Background: A considerable proportion of hypertensive patients may experience lacunar infarction. Therefore, early identification of the risk for lacunar infarction in hypertensive patients is particularly important. This study aimed to develop and validate a concise nomogram for predicting lacunar infarction in hypertensive patients. Methods: Retrospectively analyzed the clinical data of 314 patients with accurate history of hypertension in the Second Affiliated Hospital of Wannan Medical College from January 2021 to December 2022. All the patients were randomly assigned to the training set (n=220) and the validation set (n=94) with 7:3. The diagnosis of lacunar infarction in patients was confirmed using cranial CT or MRI. The independent risk factors of lacunar infarction were determined by Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analysis. The nomogram was built based on the independent risk factors. The nomogram's discrimination, calibration, and clinical usefulness were evaluated by receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA) analysis, respectively. Results: The incidence of lacunar infarction was 34.50% and 33.00% in the training and validation sets, respectively. Five independent predictors were made up of the nomogram, including age (OR=1.142, 95% CI: 1.089-1.198, P<0.001), diabetes mellitus (OR=3.058, 95% CI: 1.396-6.697, P=0.005), atrial fibrillation (OR=3.103, 95% CI: 1.328-7.250, P=0.009), duration of hypertension (OR=1.130, 95% CI: 1.045-1.222, P=0.002), and low-density lipoprotein (OR=2.147, 95% CI: 1.250-3.688, P=0.006). The discrimination with area under the curve (AUC) was 0.847 (95% CI: 0.789-0.905) in the training set and was a slight increase to 0.907 (95% CI: 0.838-0.976) in the validation set. The calibration curve showed high coherence between the predicted and actual probability of lacunar infarction. Moreover, the DCA analysis indicated that the nomogram had a higher overall net benefit of the threshold probability range in both two sets. Conclusion: Age, diabetes mellitus, atrial fibrillation, duration of hypertension, and low-density lipoprotein were significant predictors of lacunar infarction in hypertensive patients. The nomogram based on the clinical data was constructed, which was a useful visualized tool for clinicians to assess the risk of the lacunar infarction in hypertensive patients.

Objective Traumatic brain injury (TBI) is among the leading causes of death and disability globally. Identifying and assessing the risk of in-hospital mortality in traumatic brain injury patients at an early stage is challenging. This study aimed to develop a model for predicting in-hospital mortality in TBI patients using prehospital data from China. Methods We retrospectively included traumatic brain injury patients who sustained injuries due to external forces and were treated by pre-hospital emergency medical services (EMS) at a tertiary hospital. Data from the pre-hospital emergency database were analyzed, including demographics, trauma mechanisms, comorbidities, vital signs, clinical symptoms, and trauma scores. Eligible patients were randomly divided into a training set (241 cases) and a validation set (104 cases) at a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression were employed to identify independent risk factors. Analyzed the discrimination, calibration, and net benefit of the nomogram across both groups. Results :17.40% (42/241) of TBI patients died in the hospital in the training set, while 18.30% (19/104) in the validation set. After analysis, chest trauma (odds ratio [OR]=4.556, 95% confidence interval [CI]=1.861-11.152, P=0.001), vomiting (OR=2.944, 95%CI=1.194-7.258, P=0.019), systolic blood pressure (OR=0.939, 95%CI=0.913-0.966, P<0.001), SpO2 (OR=0.778, 95%CI=0.688-0.881, P<0.001), and heart rate (OR=1.046, 95%CI=1.015-1.078, P=0.003) were identified as independent risk factors for in-hospital mortality in TBI patients. The nomogram based on the five factors demonstrated well-predictive power, with an area under the curve (AUC) of 0.881 in the training set and 0.866 in the validation set. The calibration curve and decision curve analysis showed that the predictive model exhibited good consistency and covered a wide range of threshold probabilities in both sets. Conclusion :The nomogram based on prehospital data demonstrated well-predictive performance for in-hospital mortality in TBI patients, helping prehospital emergency physicians identify and assess severe TBI patients earlier, thereby improving the efficiency of prehospital emergency care.

Objective To evaluate the accuracy of the EDAN SA-10 oscillometric upper-arm professional office ambulatory blood pressure (BP) monitor in general population according to the Association for the Advancement of Medical Instrumentation (AAMI)/European Society of Hypertension (ESH)/International Organization for Standardization (ISO) Universal Standard (ISO 81060-2:2018). Methods Subjects were recruited according to the AAMI/ESH/ISO Universal Standard using the same arm sequential BP measurement method. Four cuffs of the test device were used for arm circumference 16–21.5 cm (extra small), 20.5–28 cm (small), 27–35 cm (medium), and 34–43 cm (large). Results A total of 105 subjects were recruited, and 97 subjects were included in the final analysis. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was −0.59 ± 4.04/−1.79 ± 4.39 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 3.10/3.80 mmHg (systolic/diastolic). Conclusion The EDAN SA-10 upper-arm ambulatory BP monitor has passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in general population and can be recommended for clinical use.

[Purpose] The aim of this study was to investigate the effects of balneotherapy on immunological parameters, trace metal elements and mood states in pilots. [Subjects] Thirty-six healthy male pilots were enrolled into this study. [Methods] All subjects received therapy for 3 weeks. They took entire-body immersion baths in thermomineral water for 30 min a day for 3 weeks. Blood samples were taken 1 day before and after the balneotherapy treatment. Blood concentrations of trace metal elements were measured using a BH5100 atomic absorption spectrometer. Blood serum concentrations of immunoglobulins and complements were measured with an automatic biochemical analyzer. The Profile of Mood States test was conducted to determine changes in mood states. [Results] After 3 weeks of balneotherapy, the concentrations of immunoglobulin A and complement component 4 increased significantly and the blood concentration of lead significantly decreased. The mood scores of tension-anxiety, anger-hostility, fatigue-inertia and confusion-bewilderment decreased. The mood score of vigor-activity significantly rose. [Conclusion] The findings indicate that balneotherapy over a 3-week period may exert a beneficial influence on the immune system and play an assistive role in improving the mood states of pilots.

[Purpose] The purpose of this study was to investigate the effects of balneotherapy on the cardiopulmonary function and physical capacity of pilots. [Subjects] Thirty-six healthy male pilots were recruited. [Methods] All subjects received entire-body immersion bath therapy in thermomineral water for 30 min a day for 21 days. Electrocardiograms, carotid pulse traces, and phonocardiograms were recorded using a cardiac function measuring device. Pulmonary function tests were performed using a Pony FX spirometer. The physical capacity of pilots was examined 1 day before and after balneotherapy. [Results] After 21 days of treatment, isovolumetric contraction time and the ratio of isovolumetric contraction time/left Ventricular ejection time were reduced. Forced vital capacity, peak expiratory flow, the ratio of forced expiratory volume in 1 second/forced expiratory volume and forced expiratory flow at 25-75% were elevated. The exercise numbers of pull-ups and sit-ups in 1 min were boosted. [Conclusion] The findings imply that balneotherapy for 21 days has a significant effect on the cardiopulmonary function and physical capacity of pilots.

A questionnaire survey was performed for the first time to assess the prevalence of visual symptoms and G-induced loss of consciousness (G-LOC) due to +Gz exposure in the Chinese Air Force (CAF) to determine the effectiveness of current G tolerance training. Responses were received from 594 individuals. Among them, 302 reported at least one episode of some sort of symptoms related to +Gz, including 110 (18.5%) with visual blurring, 231 (38.9%) with greyout, 111 (18.7%) with blackout, and 49 (8.2%) with G-LOC. Incidences were most common in aircrew with 250-1,000 flying hours (53.6%) and were more prevalent in those with fewer on type flying hours (p < 0.001). The most common situation was reported between +5 and 5.9 Gz. The results indicate a fairly high prevalence of visual symptoms and G-LOC among Chinese Air Force aircrew. There remains considerable scope for +Gz education, particularly in the early centrifuge training and selection of rational physical exercises.

BACKGROUND: One of the basic functions of bone is its adaptation to mechanical loading environment. Bone cells are the mechanosensitive cells in bone tissue. However, the mechanisms by which mechanical signals are transduced to chemical signals that influence bone growth and metabolism remain unidentified.OBJECTIVE: To understand the mechanotransduction pathways in osteoblasts and osteocytes, and to provide a theoretical basis for further study. METHODS: PubMed database was retrieved by computer with key words of "osteoblast, osteocyte, bone cells, mechanical stress". According to inclusion criteria, 69 articles were included to summarize the transduction of mechanical signals of bone cells. RESULTS AND CONCLUSION: One of the basic functions of bone is its adaptation to mechanical loading environment. Bone cells are mechanosensitive cells. However, how the transduction of mechanical signals of cells realizes and how regulates skeleton remain poorly understood. Studies confirmed that due to the construction features and cell location of skeleton, osteoblasts and osteocytes are the most important mechanosensitive cells in bone tissue. The process of mechanotransduction can be divided into four distinct steps: ① mechanocoupling; ② biochemical coupling; ③ signal transmission; ④ effector response of bone cells. Through these four steps, the loads acting on the bones are transduced into biochemical signals, and then change the function of bone cells, finally induce the changes of bone structures to adapt the mechanical environment. The regulatory mechanisms of mechanical signals in bone marrow mesenchymal stem cells require further investigation.

BACKGROUND:Musculoskeletal and cardiovascular deconditioning occurring in long-term spaceflight gives rise to the needs to develop new strategies to counteract these adverse effects. Short-arm centrifuge combined with ergometer has been proposed as a strategy to counteract adverse effects of microgravity. This study sought to investigate whether the combination of short-arm centrifuge and aerobic exercise training have advantages over short-arm centrifuge or aerobic exercise training alone.MATERIAL/METHODS:One week training was conducted by 24 healthy men. They were randomly divided into 3 groups: (1) short-arm centrifuge training, (2) aerobic exercise training, 40 W, and (3) combined short-arm centrifuge and aerobic exercise training. Before and after training, the cardiac pump function represented by stroke volume, cardiac output, left ventricular ejection time, and total peripheral resistance was evaluated. Variability of heart rate and systolic blood pressure were determined by spectral analysis. Physical working capacity was surveyed by near maximal physical working capacity test.RESULTS:The 1-week combined short-arm centrifuge and aerobic exercise training remarkably ameliorated the cardiac pump function and enhanced vasomotor sympathetic nerve modulation and improved physical working capacity by 10.9% (P<.05, n=8). In contrast, neither the short-arm centrifuge nor the aerobic exercise group showed improvements in these functions.CONCLUSIONS:These results demonstrate that combined short-arm centrifuge and aerobic exercise training has advantages over short-arm centrifuge or aerobic exercise training alone in influencing several physiologically important cardiovascular functions in humans. The combination of short-arm centrifuge and aerobic exercise offers a promising countermeasure to microgravity.

OBJECTIVE:To investigate the effect of BMP-2 on (the) gene expression of rat osteosarcoma cells (ROS17/2.8) under rotating clinostat simulated weightlessness.METHOD:ROS17/2.8 cells were cultivated in 1 G control and rotating clinostat simulated weightlessness with 500 ng/ml BMP-2 in the culture medium. Total RNA in cells was isolated after 24, 48 and 72 h. Reverse transcription PCR analysis was made to examine the gene expression of alpha 1 chain of type I collagen (collagen I alpha 1) and alkaline phosphatase (ALP).RESULT:The expression of COL-I alpha 1 mRNA induced by BMP-2 was much more than that without BMP-2 in 24 h and 48 h group (P<0.01). The level of ALP mRNA induced by BMP-2 was significantly high in 48 h or 72 h group (respectively P<0.01, P<0.05). The level of BMP-2 induced expression of COL-I alpha 1 mRNA was significantly lower under 48 h of simulated weightlessness than in 1 G condition (P<0.01). The level of ALP mRNA was significantly lower under simulated weightlessness for 48 h or 72 h (P<0.01).CONCLUSION:BMP-2 can stimulate the differentiation of ROS17/2.8 cells in 1 G condition and this process is reduced under simulated weightlessness.