Comparing income-related inequality on health service utilisation between older rural-to-urban migrant workers and older rural residents in China: a cross-sectional study.

OBJECTIVES: This study quantifies income-related inequalities in health service utilisation of older rural-to-urban migrant workers, by comparison with older rural residents, and identify with factors giving rise to the inequalities. SETTING: Nationally representative survey conducted in 29 provinces, municipalities and autonomous regions of China. PARTICIPANTS: 952 older rural-to-urban migrant workers and 2676 older rural residents were identified for further analysis. MAIN OUTCOME MEASURES: The probability of 2 weeks outpatient utilisation and inpatient utilisation. DESIGN: Coarsened exact matching was used to control the confounding factors between older rural-to-urban migrant workers and their rural counterparts. Concentration index was used to depict the inequality in health service utilisation, and it can be decomposed proportionally into contributions. RESULTS: The concentration indices of 2 weeks outpatient utilisation of two groups were -0.2061 (95% CI: 0.0193 to 0.1364) and -0.2041 (95% CI: 0.0594 to 0.1469), respectively. The concentration indices of inpatient of two groups were -0.0024 (95% CI: -0.0047 to 0.0639) and -0.1412 (95% CI: 0.0235 to 0.1125), respectively. The contributors of the inequality of 2 weeks outpatient utilisation of two groups were poor self-assessed health (SAH) status and richest group. The contributors of the inequality of inpatient utilisation of the rural elderly were poor SAH, fair SAH and sense of happiness. The horizontal inequality indices for 2 weeks outpatient of two groups were 0.1321 and -0.0.992, respectively. The horizontal inequality indices for the inpatient of two groups were -0.0032 and -0.0396, respectively. CONCLUSIONS: The results illustrated the existence of a socioeconomic gradient in health service utilisation between older rural-to-urban migrant workers and older rural residents. Our studies provided evidences to take full account of the health service needs, contributing to more reliable understandings of inequalities in the health service utilisation. The results may be referential to identify policy priorities conducive to the health policy reform in the process of active ageing in China.

Consistency in the prevalence and associated factors of frailty determined by two instruments among hospitalised older adults: A cross-sectional study.

AIMS AND OBJECTIVES: To investigate the consistency in the prevalence and associated factors of frailty determined by the physical-originated Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale and the multidimensional Tilburg Frailty Indicators (TFI) scale. BACKGROUND: Accurate assessment of frailty and the identification of its associated factors could guide the development and implementation of holistic and individualised treatment plan. However, recommendations regarding the selection of frailty assessment tools are inconclusive. DESIGN: This is a cross-sectional study, the reporting of which followed the STROBE guidelines. METHODS: A total of 1220 older adults were recruited from a university affiliated tertiary hospital in Xi'an City, Northwest China, and administrated with a social-demographic and health-related information sheet, the FRAIL, the TFI, the Short-Form Mini-Nutritional Assessment, the Pittsburgh Sleep Quality Index and the 5-level EuroQol 5 dimensions questionnaire. Descriptive statistics and binary logistic regression analysis were used to investigate the prevalence of frailty and its associated factors. RESULTS: The prevalence of physical-originated and multidimensional frailty was 55.2% and 77.6%, respectively. The consistency between the two scales was low. Taking the combined use of the two instruments as the reference, the TFI and FRAIL could identify 89.99% and 64.02% of the participants with frailty. Polypharmacy, health-related quality of life and sleep quality were found to be associated with both physical-originated and multidimensional frailty. Nutritional status and level of physical activity were additionally identified as the independent associated factors of multidimensional frailty. CONCLUSIONS: The prevalence of frailty among hospitalised older adults is high. There is low consistency between the FRAIL and TFI in detecting frailty. The TFI exhibited higher sensitivity in detecting individuals with frailty and its associated factors. RELEVANCE TO CLINICAL PRACTICE: The findings of this study supported a single use of the TFI for the assessment of frailty in the hospital setting.

Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress.

Background: Frontline healthcare workers were at a high risk of infection and developing mental health problems during the outbreak of coronavirus disease 2019 (COVID-19). It is important to monitor the symptoms of post-traumatic stress disorder (PTSD) and somatization among frontline healthcare workers in China. Aim: This study aimed to investigate PTSD, somatization, resilience, and perceived stress among frontline healthcare workers fighting against COVID-19 and examine the mediating effects of perceived stress on resilience in both PTSD and somatization. Methods: The study was conducted from December 2021 to February 2022 through an online survey of frontline healthcare workers fighting against COVID-19. The survey included questions regarding socio-demographic information, resilience (10-item Conner-Davidson Resilience Scale, CD-RISC-10), perceived stress (14-item Perceived Stress Scale, PSS), PTSD (Checklist-Civilian Version, PCL-C), and somatization (Symptom Checklist-90). The PROCESS macro for SPSS was used to examine the mediating effects of perceived stress. Results: Approximately 14.9% of healthcare workers had possible PTSD (PCL-C score of ≥ 44), and 41.04% of the workers had low resilience (CD-RISC-10 score of ≤ 25.5). Approximately 54.05% of healthcare workers were symptomatic, and 14.7% had a moderate or higher degree of somatization with sleep-related problems as the most common symptom. Perceived stress was negatively correlated with resilience (r = -0.527, p < 0.001) and positively correlated with PTSD (r = 0.505, p < 0.001) and somatization (r = 0.361, p < 0.001). In addition, perceived stress mediated the relationship between resilience and PTSD [indirect b = -0.382; bootstrapped confidence interval (CI), -0.454, -0.319] and somatization (indirect effect b = -0.159; bootstrapped CI, -0.199, -0.123). Conclusion: The prevalence of PTSD and somatic symptoms indicates that the mental health of frontline healthcare workers deserves more attention. Resilience is negatively associated with PTSD and somatization, and the relationship among resilience, PTSD, and somatization is mediated by perceived stress. Strategies for reducing perceived stress and increasing resilience may help to prevent and alleviate PTSD and somatization.

Prevalence and associated factors of frailty among community dwelling older adults in Northwest China: a cross-sectional study.

OBJECTIVES: To investigate the prevalence of the comprehensive frailty and its associated factors among community dwelling older adults. DESIGN: A cross-sectional study. SETTING: Six community healthcare centres in Xi'an City, Northwest China. PARTICIPANTS: A total of 2647 community dwelling older adults completed the study between March and August 2021. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the prevalence of frailty, measured with the Comprehensive Frailty Assessment Instrument. The secondary outcomes were potential factors associated with frailty, measured with a social-demographic and health-related information sheet, the Short-Form Mini-Nutritional Assessment and the Pittsburgh Sleep Quality Index. RESULTS: The participants averaged 27.77±10.13 in the total score of the Comprehensive Frailty Assessment Instrument. According to the cut-off points defining the classification of frailty, the majority of the participants were with mild (n=1478, 55.8%) or high (n=390, 14.8%) frailty. Multivariate stepwise linear regression analysis demonstrated that older age, lower educational level, empty nesters, higher level of self-perceived medical burden, abnormal body weight, physical inactivity, medication taking, increased number of clinic visit, undernutrition and poor sleep quality are associated with higher total score in the Comprehensive Frailty Assessment Instrument, indicating higher level of frailty. Multivariate multinomial logistic regression analysis exhibited similar findings but further captured female gender as a risk factor for the presence of mild and high frailty compared with no-low frailty. CONCLUSION: The prevalence of the comprehensive frailty and frailty in the physiological, psychological, social and environmental domains is high. A variety of social-demographic, health-related and behavioural factors were associated with the comprehensive frailty. Further investigations on frailty prevalence and its associated factors based on comprehensive assessments are desirable.

Sensitive and Label-free Detection of Bacteria in Osteomyelitis through Exo III-Assisted Cascade Signal Amplification.

Rapid and sensitive pathogenic bacterial identification and isolation from complicated clinical specimens are of great importance for the early diagnosis and prevention of osteomyelitis. Herein, we proposed a novel methicillin-resistant Staphylococcus aureus (MRSA) detection strategy through two specially designed streptavidin magnetic bead-based probes, including a capture probe and a report probe. In detail, the capture probe takes the responsibility to specially bind with the surface protein of MRSA and leads to the liberation of the promoter which could subsequently initiate report probe-based signal amplification. Afterward, the hybridization of the promoter probe with the report probe could then transform the protruding 3' terminus of template DNA in the report probe into a blunt end. With the assistance of Exo III, the template could be digested to liberate the promoter to form a recycle and to liberate the biprobe to induce the following rolling circle amplification (RCA)-based signal amplification. Through the integration of the Exo III-assisted recycle and RCA-based signal amplification, the proposed method exhibited a favorable detection performance.

TIPE1 function as a prognosis predictor and negative regulator of lung cancer.

TIPE1 (tumor necrosis factor-α-induced protein 8-like 1 or TNFAIP8L1) belongs to the TIPE (TNFAIP8) family, which act as a regulator of cell death. However, the expression and biologic functions of TIPE1 in lung cancer are largely unknown. Here, we investigated the roles of TIPE1 in lung cancer. Evaluated by qRT-PCR and immunohistochemical staining, lower TIPE1 mRNA and protein expression was found in the lung tumor tissue, compared with adjacent non-tumor tissues, which positively correlated with tumor patient survival. Overexpression of TIPE1 by lentivirus system in TIPE1-downregulated lung cancer cells significantly diminished cell growth and colony formation, companied with proliferation inhibition, apoptosis induction and invasion inhibition. It was identified to be due to TIPE1-regulated Cyclin D1, Cyclin B1, caspase 8, Caspase3, MM2 and MMP9 expression. Consistently, using a homograft tumor model in Balb/c mice, we discovered that TIPE1 prevented the growth and tumor weight of murine lung cancer homografts. Our findings revealed the anti-tumor role of TIPE1 in lung cancer cells and TIPE1 might be a novel prognostic indicator for lung cancer patients.

[Comparison the effects between anatomical locked plate in combination with coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of Neer II b distal clavicle fractures].

OBJECTIVE: To compare the therapeutic effects between anatomical locked plate combined with coracoclavicular ligament reconstruction and clavicular hook plate for treatment of distal clavicle fracture of Neer type II b. METHODS: From August 2010 to August 2013, 42 patients with Neer II b distal clavicle fractures were randomly divided into two groups as group A and group B. In group A, there were 22 cases including 14 males and 8 females with an average age of (44.2±11.6) years old. In group B, there were 20 cases including 11 males and 9 females with an average of (45.6±12.4) years old. The patients of group A were treated with anatomical locked plate combined with coracoclavicular ligament reconstruction,the patients of group B were treated with hook plate. All fractures were fresh, the time between injuries and operation was 24 hours to 7 days (mean,72 h). General information between the two groups was comparable before operation(P>0.05). Postoperative radiographic were followed up to observe the fracture healing,internal fixation and to measure coracoclavicular distance of two groups. Shoulder function after operation was evaluated by Constant-Murley score system. RESULTS: All patients were followed up with an average of 16.8 months (ranging 12 to 24 months). There was no nonunion,infection and other complications between two groups. The clavicular stress fracture occurred in 1 clavicular hook patient at 6 months after the operation. According to the Constant-Murley score system, that the scores of group A were 90.6±6.2, 91.8±4.8, 94.7±3.6 and 97.8±1.2 at 1st, 3rd, 6 month and last follow-up after operation were higher than those of group B 74.8±3.4, 78.4±4.4, 82.2±2.8 and 94.6±3.6 (P 0.05). The fracture healing time of group A (21.6±2.2) weeks was shorter than that of group B (25.8±2.5) weeks (P 0.05). There were no statistically significant differences between two groups in coracoclavicular distance at last follow-up (P>0.05). CONCLUSION: The anatomical locked plate combined with coracoclavicular ligament reconstruction need not expose shoulder and can reduce the incidence of postoperative pain and limited activity of shoulder, with fewer complication, it is advantageous to the shoulder joint function early recovery.

[Comparison of the relativity of MRI appearance of cartilage injuries and postoperative effect of arthroscope on articular cartilage disease of knee].

OBJECTIVE: To analyze the indication of arthroscope by examining the correlations between cartilage injury degree confirmed by MRI and postoperative effect. METHODS: From Aug. 2005 to April 2008, 87 cases with knee osteoarthritis were treated by arthroscopes including 44 males and 43 females,aged from 16 to 67 years (means 46.3 years). Arthrodial cartilage of knee was graded by ICRS MR, and the therapeutic effect was evaluated by Lysholm scoring. RESULTS: All 87 knees of 87 cases were followed-up for from 12 to 30 months (averaged 23 months). The cartilage injury degree of knees was graded as follows: grade 4 in 30 cases, grade 3 in 23 cases, grade 2 in 20 cases, grade 1 in 12 cases, grade 0 in 2 cases, means grade (2.770 +/- 1.138). Postoperative Lysholm score was from 59 to 100, means (95.170 +/- 7.556). Coefficient correlation (r) = -0.152, P = 0.159 > 0.05. Although the results had no correlations between cartilage injury degree and Lysholm score, negative correlation tendency existed. CONCLUSION: The patients with higher grade of knee cartilage injury degree confirmed by MRI (1.5T) have worse effect after operation, the grade is not a gold standard as a operation indication in arthroscopic procedure.

[Study on the correlation between knee osteoarthritis imaging and effects of arthroscope].

OBJECTIVE: To explore the indications of arthroscope for the treatment of knee osteoarthritis and investigate the correlation between knee osteoarthritis imaging and effects of arthroscope. METHODS: From 2005.8 to 2008.4, 86 patients with knee osteoarthritis underwent arthroscope examination and treatment. Among the patients, 44 patients were male, and 42 patients were female, ranging in age from 46 to 67 years, averaged 56.3 years. Arthrodial cartilage of knee was graded by ICRS MR, and by Kellgern Laqrence X-ray. All the patients were followed up, and the duration ranged from 12 to 30 months. The Lysholm score was evaluated at the follow-up time. RESULTS: Among 86 knees in 86 cases, cartilage injury degree of knees was graded as follows: grade 4 in 30 cases, grade 3 in 22 cases, grade 2 in 20 cases, grade 1 in 12 cases, grade 0 in 2 cases, mean grade (2.77 +/- 1.138). Postoperative Lysholm score ranged from 59 to 100, averaged (95.17 +/- 7.556), Kendall's correlation coefficient was -0.089, P = 0.317. There was no correlations between cartilage injury degree and Lysholm score. X-ray of knees was graded as follows: grade 4 in 0 cases, grade 3 in 24 cases, grade 2 in 38 cases, grade 1 in 17 cases, grade 0 in 7 cases, mean grade was (2.13 +/- 0.67), the Kendall's correlation coefficient was -0.851 with negative correlations (P = 0.036) between postoperative Lysholm score and K/L grade. CONCLUSION: There is no correlation between the grade of knee cartilage injury confirmed by MRI (1.5T) and effects of arthroscopy, and the grade is not a gold standard as an operation indication in arthroscope procedure. The K/L grade in X-ray had important effects.

[Suture menisci with epidural transfixion pin to treating acute meniscus tear under arthroscope].

OBJECTIVE: To study the utility and effect of suturing menisci with epidural transfixion pin to treating acute meniscus tear under arthroscope. METHODS: Twenty-two cases with acute meniscus tear were selected, in which 18 were male and 4 were female,aged from 17 to 42 years with average of 28.5. The tearing menisci were sutured with epidural transfixion pin and unabsorbed suture. The follow-up were 6-12 months after operation. Meanwhile, Lysholm score, subjective symptoms and examination were recorded. RESULTS: Preoperative Lysholm scores were 46.72 +/- 13.46, whereas, postoperative ones were 89.43 +/- 18.21. There was significant difference between before and after operation (t = 1.85, P < 0.01). No recurrent interlocking, no pain in joint medialis and post-medialis space. McMurray test was negative. The complications about injury of blood vessel, nerves and tendons were not found during 6-12 months follow-up. CONCLUSION: The technique is advantageous in convenience, reliability, large suture strength and definite curative effect.