Objective To investigate the relationships of pre-radiotherapy body weight,gender,age,EBVDNA,hemoglobin,plasma albumin,and induction chemotherapy regimen with the changes of target area and lymph node volume in adaptive radiotherapy,so as to provide a reference for the timing and population selection of adaptive radiotherapy.Methods A retrospective analysis was conducted on 34 patients who received the first course of radiotherapy at Sun Yat-sen University Cancer Center from January 2022 to November 2022.All patients underwent CT scans again after 20 sessions of radiotherapy for developing the secondary radiotherapy plans.The body weight,gender,age,tumor stage,hemoglobin,plasma albumin,induction chemotherapy regimen,and EBVDNA were collected.Results The tumor volume reduction in the primary focus was more evident in patients with pre-treatment plasma albumin≥40 g/L than in those with pre-treatment plasma albumin<40 g/L(t=3.971,P=0.001),and in patients with pretreatment EBVDNA≤4000 copies/mL than in those with pretreatment EBVDNA>4000 copies/mL(t=4.080,P=0.001).Pearson analysis showed that GTVnx volume difference was positively correlated with pre-radiotherapy GTVnx volume(r=0.444,P=0.009),right parotid gland volume difference(r=0.737,P<0.001),left parotid gland volume difference(r=0.435,P=0.010),and hemoglobin(r=0.722,P<0.001).Conclusion The reduction in tumor volume during radiotherapy is more pronounced in nasopharyngeal cancer patients with normal plasma albumin level and those with pretreatment EBVDNA≤4000 copies/mL.The pre-radiotherapy treatment volume of primary focus,parotid gland volume change before and after radiotherapy,and pre-radiotherapy EBVDNA,hemoglobin and plasma albumin levels can be used to predict the degree of tumor volume shrinkage during radiotherapy,providing a reference for the selection of the timing of adaptive radiotherapy for nasopharyngeal carcinoma.

Objective:To investigate the value of nerve conduction velocity testing combined with F-waves, H-reflexes, and sympathetic skin responses in electroneuromyography in the diagnosis of diabetic peripheral neuropathy.Methods:A total of 212 patients with diabetic peripheral neuropathy who received treatment at Fenyang Hospital of Shanxi Province (Fenyang Hospital Affiliated to Shanxi Medical University) from October 2022 to October 2023 were included in this study. These patients were divided into an asymptomatic group ( n = 100) and a symptomatic group ( n = 112) based on the presence or absence of peripheral neuropathy symptoms. Additionally, 100 healthy individuals who underwent physical examinations at the same hospital during this period were included in the control group. Motor nerve conduction velocities were measured for the median nerve, ulnar nerve, tibial nerve, and common peroneal nerve, while sensory nerve conduction velocities were assessed for the median nerve, ulnar nerve, superficial peroneal nerve, and gastrocnemius nerve. F-waves were recorded for the median and tibial nerves. The H-reflexes of the tibial nerve and sympathetic skin response were also evaluated. Differences in motor nerve conduction velocity, sensory nerve conduction velocity, F-waves, H-reflexes, and sympathetic skin responses among the different groups were compared. Results:In the asymptomatic and symptomatic groups, motor conduction velocities were lower ( F = 390.32, 264.63, 228.58, 714.30), distal motor latencies were longer ( F = 316.87, 106.88, 108.58, 217.86), compound muscle action potential amplitudes were lower ( F = 113.38, 59.58, 14.92, 10.36), sensory conduction velocities were slower ( F = 568.87, 532.74, 973.75, 1181.27), sensory nerve action potential amplitudes were lower ( F = 229.53, 309.97, 251.07, 414.82), F-waves were longer ( F = 653.96, 538.20), H-wave latencies were longer ( F = 401.54), and sympathetic skin response latencies were also longer ( F = 147.93, 98.85) compared with those in the control group (all P < 0.05). There were significant differences in motor nerve conduction velocity ( t = 7.33, 13.31), distal motor latency ( t = 13.56, 4.34), compound muscle action potential amplitude ( t = 2.98, 2.99) of the tibial nerve and common peroneal nerve between the asymptomatic and symptomatic groups (all P < 0.05). Significant differences were also observed in the sensory nerve conduction velocity ( t = 12.85, 13.70, 11.08, 15.66) and sensory nerve action potential amplitude ( t = 20.15, 20.26, 8.96, 18.55) of the median nerve, ulnar nerve, gastrocnemius nerve, and superficial peroneal nerve (all P < 0.05). Additionally, differences in F-waves of the median and tibial nerves were significant ( t = 31.96, 13.70, both P < 0.05). The abnormal detection rate of nerve conduction velocity test in the asymptomatic group was 86% (86/100), while the abnormal detection rate of combined nerve conduction velocity test, F-waves, H-reflexes, and sympathetic skin response was 91% (91/100). In the symptomatic group, the abnormal detection rate of nerve conduction velocity test alone was 90.18% (101/112), and the abnormal detection rate of combined nerve conduction velocity test, F-waves, H-reflexes, and sympathetic skin responses was 98.21% (110/112). The abnormal detection rate of combined therapy in the symptomatic group was significantly higher than that in the asymptomatic group ( χ2 = 5.58, P = 0.018). Conclusion:Neuroelectromyography has high diagnostic value for diabetic peripheral neuropathy. The use of F-waves, H-reflexes, and sympathetic skin responses, in conjunction with nerve conduction velocity testing, can enhance the early diagnosis of diabetic peripheral neuropathy in patients who do not exhibit peripheral neuropathy symptoms.

Objective:To investigate the correlation between cognitive function and living ability of older adult patients living in a mining community.Methods:A total of 180 older adult patients living in a mining community who received treatment during July-October 2019 were included in this study. They were randomly divided into the low-age group (< 68 years old, n = 94) and the high-age group (≥ 68 years old, n = 86). Cognitive function and living ability were evaluated using the Mini-Mental State Examination (MMSE), The Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL). The relationship between cognitive function and living ability was investigated using hierarchical analysis and Pearson correlation analysis. Results:The proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA were 39.4% and 66.0%, respectively in the low-age group, and they were 32.6% and 61.6%, respectively in the high-age group. The MoCA had a greater performance in identifying abnormal cognitive function in each group than the MMSE ( χ2 = 26.69, 10.18, both P < 0.001). There were no significant differences in proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA between low-age and high-age groups ( χ2 = 0.90, 0.36, both P > 0.05). The proportion of older adult patients with abnormal living ability was not significantly different between low-age and high-age groups (4.3% vs. 10.5%, χ2 = 2.58, P > 0.05). Compared with patients negative for MMSE items, living ability and instrumental activity of daily living increased by 7.0% and 9.4% in low-age patients positive for MMSE items (both P < 0.05). Compared with patients negative for MoCA items, living ability increased by 3.5% in low-age patients positive for MoCA items ( P < 0.05). Correlation analysis revealed that total scores of MMSE and MoCA were significantly negatively correlated with ADL score ( r = -0.26, -0.27, both P < 0.001) and instrumental activity of daily living score ( r = -0.27, -0.27, P < 0.001). Conclusion:Cognitive function and living ability are correlated in older adult patients living in a mining community. We should pay attention to the screening results of cognitive disorder in older adult patients and improve their living ability by improving their cognitive function.

Objective:To investigate the characteristic of mild cognitive impairment (MCI) in the adults aged 48 years and over in a coal mine community, and to analyze its associated risk factors.Methods:From July to October 2019, a questionnaire survey for basic information was conducted among 180 middle-aged and elderly adults who met the inclusion criteria in the Datong coal mine community. The cognitive function was evaluated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The effects of gender, age, years of education, sleep, living alone, physical exercise, social activities, smoking and drinking status, body mass index and chronic diseases on cognitive level were analyzed by single factor stratification and multiple linear regression.Results:There was no significant difference in the positive rate of MCI screened by MMSE and MoCA in the age groups of 48-<64, 64-<72 and 72-90 (original and corrected P>0.05); The positive rate of MCI in MoCA screening (64.4%, 66.7%, 60.9%) was significantly higher than that in MMSE (35.6%, 45.6%, 28.1%) (all P<0.05); MMSE was positively correlated with MoCA score ( r=0.762, P<0.001). With the increase of age, the scores of memory, execution and visual space detected by MoCA decreased significantly (all P<0.05), while the scores of attention, language and orientation did not change significantly (all P>0.05). Univariate stratification showed that the significant influencing factors of MMSE or MoCA scores were gender, age, years of education and sleep status (all P<0.05). Multiple linear regression analysis showed that gender ( βMMSE=-0.192; βMoCA=-0.140), years of education ( βMMSE=0.209; βMoCA=0.328) and sleep status( βMMSE=-0.162; βMoCA=-0.136) were risk factors affecting MMSE and MoCA scores ( P<0.05). Conclusions:More middle-aged and elderly adults with MCI might be observed in a coal mine community, and the main characteristics of MCI are impaired memory, executive function and visual space. To prevent and reduce the occurrence of dementia, early interventions of MCI should be carried out among the adults with female, old age, low years of education and poor sleep quality.

Objective:To explore the effect of time-sensitive incentive nursing on psychological resilience, quality of life, nursing satisfaction and disease cognition of postoperative patients with chronic sinusitis (CS) .Methods:From January 2019 to July 2020, the convenience sampling method was used to select 60 postoperative patients with CS who were admitted to Fuyang Hospital of Anhui Medical University as the research objects. Patients were randomly divided into the observation group and the control group, with 30 cases in each group. The control group carried out conventional nursing, and the observation group was given conventional nursing combined with time-sensitive incentive nursing. The Connor-Davidson Resilience Scale (CD-RISC) , the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) dimensions of mental health, general health, physical functioning and role emotional were used to compare the psychological resilience and quality of life of the two groups of patients before and after nursing. Disease cognition and nursing satisfaction of the two groups of patients after nursing were compared.Results:The scores of the CD-RISC dimensions, disease cognition, four dimensions of the SF-36, and nursing satisfaction of patients in the observation group after nursing were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The application of time-sensitive incentive nursing in postoperative patients with CS can improve their psychological resilience, disease cognition, quality of life and nursing satisfaction.

Objective:To explore effects of psychological resilience and social support on quality of life in patients undergoing ileal conduit surgery.Methods:Using the convenient sampling method, a total of 232 patients who underwent total cystectomy and ileal conduit surgery in Department of Urology in a Class ⅢGrade A general hospital from January 2014 to December 2018 were investigated by using the general data questionnaire, City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ) , Perceived Social Support Scale (PSSS) and 10-item Connor Davidson Resilience Scale (CD-RISC-10) from March to August 2020.Results:The age of patients was (65.79±8.67) years old, the postoperative time was (42.14±15.76) months, the total score of quality of life was (263.28±28.71) , the score of social support was (71.81±8.02) and the score of psychological resilience was (31.27±5.27) . Multiple linear regression analysis showed that psychological resilience (β=0.18, P<0.01) , self-care (β=0.30, P<0.01) , age (β=0.18, P<0.01) , recurrent carcinoma (β=0.13, P<0.05) and self-paying (β=-0.21, P<0.05) were influence factors of quality of life of patients, which could explain the variability of 21.2%. Conclusions:A variety of factors affect quality of life of patients after ileal conduit surgery for a long time. Therefore, attention should be paid to continuing treatment and nursing, improving self-care ability and psychological quality, promoting quality of life and improving disease outcomes.

Objective: To investigate the differences in dentin structure, mineral content and microhardness of single premolar roots with or without an isthmus. Methods : Thirty single-root premolars with a canal isthmus (experimental group) and thirty single-root premolars without a canal isthmus (control group) were collected and analyzed by scanning electron microscopy, X-ray energy spectrometry and a Vickers microhardness tester. Structure, mineral content and microhardness were compared. Results In the experimental group, the dentinal tubules were not obvious, and the structure was disordered. In the control group, the dentin tubules of the root canal wall were arranged regularly, and the lumen opening was clear. The Ca and P contents and Ca/P ratio of the experimental group were lower than those of the control group (P < 0.05). The microhardness of the experimental group was less than that of the control group (P < 0.05). Results: In the experimental group, the dentinal tubules were not obvious, and the structure was disordered. In the control group, the dentin tubules of the root canal wall were arranged regularly, and the lumen opening was clear. The Ca and P contents and Ca/P ratio of the experimental group were lower than those of the control group (P < 0.05). The microhardness of the experimental group was less than that of the control group (P < 0.05). Conclusion The dentin structure of the root canal isthmus was changed, and the Ca, P contents and microhardness were low. The root canal isthmus was a weak link in the root, which could weaken the resistance of the hard tissue of the root tooth, which may be one of the important factors that could cause vertical root fracture.

Objective: To study the molecular epidemiology and genetic variation of coxsackievirus B5 (CV-B5) in certain areas in China. Methods: MEGA 6.0 software was used to analyze the complete VP1 region of CV-B5 isolated strains from certain areas of China by retrieving the GenBank nucleotide database. Besides, the phylogenetic tree was constructed, the homology of nucleotide and amino acids were calculated and the rate of evolution was estimated. Results: A total of 189 Chinese CV-B5 isolated strains were included in this study. Most of Chinese CV-B5 isolated strains belonged to genotype C, accounted for 90.5%. Compared with the genotype A, the homology of nucleotide sequences and amino acid sequences of complete VP1 region of 189 Chinese isolated strains were 79.8%-82.8% and 92.6%-97.9%, respectively; moreover, the nucleotide and the amino acid homology of 189 Chinese CV-B5 isolated strains among themselves ranged from 80.3% to 100.0% and ranged from 91.5% to 100.0%, respectively. The estimated rate of evolution of the CV-B5 was 4×10^-3 substitutions/site/year. Conclusions The majority of CV-B5 isolated strains belonged to genotype C, and subgenotype C1 and C2 were co-circulating together in certain areas of China.

Objective? To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA), and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods? Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale(MFS)and the Barthel Index(BI)for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results? A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95), of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P＜ 0.05). There were significant differences in the risk of falls between elderly KOA patients in "whether taking drugs", "whether using walking aids", "status of self-care ability", and "age" (P＜ 0.05). Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P＜ 0.05). Conclusions? In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life.

Objective To study the influence of different placing time of child peripheral blood on blood routine parameters in order to increase the working efficiency of clinical blood routine test.Methods Each 300 μL of peripheral blood was collected from the right hand ring finger in 50 healthy children in our hospital from January 2015 to January 2016.The blood routine was performed by using the whole blood cells analyzer at instantly after blood collection,at 0,5,10,15,30 min after blood collection under the room temperature (20 to 25 ℃).Results With the measured results at 15 min as the control,the detection results at the other times points had no statistical difference (P>0.05).Compared with the detection results at 5 min,the white blood cell count(WBC) and platelet volume distribution width (PDW),lymphocyte absolute value (LYM),neutrophil percentage absolute value (NEU),platelet count (PLT),red blood cell volume distribution width (RDW),hemotocrit (HCT) and plateletcrit(PCT) were statistically different (P<0.05).Conclusion Reasonably arranging time,eliminating pre-analysis error and reducing the influence of peripheral blood placing time on blood routine parameters have an important significance to accurately judge the clinical dat.It is recommended that the blood routine detection time should be controlled within 10-30 min in order to increase the working efficiency of clinical detections.