Objective To investigate the relationship between preoperative frailty and short-term postoperative complications in elderly breast cancer patients.Methods A convenience sampling method was used to select 231 elderly breast cancer patients who underwent elective surgery in a tertiary care hospital in Beijing from July 2022 to December 2022.General information on elderly patients was collected and the frailty assessment was performed 1 day before surgery,and the occurrence of complications in elderly patients was followed up 30 days after surgery.Results Among the 214 elderly breast cancer patients,37 patients had complications within 30 days postoperatively.Binary logistic regression analysis showed that the risk of complications at 30 days postoperatively was 5.532 times higher in elderly breast cancer patients with preoperative frailty than it in non-frail patients(P＜0.05).Elder breast cancer patients with problems of decreased free movement,increased resistance/loss of endurance,and weight loss had a high risk of postoperative complications.Conclusion Preoperative frailty affects the occurrence of complications in elderly breast cancer patients within 30 days after surgery and suggests that nursing staff should strengthen perioperative health management for elderly breast cancer patients with preoperative frailty and actively prevent the occurrence and development of frailty.

Radiotherapy is an effective way to reduce the local recurrence rate and mortality of breast cancer.However,the risk of long-term side effects of radiation-induced cardiac injury cannot be ignored.Especially for patients undergoing left breast ra-diation therapy,the risk of cardiac injury is higher due to the heart being within the radiation field,which increases the incidence of radiation induced heart disease and ultimately affects long-term survival rate and quality of life.Therefore,it is particularly important to prevent radiation induced cardiac injury.The main measures include using advanced radiation therapy techniques such as intensity modulated radiation therapy,volume modulated arc radiotherapy,deep inhalation and breath holding radiation therapy,prone position radiation therapy,proton beam therapy,etc.or optimizing the radiotherapy plan for cardiac substructure to reduce the radiation dose to key cardiac structures.This article will review the research progress of pathophysiological mechanism,clinical manifestations,risk fac-tors and preventive measures of radiation-induced cardiac injury in breast cancer.

Objective:To explore the correlation between screen sedentary behavior and sleep quality of the elderly people in the community, so as to provide a reference for improving sleep quality of the elderly people in the community.Methods:From November 2021 to April 2022, 627 older adults from 3 communities in Hefei, Anhui Province were selected as the research objects using the convenience sampling method. The General Information Questionnaire, Measure of Older Adults' Sedentary Time Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) were used to investigate the elderly people in the community. Pearson correlation analysis was used to analyse the correlation between screen sedentary behavior and sleep quality of the elderly people in the community. The influencing factors of sleep quality were assessed by Binary Logistic regression. A total of 660 questionnaires were distributed and 627 valid questionnaires were recovered, with an effective recovery rate of 95.0% (627/660) .Results:The screen sedentary behavior time of 627 elderly people in the community was (3.53±1.52) h/d, the total score of PSQI was (7.11±3.58) , and the incidence of sleep disorders was 37.48% (235/627) . Pearson correlation analysis showed that screen sedentary positively correlated with the total score of PQSI ( r=0.466, P<0.01) . Binary Logistic regression analysis results showed that the screen sedentary behavior ( OR=1.892, 95% CI: 1.638-2.185) , female ( OR=1.963, 95% CI: 1.120-3.441) , self-reported poor health status ( OR=3.332, 95% CI: 1.380-8.043) were the risk factors of sleep quality of the elderly people in the community. Conclusions:The screen sedentary behavior and sleep quality of the elderly people in the community are not optimistic, and the screen sedentary behavior, female, self-reported poor health status are the risk factors of sleep quality of the elderly people in the community. Community health staff should develop targeted intervention strategies to help the elderly people in the community reduce screen sedentary behavior time and improve sleep quality.

The methods for determining the characteristic chromatogram and index components content of Xuanfu Daizhe Decoction were established to provide a scientific basis for the quality evaluation of substance benchmarks and preparations. Eighteen batches of Xuanfu Daizhe Decoction were prepared with the decoction pieces of different batches and of the same batch were prepared respectively, and the HPLC characteristic chromatograms of these samples were established. The similarities of the chromatographic fingerprints were analyzed. With liquiritin, glycyrrhizic acid, 6-gingerol, ginsenoside Rg_1, and ginsenoside Re as index components, the high performance liquid chromatography was established for content determination with no more than 70%-130% of the mass average as the limit. The results showed that there were 19 characteristic peaks corresponding to the characteristic chromatograms of 18 batches of Xuanfu Daizhe Decoction, including 8 peaks representing liquiritin, 1,5-O-dicaffeoylqunic acid, ginsenoside Rg_1, ginsenoside Re, 1-O-acetyl britannilactone, ginsenoside Rb_1, glycyrrhizic acid, and 6-gingerol, and the fingerprint similarity was greater than 0.97. The contents of liquiritin, glycyrrhizic acid, 6-gingerol, and ginsenosides Rg_1 + Re in the prepared Xuanfu Daizhe Decoction samples were 0.53%-0.86%, 0.61%-1.2%, 0.023%-0.068%, and 0.33%-0.66%, respectively. Except for several batches, most batches of Xuanfu Daizhe Decoction showed stable contents of index components, with no discrete values. The characteristic chromatograms and index components content characterized the information of Inulae Flos, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, and Zingiberis Rhizoma Recens in Xuanfu Daizhe Decoction. This study provides a scientific basis for the further research on the key chemical properties of substance benchmark and preparations of Xuanfu Daizhe Decoction.
Benchmarking ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Ginsenosides/analysis* ; Glycyrrhizic Acid/analysis* ; Quality Control

Objective:To explore the influencing factors of bowel preparation quality in hospitalized elderly patients, and to find the appropriate waiting time from the end of bowel preparation to the beginning of colonoscopy.Methods:Baseline and clinical data of elderly patients over 60 years old who underwent colonoscopy in the Tenth People′s Hospital, Tongji University from February 2021 to August 2021 were collected. Multivariate analysis was used to screen the factors that might affect the quality of bowel preparation in hospitalized elderly patients. Patients were grouped according to waiting time before colonoscopy. After eliminating confounding factors using propensity matching analysis, the difference of bowel preparation quality among groups was compared.Results:251 patients were included in the study. Multivariate analysis revealed that, hypertension ( OR=3.530, 95% CI 1.295-9.618), chronic constipation ( OR=3.302,95% CI 1.132-9.632), dietary compliance ( OR=0.161, 95% CI 0.070-0.371), medication and drinking water compliance ( OR=0.167, 95% CI 0.070-0.397), exercise compliance after medication ( OR=2.245, 95% CI 1.040-4.845), The frequency of defecation after medication ( OR=0.446, 95% CI 0.308-0.647) and waiting time ( OR=0.537, 95% CI 0.387-0.745) were important factors affecting the quality of bowel preparation in hospitalized elderly patients ( P<0.05). There were differences in bowel preparation quality between groups of waiting times. The overall quality of bowel preparation in 120-180 min group was significantly better than that in 241-300 min group, 301-360 min group and>360 min group ( P<0.05). The overall quality of bowel preparation in 181-240 min group was better than that in >360 min group ( P<0.05). There were no significant differences among other groups( P>0.05). The scores of cecum and ascending colon were the best in 120-180 min group, and the cleanliness of descending colon, sigmoid colon and rectum was significantly higher in 241-300 min group, 301-360 min group and > 360 min group. The scores of descending colon, sigmoid colon and rectum showed that the intestinal preparation quality of 181-240 min group was better than that of 301-360 min group and > 360 min group. Conclusions:The best examination time for elderly patients is about 180 minutes after bowelpreparation. Medical workers should flexibly guide the medication time to ensure that patients are in the best clean state of intestinal tract during examination.

Objectives: To analyze the status quo and trends on the burden of cerebrovascular diseases between 1990 and 2016 in China. Methods: Morbidity mortality, years of life lost (YLL), years of lived with disability (YLD) and disability-adjusted life year (DALY) related to cerebrovascular diseases between 1990 and 2016, were collated and analyzed, according to the results of the Global Burden of Diseases Study 2016 (GBD 2016). Numbers on incidence and morbidity were used to assess the incidence of diseases, while the numbers of death and mortality were used to assess the death of diseases. Years of life lost due to premature death (YLL), years lost due to disability (YLD) and disability-adjusted life year (DALY) were used to assess the burden of diseases. Changing trend on the burden of cerebrovascular disease from 1990 to 2016 was also analyzed. Results: In 2016 and 1990, the numbers of new cases/morbidity and the number of deaths/mortality on cerebrovascular diseases in the country showed an upward trend. Rates regarding YLL and DALY on cerebrovascular diseases remained stable from 1990 to 2016, however, the YLD rate showed a slow upward trend. The changing rate of DALY was mainly influenced by YLL. Both DALY and YLL crude rates in males showed a slow upward trend, with the highest DALY rate appearing in the ≥70 age group. Disease burden on males was heavier than that of the females and in the 50-60 age group, which taking the largest proportion. As for the composition in DALY, YLL appearing much larger than YLD and slowly increasing. Analysis on the subtypes of diseases, proportions of YLL and DALY in hemorrhagic stroke were greater than that in ischemic stroke while the proportion of YLD in ischemic stroke was in the opposite. Conclusions The burden of disease on cerebrovascular diseases remained heavy and the differences appeared in age, gender and subtypes of diseases. Our findings called for the adoption of measures including screening, intervention and rehabilitation to be taken on target populations, in order to reduce the burden on both individuals and the society.

Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.

Objective? To investigate the effect of mobile health education platform in the continuous nursing after discharge for rectal cancer patients with preventive colostomy. Methods? From January to December 2017, 60 rectal cancer patients with preventive colostomy in the Department of Gastrointestinal Surgery in the First Affiliated Hospital of University of Science and Technology of China were selected as the subjects by convenient sampling. Patients were divided into two groups: observation group (n=30) and control group(n=30). The control group received regular health education and continuous nursing care of telephone follow-up after discharge, apart from which the observation group received nursing care based on the mobile health education platform. One month after discharge, the two groups were compared in terms of the effects of intervention by the use of Colostomy Patient Colostomy Knowledge Attitude and Practice Scale (CPCKAPS),Ostomy Adjustment Inventory(OAI),and Patients＇ Satisfactory Questionnaire. Results? One month after surgery, the observation group were higher than the control group in the " knowledge on stoma care(11.80±3.13)", "health belief(51.70±11.72)" and "health behavior (31.73±7.19)"with statistical significances (t=3.76, 2.90, 3.05;P＜ 0.05). There were statistical significance in the score of OAI between the observation group (43.23±11.90) and the control group (37.43±6.33); the observation group was higher than the control group in the "overall satisfaction degree towards continuous care" (76.67% vs. 43.33%) with statistical significance(χ2=7.69,P＜ 0.05). Conclusions? Compared with conventional continuous nursing mode, continuous nursing based on mobile health education platform can improve the knowledge, belief and behavior of colostomy care for rectal cancer patients with preventive colostomy, and improve the patients＇adaptability on colostomy, as well as their satisfaction.

Objective:To evaluate the clinical use rationality of edaravone injection in our hospital to improve the level of rational use of drugs in clinics.Methods:Totally 500 medical records with edaravone injection from January to June in 2016 were selected randomly based on the hospital medical record management system.According to the drug package insert,relative literatures and information,the clinical use rationality was evaluated.Results:Among the 500 medical records,neurosurgery patients accounted for 48%,nerve internal medicine patients accounted for 37%,ICU patients accounted for 7%,orthopedics patients accounted for 5%,and the patients in the other departments accounted for 3%.Among the 500 medical records,108 ones involved off-label drug use,which accounted for 21.6%,180 cases involved improper use frequency,which accounted for 36%,201 cases involved improper treatment course,which accounted for 40.2%,37 cases involved improper drug administration time,which accounted for 7.4%,3 cases involved inappropriate solvent choice,which accounted for 0.6%,and 4 cases involved special population,which accounted for 0.8%.Among the 500 medical records,totally 261 (52.2%) ones were irrational.Conclusion:The overdose use and improper treatment course of edaravone injection in our hospital are severe,meanwhile,improper frequency and notice ignorance are common as well,which should be paid more attention.

Cooling bag for heat stroke in wild field was invented in order to fulfill rapid cooling for heat stroke in field environment. The cooling bag is composed of the hood, the body cover (which is made up of the anterior portion, the linking, and the posterior portion), the fixed straps, the handles. The length is 200 cm, the regulative width is 60-70 cm, the folding volume is 26 cm× 20 cm× 9 cm, and the weight is 1.4 kg. There are a number of pockets for the cold sources in the hood and the body cover. Fixed straps are set in the upper, middle and lower of the bag. The handles are set in the hood and the body covers. Usage: put the activated cold sources in the pockets, then put off the patient's clothes, stretch his/her arms into the linking, zipper up and wrapped up by the fixed straps; the amount of cold sources can be adjusted or changed according to the temperature. The patient's temperature, blood pressure, intravenous infusion can be monitored during the cooling course. The handles in the hood and the body cover allow the patient to be easily moved and be transferred in rescue. The cooling bag for heat stroke in field has good cooling effect, and are reusable and easy to be carried, operate, monitor and move, with low cost, which make it popularization and application.