging ability, providing a new design concept and basis for assessing tumor angiogenesis.

Objective:To discuss the feasibility of prenatal MRI in evaluating fetal auricle developmental malformation and atresia of external auditory canal.Methods:Fifteen pregnant women (aged from 22 to 40 years old, mean age 31.3±5.2 years old) with fetal external ear developmental malformation suspected by ultrasound underwent MR scanning between November 2017 and May 2019. All of them were singleton. The gestational age ranged from 23 weeks to 35 weeks, with an average of (27.5±3.5) weeks. The sensitivity, specificity and accuracy of MRI and ultrasound in the diagnosis of fetal auricle malformation and atresia of external auditory canal were calculated and compared, using postnatal follow-up as the gold standard. Fisher exact test was used to compare the efficacy of MRI and ultrasound in diagnosing atresia of external auditory canal.Results:A total of 30 fetal external ears were detected in 15 fetuses, without auricle absence. Totally 19 external ears with developmental malformation were confirmed by postnatal follow-up, including 19 ears with auricle malformation and 15 ears with external auditory canal atresia. The accuracy of MRI and ultrasound in the diagnosis of auricle malformation was both 100% (19/19). For the diagnosis of external auditory canal atresia, the sensitivity, specificity and accuracy of MRI and ultrasound were 93.3% (14/15), 75.0% (3/4), 89.5% (17/19) and 33.3% (5/15), 25.0% (1/4), 31.6% (6/19), respectively. The sensitivity and accuracy of MRI in the diagnosis of atresia of external auditory canal were significantly higher than those of ultrasound, with statistically significant difference ( P=0.004, 0.001). Conclusion:MRI plays an important role in the diagnosis of fetal external ear developmental malformation, which can be used as an effective supplement to ultrasound, especially for the diagnosis of external auditory atresia.

Objective To understand the prevalence rate and related factors of chronic kidney disease (CKD) among elderly people aged more than 65 years old in the 66th regiment of the fourth division of A Crops in Xinjiang .Methods A total of 2 030 elderly people aged more than 65 years old in the 66th regiment of the fourth division of XPCC were distributed in 6 communities . Totally 334 permanent residents aged more than 65 years old were chosen from 2 communities by the stratified random sampling method .The renal injury indicators and related factors were detected .Results Among 329 residents with intact data ,after the age correction ,the prevalence rate of albuminuria ,hematuria and renal function decrease were 22 .2% ,14 .2% ,4 .9% ,respectively .The prevalence rate of CKD in this group was 32 .8% ,CKD stage 1―3 were dominated .The awareness rate was 15 .1% .The multiva‐riate Logistic regression analysis showed that gender and hypertension were independently associated with CKD .Conclusion The prevalence rate of CKD among elderly people aged over 65 years old in the 66th regiment of the fourth division of this Crops is high‐er .The related factors are gender and hypertension .

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation.Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting,including 14 cases with ＞50％ stenosis and 1 case with MCA occlusion,and 43 patients had no restenosis (non-restenosis group).The number of endothelial progenitor cells (EPC) was examined by flow cytometry,the adhesion function of EPC was tested by adhesion assay,the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor (VEGF) levels were measured by ELISA.The relationship of endothelial repairing function with restenosis was analyzed.Results The MCA stent implantations were successfully performed in all patients.The EPC number (33.7 ± 4.6 vs.61.6 ± 6.4),adhesion activities (26.1 ± 7.5 vs.56.3-± 9.6),migration activities (12.0 ± 3.9 vs.21.4 ± 6.5) and serum VEGF level [(56.7 ± 14.6) vs.(89.6 ± 17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t =18.48,13.09,6.34 and 7.73,all P ＜ 0.05).Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability,and low serum VEGF level.