Abstract:The aging situation in China is grim, and long-term care (LTC) for the elderly has become an important public health concern. Through retrospective analyses, the authors sort the current problems of LTC for the elderly in China from the aspects of care demand, care system, care model, and care manpower, and put forward prospects, so as to clarify the opportunities for the development of elderly LTC and provide references for the development of geriatric nursing.

Abstract:Objective To investigate the effects of xanthohumol (XAN) on reducing serum uric acid (UA) and regulating bone metabolism in hyperuricemia (HUA) rats. Methods Totally 48 male Wistar rats were randomly divided into 6 groups (n=8):blank group, model group, allopurinol (ALLO) group, XAN low-dose (XAN-L) group, XAN medium-dose (XAN-M) group, and XAN high-dose (XAN-H) group. The HUA model was developed by the combined use of potassium oxonate (200 mg·kg^-1·d^-1) and hypoxanthine (250 mg·kg^-1·d^-1). After HUA model was established for 2 h, corresponding concentrations of drug suspension (20 mg·kg^-1·d^-1 in ALLO group, 5 mg·kg^-1·d^-1 in XAN-L group, 15 mg·kg^-1·d^-1 in XAN-M group, and 45 mg·kg^-1·d^-1 in XAN-H group) was administered to gavage for 14 d. Orbital blood was collected on the 3^rd, 7^th, 10^th and 14^th d to detect the levels of serum UA, creatinine (CRE), blood urea nitrogen (BUN), and activity of xanthinoxidase (XOD) in each group. At the end of the experiment, the activity of alkaline phosphatase (ALP), the levels of bone metabolism-related proteins such as Runt-related transcription factor 2 (Runx 2), cathepsin K (CTSK), receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) were measured, and then the ratio of RANKL/OPG was analyzed. Results Compared with the blank group, the serum levels of UA in rats of model group were significantly increased on the 3^rd, 7^th, 10^th and 14^th d (all P<0.01), indicating that the HUA model was successfully constructed. Compared with the model group, both XAN-M and XAN-H effectively reduced the levels of serum UA in acute and chronic HUA rats (all P<0.01), inhibited the XOD activity (all P<0.01), and improved the renal function indexes CRE (all P<0.01) and BUN (all P<0.05). Although XAN-L did not significantly reduce the serum UA level in acute HUA rats, it effectively decreased the XOD activity (P<0.01) and improved its renal function indexes CRE (P<0.01) and BUN (P<0.05); while for chronic HUA rats, it had descending effects on the serum UA level (all P<0.01), but had no obvious renal protective effect. In addition, XAN also significantly enhanced ALP activity (all P<0.01), up-regulated the expression of Runx2 (all P<0.01, except for XAN-L group), down-regulated the expression of CTSK (all P<0.01), inhibited the secretion of RANKL (all P<0.01), promoted the expression of OPG (P<0.01, only for XAN-H group), and corrected the ratio of RANKL/OPG (all P<0.05). Conclusion XAN has active descending effects on serum levels of UA in HUA rats, which may be related to inhibiting XOD activity to reduce UA production and protecting renal function to enhance UA excretion. Meanwhile, XAN can also promote bone formation, inhibit bone destruction, and effectively regulate bone metabolism, which may be related to the inhibition of osteoclast differentiation through RANKL/OPG signaling pathway.

Abstract:Objective To explore the effects of focused low-intensity pulsed ultrasound (FLIPUS) on the expression of inflammatory cytokines and pyroptosis-related proteins in mouse knee joint chondrocyte injury induced by lipopolysaccharide (LPS) and the mechanism of chondroprotection. Methods Primary chondrocytes were isolated from knee cartilage of C57BL/6J mice and stimulated with LPS for 12 h to mimic osteoarthritic chondrocyte injury in vitro. The chondrocytes were divided into control group (only cultured in medium containing 10% FBS without any treatment), LPS group (LPS treatment for 12 h), and LPS+FLIPUS group (LPS treatment for 12 h followed by FLIPUS intervention for 20 min). The expression of collagen Ⅱ α1 (COL2α1), inflammatory cytokines (interleukin[IL]-18 and IL-1β), pyroptosis-related proteins (nucleotide-binding oligomerization domain-like receptor 3 [NLRP3], cleaved cysteine aspartic acid specific protease 1 (caspase 1), and N-terminal fragment of gasdermin D[GSDMD-N]), and cartilage matrix degradation factors (matrix metalloproteinase [MMP] 13, MMP3, and a disintegrin and metalloproteinase with thrombospondin 5[ADAMTS5]) were detected by Western blotting. The viability of chondrocytes was detected by calcein acetoxymethyl ester/propidium iodide (calcein AM/PI) fluorescent staining and lactate dehydrogenase (LDH) release assay, the morphology of chondrocytes was observed by scanning electron microscopy, and the levels of IL-1β and IL-18 in cell supernatant were detected by enzyme-linked immunosorbent assay. Results The primary chondrocytes were isolated from knee cartilage of the mice and osteoarthritic chondrocyte injury in vitro were successfully simulated. Compared with the control group, the expression of COL2α1 was significantly decreased in the LPS group (P<0.01), while the expression levels of MMP13, MMP3, ADAMTS5, NLRP3, GSDMD-N, cleaved caspase 1, IL-18, and IL-1β were significantly increased (all P<0.01); the levels of IL-18, IL-1β, and LDH in the cell supernatant were significantly increased (all P<0.01), with cell swelling and deformation, more pores on the membrane, loss of integrity, and increased cell mortality (P<0.01). Compared with the LPS group, the expression of COL2α1 was significantly increased in the knee chondrocytes of mice in the LPS+FLIPUS group (P<0.01), while the expression levels of MMP13, MMP3, ADAMTS5, NLRP3, GSDMD-N, cleaved caspase 1, IL-18, and IL-1β were significantly decreased (P<0.05, P<0.01); the levels of IL-18, IL-1β, and LDH in the cell supernatant were significantly decreased (P<0.05, P<0.01), with relieved cell swelling and membrane pores and decreased cell mortality (P<0.05). Conclusion FLIPUS may reduce chondrocytes injury induced by LPS in mice via inhibiting the expression of inflammatory cytokines and pyroptosis-related proteins.

Abstract:Objective To study the role of Homer1b/c in cell autophagy induced by glutamate excitotoxic injury and its mechanism. Methods Mouse hippocampal neuronal HT22 cells were treated with 500 μmol/L L-glutamate to establish cell injury model. The expression of Homer1b/c in HT22 cells was down-regulated by small interfering RNA (siRNA) lentivirus transfection. 10 μmol/L 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetrakis (acetoxymethyl ester) (BAPTA-AM, a calcium ion chelating agent) and 10 mmol/L 4-phenylbutyric acid (4-PBA, an endoplasmic reticulum stress inhibitor) were used to inhibit intracellular calcium ion release and endoplasmic reticulum stress, respectively. Then, the expression levels of Homer1b/c, autophagy proteins (beclin-1 and microtubule-associated protein 1 light chain 3 [LC3]) and endoplasmic reticulum stress marker proteins (C/EBP homologous protein [CHOP] and glucose regulated protein 78 [GRP-78]) in cells were measured by Western blotting. Results Compared with the control group, the expression of beclin-1 and the ratio of LC3-Ⅱ/LC3-Ⅰ were significantly increased after the HT22 cells were treated with L-glutamate for 12 h (both P<0.05); down-regulation of Homer1b/c expression could reduce the expression of beclin-1 and the ratio of LC3-Ⅱ/LC3-Ⅰ (both P<0.05). Inhibition of intracellular calcium release and endoplasmic reticulum stress could reduce the beclin-1 expression and LC3-Ⅱ/LC3-Ⅰ ratio (both P<0.05). After down-regulation of Homer1b/c expression, inhibiting intracellular calcium release and endoplasmic reticulum stress failed to further reduce the beclin-1 expression and LC3-Ⅱ/LC3-Ⅰ ratio. Conclusion Homer1b/c can regulate cell autophagy induced by glutamate excitotoxic injury, and its regulatory effects may be related to the function of endoplasmic reticulum.

Abstract:Objective To investigate the relationship between serum ferritin (SF) level and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM), so as to provide new molecular markers for diagnosis and treatment of T2DM patients with hyperuricemia (HUA). Methods A total of 351 T2DM patients who were hospitalized in Department of Endocrinology, First Hospital of Lanzhou University from Aug. 2021 to Sep. 2022 were enrolled and assigned to 4 groups according to the quartile level of SF:Q1 group (SF<76.2 ng/mL, n=87), Q2 group (SF 76.2-138.9 ng/mL, n=88), Q3 group (SF 139.0-240.9 ng/mL, n=87), and Q4 group (SF ≥ 241.0 ng/mL, n=89); and the SUA levels and the prevalences of HUA in different SF level groups were compared. In addition, T2DM patients were assigned to HUA group (n=54) and non-HUA group (n=297) to compare the SF levels and prevalences of hyperferritinemia. Pearson correlation, Spearman rank correlation, and multiple linear regression were used to analyze the correlation between SF and SUA in T2DM patients. The influencing factors of HUA in T2DM patients were analyzed by binary logistic regression. Results The level of SUA in the Q4 group ([344.54±105.94]μmol/L) was significantly higher than that in the Q1 group ([308.34±79.60]μmol/L, P<0.05). There was no significant difference in the prevalences of HUA between groups with different SF levels (P>0.05). The SF level in the HUA group (174.50[105.40, 295.25] ng/mL) was significantly higher than that in the non-HUA group (129.00[69.55, 226.00] ng/mL, P<0.05), and the prevalence of hyperferritinemia was higher in the HUA group (18.52%, 10/54) than in the non-HUA group (17.17%, 51/297), but the difference was not statistically significant (P>0.05). Correlation analyses indicated that SUA was positively correlated with SF (r_s=0.110, P=0.040). Multiple linear regression analysis indicated an independent positive correlation between SF and SUA in T2DM patients (P<0.05). Binary logistic regression analysis showed an independent positive correlation between SF and HUA in patients with T2DM (odds ratio=1.003, P=0.023). Conclusion SF level is closely related to SUA in T2DM patients, and SF is an independent factor of HUA in T2DM patients.

Abstract:Objective To investigate the risk factors of unexpected postoperative hypothermia (UPH) in patients undergoing da Vinci robot-assisted laparoscopic surgery for pancreatic cancer, construct a risk prediction model, and evaluate its prediction efficacy. Methods Patients who received da Vinci robot-assisted laparoscopic radical surgery for pancreatic cancer in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Dec. 2020 to Dec. 2021 were enrolled. According to the development of UPH, the patients were divided into UPH group and non-UPH group, and the general data (age, gender, American Society of Anesthesiologists classification, body mass index [BMI], preoperative hemoglobin, preoperative albumin, and basal body temperature), surgical data (operation mode, type of nerve block, anesthesia time, surgical time, artificial pneumoperitoneum time, postoperative body temperature, postoperative complications, and in-hospital outcomes), and perioperative fluid management data (crystal fluid, colloid fluid, red blood cell suspension, fresh frozen plasma, blood loss, and urine volume) were compared. Logistic regression was used to construct a UPH prediction model, receiver operating characteristic (ROC) curves and decision curves were drawn to evaluate the effectiveness of the model in predicting UPH, and a nomograph model was established. Results A total of 246 patients were enrolled, of whom 117 (47.6%) developed UPH. There were significant differences in BMI (P=0.047), preoperative plasma albumin (P=0.038), postoperative pulmonary complications (P=0.039), non-pulmonary postoperative infection (P=0.018), total length of stay (P=0.001), operation mode (P=0.042), operation time (P=0.038), intraoperative of artificial pneumoperitoneum time (P=0.004), type of nerve block (P=0.004) and postoperative body temperature (P<0.001) between the 2 groups. Logistic regression analysis showed that da Vinci robot-assisted surgery (odds ratio [OR]=9.369, 95% confidence interval [CI] 2.528-34.717, P=0.001), BMI (OR=0.787, 95% CI 0.687-0.902, P=0.001), operation time (OR=0.040, 95% CI 0.009-0.183, P<0.001), artificial pneumoperitoneum time (OR=15.608, 95% CI 3.814-63.870, P<0.001), fluid infusion rate (OR=0.808, 95% CI 0.706-0.924, P=0.002), total fluid infusion (OR=3.431, 95% CI 1.480-7.956, P=0.004) and the type of nerve block (OR=0.240, 95% CI 0.131-0.443, P<0.001) were independently correlated with the development of UPH. The area under curve value of the ROC curve was 0.739, with a sensitivity of 0.778 and a specificity of 0.628 for predicting UPH. The decision curve analysis results indicated that the predictive model had good clinical net benefits. Conclusion Low BMI, slow fluid infusion rate, large total fluid infusion volume, paravertebral blockade, pancreaticoduodenectomy, long operation time, and long artificial pneumoperitoneum time were the risk factors of UPH in patients undergoing da Vinci robot-assisted laparoscopic radical surgery for pancreatic cancer. The risk prediction model constructed according to the above factors has good effect.

Abstract:Objective To explore the relationship among fatigue, mental resilience, social support and self-efficacy in military personnel. Methods A total of 812 military personnel were tested with multidimensional fatigue inventory scale, the Connor-Davidson resilience scale, general self-efficacy scale, and Chinese version social support revalued scale. Pearson correlation analysis was used to explore the relationship between variables, and hierarchical linear regression was used to analyze the predictive effects of mental resilience, social support, and self-efficacy on fatigue. Structural equation model was constructed to investigate the mediation roles of social support and self-efficacy in the relationship between mental resilience and fatigue. Results A total of 794 valid questionnaires were collected, with an effective rate of 97.78%. The results of Pearson correlation analysis suggested that fatigue was negatively associated with mental resilience, social support, and self-efficacy (r=-0.646, -0.460, -0.520, all P<0.01), mental resilience was positively associated with social support and self-efficacy (r=0.458, 0.618, both P<0.01), and social support was positively associated with self-efficacy (r=0.423, P<0.01). Hierarchical linear regression analysis revealed that mental resilience could independently predict fatigue (P<0.01); social support and self-efficacy had a significant regression with fatigue (both P<0.01); and the 3 variables could explain 46.6% variance of fatigue. The results of structural equation model showed that social support and self-efficacy mediated the relationship between mental resilience and fatigue (P<0.001, P=0.026); furthermore, the chain mediation of social support and self-efficacy also played a mediation role in the relationship between mental resilience and fatigue (P<0.001). Conclusion The programs to enhance mental resilience, social support and self-efficacy can provide significant benefit for improving the abilities of military personnel to deal with fatigue and for improving their operational efficiency.

Abstract:Objective To construct an ensemble neural network model to achieve traditional Chinese medicine (TCM) syndrome classification for rheumatoid arthritis (RA) and explore the importance of the features and risk factors. Methods An ensemble neural network model FEN (feature extration network) was proposed to solve the issues such as poor label correlation and low generalization performance in multi-label classification of TCM syndromes of RA based on artificial intelligence technology. The FEN model utilized a feature extraction classifier based on deep neural network to extract deep features from clinical multi-label RA samples, enhancing the discriminative power of RA features. By measuring label correlation based on covariance theory, the input space of the classifier chain was adjusted to reduce the spread of RA error information and redundancy. An ensemble learning method was used to mitigate the impact of unreasonable label sequences in the classifier chain on RA feature classification. Additionally, the importance of main and accompanying TCM syndrome features of RA was analyzed and potential risk factors were explored. Results The FEN model had excellent performance in a 10-fold cross-validation, with Hamming loss, one-error, accuracy, and F1-score being 0.003 6, 0.024 8, 97.52%, and 99.18%, respectively. Compared with 7 typical multi-label classifiers (classifier chain, label powerset, binary relevance, random k-labelsets, multi-label K-nearest neighbor, ensemble classifier chain, and ensemble binary relevance), the FEN model had better classification capabilities. The analysis of feature contribution indicated that the features of main and secondary symptoms might be used as important indicators of classification of TCM syndromes of RA, and were the main factors affecting the classification of main and accompanying syndromes. Conclusion The RA TCM syndrome classifier based on ensemble neural network has high classification accuracy and efficiency, providing important reference for the clinical diagnosis and treatment of RA.

Abstract:Objective To investigate the effect of the blastomere number on the 3^rd day of fresh embryo transfer cycles and assisted pregnancy methods on pregnancy outcomes. Methods The data of patients who received embryo transfer for the first time, assisted by conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), whose embryo quality was gradeⅠor gradeⅡ, and who were admitted to Department of Reproductive Medicine, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2012 to Aug. 2020 were retrospectively analyzed. A total of 1 788 fresh transfer cycles on the 3^rd day were included and divided into 2 categories:single embryo transfer and double embryo transfer, and each category was further divided into ≤ 6-cell group, 7-cell group, 8-cell group, 9-cell group, and ≥ 10-cell group according to the number of blastomeres. In the fresh single embryo transfer cycles, there were 36 in ≤ 6-cell group (IVF 21, ICSI 15), 53 in 7-cell group (IVF 25, ICSI 28), 204 in 8-cell group (IVF 146, ICSI 58), 36 in 9-cell group (IVF 22, ICSI 14), and 50 in ≥ 10-cell group (IVF 34, ICSI 16). In the fresh double embryo transfer cycles, there were 59 in ≤ 6-cell group (IVF 27, ICSI 32), 72 in 7-cell group (IVF 48, ICSI 24), 1 178 in 8-cell group (IVF 820, ICSI 358), 44 in 9-cell group (IVF 24, ICSI 20), and 56 in ≥ 10-cell group (IVF 24, ICSI 32). The implantation rate, clinical pregnancy rate, live birth rate, and abortion rate were compared. Results In the fresh single embryo transfer cycles, implantation rate and the clinical pregnancy rate in the 8-cell group were significantly higher than those in the ≤ 6-cell, 7-cell, 9-cell, or ≥ 10-cell groups (all P<0.05) and the live birth rate was significantly higher than those in the ≤ 6-cell or 7-cell groups (both P<0.05); there was no significant difference in the abortion rate between 8-cell group and ≤ 6-cell, 7-cell, 9-cell, or ≥ 10-cell groups (all P>0.05); the implantation rate, clinical pregnancy rate, and live birth rate after ICSI embryo transfer in the 8-cell group were significantly higher than those after IVF embryo transfer (all P<0.05), while there were no significant differences in the implantation rate, clinical pregnancy rate, or live birth rate between IVF and ICSI in the ≤ 6-cell, 7-cell, 9-cell, or ≥ 10-cell groups (all P>0.05). In the fresh double embryo transfer cycles, the implantation rate, clinical pregnancy rate, and live birth rate of the 8-cell group were significantly higher than those of the ≤ 6-cell, 7-cell, 9-cell, or ≥ 10-cell groups (all P<0.05), the abortion rate was not significantly different from those of the ≤ 6-cell, 7-cell, or ≥ 10-cell groups (all P>0.05), but was significantly lower than that of the 9-cell group (P<0.05); the implantation rate, clinical pregnancy rate, and the live birth rate after ICSI embryo transfer in the ≤ 6-cell group were significantly higher than those after IVF embryo transfer (all P<0.05), while there were no significant differences in the implantation rate, clinical pregnancy rate, or live birth rate between IVF and ICSI in the 7-cell, 8-cell, 9-cell, or ≥ 10-cell groups (all P>0.05). Conclusion On the 3^rd day of fresh transfer cycles, 8-cell embryos are the first choice, followed by 9-cell, ≥ 10-cell, 7-cell, and ≤ 6-cell embryos. The implantation rate, clinical pregnancy rate, and live birth rate of 8-cell embryos with ICSI are higher than those with IVF, so ICSI can be selected preferentially. For some ICSI assisted pregnancy patients with no other high-quality embryos, transferring ≤ 6-cell embryos can also achieve good pregnancy outcomes.

Abstract:Keeping the balance of autonomic nervous system function is essential to maintain the physiologic function of human body, and the circadian rhythm system is involved in the regulation of autonomic nervous system function. Circadian disruption can increase sympathetic nervous activity and decrease vagus nerve activity, thus promoting the development and progression of cardiovascular disease. However, the mechanism of autonomic nervous function imbalance caused by circadian disruption is not clear. Based on the influence of circadian rhythm on autonomic nervous function, this paper aims to clarify the possible mechanism of autonomic nervous function imbalance caused by circadian disruption, and summarizes the prevention and treatment measures such as melatonin treatment, light regulation, exercise therapy, vagus nerve stimulation, etc.

Abstract:Insulin has recently been proved to be closely associated with central degenerative diseases such as Alzheimer's disease (AD) and may be a target for the treatment and improvement of memory and cognitive performance of AD patients. However, the blood-brain barrier prevents subcutaneously administered insulin from reaching the desired concentration in the brain. The nasal route is the easiest and most efficient way to avoid the first-pass effect of the liver and directly deliver drugs into the central nervous system. Clinical trials have demonstrated that intranasal insulin can improve the cognitive function of AD patients. This article reviews the advantages and disadvantages of different insulin delivery routes, the relationship between insulin and AD, and the efficacy of intranasal insulin in the treatment of AD.

Abstract:Thyroid carcinoma (TC) is one of the fastest-growing cancers in the world. Finding new biomarkers with high specificity, high sensitivity and non-invasive characteristic for early diagnosis and postoperative detection has become a research focus. Exosome, an important carrier of intercellular communication with high stability, low cytotoxicity, low immunogenicity, and high membrane permeability, has the potential to become a non-invasive and new means of disease diagnosis and treatment. In recent years, there have been substantial breakthroughs for exosomes in non-invasive diagnosis, detection, administration, treatment, and prognostic evaluation of thyroid cancer. This article reviews the research progress of TC-derived exosomes in tumor development and progression, diagnosis, and therapy.

Abstract:With the increasing incidence of various malignancies and the patients' prolonged time of surviving with tumors, cancer-related fatigue (CRF) caused by tumor or anti-tumor therapies has an increasingly significant negative impact on sociality, emotion, sleep, and survival of patients. The underlying mechanism of CRF is unclear and the efficacy of Western medicine treating CRF is unsatisfactory. This paper reviews the relevant research progress of traditional Chinese medicine (TCM) in the treatment of CRF. With the guidance of TCM principle "consolidating basis and cultivating primordial qi", treatments including Chinese patent medicine, acupoint stimulation, and guided exercise can effectively alleviate CRF. Meanwhile, TCM treatment for CRF emphasizes studying the relevant mechanism and tonifying the spleen and kidney to strengthen qi, so as to reduce the pain of CRF patients, improve the quality of life of patients, and enhance the humanistic care in the process of tumor diagnosis and treatment.

Abstract:Coronavirus disease 2019 (COVID-19) affects almost all the organs in the human body, especially the lungs and heart. As the number of patients recovered from COVID-19 continues to increase, increasing evidence suggests that a significant proportion of inpatients recovered from COVID-19 experience sequelae, and they mainly have the symptoms of respiratory and cardiovascular systems. For divers, the exercise tolerance and cardiopulmonary function after recovery from COVID-19 significantly affect their fitness to dive. Some organizations and institutions have released guidelines for the assessment of fitness to dive in divers after recovery from COVID-19. Herein, we briefly introduce the respiratory and cardiovascular sequelae and the assessment of fitness to dive in divers after recovery from COVID-19, and preliminarily provide the potential requirements for the assessment of fitness to dive in Chinese divers after COVID-19 based on the current conditions in China.

Abstract:Objective To explore the therapeutic effect of extracorporeal shock wave combined with joint mobilization in the treatment of partial rotator cuff injury. Methods A total of 75 patients with partial rotator cuff injury and shoulder stiffness treated in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2020 to Jan. 2021 were enrolled and were randomly divided into 3 groups:shock wave group (group A), joint mobilization group (group B), and shock wave combined with joint mobilization group (group C), with 25 cases in each group. The patients in group A were treated with extracorporeal shock wave and routine physiotherapy (interference electricity, shortwave, etc.) and were offered exercise guidance. The patients in group B were treated with joint mobilization and routine physiotherapy and were offered exercise guidance. The patients in group C were treated with extracorporeal shock wave combined with joint mobilization, routine physiotherapy and were offered exercise guidance. The clinical effects of the 3 groups were compared after 3 weeks of treatment. Results After 3 weeks of treatment, the visual analogue scale (VAS) scores of the 3 groups were decreased, and the University of California, Los Angeles (UCLA) shoulder joint scores were increased, and the differences were statistically significant in each group compared with those before treatment (all P<0.01). The VAS score of group C (1.80±1.08) was significantly lower than that of group A (3.08±1.44) or group B (2.96±1.57) after treatment (both P<0.05). The UCLA shoulder joint scores of group C (27.44±1.96) were significantly higher than those of group A (24.76±2.24) or group B (22.92±3.93) (both P<0.05). The total effective rate of group C (92.00%[23/25]) was significantly higher than that of group A (72.00%[18/25]) or group B (76.00%[19/25]) (both P<0.05). Conclusion Extracorporeal shock wave combined with joint mobilization has a better short-term effect in the treatment of partial rotator cuff injury than extracorporeal shock wave or joint mobilization alone.

Abstract:Objective To analyze the clinical characteristics of Wilson disease (WD) patients with normal serum ceruloplasmin (CP) level. Methods With serum CP ≥ 200 mg/L as normal value, 82 WD patients with normal serum CP level (normal CP group) admitted from Jan. 2018 to Oct. 2022 were selected as the subjects, and 82 WD patients with serum CP< 200 mg/L admitted at the same time were selected as control group. General data, complications, laboratory parameters, King score, and the copper biochemical indicators before and after treatment were compared between the 2 groups. Results The age of the normal CP group was older than that of the control group (P<0.001). The proportion of hepatic type patients was significantly higher than that of the control group (P<0.001). The incidences of liver cirrhosis and ascites were significantly higher than those of the control group (both P<0.05). Total bile acid, alanine transaminase, aspartate transaminase, γ-glutamyltransferase, ammonia, D-dimer, serum CP, serum copper, copper oxidase, liver fibrosis indexes (hyaluronic acid, laminin, and collagenⅣ), and King score were significantly higher than those of the control group, and albumin was significantly lower than that of the control group (all P<0.05). After treatment, the levels of serum CP, serum copper, and copper oxidase were significantly lower than those before treatment in 58 rehospitalized cases in the normal CP group (all P<0.001), the levels of serum CP in 44.83% (26/58) patients in normal CP group were still ≥ 200 mg/L, and only serum copper level of 66 rehospitalized cases in the control group was significantly lower than that before treatment (P=0.001). Conclusion WD patients with normal serum CP level are mainly hepatic type, with older age, and some patients have more severe liver damage. Serum CP level can be slightly decreased after treatment.

Abstract:Objective To analyze the distribution and causes of QT interval prolongation in hospitalized patients. Methods A total of 61 patients with QT interval prolongation (corrected QT interval ≥ 500 ms) diagnosed by electrocardiogram in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 30, 2019 to Jul. 27, 2022 were enrolled. The baseline characteristics of patients were collected, and the departments of the patients and the causes of QT interval prolongation were analyzed. Results Coronary heart disease, hypertension, diabetes mellitus, and tumor accounted for 50.8% (31/61), 45.9% (28/61), 23.0% (14/61), and 8.2% (5/61) of hospitalized patients with QT interval prolongation, respectively. The inpatient departments of patients with QT interval prolongation were mainly Department of Emergency (45.9%, 28/61) and Department of Cardiovasology (31.1%, 19/61). The causes of QT interval prolongation were drugs (44.3%, 27/61), coronary heart disease (26.2%, 16/61), and electrolyte disturbances (24.6%, 15/61). The common drugs that prolonged QT interval were classⅢ antiarrhythmic drugs, antibiotics (macrolides and quinolones), and 5-hydroxytryptamine receptor antagonists. Among the 61 patients, 3 (4.9%) cases had torsade de pointes and 6 (9.8%) died during hospitalization. Conclusion In hospitalized patients, QT interval prolongation is more common in Department of Emergency and Department of Cardiovasology. Most of them are acquired QT interval prolongation, and the common causes are drugs, coronary heart disease, and electrolyte disturbances.

Abstract: