Objective: To examine the association between frailty and cognitive function in middle-aged and elderly populations using group-based trajectory model (GBTM), so as to provide insights into the prevention and intervention strategies for cognitive impairment in this population. Methods: From 2011 to 2018, data of demographic information and lifestyle behavior for individuals aged ≥45 years were collected from the China Health and Retirement Longitudinal Study. Frailty status was assessed using the frailty index, and cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination. GBTM was applied to establish frailty trajectories based on the frailty index from 2011 to 2018 to analyze the trajectory of frailty changes. The association between frailty and cognitive function was analyzed using multiple linear regression model. Results: A total of 4 809 participants were included, with a mean age of (56.63±7.73) years. There were 2 621 males (54.50%) and 2 188 females (45.50%). The 2018 survey identified 574 individuals (11.94%) with cognitive function decline. GBTM identified four distinct frailty trajectories including the normal and stable group (69.27%), recovering frail group (9.32%), progressing pre-frail group (16.20%) and persistently frail group (5.22%). The mean cognitive funtion scores for these groups were (17.24±4.83) (16.38±5.53) (15.74±5.20) (15.02±5.11) points, respectively. The differences in cognitive funtion scores across groups were statistically significant (P<0.05). Multiple linear regression analysis showed, after adjusting for confounding factors such as gender, age, nighttime sleep duration, and smoking, compared with the normal and stable group, the cognitive function decline risk was higher in the frailty recovery group (β=-0.581), the pre-frail progression group (β=-0.583), and the persistently frail group (β=-0.662) compared with the non-frail stable group (all P<0.05). Conclusions There are four groups of changes in frailty among the middle-aged and elderly populations. Compared with the normal and stable group, the groups experiencing progression, persistence, and recovery of frailty exhibit a more pronounced risk of cognitive funtion decline.

ObjectiveTo explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China. MethodsA total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q₁‒Q₄. Trend χ² test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q₂， Q₃， Q₄） and the reference group Q₁. ResultA total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （P_trend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q₁ and the highest quartile group Q₄ （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （P_trend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （P_trend=0.005）. With the lowest quartile of SMI Q₁ as the reference group， the risk of MS in Q₂ （OR=0.63， 95%CI： 0.40‒1.00）， Q₃ （OR=0.56， 95%CI： 0.34‒0.94）， Q₄ （OR=0.42， 95%CI： 0.23‒0.76） decreased. ConclusionAn increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

Objective To compare the clinical effects of totally thoracoscopic surgery and conventional median thoracoto my surgery in the repair of atrial septal defect(ASD),so as to provide reference for the clinical choice of atrial septal defect repair.Methods 131 patients with ASD from January 2015 to November 2016 in the First Affiliated Hospital of Xinjiang Medical University were divided into two groups according to operation type:totally thoracoscopic group(58 cases),median thoracotomy group.The differences in operative time,cardiopulmonary bypass time(CPB),ventilator assist time,ICU stay time,postoperative hospital stay and other aspects were compared.Results There was no death and no serious complication in the two groups.There was no statistical difference between the two groups (P ＞ 0.05) in sex,weight,age,right atrial size and cardiac function.The time of thoracoscopic surgery [(3.6 ± 1.0) h vs.(2.6 ± 0.6) h] and the duration of CPB [(98.3 ± 35.8)min vs.(32.3 ± 16.1) min] were longer than those of median thoracotomy group (P ＜ 0.05).There was no statistical difference between two groups in the time of mechanical ventilation,ICU stay,postoperative drainage and postoperative hospital stay (P ＞ 0.05).Conclusion Although ASD repair of thoracoscopic surgery is difficult and the learning curve is long,but it can be said that the totally thoracoscopic ASD repair can achieve the same results as conventional median thoracotomy does,and it is effective and safe,and thoracoscopic surgery also has less trauma and cosmetic appearance,no bone structure damage,worthy of clinical promotion.

OBJECTIVETo innovatively establish a new platform of myocardial ischemia-reperfusion injury (MIRI) animal model by observing abnormal savda carrier MIRI indicators, and to observe changes of myocardial ultrastructure.

METHODSAccording to Uyghur medical theories, an abnormal savda carrier animal model was established and confirmed using multifactor, and then MIRI models set up. Totally 36 male white SD rats were randomly divided into the normal sham-operation group, the normal operation group, the model sham-operation group, and the model operation group, 9 in each group. ECG changes, myocardial enzymes (CK-MB), and cardiac troponin (cTnT), and ultramicrostructures were observed.

RESULTSCompared with the normal sham-operation group, some damage of ultramicrostructures occurred in heart muscles of rats in the normal operation group and the model operation group, such as lowered myoplasm density, loosely arranged myofilament, dilated myofibris, reduced mitochondria number, vacuole and swelling mitochondrion. Ultramicrostructural damage of cardiac muscle cells was more severe in rats of the model operation group. Compared with the normal sham-operation group, CK-MB and cTnT increased in the normal operation group with statistical difference (P < 0.01). Compared with the normal sham-operation group, there was no statistical difference in CK-MB or cTnT in the model sham-operation group (P > 0.05). Compared with the model operation group, CK-MB and cTnT obviously decreased in the model sham-operation group and the normal operation group with statistical difference (all P < 0.01).

CONCLUSIONAbnormal savda carrier MIRI model established in this experiment could provide favorable conditions for further MIRI intervention treatment.

Animals ; Disease Models, Animal ; Male ; Medicine, Traditional ; Myocardial Reperfusion Injury ; Myocardium ; ultrastructure ; Myocytes, Cardiac ; Rats ; Rats, Sprague-Dawley

Objective: To determine the clinical efficacy and feasibility of multiple special formed titanium mesh cages (TMCs) to treat lumbo-sacral spinal tuberculosis via posterior approach. Methods: From July, 2007 to June, 2013, 25 patients with lumbo-sacral spinal tuberculosis underwent one-stage posterior debridement, internal if xation, and interbody fusion using multiple special formed titanium meshes. We compared the parameters as follow: the pre- and post-operative American Spinal Injury Association (ASIA) score, lumbo-sacral angle, the height of intervertebral space, visual analogue scale (VAS), and erythrocyte sedimentation rate (ESR), and observedoperation time, intraoperative blood loss, and time of bone gratf fusion. Results: Operation time ranged from 90 to 180 min, (128±24) min in average. Blood loss in the operation ranged from 100 to 800 mL, (310±125) mL in average. hTe patients were followed up for 24 to 59 months, (43±7) months in average. One patient delayed healing of wound. ASIA score was improved in a certain degree in patients with neurological dysfunctions. hTe lumbo-sacral angle and the height of intervertebral space in the post-operation were signiifcantly higher than those in the pre-operation (P<0.001). VAS was reduced obviously atfer 2 weeks of operation. hTe ESR recovered to the normal level 6 months atfer operation in all the patients. Solid fusion was achieved within 4 to 8 months, 6 months in average. No sinus tract, cerebrospinal meningitis, tuberculosis recurrence and titanium mesh subsidence were found. Conclusion: For lumbo-sacral tuberculosis, multiple special formed titanium mesh cages via posterior approach is safe and effective, which is good to the stability in spine reconstruction.