Objective:To explore the effect of "Internet +" combined with multidisciplinary out of hospital management in hospital-home transitional period management of patients after lumbar internal fixation.Methods:From October 2021 to September 2022, convenience sampling was used to select 176 patients who underwent lumbar internal fixation at the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University. According to the admission time, patients enrolled from October 2021 to March 2022 were included in the control group, and patients enrolled from April to September 2022 were included in the observation group, with 88 cases in each group. The control group implemented routine out of hospital follow-up management, while the observation group implemented "Internet +" combined with multidisciplinary out of hospital management. After three months of intervention, the recovery of lumbar and back function [Oswestry Disability Index (ODI) and Macnab score], surgical efficacy (NaKa grading), nursing satisfaction, and readmission rate were compared between the two groups.Results:After three months, the ODI score of the observation group was lower than that of the control group, and the Macnab score was higher than that of the control group, the NaKa grading was better than that of the control group, with statistically significant differences ( P<0.05). In the observation group and control group, the total effective rate of surgery, nursing satisfaction, and readmission rate were 88.64% (78/88) vs. 67.05% (59/88), 94.32% (83/88) vs. 78.41% (69/88), 4.55% (4/88) vs. 17.05% (15/88), respectively. The total effective rate and nursing satisfaction of the observation group were higher than those of the control group, and the readmission rate was lower than that of the control group, with statistical differences ( P<0.05) . Conclusions:"Internet +" combined with multidisciplinary out of hospital management can effectively improve the recovery of lumbar function in hospital-home transitional period management of patients after lumbar internal fixation, enhance the surgical efficacy and nursing satisfaction, and reduce the readmission rate.

【Objective】 To compare the ability of body mass index （BMI）， body fat percentage （BFP）， waist circumference （WC）， waist-to-height ratio （WHtR）， visceral fat index （VFI） and the combinations of two kinds of obesity indices to predict the risk of hypertension. 【Methods】 Data collected in the baseline survey of “Gansu Province’s Urban and Rural Natural Population Cohort Establishment and Tumor Follow-up Study” were analyzed. Area under the curve （AUC） of ROC curve with covariates was used to analyze and compare the effects of individual obesity evaluation index and the combination of two kinds of obesity indices in predicting the risk of hypertension. 【Results】 Analyses of data of 20，079 adults showed that the AUC of BMI， WC， WHtR， BFP and VFI was 0.636， 0.604， 0.615， 0.614 and 0.619， respectively. AUC of the combination of BMI and WC （0.643） was higher than that of BMI （0.636）； however， the change rate of AUC was only 1.09%. AUC of the combinations of WC， WHtR and VFI， the three central obesity evaluation indices， and BFP， a general obesity evaluation index， were lower than that of BMI. The optimal cutoff value for BMI was 24.2 kg/m². 【Conclusion】 The effect of BMI in predicting the risk of hypertension is better than that of BFP， WC， WHtR and VFI. The effects of the combinations of the two kinds of obesity evaluation indices are not better than that of BMI. To prevent and control hypertension， adults should keep their BMI under overweight.

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

Objective:To summarize the practices in measuring the gross α and gross β radioactivity in IAEA-2020-intercomparison samples, which could be expected to be beneficial to the similar analysis and research.Methods:With 241Am, Th, 90Sr/ 90Y, 40K and 137Cs solution as standard materials, the gross α and gross β radioactivity in water and aerosol samples were determined using thin source method. With 241Am, 40K powder as standard materials, the gross α and gross β radioactivity in water and fish samples were measured using thick source method combined with evaporation. Results:The result showed that the relative deviation and Z-score by using thin source method were 4.12%-31.6% and 0.14-1.71, respectively, and those from thick source combined with evaporation were 2.63%-32.5% and 0.11-0.93, respectively, with the acceptance rate being 100%. Conclusions:Generally, standard material shall be selected in the same types of radionuclides and energies as in samples. The thin source method is appropriate for emergency monitoring in the event of an accident. The thick source combined with evaporation should be perfered to the environmental monitoring or the analysis of unknown samples in laboratory. And then an intercomparison should be done with thin source method based on the radioactivity in samples. This work can provide a technical reference for similar measurements.

Objective:To explore the effect of early quantitative pulmonary rehabilitation assessment in adult Intensive Care Unit (ICU) patients with mechanical ventilation in high altitude area.Methods:From March 2019 to October 2021, convenience sampling was used to select 287 adult ICU patients with mechanical ventilation of Qinghai Red Cross Hospital as the research object. According to the time of admission, the patients were divided into the control group (142 cases) and the experimental group (145 cases) . The control group was given the routine pulmonary rehabilitation, and the experimental group received the early pulmonary rehabilitation based on quantitative assessment. The Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score and the Intensive Care Units Mobility Scale (IMS) score were compared between the two groups before enrollment, on the eighth and sixteenth days of pulmonary rehabilitation. The oxygenation index of the two groups of patients before enrollment and on the first, fourth, sixth, eighth and sixteenth days of pulmonary rehabilitation, the time of ICU stay, the time of mechanical ventilation, the success rate of ventilator removal and the complications of the two groups of patients with mechanical ventilation were also compared.Results:On the eighth and sixteenth days of pulmonary rehabilitation, the APACHE Ⅱ score of the experimental group was lower than that of the control group, and the IMS score was higher than that of the control group, with statistical differences ( P<0.05) . On the sixth, eighth and sixteenth days of pulmonary rehabilitation, the oxygenation index of the experimental group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The ICU stay time and mechanical ventilation time in the experimental group were lower than those in the control group, and the success rate of ventilator removal in the experimental group was higher than that in the control group, with statistical differences ( P<0.05) . Conclusions:Implementing early pulmonary rehabilitation for adult ICU patients with mechanical ventilation in high altitude area is conducive to promoting pulmonary rehabilitation of patients, improving the success rate of ventilator removal, and reducing patients' ICU stay time, mechanical ventilation time and the occurrence of complications.

Objective:To explore the effect of early quantitative pulmonary rehabilitation assessment in adult Intensive Care Unit (ICU) patients with mechanical ventilation in high altitude area.Methods:From March 2019 to October 2021, convenience sampling was used to select 287 adult ICU patients with mechanical ventilation of Qinghai Red Cross Hospital as the research object. According to the time of admission, the patients were divided into the control group (142 cases) and the experimental group (145 cases) . The control group was given the routine pulmonary rehabilitation, and the experimental group received the early pulmonary rehabilitation based on quantitative assessment. The Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score and the Intensive Care Units Mobility Scale (IMS) score were compared between the two groups before enrollment, on the eighth and sixteenth days of pulmonary rehabilitation. The oxygenation index of the two groups of patients before enrollment and on the first, fourth, sixth, eighth and sixteenth days of pulmonary rehabilitation, the time of ICU stay, the time of mechanical ventilation, the success rate of ventilator removal and the complications of the two groups of patients with mechanical ventilation were also compared.Results:On the eighth and sixteenth days of pulmonary rehabilitation, the APACHE Ⅱ score of the experimental group was lower than that of the control group, and the IMS score was higher than that of the control group, with statistical differences ( P<0.05) . On the sixth, eighth and sixteenth days of pulmonary rehabilitation, the oxygenation index of the experimental group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The ICU stay time and mechanical ventilation time in the experimental group were lower than those in the control group, and the success rate of ventilator removal in the experimental group was higher than that in the control group, with statistical differences ( P<0.05) . Conclusions:Implementing early pulmonary rehabilitation for adult ICU patients with mechanical ventilation in high altitude area is conducive to promoting pulmonary rehabilitation of patients, improving the success rate of ventilator removal, and reducing patients' ICU stay time, mechanical ventilation time and the occurrence of complications.

OBJECTIVE：To study the effects of Mahuang xixin fuzi decoction on Toll-like receptors （TLRs）response and cytochrome C oxidase （Cyt-CO）-mediated apoptosis regulation in mice with influenza disease of kidney-yang deficiency. METHODS：Totally 48 male Balb/c mice were randomly divided into normal group （n＝12）and modeling group （n＝36）. The modeling group was intraperitoneally injected with estradiol benzoate solution （8 mg/kg）and intranasally injected with influenza virus H 1N1（20 μL/mice）to establish the influenza disease compound model of kidney-yang deficiency. After modeling ，the mice were randomly divided into model group ，positive drug group （Oseltamivir phosphate capsules ，0.195 g/kg），Mahuang xixin fuzi decoction group （1.802 g/kg，by crude dru g），with 12 mice in each group. Each group was given relevant medicine intragastrically，normal group and model group were given， corresponding volume of normal saline intragastrically 20 mL/kg，once a day ，for consecutive 6 days. During admi-nistration，body weight and anal temperature of mice were mail：xsy407861520@163.com measured daily ；the percentage of initial body weight was calculated. After last medication ，the organ （spleen，thymus and lung ）indexes were calculated ；the pathological changes of lung tissue were observed. The viral load of influenza A virus H 1N1 in lung tissue was detected （reflected by M gene mRNA expression）；mRNA expressions of TLR3，TLR7，myeloid differentiation factor （MyD88）and Caspase- 3 in cardiac tissue as well as the activity of Cyt-CO and the content of cytochrome C （Cyt-C）were also determined. RESULTS ：Compared with normal group，initial body weight percentage and anal temperature of the model group continued to decrease （P＜0.05）；the spleen and thymus indexes were decreased significantly （P＜0.05），while lung index was increased significantly （P＜0.05）；the lung tissue lesions were serious. Viral load in lung tissue ，mRNA expressions of TLR 3，TLR7，MyD88 and Caspase- 3 in cardiac tissue as well as the content of Cyt-C were increased significantly （P＜0.05 or P＜0.01），while the activity of Cyt-CO in cardiac tissue was significantly decreased （P＜0.01）. Compared with model group ，initial body weight percentage and anal temperature of mice in Mahuang xixin fuzi decoction group showed an increasing trend from the fourth day of administration （P＜0.05 or P＜0.01）. The spleen and thymus indexes were increased significantly （P＜0.05），while the lung index was significantly decreased （P＜0.05）；the pathological injury of lung tissue was significantly improved ；viral load in lung tissue ，mRNA expressions of TLR 3 and Caspase- 3 as well as the content of Cyt-C in cardiac tissue were decreased significantly （P＜0.05 or P＜0.01），while the activity of Cyt-CO was increased significantly in cardiac tissue （P＜0.01）. CONCLUSIONS ：Mahuang xixin fuzi decoction can improve influenza disease of kidney-yang deficiency in mice ，the effect may related to inhibit TLRs response and apoptosis regulation pathway mediated by Cyt-CO.

Objective To investigate the distribution of gross α and gross β levels of centralized drinking-water of township in Beijing from 2018 to 2019, so as to carry out better monitoring and evaluating the radioactivity in water. Methods A total of 215 underground drinking water samples were collected from 12 districts of Beijing, then monitored and evaluated according to the Determination of gross alpha activity in water-thick source method EJ/T 1075—1998 and Determination of gross beta activity in water-evaporation method EJ/T 900—1994. Results The gross α level of centralized drinking water of township in Beijing was 0.050 (0.052) Bq/L, ranging from 0.001 to 0.210 Bq/L, and the gross β level was 0.048 (0.038) Bq/L, ranging from 0.002 to 0.261 Bq/L from 2018 to 2019. Gross α and gross β levels of all samples did not exceed the guidance value recommended by standards for drinking water quality. There was no significant difference in the distribution of gross α and gross β levels of samples of all districts from 2018 to 2019(P > 0.05), there were significant differences in the distribution of gross α and gross β levels of samples from different district in the same period (P < 0.05). And the levels of Miyun, Huairou and Shunyi in Chaobai River system were higher than other districts. Conclusion The distribution of radioactive background of centralized drinking-water of township in Beijing was mastered, which was in the normal range.

Objective: To investigate the effects of proteasome beta 5 subunit (PSMB5) on proliferation and bortezomib (BTZ) chemo-sensitivity of multiple myeloma (MM) and its related molecular mechanisms. Methods: We used two MM cell lines, RPMI 8226 and BTZ drug-resistant cell line RPMI 8226/BTZ100 (hereinafter referred to as BTZ100) , as the research object. PSMB5 was overexpressed or knocked down in two myeloma cell lines via lentivirus transfection. CCK8 assay was used to detect the impact of PSMB5 on cell viability and bortezomib sensitivity in human myeloma cells; Using flow cytometry to test the effects of PSMB5 on apoptosis rate of human myeloma cells under the treatment of bortezomib; Apoptosis-related gene expression of Bax, Bcl-2, p-Akt and cleaved caspase-3 were detected by Western blot. Results: ①PSMB5 overexpression and knockdown were successfully constructed in RPMI 8226 and BTZ100 cells. ②PSMB5 expression was positively correlated with cell proliferation of RPMI 8226 and BTZ100 cells (P<0.05) . ③The cell viability was lower after PSMB5 knockdown in RPMI 8226 cells than control cells under the same concentration of BTZ[IC₅₀ at 24 h: (7.01±0.47) and (9.64±0.55) nmol/L respectively, t=6.289, P=0.003]. The cell viability was higher after PSMB5 overexpression in RPMI 8226 cells than control cells under the same concentration of BTZ[IC₅₀ at 24 h: (10.99±0.58) and (9.51±0.37) nmol/L respectively, t=3.724, P=0.020) . PSMB5 expression was negatively correlated with the sensitivity of RPMI 8226 cells to BTZ. The results of BTZ100 cells were similar. ④The expression of PSMB5 was negatively correlated with the apoptosis of RPMI 8226 and BTZ100 under the treatment of BTZ. ⑤Meanwhile, PSMB5 knockdown could increase the expression of pro-apoptosis gene Bax and cleaved caspase-3 and decrease the expression of anti-apoptotic gene Bcl-2 and p-Akt. PSMB5 over-expression has the opposite results. Conclusion PSMB5 knockdown could improve the bortezomib sensitivity of MM cells via activation of apoptosis signaling. PSMB5 may be a potential therapeutic target for MM.

Objective:To observe the influence of commonly used dental cast metal posts and cores on magnetic resonance imaging (MRI)for head and neck.Methods:Six kinds of posts and cores made of metal alloy (Ni-Cr alloy,Co-Cr alloy,titanium alloy,pure titanium,Pd-Au alloy and Au-Pt alloy)were respectively fixed on the mucosa of left palate of a volunteer.The maxillofacial region of the subjects was scanned by routine head sequences SE-T1WI and TSE-T2WI respectively.Results:ANOVA of factorial design analy-sis indicated significant differences of artifacts among metal materials(F=153.63,P<0.05),scanning sequences(F=70.94,P<0.05)and the number of cast posts and cores(F=102.73,P<0.05).In both sequences the size of metal artifacts were as following:Pd -Au alloy>Co-Cr alloy>Ni-Cr alloy>Au-Pt alloy>titanium alloy>pure titanium;two posts and cores>one post and core;SE-T1WI>TSE-T2WI.Conclusion:Different cast metal posts and cores have different influences on MRI artifact.Reasonably choosing the metal materials and scanning sequences can minimize artifacts on MRI.