Abstract:China is heavily affected by cancer. In 2022, the population in Chinese mainland accounted for 18.66% of the world, but new cancer cases and cancer-related deaths accounted for 24.17% and 26.44% of the world, respectively. Lung cancer, liver cancer, gastric cancer, colorectal cancer, and esophageal cancer are the top 5 histological types, accounting for 67.50% of all cancer-related deaths. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of liver cancer, gastric cancer, and esophageal cancer keep decreasing whereas their corresponding crude rates are increasing. The ASMR of lung cancer keeps decreasing in urban areas but increasing in rural areas. The ASIR and ASMR of colorectal cancer are increasing gradually. These data indicate that aging, movement of industrial pollution to rural areas, and alterations in lifestyle seriously affect cancer burden. Due to the rapid transformation of China’s economic, modern lifestyle-related risk factors including physical inactivity, smoking and alcohol consumption, metabolic syndrome, unhealthy diet, and psychological problems continue to increase; furthermore, poverty-related risk factors including environmental pollution, food contamination, and chronic infections (including the infections with hepatitis B virus, human papillomavirus, Helicobacter pylori, and Clonorchis sinensis) still exist, both pushing up the high burden of cancers in China at this stage. These causal factors are carcinogenic either by directly interfering genetic and epigenetic mechanisms, or most frequently induce chronic inflammation to inflammation-cancer transformation. Targeted interventions to the modifiable risk factors, such as improving lifestyle and increasing physical activity can reduce systemic inflammation and improve immunity, so as to decrease cancer occurrence and cancer-related death. In addition, cancer screening is helpful in decreasing the ASMRs of several slowly progressive cancer types including colorectal cancer. Epidemiological cohort study and experimental epidemiology are key to clarify the effects of primary prophylaxis, screening, and clinical treatments on the occurrence and prognosis of cancers, which is the key for improvement of cancer tertiary prophylaxis. Optimal combination of cancer prevention and clinical diagnosis and treatment should be an effective strategy to control the cancer-caused loss of life expectancy in a cost-effective way.

Abstract:Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity involving coronal, sagittal, and axial planes, with a prevalence that should not be overlooked. With advancements in technology and in-depth research, an increasing number of hospitals and physicians are exploring standardized diagnostic and treatment approaches for AIS. Comprehensive and in-depth understanding is required for AIS, including its etiology, screening and diagnosis, classification, assessment and examination, treatment options, exploration of current focus, and evaluation of quality of life. Such understanding ensures that the diagnostic and treatment are scientific, standardized, and timely. Based on the principles of evidence-based medicine, a consensus on the diagnosis and treatment of AIS is reached after multiple discussions among spinal surgery experts, aiming to provide reference and guidance for clinical practice.

Abstract:Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity that occurs in adolescents aged 10-18 years. It is more common in female adolescents. Despite extensive research, the precise pathological mechanisms underlying AIS are yet to be fully elucidated. Given its links to abnormal bone growth and reduced bone mineral density, the involvement of mesenchymal stem cells (MSCs) in bone metabolic disorders is considered a plausible contributing factor of AIS. This review summarizes the role of MSCs in the pathogenesis of AIS and provides a forward-looking perspective on the potential clinical application.

Abstract:Objective To investigate the influence of basic condition, surgical strategy, and postoperative condition of adolescent idiopathic scoliosis (AIS) patients on the length of hospitalization. Methods A total of 145 AIS patients who underwent posterior spinal fusion and internal fixation in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 1, 2014 to Dec. 31, 2023 with more than 2 years of follow-up were retrospectively enrolled. According to the surgical strategy, they were assigned to selective fusion group (n＝50) and non-selective fusion group (n＝95). AIS patients were assigned to intensive care unit (ICU) group (n＝81) and non-ICU group (n＝64) according to whether they were admitted to ICU. Parameters related to basic, surgical and postoperative conditions, hospital stay and postoperative hospital stay were analyzed. Multiple linear regression analysis was used to study the influencing factors of hospital stay and postoperative hospital stay. Results The number of surgical segments, surgical time, intraoperative blood loss, drainage volume on the 3^rd day postoperatively, hospital stay, and postoperative hospital stay in the selective fusion group were significantly less than those in the non-selective fusion group (all P＜0.05). The patients in the ICU group were younger, had longer surgery time, had more intraoperative blood loss and blood transfusion, and had longer hospital stay and postoperative hospital stay compared with those in the non-ICU group (all P＜0.05). Correlation analysis showed that hospital stay and postoperative hospital stay were both positively correlated with ICU admission (r＝0.179, 0.240; both P＜0.05) and were both negatively correlated with selective fusion (r＝－0.187, －0.242; both P＜0.05). Conclusion The hospital stay and postoperative hospital stay of AIS patients with non-selective fusion in posterior spinal fusion and internal fixation is longer than those of patients with selective fusion. Non-selective fusion and ICU admission may be factors contributing to the prolonged hospital stay and postoperative hospital stay in AIS patients.

Abstract:Objective To compare the surgical outcomes of the sequence of screw and rod placement for Lenke type 5C adolescent idiopathic scoliosis (AIS). Methods Lenke type 5C AIS patients who underwent posterior orthopedic fusion and fixation in our hospital from Jan. 2013 to Dec. 2020 were recruited. Based on surgical sequences, 22 cases were assigned to bilateral group (after bilateral screw placement, orthopedics was performed on the convex side and then on the concave side), and 20 cases were assigned to convex group (screws placed on the convex side and performed orthopedics, followed by the concave side). The operation-related indicators (including operation time), imaging parameters, quality of life scores were compared between the 2 groups before and 2 years after surgery. Complications of the 2 groups were analyzed. Results The operation time in the bilateral group was significantly longer than that in the convex group (［232.8±13.1］ min vs ［198.4±16.5］ min, P＜0.01). At the last follow-up 2 years after operation, the Cobb angle and its correction rate in the convex group were better than those in the bilateral group (［8.0±2.3］° vs ［9.9±3.2］°, P＝0.03; ［81.9±5.4］% vs ［77.8±5.8］%，P＝0.02). The rate of pedicle screw breach rate was 5.4% (17/ 312) in the bilateral group and 1.4% (4/280) in the convex group, with significant difference (P＜0.01). At the last follow-up 2 years after operation, the treatment satisfaction of quality of life assessment of the bilateral group was 4.61±1.38, and that of the convex group was 4.50±1.44, but there was no significant difference between the 2 groups (P＞0.05). There were no abnormal electrophysiological monitoring or operation-related complications in the 2 groups. Conclusion For Lenke type 5C AIS, the convex side of pedicle screw placement and orthopedics followed by concave side of pedicle screw placement and orthopedics can achieve better surgical effect.

Abstract:Objective To explore the clinical effect of nursing guided by Neuman’s systems model on adolescent idiopathic scoliosis surgery patients. Methods This study is a randomized controlled trial. A total of 120 patients with adolescent idiopathic scoliosis who underwent surgery in our hospital from Jan. to Dec. 2023 were enrolled. According to the order of enrollment, they were randomly assigned to experimental group or control group, with 60 patients in each group. The control group received routine nursing, while the experimental group received nursing guided by Neuman’s systems model. Independent-sample t test and χ² test were used to compare the surgical efficacy, postoperative recovery, quality of life, and self-management ability of the 2 groups. Results Six months post-surgery, the main curve Cobb angle in the experimental group was significantly smaller than that in the control group (［14.33±0.78］° vs ［16.65±1.02］°, P＜0.001). The postoperative bedtime (［4.78±1.32］) d vs ［6.13±1.26］ d), incision healing time (［13.43±3.29］ d vs ［15.32±5.23］ d), and hospital stay (［13.17±5.36］ d vs ［16.93±3.14］ d) were all significantly shorter in the experimental group than those in the control group (all P＜ 0.05). The overall complication rate in the experimental group was significantly lower than that in the control group (5.00% ［3/60］ vs 21.67% ［13/60］, P＝0.016). Six months post-surgery, the experimental group scored better in terms of physical functioning, bodily pain, general health, vitality, social functioning, role-emotional, and mental health compared to the control group (all P＜0.05). In terms of patient self-management, the experimental group also had significantly higher scores in common management (17.53±5.98 vs 13.34±7.32) and symptom management (30.95±8.12 vs 27.32±7.87) compared to the control group (both P＜0.05). Conclusion The nursing guided by Neuman’s systems model for adolescent idiopathic scoliosis surgery patients can promote their postoperative recovery and improve their quality of life and self-management capabilities.

Abstract:Objective To summarize the perioperative nursing experience of a child with Angelman syndrome (AS) complicated with moderate scoliosis undergoing posterior 3-dimensional osteotomy correction, fusion, and internal fixation under general anesthesia. Methods The clinical data of the child with AS and moderate scoliosis who underwent surgical treatment in our hospital on Aug. 4, 2023, were analyzed. A multidisciplinary team was established upon admission. Relevant literatures and evidences were reviewed to develop and implement a “1＋X” nursing plan, which included 2 components: “1” (core perioperative nursing priorities for scoliosis) and “X” (multiple AS-related nursing issues and corresponding strategies). Results The surgery was successful, with stable postoperative conditions and significant improvement in spinal curvature. The child’s height increased by 7 cm. Discharge occurred on postoperative day 10, with 100% follow-up compliance. The child regained preoperative independent walking ability during follow-up. Conclusion The “1＋X” nursing protocol for AS complicated with scoliosis can effectively ensure perioperative safety and promote recovery, which providing insights for perioperative nursing care of other rare diseases complicated with scoliosis.

Abstract:Objective To explore the value of inflammatory markers in predicting paroxysmal sympathetic hyperactivity (PSH) after traumatic brain injury (TBI). Methods A total of 84 TBI patients who were admitted to The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Dec. 2016 to Nov. 2020 were retrospectively analyzed. They were classified into PSH group (n＝41) and non-PSH group (n＝43) according to whether PSH occurred during hospitalization. The baseline data and laboratory results of the 2 groups were collected and compared. Kendall correlation analysis was used to analyze the correlation between inflammatory markers and the occurrence of PSH after TBI, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of inflammatory markers to PSH. Results There were no significant differences in baseline data, including age, gender, or Glasgow coma scale score, between the 2 groups (all P＞0.05). Compared with patients in the non-PSH group, the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophils and leukocytes in the PSH group were significantly increased (all P＜0.05). NLR, SII and neutrophil were positively correlated with PSH (r＝0.360, 0.308, 0.289; all P＜0.01), with the corresponding ROC area under curve values being 0.752, 0.716 and 0.702, respectively. Conclusion NLR, SII and neutrophils have a value in predicting the occurrence of PSH after TBI.

Abstract:Objective To evaluate the promoting effect of continuous low-intensity pulsed ultrasound (LIPUS) combined with microbubble (MB) cavitation therapy (hereinafter referred to as ultrasound cavitation therapy) on microcirculatory perfusion in the ischemic hindlimbs of mice, and to explore the non-invasive therapeutic potential of this treatment for limb arterial ischemic injury. Methods A mouse model of left hindlimb ischemia was established, and the mice were randomly assigned to 4 groups (16 mice per group) according to different treatment methods: model group, ultrasound contrast microbubble group (MB group), LIPUS treatment group (LIPUS group), and ultrasound cavitation therapy group (LIPUS＋MB group). Mice in the model group were injected with 0.1 mL of normal saline via the tail vein, those in the MB group were injected with 0.1 mL of MB via the tail vein, those in the LIPUS group were treated with LIPUS on the ischemic hindlimb after injection of 0.1 mL of normal saline via the tail vein, and those in the LIPUS＋ MB group were treated with LIPUS on the ischemic hindlimb after injection of 0.1 mL of MB via the tail vein; each group was injected once a day for a total of 7 d. On the 1^st, 4^th and 7^th days after treatment, the microcirculatory perfusion in the ischemic hindlimbs of mice was evaluated using contrast-enhanced ultrasound. The effects of different treatments on promoting microcirculatory perfusion in the ischemic hindlimbs of mice were assessed by combining hematoxylin-eosin (H-E) staining and CD31 immunohistochemical staining of the gastrocnemius muscle tissue in the hindlimbs. Results The left hindlimb ischemia model was successfully constructed, and all model mice showed obvious ischemic microcirculation perfusion disorders with good model stability. After the 7^th day of treatment, the LIPUS＋MB group showed a increase in microcirculation perfusion in the ischemic hindlimb, with the ratio of microvascular flow on the ischemic to non-ischemic sides higher than that of the LIPUS group (［94.33±4.51］% vs［70.33±2.09］%, P＜0.05). H-E staining results showed that the LIPUS＋MB group had more newly formed capillaries and myofibroblasts in the gastrocnemius muscle, with better muscle structure repair compared to the LIPUS group, while the model group and MB group showed muscle cell necrosis, disorganized arrangement of muscle bundles, and sparse capillaries. CD31 immunohistochemical analysis further confirmed that ultrasonic cavitation therapy significantly outperformed traditional LIPUS treatment in promoting microcirculation perfusion, microvascular neogenesis, and tissue repair in ischemic skeletal muscles (CD31 relative expression level 5.03±0.33 vs 3.57±0.21, P＜0.01). Conclusion Compared with single LIPUS treatment, continuous ultrasound cavitation therapy has a more significant effect on promoting microcirculation perfusion in the ischemic hindlimb of mice, which provides a new strategy for microcirculatory perfusion disorders in skeletal muscles of limbs caused by peripheral arterial ischemic diseases.

Abstract:Objective To investigate the status of self-management ability in elderly patients with type 2 diabetes mellitus (T2DM) in community, and to analyze the influencing factors using structural equation model. Methods A convenient sampling method was used to investigate patients aged 65 years and above with T2DM in Hongkou district of Shanghai. The patients were assessed using diabetes self-management questionnaire (DSMQ), Beck depression inventory (BDI), diabetes management self-efficacy scale (DMSES), and diabetes distress scale (DDS). Spearman correlation analysis was conducted to explore the relationship among the variables. A structural equation model was constructed to analyze the effect of depression, self-efficacy, and diabetes distress on self-management levels among the patients. Results A total of 588 elderly patients with T2DM were included in this survey, the DSMQ score was 32.00 (28.00, 38.00), the DMSES score was 158.50 (135.25, 172.00), the BDI score was 0.00 (0.00, 2.00), and the DDS score was 23.00 (18.00, 31.00). The final model demonstrated good fit to the sample data, self-efficacy had a positive impact on self-management levels (β＝0.558, P＜0.001), and depression had a positive impact on diabetes distress (β＝0.599, P＜0.001). Conversely, depression had a negative impact on self-efficacy (β＝－0.314, P＜0.001), and diabetes distress also had a negative impact on self-efficacy (β＝－0.267, P＜0.001). Self-efficacy had the greatest impact on self-management level (the total effect was 0.558), and it was a direct impact. Depression (the total effect was －0.264) and diabetes distress (the total effect was －0.149) had indirect effects. Self-efficacy played a mediating role between depression and self-management, with an indirect effect of －0.175, accounting for 66.3% of the total effect. Self-efficacy and diabetes distress played a chain mediating role between depression and self-management, with an indirect effect of －0.089, accounting for 33.7% of the total effect. Conclusion Self-efficacy has the greatest effect on the self-management level of elderly patients with diabetes mellitus. Depression and diabetes distress indirectly affect self-management levels through the mediating role of self-efficacy. Community and clinical healthcare workers should focus on enhancing the self-efficacy of patients with diabetes mellitus and implementing targeted interventions for their symptoms of depression and diabetes distress, so as to improve their self-management capabilities.

Abstract:Objective To explore the effects of mental fatigue on attention maintenance function by electroencephalogram (EEG) signal characteristics and cortical source analysis. Methods A total of 25 healthy males were recruited as subjects and contingent negative variation (CNV) auditory paradigm was used to assess the differences in EEG characteristics before and after mental fatigue, with the average amplitude of CNV at different processing stages as the analysis indices. Then, the 3-dimensional distribution of cortical current density changes of CNV after mental fatigue were calculated by standardized low-resolution electromagnetic tomography analysis (sLORETA). Results The reaction time of the CNV signal remained unchanged following mental fatigue (P＞0.05), while the lapse rate exhibited a significant increase (P＜0.05). Besides, mental fatigue was related to a notable decrease in the amplitude of CNV early components (500-1 000 ms after warning stimulus) at the central and central parietal electrodes, and a significant reduction in the amplitude of CNV late components (2 550-3 050 ms after warning stimulus) at the prefrontal, frontal, central, and central parietal electrodes (all P＜0.05). The results of sLORETA source analysis showed that the brain activity in the left posterior insular cortex decreased after mental fatigue during the late component of CNV (P＜0.05). Conclusion The decreased activation of the posterior insula, which plays a crucial role in sensorimotor information integration, could potentially serve as a neural mechanism for the reduction of CNV amplitude and the impairment of attention maintenance function following mental fatigue.

Abstract:Objective To study the protective effects and mechanism of sacubitril (Sac)/valsartan (Val) on cardiomyocytes of rabbits with heart failure induced by doxorubicin (DOX). Methods Thirty New Zealand rabbits were selected to establish DOX-induced heart failure rabbit model. Twenty-five rabbits with successful modeling were randomly assigned to model group (DOX group, n＝9), DOX＋Val group (n＝8), and DOX＋Sac/Val group (n＝8); and another 8 New Zealand rabbits were selected as blank group. The DOX＋Val group was gavaged with 4.65 mg/kg Val suspension each time, the DOX＋Sac/Val group was gavaged with 9.3 mg/kg Sac/Val suspension each time, and the blank group and DOX group were gavaged with equal volume of distilled water each time. Each group was gavaged twice a day for 8 weeks. After 8 weeks of administration, echocardiography was used to measure left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS). The heart mass index (HMI) and left ventricular mass index (LVMI) were calculated. The pathological morphology and myocardial fibrosis of myocardial tissue were observed by hematoxylin-eosin (H-E) and Masson staining. The ultrastructure of cardiomyocytes was observed by transmission electron microscope. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining was used to observe cardiomyocytes apoptosis and apoptosis rate was calculated. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin I (Hs-cTNI), angiotensinⅡ (AngⅡ), aldosterone (ALD), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), cyclic guanosine monophosphate (cGMP), and protein kinase G (PKG) in serum. Quantitative polymerase chain reaction (qPCR) was used to detect the expression of natriuretic peptide receptor A (NPR-A), cGMP-specific phosphodiesterase 5A (PDE5A［cGMP］), PKG, B-cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein (Bax), and cysteine aspartate protease 3 (caspase 3) mRNA in myocardial tissue. Western blotting was used to detect the expression of phosphorylated cAMP response element-binding protein (p-CREB), phosphorylated Bcl-2 related death promoting factor (p-Bad), Bcl-2, Bax, and caspase 3 proteins in myocardial tissue. Results Compared with the blank group, the LVDD and LVSD in the DOX group were increased (both P＜0.01), the LVEF and LVFS were decreased (both P＜0.01) and the HMI and LVMI were increased (both P＜0.01); the apoptosis and apoptosis rate of cardiomyocytes were increased (P＜0.01); the levels of NT-proBNP, Hs-cTNI, AngⅡ, ALD, ANP, BNP, cGMP and PKG and the expression of NPR-A, PDE5A (cGMP), PKG, p-CREB, Bax and caspase 3 were all increased (all P＜0.01), while the expression of Bcl-2 was decreased (P＜0.01), and the expression of p-Bad had no significant difference (P＞0.05). Compared with the DOX group, the LVDD and LVSD of the DOX＋Sac/Val group and DOX＋Val group were decreased (all P＜0.01), the LVEF and LVFS were increased (all P＜0.01) and the HMI and the LVMI were decreased (all P＜0.01); the apoptosis and apoptosis rate of cardiomyocytes were decreased (all P＜0.01); the levels of NT-proBNP, Hs-cTNI, Ang Ⅱ, ALD, ANP, BNP, cGMP and PKG and the expression of NPR-A, PDE5A (cGMP), PKG, Bax and caspase 3 were all decreased (all P＜0.01), while the expression of Bcl-2 was increased (P＜0.01); and the expression of p-CREB and p-Bad was increased in the DOX＋Sac/Val group (both P＜0.01), but there was no significant difference in the DOX＋Val group (both P＞0.05). Compared with the DOX＋Val group, the DOX＋Sac/Val group showed a decrease in all indicators except for LVEF, LVFS, NPR-A, ANP, BNP, cGMP, PDE5A (cGMP), PKG, p-CREB, p-Bad, and Bcl-2, which were all elevated (all P＜0.05). Myocardial pathology and transmission electron microscopy showed that Sac/Val effectively protected cardiomyocytes, reduced cardiomyocytes apoptosis and myocardial fibrosis, and these effects were significantly better than those of Val. Conclusion Sac/Val can effectively reduce cardiomyocytes apoptosis, improve cardiac function and reduce myocardial fibrosis in rabbits with heart failure, and these effects are superior to Val. Its mechanism may be related to activating the NPR-A/cGMP/PKG signaling pathway and inhibiting renin-angiotensin-aldosterone system.

Abstract:During the healing of diabetic wounds, prolonged inflammation, difficulty in angiogenesis, and decreased epithelialization ability of keratinocytes often appear, which lead to delayed wound healing. Autophagy is a catabolic pathway that degrades intracellular proteins, promotes cell survival, and maintains cellular biological functions. Recent studies have shown that autophagy affects the healing of diabetic wounds through various mechanisms. This article reviews the potential mechanism of autophagy in diabetic wound healing: autophagy may delay wound healing by causing a decrease in the phagocytic ability and polarization of macrophages, a decrease in the angiogenesis ability of endothelial progenitor cells, a decrease in the migration ability and proliferation of keratinocytes, and an increase in the apoptosis of fibroblasts, which may provide new ideas for finding therapeutic targets for diabetic wound healing.

Abstract:Innate lymphoid cells are an important part of innate mucosal immunity and participate in immune response by secreting effector cytokines and regulating the functions of other immune cells. They are similar to T helper cells in transcription factors and secretory cytokines, but they also have some unique functions. Different innate lymphocyte subsets play different roles in chronic obstructive pulmonary disease (COPD) according to their respective characteristics. Compared with adaptive lymphocyte, innate lymphocyte is relatively less in lymphoid tissue, accounting for only a small part of lung immune cells, but these lymphocyte cells play a crucial role in the development and progression of COPD. In this paper, the role of innate lymphoid cells in COPD and the related research progress were reviewed.

Abstract:Pancreatic cancer patients are at the highest risk of malnutrition among all cancer patients, and radiochemotherapy may further exacerbate the risk of malnutrition in these patients. Malnutrition can reduce the therapeutic efficacy of radiochemotherapy and increase adverse reactions, thereby adversely impacting patients’ quality of life and prognosis. Consequently, nutrition intervention is particularly crucial in the management of pancreatic cancer. Researches have shown that nutrition intervention can effectively ameliorate cachexia associated with pancreatic cancer, reduce the risk of malnutrition, and thereby maintain the sensitivity and tolerance to radiochemotherapy, alleviate adverse reactions, and reduce the complications of adjuvant therapy and surgical treatment. The combination of nutrition intervention and radiochemotherapy can disrupt the metabolism of pancreatic cancer and inhibit tumor growth, reduce the hospitalization rate of patients, and improve their quality of life. This review discusses the methods of nutritional assessment, nutrition intervention strategies for pancreatic cancer patients, and the impact of nutrition intervention on the efficacy and adverse reactions of radiochemotherapy in pancreatic cancer patients.

Abstract:Objective To explore the characteristics and evolution of disability prevention policies for the elderly by quantitative analysis and text-mining analysis of disability prevention policy texts for the elderly in China from 1988 to 2024, so as to provide a basis for improving disability prevention policies for the elderly in China. Methods CiteSpace 6.3.R1 and Rost CM6 software were used for bibliometric and text-mining analyses of policy texts related to the elderly disability prevention in China, such as policy quantity, issuing agencies, formats, and thematic changes. Results A total of 111 policy texts were analyzed, with only 5.4% (6/111) specifically focusing on elderly disability prevention. Policy development had 3 stages: 1988-2005, an initial construction phase for the rehabilitation and prevention system, primarily focused on the establishment of fundamental systems for disability rehabilitation and basic institutional development, such as community security; 2006-2015, a goal-oriented phase enhancing disability prevention and social security, particularly targeting fall prevention, chronic disease control, and subsidies for the elderly with disabilities; and 2016-2024, a phase of refined disability prevention strategies and integration with elderly health services, where the focus has increasingly shifted to precise prevention measures and the alignment of disability prevention with elderly health service systems. Conclusion China’s disability prevention policy system and the policy system related to aging health have gradually formed, but the 2 have not been effectively integrated. While universal policies offer public awareness benefits, the lack of pertinent policies limits elderly disability prevention outcomes. It is necessary to introduce more pertinent elderly disability prevention policies.

Abstract:Objective To analyze the characteristics of intestinal flora of personnel stationed on an island, so as to lay the foundation for maintaining the intestinal microecological balance of personnel stationed on island and provide accurate medical security. Methods Several subjects stationed on an island and several subjects from coastal areas were enrolled by random and sampling method, and their fecal samples were sequenced by 16S rRNA high-throughput sequencing. Diversity and composition of gut microbiota in 2 cohorts of personnel were compared. Results Alpha diversity analysis of intestinal flora showed that the abundance of intestinal flora in subjects stationed on the island was significantly higher than that of subjects from coastal areas. Beta diversity analysis indicated significant differences in the composition of intestinal microbial communities between the subjects stationed on the island and those from coastal areas (P＝0.001). The abundance of the Bacteroidota in the intestinal tract of subjects stationed on the island was significantly lower than that of subjects from coastal areas (30.8% vs 48.3%, P＜0.001), while the abundance of the Proteobacteria was significantly higher than that of subjects from coastal areas (28.3% vs 10.2%, P＜0.001). After multiple hypothesis testing correction, it was found that the abundance of the Bacteroides, Roseburia, Alistipes, and Parabacteroides in the intestines of subjects stationed on the island decreased significantly, while the abundance of the Prevotella, Escherichia-Shigella, Citrobacter, and Eubacterium_coprostanoligenes increased significantly. Conclusion The special environment of islands affects the characteristics of intestinal flora of personnel, and the intestinal microecological health needs precise maintenance.

Abstract:Primary blast lung injury is an acute lung injury caused by the direct impact of explosive shock wave acting on the lung; the serious case can develop acute respiratory distress syndrome, which is one of the leading causes of mortality in blast injury personnel. The pathophysiological characteristics of primary lung blast injury are relatively clear: rupture of the alveolar capillaries and subsequent intrapulmonary haemorrhage and edema, accompanied by oxidative stress, apoptosis, inflammatory reaction and other physiological processes. However, the molecular mechanism needs to be further studied. This paper focuses on the research progress of phosphatidylinositol 3-kinase/protein kinase, nuclear factor κB, mitogen-activated protein kinase and other signaling pathways in the research of primary blast lung injury.

Abstract:Objective To observe the effects of electroacupuncture (EA) on morphine-induced microglia activation and analgesic tolerance, and explore the potential mechanism of EA in the treatment of morphine analgesic tolerance. Methods A total of 60 clean-grade SD rats were randomly assigned to control group, morphine group, morphine＋EA group, and morphine＋EA＋colony-stimulating factor 1 (CSF1) group, with 15 rats in each group. Morphine analgesic tolerance model was established by continuous 7-d intrathecal injection of morphine in the morphine, morphine＋EA and morphine＋EA＋CSF1 groups. EA was given in the rats of morphine＋EA and morphine＋EA＋CSF1 groups at “Zusanli” and “Sanyinjiao” acupoints, with dilatational wave, frequency of 2/100 Hz, stimulation intensities of 0.5, 1.0, and 1.5 mA (10 min per intensity), once a day, for 7 consecutive days. Rats in morphine＋EA＋CSF1 group were given intrathecal injection with recombinant CSF1 protein for 7 consecutive days. The effect of EA on morphine analgesic tolerance in rats was observed by mechanical withdrawal threshold (MWT). After 7 d, the rats were sacrificed, and the L_4-6 spinal dorsal horn and dorsal root ganglion tissues were isolated. The expression of CSF1 protein and mRNA in the dorsal root ganglia and spinal dorsal horn was detected by Western blotting and quantitative polymerase chain reaction. The expression of ionized calcium-binding adapter molecule 1 (IBA-1), a marker of microglia in the spinal dorsal horn, was detected by immunofluorescence method, and the expression of interleukin (IL)-1β，IL-6 and tumor necrosis factor (TNF)-α in the spinal cord was detected by enzyme-linked immunosorbent assay (ELISA). Results After intrathecal injection of morphine, the percentage of maximal possible potential effect (%MPE) in the morphine group was decreased progressively, indicating that the morphine analgesic tolerance model was successfully constructed. Compared with the morphine group, the %MPE in the morphine＋EA group was increased after intrathecal injection at 3, 5 and 7 d (all P＜0.05). Compared with the morphine＋EA group, the %MPE in the morphine＋EA＋CSF1 group was all decreased after intrathecal injection at 3, 5 and 7 d (all P＜0.05). Compared with the control group, the expression of CSF1 protein and mRNA in dorsal root ganglion and the expression of CSF1 protein in spinal dorsal horn in the morphine group were increased (all P＜0.05). Compared with the morphine group, the expression levels of CSF1 protein and mRNA in dorsal root ganglion and CSF1 protein in spinal dorsal horn in the morphine＋EA group were decreased (all P＜0.05). There was no significant difference in the expression of CSF1 mRNA in the spinal dorsal horn among those groups (all P＞0.05). Compared with the control group, the expression of IBA-1 in the spinal dorsal horn of the morphine group was increased (P＜0.05). Compared with the morphine group, the expression of IBA-1 in the spinal dorsal horn of the morphine＋EA group was decreased (P＜0.05). Compared with the morphine＋EA group, the expression of IBA-1 in the spinal dorsal horn of the morphine＋EA＋CSF1 group was increased (P＜0.05). Conclusion EA can inhibit the activation of microglia in the spinal dorsal horn of rats and improve morphine analgesic tolerance in rats. The mechanism may be related to the reduction of CSF1 protein expression in the spinal dorsal horn.

Abstract:Objective To investigate the clinical characteristics of intestinal obstruction caused by Meckel diverticulum in children, so as to improve the understanding, diagnosis and treatment of this disease. Methods The clinical data of 103 children with intestinal obstruction caused by Meckel diverticulum admitted to Department of General Surgery, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology from Jul. 2015 to Jun. 2022 were retrospectively analyzed. There were 78 males and 25 females, with an average age of (4.7±2.6) years old (ranged from 4 months to 12 years old). All 103 cases were admitted for abdominal pain, crying, vomiting or abdominal distension with unknown causes. Results Seventy-four children underwent exploratory laparotomy and 29 underwent laparoscopic exploration. During the operation, it was found that Meckel diverticulum combined with the formation of cord oppressed the intestinal tract, resulting in intestinal obstruction in 65 cases; diverticulum perforation and adhesion obstruction in 15 cases; and secondary intussusception leading to obstruction in 23 cases. Twenty-three cases of secondary intussusception underwent manual reduction of intussusception and Meckel diverticulectomy. Thirty-nine cases were complicated with intestinal necrosis, of which 38 cases underwent cord release, necrotic bowel resection, and intestinal anastomosis; 1 case underwent necrotic bowel resection and intestinal fistula due to septic shock. Twelve cases underwent cord release and diverticulectomy, 14 cases underwent laparoscopic cord release and diverticulectomy, and 15 cases underwent laparoscopic surgery conversion to diverticulectomy. All patients were clinically cured and followed up for more than 1 year, and no anastomotic leakage, wound infection or other complications occurred. Conclusion The formation of cord is the main cause of intestinal obstruction caused by Meckel diverticulum, with atypical early symptoms, lack of specific symptoms, signs and examination methods, leading to a high misdiagnosis rate. It often causes serious complications such as intestinal necrosis and septic shock. For cases of intestinal obstruction with unknown causes, we should be alert to the possibility of intestinal obstruction caused by Meckel diverticulum.

Abstract: