Objective:To investigate the clinical efficacy and safety of pulmonary rehabilitation in elderly patients with chronic obstructive pulmonary disease(COPD)who are undergoing long-term home oxygen therapy.Methods:The study included a total of 60 elderly patients with COPD who were successfully discharged after receiving treatment at the First Hospital of Shanxi Medical University from November 2021 to October 2022.The enrolled patients were randomly divided into two groups: the pulmonary rehabilitation group and the control group, with 30 patients in each group.The allocation was determined using a random number table and prospective research methods.Patients in the pulmonary rehabilitation group underwent a 12-week pulmonary rehabilitation training program, while patients in the control group received pulmonary rehabilitation education and nutrition education.The general data of the two groups of patients were compared, including lung function parameters[forced expiratory volume in one second(FEV 1), forced vital capacity(FVC), forced expiratory volume in one second to forced vital capacity ratio(FEV 1/FVC), and percentage of predicted forced expiratory volume in one second(FEV 1%pred)], blood gas analysis[partial pressure of arterial oxygen(PaO 2), partial pressure of arterial carbon dioxide(PaCO 2), arterial oxygen saturation(SaO 2)], 6-minute walking distance(6MWD), grip strength, 5-round sit to stand test(5R-STST), modified British medical research council(mMRC)score, COPD assessment test(CAT)score, closed cycles test(CCT), Berg balance scale(BBS), and safety measures.These parameters were assessed before and after the intervention. Results:A total of 29 patients in the pulmonary rehabilitation group and 28 patients in the control group completed the study.The general data between the two groups showed no significant difference(all P>0.05).After the intervention, patients in the pulmonary rehabilitation group showed improvements in FEV 1/FVC, PaO 2, PaCO 2, SaO 2, 6MWD, grip strength, 5R-STST, CAT, CCT, and BBS( t=-2.242, -4.630, W=-3.439, t=-6.512, -10.563, -6.197, W=-3.968, t=10.847, -7.334, W=-4.189, all P<0.05).Additionally, 6MWD, CAT, and CCT showed significant improvement after the intervention compared to the control group( t=-2.104, 2.183, 2.106, all P<0.05).No training-related adverse effects were observed during the study. Conclusions:The 12-week pulmonary rehabilitation program is shown to be effective for elderly patients with COPD who are undergoing long-term home oxygen therapy.This program helps to improve respiratory function, systemic symptoms, exercise endurance, muscle strength, and balance function.It is designed to be simple and easy to implement, allowing patients to achieve their training goals and improve their clinical symptoms.Additionally, the program has been found to be safe and well-tolerated by patients, making it a valuable intervention that should be promoted and widely applied.

Objective:To analyze the spatiotemporal characteristics and spatial aggregation of the incidence of hemorrhagic fever with renal syndrome (HFRS) in China from 2004 to 2020, and to provide a scientific basis for prevention and control of HFRS.Methods:The epidemic information of HFRS in China from 2004 to 2020 was collected from the Public Health Science Data Center, the China Health Statistics Yearbook, and the National Statutory Infectious Disease Epidemic Profile Report. The Joinpoint model was used to analyze the annual average incidence rate change trend, ArcGIS 10.5 software was used for spatial visualization analysis, and global spatial autocorrelation, local spatial autocorrelation and spatiotemporal scan analysis were applied to detect hot spots and aggregation areas.Results:From 2004 to 2020, a total of 208 441 cases of HFRS were reported in China, with an average annual incidence rate of 0.91/100 000. Joinpoint model analysis showed that the average annual incidence rate of HFRS in China showed a decreasing trend from 2004 to 2020. In the provinces with high incidence, the disease was mostly distributed with multimodal distribution in spring, autumn and winter, especially in autumn and winter. The results of global spatial autocorrelation analysis showed that the global Moran's I of HFRS incidence rate in China from 2004 to 2019 were all positive. Except 2012 and 2020, the random distribution pattern was not excluded, other years showed spatial clustering ( Z > 1.65, P < 0.05). The results of phased local spatial autocorrelation analysis indicated that Heilongjiang, Jilin and Liaoning provinces were high-high aggregation regions. A total of five aggregation regions were detected in the month-by-month spatiotemporal scan analysis, and the differences of each aggregation region were statistically significant ( P < 0.001). Conclusions:From 2004 to 2020, the overall incidence of HFRS in China shows a downward trend, and the incidence rate has obvious spatial aggregation. High-risk areas still exist, and it is necessary to focus on and take targeted prevention and control measures.

Objective:To analyze the expression and clinical significance of SHC SH2-binding protein 1(SHCBP1)in lung adenocarcinoma(LUAD).Methods:Oncomine,TIMER,UALCAN,GEPIA,Kaplan-Meier plotter and STRING databases were used to explore the effect of SHCBP1 on progression and immune infiltration of LUAD.Results:Expression of SHCBP1 mRNA in LUAD tissue was significantly higher than that in normal lung tissue(P<0.05).Expression of SHCBP1 mRNA was significantly increased in LUAD patients with smoking history,nodal metastasis,late clinical stage and TP53 mutation(P<0.05).Survival analysis by GEPIA and Kaplan-Meier plotter databases showed that LUAD patients with high SHCBP1 mRNA expression had a lower overall survival rate(P<0.05).SHCBP1 mRNA was correlated with immune cell infiltration,immune cell markers and immune checkpoint expression in LUAD.Conclusion:High expression of SHCBP1 is related to poor prognosis and tumor immune infiltration of LUAD patients.

Objective: To understand sexual and reproductive health (SRH) knowledge and access to sexual health information among pupils in higher grades, and to provide the scientific basis for conducting sexual education in family and school. Methods: A total of 1 098 pupils in grade four and five from 4 primary schools in a county, Jiaxing City, Zhejiang Province were selected for an anonymous computer assisted self-interview to get the information, including sexual and reproductive information and its sources, the condition about getting sexual education from school and family, and so on. Results: The percentage of correct answers about boy’s and girl’s puberty changes ranged from 15%~54%, and about reproduction and physiology ranges from 14%~70%. The awareness of private body parts ranged from 59%~98%. About 70%~95% could correctly identify sexual abuse scenes. The average score for knowledge on puberty changes, reproduction and physiology, identification of private body and identification of sexual abuse scenes was 31.89, 38.21, 77.03, and 85.72, with total average score of 58.21. In general, girls and students from urban areas or in grade five had higher knowledge level than boys and students from rural areas or in grade four did (P<0.05). Participants mainly obtained SRH knowledge from their mother(63.02%), father(40.53%) and teachers(27.50%). Girls and students from urban areas or in grade five reported higher proportion in access to information on human development, puberty development and health care, self-protection from parents and school teachers than boys and students from rural areas or in grade four(P<0.05). Conclusion Pupils in higher grades lacked SRH knowledge. It is necessary to raise awareness among school teachers and parents about the importance of providing sexuality education for pupils.

Objective To investigate the evaluation and suggestion of the courses of Chinese Medicine for clinical students majoring in medical college. Methods In January 2017, at the end of the Chinese Medicine courses, a total of 35 clinical students of Capital Medical University were investigated through a questionnaire, mainly related to students' understanding of Chinese medicine; evaluation and suggestions for Chinese Medicine education and teaching. Results The majority of students believed that Chinese medicine was safe and effective. The proportion of believing worthing learning that the Chinese medicine accounted for 94.3% (33/35), and who believed Chinese medicine helpful for the clinical work accounted for 82.9% (29/35). However, the proportion of satisfaction with the current teaching method was 60% (21/35). Conclusions Most of the clinical students in this investigation have recognized the role of Chinese medicine, and have shown great interest in studying the course, but they are not satisfied with the current teaching. To improve the teaching quality of Chinese Medicine through the reform should be the direction of teachers' efforts in the future.

Objective To compare the clinical efficacy of single utility port and multiple utility ports thoracoscopic lobectomy in the treatment of peripheral lung cancer, and to study the operation skills, relative merit and feasibility of the single utility port thoracoscopic lobectomy. Methods The clinical data was analyzed retrospectively for 223 cases with stage Ⅰ orⅡ of peripheral lung cancer who underwent thoracoscopic lobectomy from July 2011 to November 2014 in Shanxi Provincial Cancer Hospital. Among 223 cases, 78 cases received single utility port thoracoscopic lobectomy (single utility port group), 145 cases received 2 or 3 utility ports thoracoscopic lobectomy (multiple utility ports group). The clinical outcomes involved time of operation, intraoperative blood loss,chest drainage, postoperative hospital stay, stations of lymph node dissection, numbers of lymph node dissection, rate of turn to open, postoperative complications, 2-year survival rate and disease free survival rate. Results No perioperative death occurred in both groups. There was no statistical difference between single utility port group and multiple utility ports group in operation time [(157.4 ±13.6) min vs. (151.3 ±23.2) min], intraoperative blood loss [(180.77 ±59.97) ml vs.(171.31 ±77.51) ml],chest drainage [(370.26 ±146.09) ml vs. (351.17 ±159.07) ml], lymph node dissection stations (4.29±0.65 vs. 4.21±0.73), lymph node dissection number (11.50±2.30 vs. 11.04±2.29), rate of turn to open [(5.13 ％ (4/78) vs. 4.83 ％ (7/145)], incidence of postoperative complications [17.95 ％ (14/78) vs. 15.86％(23/145)], postoperative hospital stay [(8.74±0.51) d vs. (9.48±0.63) d], 2-year survival rate [96.15 ％(75/78) vs. 93.79％(136/145)] and 2-year disease free survival rate [80.77 ％ (63/78) vs. 82.07 ％ (119/145)] (all P>0.05). Conclusions The single utility port thoracoscopic lobectomy could achieve the same clinical results as the multiple utility ports. The single utility port thoracoscopic lobectomy is a safe, effective and feasible surgical procedure.

Objective To observe the incidence and clinical feature of sleep-related breathing disorder in patients with idiopathic pulmonary fibrosis (IPF). Methods Thirty-four IPF patients who were measured by polysomnography (PSG) were collected in the Department of Respiration of Tianjin Medical University General Hospital. According to the results of apnea hypoventilation index (AHI), patients were divided into pure IPF group (AHI<5 events/h, n=7) and IPF combined with obstructive sleep apnea hypopnea syndrome (IPF+OSAHS) group (AHI≥5 events/h, n=27). The PSG reports of two groups were analyzed, and the correlation between AHI and pulmonary function and oxygen saturation in sleep and at wake were analyzed. Results (1)Thirty-four IPF patients were all demonstrated sleep disorders, low sleep efficiency, increased proportion of stageⅠand stageⅡand decreased proportion of stageⅢand rapid eye movement (REM). The arousal index and the proportion of stageⅠand stageⅡwere higher in IPF+OSAHS group than those of pure IPF group (P<0.01), while the proportion of stageⅢwas lower in IPF+OSAHS group than that of pure IPF group (P<0.01). There was no significant difference in stage REM between two groups. (2)Twenty-seven patients (79%) combined with OSAHS, among which five subjects (15%) were mild OSAHS with 5 events/h≤AHI<15 events/h, and 22 subjects (65%) were moderate-severe with AHI≥15 events/h. The main type of sleep-disorder breathing was hypoventilation, which mainly happened in stage REM. (3) Thirty-four IPF patients showed sleep hypoxemia, and the oxygen desaturation index (ODI) was higher in IPF-OSAHS group than those of pure IPF group (P<0.05). (4)The AHI was positively correlated with body mass index (r=0.791, P<0.05), and was negatively correlated with forced vital capacity (FVC%pred) (r=-0.574, P<0.05) and forced expiratory volume in 1 second (FEV1%pred) in IPF patients (r=-0.664, P<0.05). The lowest oxygen saturation (LSO2) and mean oxygen saturation (MSO2) in sleep were positively related with oxygen saturation at wake (r=0.421 and r=0.464, P<0.05 respectively). Conclusion The IPF patients show severe sleep disorder and hypoxemia, which can be worsen by OSAHS and produce negative effect on daily life. We should initiate active treatment in patients with sleep-related breathing disorders.

Humans are exposed to the ubiquitous radiofrequency (RF, 100 kHz-300 GHz) electromagnetic fields because of the mushroom development of wireless communications,raising concerns over the possible hazards of RF radiations.Epidemiological investigation has showed that chronic use of cellphones increases the risk of brain tumors.Since genetic damage is closely related to tumors, researchers have been trying to find out whether cellphones and other RF devices are genotoxic.However, the investigations have yielded both negative and positive results.This review summarized the recent in vitro and in vivo researches about genotoxicity of RF radiations and proposed a possible mechanism by which of RF radiations cause genetic damage.

BACKGROUND/AIMS: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. METHODS: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures. RESULTS: A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010. CONCLUSIONS: The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.
Appendicitis ; Asian Continental Ancestry Group ; China* ; Colitis, Ulcerative ; Crohn Disease ; Diagnostic Errors ; Emergencies ; Hospital Mortality ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Prevalence ; Prospective Studies