Objective To investigate the impact of whole body vibration training combined with intermittent blood flow restriction on the motor function and community activity in elderly stroke patients with hemiplegia.Methods A total of 80 convalescent hemiplegic patients after stroke who were hospitalized in the Rehabilitation Medicine Department of Yichang Central People's Hospital(Xiling Campus)from October 2021 to December 2023 were included and randomly divided into control group(n=25),vibration group(n=28)and combination group(n=27)using the random number table method.All patients received conventional rehabilitation training,on the basis;the vabration group received whole body vibration training,while the combination group received whole body vibration training combined with intermittent blood flow restriction.Before and after 6 weeks of training,the balance function was evaluated with Berg balance scale(BBS),while the gait function was tested with 6-minute walking test(6MWT)and the Community Balance and Mobility scale(CB&M)was used to assess the community activity ability.The community balance and mobility(CB&M)were evaluated in the first and third month after discharge.Results There was no significant difference in BBS,CB&M scores and 6MWT walking distance between the three groups before training(P>0.05).After 6 weeks of training,the three groups showed significant increases in the BBS,CB&Mscores and the walk distance of 6MWT(P<0.001).Furthermore,compared with the control group,the combination group and the vibration group were significantly beter(P<0.05),and there was no signifi-cant difference between the combination group and the vibration group(P>0.05).At the first and third month of follw-up after discharge,the CB&M scores of the three groups were significantly higher than those of the control group(P<0.05),while there was no significant difference between the CB&M scores of the combination group and the vibration group at the first month of follow-up(P>0.05).But the CB&M scores of the combination group was higher than those of the vibration group at the third month of follow-up,and the difference was statistically signifi-cant(P<0.05).Conclusion On the basis of conventional rehabilitation,whole body vibration training combined with intermittent blood flow restriction can significantly enhance balance function,balance confidence,walking ability and mobility in early stage of community life for elderly stroke patients with hemiplegia,potentially facilitat-ing their return to community life.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.

Objective: To understand the differences in the application of three distant vision examination methods in children, so as to provide a reference for developing a unified distant vision examination for this population. Methods: The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children s hospital in Anhui Province between August 15 and 25, 2022. Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey (V1), the 2019 National Student Physical Fitness and Health Survey (V2), and Specification for Screening of Refractive Error in Primary and Secondary School Students (WS/T 663-2020) (V3). The paired samples McNemar s test and Wilcoxon test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods. Results: The results of the 98 children examined according to V1, V2, and V3 showed that the M (P25, P 75 ) of the right eye were 4.8（4.6，5.0），4.8（4.7，5.0），and 4.8（4.7，5.0）while the left eye visual acuity M ( P 25 , P 75 ) were 4.8 （4.6，5.0），4.9（ 4.7 ，5.0），and 4.9（4.7，5.0），respectively. The rates of poor visual acuity detection for the right eye were 63.3%, 58.2% and 58.2 % for V1, V2, and V3, respectively, while for the left eye, they were 58.2%, 54.1% and 53.1%, respectively. McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs. V2, V1 vs. V3, and V2 vs. V3 (left eyes： χ 2=2.25，2.29，0.00，right eyes： χ 2=3.20，3.20，0.00， P >0.05).Wilcoxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs. V2 and V1 vs. V3 (left eyes： Z =-4.15，-4.60, right eyes： Z = -4.70，-4.99, P <0.01). Conclusion Irrespective of whether the starting visual standard starts at row 4.0 or 5.0, different standards of visual standard passage have an impact on the visual acuity results. It is recommended that existing methods of screening for distance vision are standardized.

The implantation of biventricular assist device (BiVAD) is more challenging than that of left ventricular assist device for the interaction in the process of multiple input and output. Besides, ventricular assist device (VAD) often runs in constant speed (CS) mode in clinical use and thus BiVAD also faces the problems of low pulsation and imbalance of blood volume between systemic circulation and pulmonary circulation. In this paper, a delay assist mode for a VAD by shortening the support time of VAD was put forward. Then, the effect of the delay mode on cardiac output, pulsation and the function of the aortic valve was observed by numerical method and the rules of hemodynamics were revealed. The research showed that compared with VAD supported in CS mode, the VAD using delay mode in systolic and diastolic period proposed in this paper could meet the demand of cardiac output perfusion and restore the function of the arterial valves. The open ratio of aortic valve (AV) and pulmonary valve (PV) increased with the time set in delay mode, and the blood through the AV/PV helped to balance the left and the right cardiac volume. Besides, delay mode also improved the pulsation index of arterial blood flow, which is conducive to the recovery of the ventricular pulse function of patients.
Cardiovascular System ; Diastole ; Heart Failure ; Heart Rate ; Heart-Assist Devices ; Hemodynamics ; Humans ; Models, Cardiovascular

Objective To investigate the characteristics on the time of sunshine exposure in Chinese primary and middle school students.Methods A total of 43 771 primary and middle school students were randomly selected from 12 provinces in China.A self-reported questionnaire was used to understand their time of sunshine exposure on weekdays and weekends as well as related family information and behaviors.x2 test was used to compare the hours of sunshine exposure among different groups.Multivariate logistic regression analysis was conducted to identify the influencing factors.Results Results from the current survey indicated that the average time of sunshine exposure on weekdays and weekends were 2.49 and 3.22 hours,respectively.On weekdays,proportions of students with time of sunshine exposure ≤2 h/d or ＞2 h/d were 60.81％ and 39.19％,respectively.On weekends,the proportions became 44.05％ and 55.95％,respectively.On weekdays,the time of sunshine exposure as ≤2 h/d was significantly different among factors as sex,urban or rural area,residential area,self-rating academic performance,type of housing or ways of commuting to school.On weekends,the time of sunshine exposure ≤2 h/d were significantly different among sex,residential areas,self-rating academic performance,type of housing and ways of commuting to school.Data from the multivariate logistic regression analysis showed that the limited sunshine exposure was significantly associated with factors as:type of primary schools,being girls,students living in the urban area or living in central or western areas,with normal or better academic performances,living in a fiat apartment and the time spent on watching video program ＞2 h/d both on weekdays and weekends.Conclusion The time of sunshine exposure seemed not enough among school students and significant differences were seen among different groups.

Objective:To explore the influence of different transport modes on the efficacy of direct percutaneous coronary intervention (PCI) in patients with acute ST‐elevation myocardial infarction (STEMI) .Methods :A total of 268 STEMI patients undergoing emergency PCI during Jan 2013 and Dec 2014 were selected .Among them ,there were 139 patients whose single‐time 12‐lead ECG results were scanned and sent to specified cardiologists ’ cellphones by ambulances or community doctors via wechat app (chest pain center mode exploration group ) and 129 patients who went to hospital by themselves (common treatment group) .The door to balloon dilatation time (D‐to‐B) ,the probability of D‐to‐B shorter than 90 minutes (target rate ) , the mortality during hospitalization , the incidence of heart failure , the average hospitalization days and hospitalization cost were compared between the two groups .Results:The results of comparison between the chest pain center mode exploration group and the common treatment group were shown as below :the D‐to‐B time ([86 .4 ± 4 .5] min vs .[97 .4 ± 10 .3] min ,P<0 .01) ,hospital during mortality (2 .9% vs9 .3% ,P<0 .05) ,the incidence of heart failure (4 .3% vs .11 .6% ,P<0 .05) ,the average hospitalization days ([8 .7 ± 3 .2] d vs .[10 .9 ± 4 .5] d ,P<0 .05] and hospitalization costs ([50 347 ± 19 310] yuan vs .[58 102 ± 41 178] yuan ,P<0 .05) .And all the differences were statistically significant .Conclusions :Regional chest pain center mode can shorten the reperfusion time and reduce the short‐term mortality for STEMI patients .

Objective To observe the metabolic changes in the whole brain of chronic unpredictable mild stimulations ( CUMS)-induced depressive rats using PET imaging technology.Methods After 4 weeks’ of CUMS, rats of experimental group were divided into two groups:Group D( depression) and Group ND( no depression) , according to the degree of sugar addiction, distance of spontaneous activity and relative body mass.Then metabolic changes in the whole brain of these rats and those in control group ( CON) were observed using PET technology, and the differences were companred between the threegroups.Results (1)ComparedwithGroupCON,metabolismofGroupDwaselevatedinbilateralS1,thalamus, globus pallidus, insula, M2 and left claustrum, but descended in right inferior colliculus, splenium of corpus callosum and cerebellum.(2) Metabolism of Group D increased in the bilateral CA3 region of hippocampus, M1, M2, striatum, S1 and olfactory bulb, but decreased in the left cuneate nucleus and hippocampus compared to Group ND.( 3 ) Compared with Group CON, there was no region of the brain in Group ND where metabolism was enhanced, but metabolism in the lateral septal nucleus, bilateral striatum, hypothalamic paraventricular nucleus, bilateral S1 and right globus pallidus of Group ND was reduced.Conclusion The metabolic characteristic in the brain of depressive rats is that heightened regions are all in front of the coronal plane 4 mm post bregma, while lowered regions are behind.Moreover, both cerebral hemispheres are roughly symmetrical.It can be concluded that abnormal interactions between different regions of the brain contributes to the occurrence of depression.

Objective To explore the aesthetic efficacy of modified endoscopic rhytidectomy by using the techniques to minimize tissue damage,to obviate injury to the vessels and nerves,and to control bleeding and to firm fixation.Methods Two discontinuous incisions were made in the temporal scalp during the procedure,obviating injury to the branches of the superficial temporal vessels.Endoscopic technique was used to facilitate elevating,hemostasis,slinging and fixation in the plane under superficial temporal fascia.Three transverse incisions were made after the hairline in the forhead scalp,the operation was carried out by using endoscopic equipment,and the elevated forhead flap was slinged and fixed upward to the lamina externa cranii.Results 58 cases were received endoscopic forehead and temporal rhytidectomy,only slight edema was observed after surgery,and no obvisous ecchymosis was found.All patients returned home 7 days after operation.Degree of satisfaction on long-term follow-up showed that 56 cases(96.55%)improved obviously one year postoperatively;35 cases followed up 2 years,33(94.29%)of them improved obviously.None case was suffered from facial nerve injury.Conclusion The purpose of endoscopic rhytidectomy is to avoid carrying out the operation out of sight,to minimize unexpected damage to vessels and nerves,and to facilitate dissection,hemostasis,suturing,slingling and fixation.By refining the technique,we can achieve minimal injury,shorten recovery period,and obtain more satisfactory results,so the indication for operation is extended.

Objective To investigate the effect of metformin on proliferation and differentiation of bone marrow mesenchymal stem cells (MSCs) cultured in adipogenie medium. Methods Bone marrow MSCs were isolated from SD rats and cultured in adipogenic medi- um with or without 100?mol/L metformin. MTT test was performed to evaluate the proliferation of cells, while oil red O staining and real time RT - PCR were performed to evaluate the differentiation of cells. Results The number of bone marrow MSCs in two groups both increased over time, and metformin induced more cells. However, the cells affected by metformin showed smaller and less cytoplasmic lipid droplets compared with the cells in control group. Moreover, real time RT - PCR has shown the inhibitory effect of metformin on adipocyte differentiation, with significantly decreased mRNA levels for adipogenic markers. Conclusion Metformin may promote proliferation, but inhibit differentiation of bone marrow MSCs cultured in adipogenic medium.