BACKGROUND:It has been found that abnormal apoptosis of bone tissue cells induced by abnormal iron metabolism plays an important role in the progression of osteoporosis. OBJECTIVE:To investigate the effect of naringin on iron metabolism and cell apoptosis in bone tissue of rats with osteoporosis. METHODS:Fifty 2-month-old female Sprague-Dawley rats were randomly divided into five groups with 10 rats in each group:sham group,osteoporosis group,naringin low-dose group,naringin high-dose group,and naringin high-dose+DKK-1 group.Except for the sham group,rat models of osteoporosis were established by removing bilateral ovarian tissues in the other groups.At 8 weeks after modeling,rats in the naringin low-and high-dose groups were given 100 and 400 mg/kg/d naringenin by gavage,respectively,and rats in the naringenin high dose+DKK-1 group were given 400 mg/kg/d naringin by gavage and subcutaneous injection of 25 mg/kg/d DKK-1,an inhibitor of the Wnt1 signaling pathway,for 7 consecutive days.Relevant indexes were detected after administration. RESULTS AND CONCLUSION:Compared with the osteoporosis group,naringin could enhance the bone mineral density and serum calcium and superoxide dismutase levels in rats(P<0.05),and reduce the serum levels of osteocalcin,malondialdehyde,and phosphorus(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Micro-CT scanning,hematoxylin-eosin and TUNEL staining showed that compared with the osteoporosis group,naringin significantly improved bone microstructure and reduced the rate of cell apoptosis,while DKK-1 partially inhibited the interventional effect of naringin.Immunofluorescence staining results showed that compared with the osteoporosis group,naringin could reduce the oxygen content,anti-tartaric acid phosphatase expression,and elevate the expression of alkaline phosphatase in active tibia tissues(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Prussian blue staining and immunohistochemical staining showed that compared with the osteoporosis group,naringin reduced iron deposition in bone and liver tissues as well as the expression of transferrin receptor 1(P<0.05),and elevated the protein expression of ferroportin 1(P<0.05)in bone tissue,and DKK-1 partially inhibited the intervention of naringin(P<0.05).PCR and western blot assay of tibia specimens showed that compared with the osteoporosis group,naringin decreased the expression of anti-tartrate acid phosphatase,transferrin receptor 1 and Bax(P<0.05),and elevated the expression of alkaline phosphatase,ferroportin 1,Bcl-2,Wnt1 and β-catenin(P<0.05),while DKK-1 partially inhibited the interfering effect of naringin(P<0.05).To conclude,naringin inhibits the progression of osteoporosis by reducing iron deposition and apoptosis rate in bone tissue,which may be related to the activation of the Wnt1 signaling pathway.

Objective Motortherapy and neck muscle resistance training are used to study the effects of resistance training on neck pain level and surface myoelectric activity of student pilots of carrier aircraft.Methods We conducted an intervention experiment on the neck pain of the carrier-based aircraft student pilots.The experiment period was 3 months.The experimental subjects were male carrier-based aircraft student pilots aged from 23 to 35.Questionnaires,including the Cervical Dysfunction Index and the Chinese Physical Activity Questionnaire,were issued,followed by cervical muscle function tests,including cervical maximum muscle strength,cervical range of motion,and surface electromyography tests.The experimental subjects were randomly divided into the control group and the resistance training group,with 8 in each.The subjects in the control group recieved usual military training.Those in the resistance training group recieved targeted training programs developed by using the self-developed cervical spondylosis prevention training device in addition to usual military training.The programs were carried out for resistance training three times a week for 20 minutes in each.Cervical maximum muscle strength,cervical range of motion,and surface electromyography were tested again before the end of the intervention experiment.The data were analyzed by SPSS 22.0.The results were expressed by mean±standard deviation((-x)±s).P<0.05 was considered statistically significant.Results(1)After 12-week intervention,resistance training had a significant effect on visual pain analog scale(VAS).(2)After the intervention,the comparison results of the subjects'cervical spine dysfunction index(NDI)before and after their own tests showed that the level of cervical spine dysfunction was significantly improved.(3)After the intervention,the results of inter-group comparison of the subjects'own joint motion showed that the self-variation difference of the subjects in the resistance training group was significantly different in forward flexion,backward extension,left flexion,right flexion,right rotation and left rotation.(4)After the intervention,the comparison results between the two groups of subjects'own neck muscle strength showed that there was no significant difference in the self-change of the six movements of subjects in the resistance training group.(5)The root mean square(RMS)values in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle.(6)The integrated electromyography(iEMG)in the four movement tests of flexion,extension,flexion and flexion before and after the intervention in the resistance training group showed no significant difference between the left and right sternocleidomastoid muscle and the right and right trapezius muscle superior bundle.Conclusion After 12 weeks of resistance training,VAS scores and NDI scores of resistance training subjects are significantly reduced,indicating that resistance training can alleviate neck pain and improve cervical spine dysfunction.12-week resistance training can enhance the strength of neck muscles of carrier-based aircraft student pilots and improve the anti-fatigue ability of neck muscles.Meanwhile,it can enhance the range of motion of neck joints,improve the load of the deep and shallow muscle fibers of the four tested muscles in the neck and optimize the activation mode of the deep and shallow muscles in the neck.

Objective To explore the intervention effect of badminton exercise on neck pain in naval carrier-based aircraft flight trainees,and provide data support for the prevention and relief of neck pain in these trainees.Methods A total of 16 naval carrier-based aircraft flight trainees were selected as subjects based on inclusion and exclusion criteria,and randomly divided into the sports rehabilitation group and the control group,with eight participants in each group.The sports rehabilitation group engaged in badminton exercise three times a week for one hour each time,in addition to their regular military training.The control group received no other interventions apart from their regular military training.Neck Disability Index(NDI),Visual Analog Scale(VAS)for pain simulation,Cervical Range of Motion(CROM),maximum neck strength,Root Mean Square(RMS)value of surface electromyographic signals,and integrated electromyography(iEMG)values were used as evaluation indexes for the intervention effect of neck pain.Results There was a significant difference in NDI scores among members of the sports rehabilitation group before and after intervention(P<0.05).However,there was no significant difference observed in NDI scores among members of the control group before and after intervention(P>0.05).Furthermore,there was a significant difference in VAS scores among members of the sports rehabilitation group before and after intervention(P<0.01).The VAS scores of the control group members showed no significant difference compared to pre-intervention testing(P>0.05).The maximum range of motion in all directions increased for the exercise rehabilitation group,with significant differences observed in left and right flexion(P<0.05),but no significant differences were found in other directions(P>0.05)compared to pre-intervention levels.There was no significant change in maximum range of motion within the control group before and after intervention(P>0.05).The exercise rehabilitation group demonstrated a significant increase in neck muscle strength during forward flexion,backward extension,left flexion(P<0.01),and right flexion as well as left and right rotation values(P<0.05)compared to pre-intervention levels.There was no significant difference observed between RMS values on both sides of the sternocleidomastoid muscles during movement in four different directions for the exercise rehabilitation group(P>0.05).However,there was a significant difference observed on the left side of the upper trapezius muscle during forward and rightward movements(P<0.05),but not during backward or leftward movements(P>0.05).No statistically significant differences were found among any direction's iEMG values before or after intervention for four muscles tested except that iEMG value increased slightly without significance after intervention when performing forward bending,backward extension and rightward bending exercises within exercise rehabilitation groups(P>0.05).Conclusion After badminton training,neck pain among carrier-based fighter pilots is allivated while cervical dysfunction recovers somewhat.Furthermore,their neck flexibility increases along with their neck muscle strength while deep muscles are activated to maintain stability to effectively enhance fatigue resistance capacity within these muscle groups around their necks.

Objective:To explore the risk factors of hypomagnesemia in elderly patients with sepsis and the influence of hypomagnesemia on the prognosis of elderly patients with sepsis.Methods:In this retrospective study, 249 elderly patients with sepsis or septic shock were recruited between January 2018 and January 2021 from the Department of Geriatrics and the Department of Emergency Medicine, General Hospital of Tianjin Medical University, and relevant clinical data were collected.The Logistic regression analysis model was used to identify the relationship between risk factors and hypomagnesemia in patients with sepsis.The prognosis criteria such as hospitalization time in intensive care unit(ICU), 28-day mortality rate, mechanical ventilation time, double infection rate, shock reversal time, etc., were compared between the hypomagnesemia group and the normal magnesium group.Results:Among the 249 elderly patients with sepsis, 187 had normal blood magnesium, 43 had low blood magnesium and 19 had high blood magnesium, accounting for 75.10%, 17.27% and 7.63%, respectively.Compared with the normal blood magnesium group, elderly sepsis patients with hypomagnesemia had a longer hospitalization time in ICU[(16.21±3.68)d vs.(13.86±3.58)d, t=-4.845, P=0.036], and a significantly prolonged mechanical ventilation time[11(3, 18)d vs.3(1, 6)d, Z=-1.782, P=0.033]. There was no significant difference in mortality and double infection rate between the two groups(both P>0.05). The sequential organ failure assessment(SOFA)score of elderly sepsis patients in the low magnesium group was significantly higher than that in the normal magnesium group[(5.69±1.28)scores vs.(3.09±0.68)scores, t=-0.322, P=0.008], but there was no significant difference in acute physiology and chronic health evaluation(APACHE) Ⅱ score between the two groups( P>0.05). Multivariate Logistic regression analysis showed that high SOFA score( OR=1.111, 95% CI: 1.025-1.758, P=0.001)was an independent risk factor for hypomagnesemia. Conclusions:A high SOFA score is an independent risk factor for hypomagnesemia in elderly sepsis patients, and the clinical prognosis of elderly sepsis patients with hypomagnesemia is poor.

Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
.

Objective:To investigate the correlation between mild cognitive impairment(MCI)and abnormal glucose metabolism and thus to provide a basis for MCI prevention.Methods:A total of 1 074 elderly outpatients with normal cognitive function and without confirmed diabetes mellitus, hyperlipoidemia or gout were enrolled.During a five-year follow-up period, 121 subjects were diagnosed with MCI based on the mini mental state examination(MMSE)and the Montreal cognitive assessment(MoCA). Furthermore, annual blood glucose and glycated hemoglobin monitoring was carried out to examine the long-term effects of abnormal glucose metabolism on MCI risk.Results:According to cognitive function, 1 074 subjects were divided into the MCI group and the non-MCI group.Compared with the non-MCI group, the mean values of fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), triglycerides(TG)and total cholesterol(TC)in the MCI group were elevated( P<0.05). The receiver operating characteristic(ROC)curve showed that the cut-off value of FBG was 6.2 mmol/L for the hyperglycemia group(sensitivity: 84.1%, specificity: 90.9%, area under curve: 0.875, P<0.001)and 4.5mmol/L for the hypoglycemic group(sensitivity: 77.4%, specificity: 87.3%, area under curve: 0.823, P<0.001); the cut-off value of HbA1c was 5.5%(sensitivity: 76.0%, specificity: 87.0%, area under curve: 0.815, P<0.001). Multiple Logistic regression analysis showed that increased risk of MCI was associated with the mean values of fasting blood glucose <4.5 mmol/L( RR: 1.69, 95% CI: 1.11-2.59)or ≥6.2 mmol/L( RR: 1.81, 95% CI: 1.15-2.86)and of glycosylated hemoglobin ≥ 5.5%( RR: 2.13, 95% CI: 1.51-2.99). Conclusions:Impaired fasting glucose tolerance and low fasting blood glucose are independent risk factors for MCI in the elderly.

Objective:To learn the influencing factors for acceptance and approval of Internet plus medicine by patients in Wuhan, and to provide relevant references.Methods:A questionnaire was developed to analyze the acceptance and approval of Internet plus medicine for 543 pationts in Wuhan, while Chi-square test and logistic regression analysis were used to analyze the influencing factors of acceptance and approval of Internet plus medicine in Wuhan.Results:The acceptance of Internet plus medicine was significantly related to age( χ2=51.340, P<0.01), education level( χ2=55.745, P<0.01)and daily online hours( χ2=50.210, P<0.01). The approval of Internet plus medicine was significantly related to age( χ2=42.278, P<0.01), education level( χ2=26.531, P<0.01)and average traffic hours spent on visiting doctors( χ2=29.373, P<0.01). Conclusions:The younger patients had a higher acceptance and approval of Internet plus medicine of all age groups. The patients with a higher degree of education had higher acceptance and approval of Internet plus medicine. The patients with longer daily online hours had a higher acceptance of Internet plus medicine. The patients with longer average traffic hours to see doctors had a higher approval of Internet plus medicine.

Objective:To discuss the diagnosis and treatment of ectopic ureter company with the bladder neck and urethral maldevelopment in children.Methods:The clinical data of the 6 patients admitted to Children’s Hospital affiliated to Chongqing Medical University from September 1993 to April 2019 diagnosed as ectopic ureter company with the bladder neck and urethral maldevelopment were retrospectively reviewed. The 6 children were girls and the median age was 7 years old , ranged from 2 to 15 years old. All children had ectopic ureter, including 3 in left-sided, 1 in right-sided, and 2 in bilateral-sided. Five children presented the intermittent dribbling incontinence and one child presented the continuously incontinence without normal voiding. Through ultrasound, IVP, MRI, cystoscopy and retrograde urography, seven ureters were found ectopic position, including bladder neck in 4 cases, two ureters inserted in the vagina in 2 cases. There were two cases with duplex kidney and 4 cases with renal dysplasia. Preoperative cystoscopy revealed wide and short urethra in 1 case, wide bladder neck combined with wide and short urethra in 4 cases. The surgery type included nephrectomy in cases 1-3, bilateral ureter reimplantation in case 4 who had the bilateral ectopic ureter , bilateral ureter reimplantation and bladder neck reconstruction at the same time in case 5. Nephrectomy associated with bladder neck and urethral reconstruction in case 6.Results:Five patients were followed-up and one patient was lost to follow-up after the first operation. Mean follow-up was 41.2 months (ranging 2 to 84 months). Four patients with bladder neck and maldevelopment that were not solved intraoperatively got reoperations due to incontinence without remission. Case 1, who underwent urethral reconstruction and extension, and urinary incontinence was partially relieved. Case 2 was found to have wide bladder neck deformity, and then retrospectively got bladder neck reconstruction and urethrovaginal fistula repair in 3 years and 5 years later. The urinary incontinence was completely relieved. The ureteral stump of case 3 was resected 2 years after operation due to recurrent urinary tract infection, and then got twice bladder neck and urethral reconstruction in 3 years and 6 years later of nephrectomy. His incontinence was partially relieved. The case 4 got bladder neck and urethral reconstruction in one year after bilateral ureter reimplantation, and incontinence was partially relieved too. Among the two patients underwent combined surgery, the case 5, who got bilateral ureteral bladder replantation combined with bladder neck reconstruction, were lost to follow-up after surgery. The case 6 got dysplasia nephrectomy combined with bladder neck reconstruction and urethroplasty were completely relieved of urinary incontinence.Conclusions:Bladder neck and urethra maldevelopment is one of the main causes of urinary incontinence after surgery in children with ectopic ureter. The diagnosis mainly relies on cystoscopy. The treatment mainly relies on surgery. Bladder neck and urethral reconstruction is expected to be available. If the operative conditions permit, synchronous surgical treatment of ectopic ureter and bladder neck and urethral maldevelopment will get a better prognosis than staging surgery.

Objective:To determine the relationship between uric acid (UA) and mild cognitive impairment (MCI), and its potential effect on inflammation.Methods:450 patients with MCI diagnosed by neuropsychological scale and 450 controls with normal cognitive function were included. All subjects were≥60 years old. There were 184 obese subjects in MCI group and 199 obese subjects in control group.Results:A correlation between increased serum UA level and decreased risk of MCI was found in all MCI patients and non-obese MCI patients ( OR: 0.60, 95% CI 0.45-0.78; OR: 0.42, 95% CI 0.29-0.62), but not in obese MCI patients ( OR: 0.86, 95% CI: 0.54-1.35). The levels of UA and hypersensitive C reactive protein (hs-CRP) in obese patients with MCI were higher than those in non-obese patients ( P<0.01). There was a linear positive correlation between serum UA and hs-CRP levels in obese patients with MCI ( r=0.505, P<0.01), but not in non-obese MCI patients ( r=0.053, P=0.385). Conclusion:A significant correlation between lower serum uric acid levels and higher risk of MCI in non-obese subjects was found. Inflammation caused by obesity may weaken this relationship.