Objective To explore the effects of multi-component exercise intervention (MET) based on different rates of resistance training on physical function and depression status in elderly patients with frailty. Methods Eighty hospitalized elderly patients with frailty in the Geriatric Department were randomly divided into control group (n=40) and study group (n=40). The elderly patients with frailty in the control group received routine medical intervention, while those in the study group received MET on the basis of the control group. According to the principle of random allocation, the study group was further divided into high-resistance group (n=20) and low-resistance group (n=20). The high-resistance group performed three sets of resistance training at 75% of the one-repetition maximum (1RM) intensity, while the low-resistance group performed three sets of resistance training at 45%, 60% and 75% of the 1RM intensity. The changes in 1RM of shoulder, hip, and knee flexion and extension activities were compared among the three groups before and after the intervention; the scores of the Short-form Physical Performance Battery (SPPB), the Hamilton Depression Rating Scale (HAMD), and the Short-form Quality of Life with 12 items (SF-12) were also compared among the three groups before and after the intervention. Results After the intervention, the 1RM of joint activities in the high-resistance group was significantly higher than that in the low-resistance group and the control group, and the 1RM of joint activities in the low-resistance group was also significantly higher than that in the control group (P < 0.05). After the intervention, the SPPB score in the high-resistance group was significantly higher than that in the low-resistance group and the control group, and the SPPB score in the low-resistance group was also significantly higher than that in the control group (P < 0.05); the HAMD score in the high-resistance group was significantly lower than that in the low-resistance group and the control group, and the HAMD score in the low-resistance group was also significantly lower than that in the control group (P < 0.05). After the intervention, the total Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in the high-resistance group were significantly higher than those in the low-resistance group and the control group, and the PCS and MCS scores in the low-resistance group were also significantly higher than those in the control group (P < 0.05). Conclusion MET can improve physical function and depression status in elderly patients with frailty, and appropriate increase of the resistance training rate can further enhance the positive effects of MET.

Objective To investigate the relationship between the vaginal microecology and CC chemokine ligand 28(CCL28)expression levels in the vaginal lavage fluid of patients with persistent high-risk human papillomavirus(HR-HPV)infection.Methods A total of 132 patients with HR-HPV infection at Tangshan Maternal and Child Health Hospital from April 2021 to April 2023 were selected as study subjects.Patients with HR-HPV infection were categorized into the single infection group and the persistent infection group according to the review results.The CCL28 and vaginal microecological indicators of the two groups were compared.Logistic regression was used to analyze the risk factors for persistent HR-HPV infection.The dose-response relationship between CCL28 and persistent HR-HPV infection was analyzed by fitting restricted cubic splines with logistic regression.Spearman and multiple linear regression were used to analyze the relationship between CCL28 and vaginal microecological indicators.Results After the re-examination of patients,there were 84(63.64％)cases of single infection and 48(36.36％)cases of persistent infection.The percentage of colony density grade Ⅰ(54.17％vs 16.67％),colony diversity grade Ⅰ(47.92％),pH＞4.5(47.92％),hydrogen peroxide positivity(54.17％),and vaginal microecological imbalance(66.67％),and the level of CCL28[83.63(77.11,99.62)ng/L]in the persistent infection group were higher than those of the single infection group[16.76％,21.43％,15.48％,30.95％,41.67％,71.11(58.12,82.16)ng/L],and the differences were statistically significant(x2/Z=5.064～20.338,all P＜0.05).Logistic regression analysis showed that colony density grade Ⅰ(OR=3.556,95％CI:1.241～10.194,P=0.018),PH＞4.5(OR=4.366,95％CI:1.164～16.380,P=0.029),and high CCL28 levels(OR=1.048,95％CI:1.018～1.080,P=0.002)were independent risk factors for persistent infection in HR-HPV-infected patients.Logistic regression fitting restricted cubic splines showed a linear relationship between CCL28 and persistent HR-HPV infection(nonlinear test x2=0.61,P=0.437).Spearman correlation analysis results showed that CCL28 was positively correlated with age(r=0.205,P=0.018),colony density(r=0.429,P＜0.001),colony diversity(r=0.389,P＜0.001),pH(r=0.357,P＜0.00l),hydrogen peroxide(r=0.409,P＜0.001),leukocyte esterase(r=0.392,P＜0.00l),and vaginal microecology(r=0.473,P＜0.001).Linear regression analysis showed that colony density(β=12.295,P=0.003)and colony diversity(β=9.196,P=0.032)were independently associated with CCL28.Conclusion Colony density and colony diversity were independently correlated with CCL28.Colony density grade Ⅰ,pH＞4.5,and high CCL28 levels suggest an increased risk of persistent infection in patients with HR-HPV infection.

Objective:To observe the characteristics of back scraping skin symptoms in sub-health people through diagnostic scraping, and explore the characteristics of back scraping skin symptoms in sub-health people with different constitutions.Methods:By adopting a cross-sectional study method, the Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine recruited volunteers through a combination of offline and online methods from March 2021 to September 2022. Totally 2 239 sub-health people were treated for TCM constitution identification and were diagnostic scraped with Wentong scraping cup. The differences of back scraping skin symptoms in the color, speed, amount, shape, nature of pain and feeling characteristics under scraping board were compared between sub-health people with different TCM constitutions and gentle constitution.Results:There were differences in the characteristics of Sha Xiang among sub-health individuals with different constitutions. Among them, 49.02% (351/716) of individuals with a gentle constitution had a bright red color, 90.64% (649/716) had a fast rate of appearance, 5.73% (41/716) had a large amount of sha, 3.35% (24/716) had a patchy shape, 3.35% (24/716) felt a stabbing pain, and 0 felt nodules under the scraping plate. Among individuals with a damp-heat constitution, 86.72% (457/527) had a bright red color, 95.64% (504/527) had a fast rate of appearance, 100.00% (527/527) had a large amount of sha, 88.80% (468/527) had a patchy shape, 95.64% (504/527) felt a stabbing pain and 97.72% (515/527) felt nodules under the scraping plate. There was a statistically significant difference between the two groups ( χ2 values were 11.27 to 1 243.00, all P<0.05). Conclusions:The characteristics of back scraping skin symptoms of sub-health people with different constitutions are different. It is expected that the type of TCM constitution of sub-health people can be judged according to the characteristics of scraping skin symptoms in the future, in order to guide patients in health management and improve their satisfaction with traditional Chinese medicine scraping treatment.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Objective:To extract and summarize the best evidence of early ambulation after anterior cervical surgery, so as to provide practical basis for early ambulation of clinical patients.Methods:The research questions were proposed based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model. According to the "6S" model, the clinical guidelines, expert consensus, clinical decision-making, evidence summary, systematic reviews and randomized controlled trials related to "early postoperative activities of patients undergoing anterior cervical surgery" in databases such as UpToDate, British Medical Journal (BMJ) Best Practice website, Cochrane Library, China National Knowledge Infrastructure and WanFang Data were systematically retrieved. The retrieval time was from the establishment of the database to February 1, 2022. Two researchers independently evaluated the quality of the articles, and extracted and integrated the evidence of the articles meeting the quality standards.Results:A total of 10 articles were included, including two guidelines, three expert consensus, three systematic reviews, and two randomized controlled trials. It is summarized into 28 pieces of evidence and 7 dimensions, including multidisciplinary team cooperation, optimization of preoperative health education, preparation before ambulation, content of ambulation, multimodal analgesia management, nausea and vomiting management, and safety management of ambulation.Conclusions:The evidence included in this study provides a series of information for early ambulation after anterior cervical surgery. The medical and nursing staff should combine the evidence with the actual clinical situation, consider the value and expectation of the patient, comprehensively and individually evaluate the patient, and then make an early ambulation plan.

Objective:To explore the clinical and laboratory characteristics of acquired immunodeficiency syndrome (AIDS) patients complicated with disseminated nontuberculous mycobacterial (NTM) disease, in order to provide basis for clinical therapy.Methods:The clinical findings, imaging and etiological data of the 71 AIDS patients complicated with disseminated NTM disease admitted to Beijing You′an Hospital from June 2016 to June 2021 were retrospectively analyzed.Results:Among 71 patients with disseminated NTM disease, the most common initial symptom was fever, followed with cough, expectoration, fatigue, poor appetite, abdominal pain and diarrhea. Seventy point four percent (50/71) of these patients had at least two comorbidities, with oral candida infection, cytomegalovirus infection, syphilis, pneumocystis pneumonia and bacterial pneumonia being the most common. Hemoglobin ((87.8±24.2) g/L) and albumin ((27.3±7.0) g/L) levels significantly decreased, while erythrocyte sedimentation rate ((59.8±28.6) mm/1 h) and C-reactive protein ((74.7±50.8) mg/L) levels increased in most cases. The median CD4 + T lymphocyte count was 7×10 6/L. The median time of positive blood culture of NTM was 260 h. Among the 71 patients, 40 cases (56.3%) were infected with Mycobacterium avium, 15 cases (21.1%) with Mycobacterium intracellulare, 10 cases (14.1%) with Mycobacterium colombiense, three cases (4.2%) with Mycobacterium marseillense and three cases (4.2%) with Mycobacterium kansasii.The frequent imaging findings were patchy and nodular shadows in lungs, and most patients had mediastinal or hilar lymph node enlargement and splenomegaly. Conclusions:AIDS complicated with disseminated NTM disease is prevalently occurred in patients with severe immune deficiency, and most of the bacteria belong to the Mycobacterium avium- intracellulare complex. Early obtaining positive etiological results of NTM is essential to guide the correct clinical diagnosis and accurate treatment.

Abstract Oral health problems is one of major public health problems that threatens children s overall health. Children s oral health is closely related to family parenting styles. Currently, grandparenting is becoming increasingly common in China, and its impact on children s oral health should not be underestimated. This article reviews the impacts of the oral health knowledge level, behavior habits, gender, socioeconomic status, and other factors related to grandparenting on children s oral health, in order to reduce the negative impact of grandparenting involvement on children s oral health, and to provide theoretical basis and guidance.

There remains a significant gap in our quantitative understanding of crosstalk between apoptosis and necroptosis pathways. By employing the SWATH-MS technique, we quantified absolute amounts of up to thousands of proteins in dynamic assembling/de-assembling of TNF signaling complexes. Combining SWATH-MS-based network modeling and experimental validation, we found that when RIP1 level is below ~1000 molecules/cell (mpc), the cell solely undergoes TRADD-dependent apoptosis. When RIP1 is above ~1000 mpc, pro-caspase-8 and RIP3 are recruited to necrosome respectively with linear and nonlinear dependence on RIP1 amount, which well explains the co-occurrence of apoptosis and necroptosis and the paradoxical observations that RIP1 is required for necroptosis but its increase down-regulates necroptosis. Higher amount of RIP1 (>~46,000 mpc) suppresses apoptosis, leading to necroptosis alone. The relation between RIP1 level and occurrence of necroptosis or total cell death is biphasic. Our study provides a resource for encoding the complexity of TNF signaling and a quantitative picture how distinct dynamic interplay among proteins function as basis sets in signaling complexes, enabling RIP1 to play diverse roles in governing cell fate decisions.
Animals ; Apoptosis ; Caspase 8/metabolism* ; GTPase-Activating Proteins/metabolism* ; HEK293 Cells ; Humans ; Mice ; Mice, Knockout ; Necroptosis ; Receptor-Interacting Protein Serine-Threonine Kinases/metabolism*

Objective:To explore the effect of virtual reality (VR)-based baduanjin exercise on the cognition, physical functioning and life quality of elderly persons with mild cognitive impairment (MCI).Methods:Fifty-seven mildly impaired elderly persons were randomly divided into an observation group ( n=29) and a control group ( n=28). Both groups were given routine care and health education in their nursing homes, while the observation group additionally performed 50 minutes of VR baduanjin exercise three times a week for 24 weeks. Both groups were assessed using the Montreal cognitive assessment (MoCA), the Rivermead behavioural memory test (second edition) (RBMT-Ⅱ), a digit-symbol substitution test (DSST) and the Trail Making Test (TMT). The short physical performance battery (SPPB) and Alzheimer′s disease quality of life (QOL-AD) instrument were also administered before and after the 24-week intervention. Results:After the intervention the average MoCA, RBMT-Ⅱ, DSST, TMT-A, SPPB and QOL-AD results of the observation group were all significantly better than before the intervention and better than the control group′s averages. The observation group also performed better on the 5 times sit-to-stand test, the tandem standing test and a walking speed test after the intervention.Conclusions:VR-based baduanjin practice can effectively improve the cognition and physical functioning of mildly impaired elderly persons, as well as improving their quality of life.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.