This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.

Objective To explore the potential category characteristics of self-management behavior in patients with lung cancer based on potential profile analysis,and to analyze the characteristic differences and influencing factors of self-management behavior in patients with different categories of lung cancer.Methods A total of 260 patients with lung cancer who had completed the main treatment program and were about to enter the follow-up period in a tertiary A general hospital in Zhejiang Province from July 2022 to May 2023 were selected by convenience sampling method as the investigation subjects.General Information Questionnaire,Lung Cancer Survivor Self-management Behavior Assessment Scale,Strategies Used by People to Promote Health,Hospital Anxiety and Depression Scale and Social Support Rating Scale were used for investigation.Potential profile analysis was used to explore the potential categories of self-management behavior in lung cancer patients and analyze its influencing factors.Results 252 patients were finally included.The results of potential profile analysis showed that lung cancer patients'self-management behavior could be divided into 3 potential categories,namely low self-management behavior-low emotion management group(11.90％),medium self-management behavior-low resource management group(45.24％),and high self-management behavior-low hope management group(42.86％).Logistic regression analysis showed that education level,previous surgery,tumor stage,anxiety level,depression level,self-efficacy level and social support level were the influencing factors of lung cancer patients'self-management behavior(P＜0.05).Conclusion The self-management behavior of lung cancer patients is at a moderate level,and there are obvious classification characteristics.It is suggested that medical staff should carry out personalized intervention measures according to the characteristics of self-management behavior of patients of various categories,so as to improve the level of self-management behavior of lung cancer survivors.

Objective:To investigate the effects of compound Duzhong Jiangu Granules on joint function and gut microbiota in patients with Kashin-Beck disease.Methods:A single group pre- and post-experimental design was conducted, the patients with Kashin-Beck disease were selected as the subjects in Xunyi County, Xianyang City, Shaanxi Province; and treated with oral administration of compound Duzhong Jiangu Granules (12 g/bag, 1 bag/time, 3 times/day) for a period of 1 month. The improvement of joint function was evaluated using the joint dysfunction index scoring method before and after treatment. Morning stool samples of patients were collected and the changes in gut microbiota were analyzed before and after treatment using 16S rDNA sequencing technology.Results:A total of 87 patients with Kashin-Beck disease were included, including 44 males and 43 females; the age was (60.38 ± 7.12) years old, and the body mass index was (23.67 ± 3.59) kg/m 2. The comprehensive scores of joint dysfunction index for patients with Kashin-Beck disease before and after treatment were (7.27 ± 2.05) and (5.86 ± 2.01) points, respectively, and the difference was statistically significant ( t = 5.88, P < 0.001). The sequencing results of gut microbiota showed that there were statistically significant differences in the alpha diversity (chao1, observed species index) and beta diversity of gut microbiota in patients with Kashin-Beck disease before and after treatment ( Z = - 5.08, - 5.03, R = 0.09, P < 0.001). In the distribution of gut microbiota, Firmicutes was the dominant phylum, with relative abundances of 50.21% and 52.09% before and after treatment, respectively; the Bifidobacterium was the dominant bacterial genus, with relative abundances of 16.83% and 18.81% before and after treatment, respectively. At the genus level, a total of 17 gut microbiota genera were screened out, among which the relative abundances of Hafnia-Obesumbacterium, Gammaproteobacteria_unclassified, Acinetobacter, Pantoea, Leuconostoc, and Akkermanisia were significantly higher than before treatment ( Z = - 2.40, - 2.24, - 2.06, - 3.59, - 2.24, - 2.11, P < 0.05). The relative abundances of Dubosiella, Selenomonas, Anaeroplasma, Lachnospiraceae_ NK4A136_group, Rikenella, Prevotella, Megasphaera, Lactobacillus, Prevotella-9, Phascolarctobacterium, and Desulfovibrio were significantly lower than before treatment ( Z = - 9.38, - 2.61, - 2.18, - 8.43, - 2.45, - 2.46, - 2.49, - 7.29, - 2.29, - 2.55, - 2.08, P < 0.05). Conclusions:Compound Duzhong Jiangu Granules can effectively improve the joint function of patients with Kashin-Beck disease, and alter the diversity and richness of the gut microbiota community. It may reduce clinical symptoms in patients by regulating the structure of gut microbiota.

Objective:To compare the coverage rate of non-iodized salts, children's iodine nutrition and the change trend of goiter rate between the original water source high iodine areas in Henan Province in 2017 and the newly designated water source high iodine areas in 2019.Methods:Using a cross-sectional survey method, household edible salt monitoring was conducted in all 20 counties (cities, districts) with high iodine content in Henan Province in 2017. Ten counties (cities, districts) were selected to monitor water iodine, urinary iodine and thyroid volume of children aged 8 to 10 years. A total of 4 430 salt samples and 1 012 urine samples were collected, and thyroid volume of 1 012 children were measured. In 2019, monitoring of household edible salt, water iodine, urinary iodine, and thyroid volume was carried out in all 55 newly designated counties (cities, districts) with high iodine village. A total of 9 835 salt samples and 9 830 urine samples were collected, and the thyroid volume of 8 896 children was measured. The monitoring results of two years were compared, and the relationship between children's urinary iodine and goiter rate was analyzed by univariate logistic regression.Results:In 2019, the water iodine content in newly designated high iodine areas decreased compared to the original high iodine areas in 2017 (119.8 to 191.0 μg/L), and the difference was statistically significant ( Z = - 2.48, P = 0.013). The rate of non-iodized salts in 2019 was only 35.5% (3 494/9 835), significantly lower than that in 2017 (96.2%, 4 263/4 430, χ 2 = 4 536.74, P < 0.001). The median urinary iodine of children in 2017 and 2019 were 338.2 and 317.8 μg/L, respectively, the difference between the two years was statistically significant ( Z = - 2.46, P = 0.014). In 2017 and 2019, the goiter rate of children aged 8 to 10 years was 1.5% (15/1 012) and 2.1% (187/8 896), respectively, and there was no significant difference between the two years (χ 2 = 1.76, P = 0.185). The results of univariate logistic regression analysis showed that, compared with the control group with urinary iodine < 100 μg/L, the risk of goiter rate (but the enlargement rate did not exceed 5%) increased with the increase of urinary iodine level (100 - 199, 200 - 299 and ≥300 μg/L groups), and the differences were statistically significant [odds ratio ( OR) = 8.64, 7.68, 10.69, P < 0.05]. Conclusion:After the implementation of the new demarcation standard for areas with excessive iodine in water sources, the supply of non-iodized salts in Henan Province is relatively lagging behind, and the iodine nutrition level of children is still high, but the goiter rate is relatively stable.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To explore the application effect of rehabilitation nursing based on gratitude extension-construction theory in postoperative patients with endometrial cancer.Methods:Using the convenient sampling method, a total of 80 patients with endometrial cancer who were admitted to the Affiliated Hospital of Jining Medical University from January 2019 to December 2021 were selected as the research objects. The patients were divided into the observation group (42 cases) and the control group (38 cases) using the random number table method. The control group received routine nursing interventions, while the observation group received rehabilitation nursing interventions based on gratitude extension-construction theory. Psychological distress, gratitude, fear of cancer recurrence, quality of life and pelvic floor function were compared between the two groups before and after intervention.Results:After intervention, the scores of psychological distress, cancer recurrence and Pelvic Floor Distress Inventory score in the observation group were lower than those in the control group, and the scores of gratitude and quality of life in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Rehabilitation nursing based on gratitude extension-construction theory can increase the gratitude level of patients undergoing endometrial cancer surgery, promote the recovery of pelvic floor function, reduce psychological pain and cancer recurrence concerns and improve their quality of life.

Gut microbiota plays an important role in development of diabetes with frailty. Therefore, it is of great significance to study the structural and functional characteristics of gut microbiota in Chinese with frailty. Totally 30 middle-aged and the aged participants in communities with diabetes were enrolled in this study, and their feces were collected. At the same time, we developed a metagenome analysis to explore the different of the structural and functional characteristics between diabetes with frailty and diabetes without frailty. The results showed the alpha diversity of intestinal microbiota in diabetes with frailty was lower.
Aged ; Diabetes Mellitus ; Epstein-Barr Virus Infections ; Frailty ; Gastrointestinal Microbiome ; Herpesvirus 4, Human ; Humans ; Middle Aged

Objective    To observe the short-term therapeutic outcomes of atrial septal defects (ASD) repair using on-pump beating-heart technique assisted by robotic surgery system (Da Vinci Si) or thoracoscopy. Methods    Clinical data of 50 patients undergoing ASD repair at the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2018 were retrospectively analyzed. According to the different surgical methods, patients were divided into a robot group and a total thoracoscopy group. In the robot group, there were 35 patients including 11 males and 24 females, at an average age of 42.1±16.8 years, and in the total thoracoscopy group there were 15 patients including 8 males and 7 females at an average age of 38.4±10.9 years. During follow-up, the left ventricular ejection fraction, left and right atrial diameter, and right ventricular end-diastolic diameter in the cardiac Doppler echocardiography were recorded. The operation time, extracorporeal circulation time, ventilation time, postoperative ICU stay, postoperative hospital stay, perioperative pleural drainage and early complications were compared between the two groups. Results    In the perioperative period, the robot group had less operation time (3.8±0.3 h vs. 6.1±1.4 h), extracorporeal circulation time (72.3 ± 10.4 min vs. 139.1 ± 32.8 min), ventilation time (5.5±1.2 h vs. 9.5 ± 2.1 h), postoperative hospital stay (6.7±0.5 d vs. 9.8 ± 0.6 d) and thoracic drainage (253.4±26.8 mL vs. 289.3 ± 29.5 mL) than the total thoracoscopy group (P<0.05), while the postoperative complications were not statistically significant between the two groups (P>0.05). All patients were reviewed by color Doppler ultrasound at 1 month after operation. The postoperative dilated right atrium, right ventricle and left atrium were smaller than those before surgery. Conclusion    For patients undergoing ASD repair, robot-assisted and total thoracoscopy can achieve good results, but the robot group has more advantages in terms of operation time, extracorporeal circulation time, ventilation time, postoperative hospital stay and thoracic drainage.

Objective:To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period.Methods:In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［107 males and 85 females, age (34.2±10.7) years］ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［28 males, 36 females, age (30.2±8.3) years］ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results:In part one, the coincidence rate between the second prediction and the actual results ［97.4%(187/192)］ was significantly higher than that of the first prediction ［93.2%(179/192)］ ( P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group ( P<0.05). Conclusions:The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

Objective To investigate the iodine nutritional status among children aged 8-10 years old in Henan Province after five years of implementation of new standard iodized salt,and to provide evidence for scientific adjustment of control strategy.Methods In 2017,according to "Henan Surveillance Program on Iodine Deficiency Disorders",children aged 8-10 years old (half males and half females) were chosen as research targets.In nonhigh iodine areas of 156 non-high iodine counties (cities,districts) and high iodine counties (cities,districts) in Henan Province,household salt samples were collected;in 113 counties (cities,districts),urine samples were collected;in 67 counties (cities,districts),thyroid volume was measured.Salt iodine was tested by direction titration,the salt samples from Sichuan and other enhanced salt samples were tested by the arbitration method;urinary iodine was tested by arsenic cerium catalytic spectrophometry;thyroid volume was measured by ultrasound method.Results In 2017,totally 31 174 household salt samples of 8-10 years old children were collected and tested,the median of salt iodine was 25.8 mg/kg;the coverage rate of iodized salt was 95.0％ (29 613/31 174) and the consumption rate of qualified iodized salt was 85.6％ (26 673/31 174).Totally 22 442 urine samples were collected and the median of urinary iodine content was 208.0 μg/L.Totally 13 439 school children were examined thyroid volume and the goiter rate.was 1.5％ (196/13 439).Conclusions After the promotion of new standard iodized salt,the iodine nutritional status of children aged 8-10 years old in Henan Province is appropriate.However,the consumption rate of qualified iodized salt is lower,so the universal salt iodization prevention and control strategies should be performed for a long time.At the same time,health education of iodine deficiency knowledge should be strengthened.