ObjectiveTo analyze the dead reasons in treatment of acute myocardial infarction (AMI) by emergent percutaneous coronary intervention (EPCI) during perioperation. Methods The clinical characteristics of the dead patients,results of EPCI and reasons of death were retrospectively analyzed in 473 patients with AMI who received EPCI treatment during March 2004 to March 2011. ResultsAmong the 18 cases(3.8％)dead patients,there were 8 case with three-vessel lesions,5 cases with two-vessel lesions, 2 cases with single vessel lesion and 3 cases with left main lesion. Nine patients were accompanied with hypertensions,5 cases with diabetes mellitus, 1 case with old myocardial infarction, 2 cases with old cerebral infarction, 1 case with chronic obstructive pulmonary disease complicated by severe pneumonia, and 1 case with chronic renal insufficiency. Nine patients died of cardiogenic shocks , 4 cases (22. 2％) of heart ruptures, 2 cases (11.1％) of noreflow,1 case (5.6％) of massive hemorrhage of the upper alimentary tract, 1 case (5.6％) of respiratory failure and 1 cases (5.6％) of refractory ventricular fibrillation.ConclusionsPrimary reasons for perioperative death were cardiac shock and heart rupture in treatment of acute myocardial infarction by EPCI. Multi-vessel lesion, complications with hypertensions and diabetes mellitus may serve as succumbed factors of death.

Objective To assess the risk of malnutrition in elder home-care patients through mini nutritional assessment (MNA) and study the correlations between total MNA score and 18 individual questions in this patient group.Methods In May 2011,62 elder home-care patients from our center answered the MNA questionnaire.And the results were used to analyze the correlations between total MNA score and individual questions and the correlations among MNA classifications and body mass index(BMI),mid-arm muscle circumference (MAMC) and calf circunference (CC).Results According to MNA,18％ were malnourished ( 11/62 ),47％ at risk of malnutrition ( 29/62 ) and 35％ well-nourished ( 22/62 ) ; BMI,independence,mobility,neuropsychological problems,ingesting method,MAMC,CC and selfperceived nutritional status,self-perceived health status showed strong correlations with total MNA score (0.601,0.600,0.666,0.611,0.627,0.618,0.726,0.612,0.672,P ＜0.05).And weight loss within a month,number of daily meals and intake of drinks showed weak correlations with total MNA score (0.35,0.319,0.288,P ＜ 0.05 ).Positive correlations existed among MNA classifications and BMI,MAMC,CC (15.45,19.85,31.89,P＜0.05).Conclusions The elder home-care patients have a high risk for malnutrition.Half of 18 individual questions are strongly correlated with total MNA score in this patient group.

Abstract: Objective To evaluate the impact of meningococcal vaccine immunization on the incidence of meningococcal meningitis, aiming to refine the local immunization strategies and programs. Methods Data on the reported incidence of meningococcal meningitis in Hebei province for 1970-2023 were collected, and interrupted time-series( ITS) analysis was used to quantitatively analyze the levels and slope change of the incidence of meningococcal meningitis before and after vaccine immunization and before and after inclusion in the Expanded Program on Immunization (EPI). Results The annual average reported incidences of meningococcal meningitis in Hebei province before vaccination (1970-1979), before (1980-2007) and after (2008-2023) the inclusion of the vaccine in the EPI were respectively 20.79 per 100 000, 1.66 per 100 000, and 0.018 per 100 000. The interrupted time-series analysis from 1970 to 2023 showed an initial meningitis incidence rate of 24.12 per 100 000 (t=9.86, P<0.05), with an average annual decrease of 1.07 per 100 000 (t=-2.42, P<0.05). After the introduction of the meningococcal vaccine in 1980, the incidence of meningococcal meningitis decreased quickly with an annual average decline of 18.39 per 100 000, showing a significant short-term intervention effect (t=-2.70, P<0.05); however, the rate of decrease slowed over the long term to 0.13 per 100 000, with the long-term intervention effect not being significant (P>0.05). And the incidence was significantly increased due to the outbreak (t=7.80, P<0.05). From 1980 to 2023, the initial level of incidence was 5.13 per 100 000 (t=8.70, P<0.05), and decreased by 0.23/100 000 per year on average (t=-6.42, P<0.05). After the inclusion of the vaccine in the EPI in 2008, the rate of decrease further slowed down to an average of 0.008 per 100,000 per year, with the long-term intervention effect being significant (t=2.50, P<0.05); the impact of epidemic outbreaks on incidence during this period was not statistically significant (P>0.05). Conclusions Meningococcal meningitis vaccination has led to a general downward trend in the incidence of meningitis in Hebei Province, and has flattened the trend of increased incidence caused by outbreaks. Therefore, long-term maintenance in immunization programs on the meningococcal meningitis is necessary. In addition, it is important to strengthen the monitoring of the distribution of epidemic serogroups in patients and healthy carriers, and to adjust immunization strategies timely based on changes in bacterial populations, selecting and promoting vaccines accordingly for the prevalent strains.

Objective:To identify differentially expressed proteins related with malignant transformation of esophageal squamous cell carcinoma (ESCC) using proteomic analysis. Methods:Two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization timE-of flight mass spectrometry (MALDI-TOF-MS) in combination with protein database searching were used to determine and identify differentially expressed proteins in esophageal cancer cell lines (EC1, EC18, and EC109) and immortal cell line (NECA-E6E7-hTERT). Western blotting and immunocytochemistry were used to verify the differential expression of annexin 2 in esophageal cancer cell lines and immortal cell line (NECA-E6E7-hTERT). Real-time fluorogentic quantitative PCR(RFQ-PCR) was performed to analyze the expression level of annexin A2 mRNA.Results: A total of 15 differentially expressed proteins were identified with more than 5 folds difference. Among them three proteins were down-regulated and 12 proteins were up-regulated. Western blotting and immunocytochemical analysis verified the down-regulation of annexin A2 protein in ESCC cell lines. However, differential expression pattern of annexin A2 mRNA was not consistant with its protein expression in ESCC cell lines and immortal cell line (NECA-E6E7-hTERT). Conclusion:The findings provide important clues for identifying the candidate biomarkers for high-risk population screening and early diagnosis of ESCC. Post-translative regulation/modification contributes to the down-regulation of annexin A2 protein.

Stroke is one of the main causes of mortality, long-term physical and cognitive impairment in China. In order to meet the challenge, Stroke Prevention and Treatment Project of the National Health Commission(SPTPC) was established in April 2011 in the Ministry of Health. In 2016, SPTPC issued a work plan of stroke center hospital. In order to shorten the time of pre-hospital, the SPTPC established the stroke center network, stroke map and stroke green channel to create "the three 1-hour gold rescue circle" to form a hierarchical stroke diagnosis and treatment system. The current construction of the Chinese Stroke Center is divided into two levels and four layers. As of December 31, 2018, SPTPC has certified a total of 310 advanced stroke centers, including 30 demonstration advanced stroke centers and 280 advanced stroke centers, and 127 stroke prevention centers, including 85 demonstration stroke prevention centers and 42 stroke prevention centers. The median time from admission to intravenous thrombolysis (DNT) at the advanced stroke center was decreased by 13.2% (53 min vs. 46 min) in the fourth quarter of 2018 as compared with that in the first quarter of 2017.The national thrombolytic rate of acute ischemic stroke was increased 3.24 times (1.78% vs. 0.42%) in 2017 compared that in 2010. In the next step, SPTPC will vigorously promote the construction of stroke centers and graded diagnosis and treatment mechanisms, consolidate quality control and standardization, increase the scope of influence of mobile stroke and remote diagnosis and treatment, and further improve the construction of stroke center systems with Chinese characteristics.

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Objective? To explore the effects of nursing project management on reducing the incidence of red buttock in neonates. Methods? The data of 289 neonates hospitalized in Peking University Third Hospital between February and April 2018 were collected as the control group by convenient sampling. The causes of red buttock were identified, and targeted measured were developed for continuous quality improvement. Another 333 neonates hospitalized from June to August 2018 were selected as the treatment group, who received nursing care using the nursing project. The incidence rate of red buttock was compared between the two groups. Results? After the nursing project was implemented, the incidence rate of red buttock was reduced from 13.15%(38/289) in the control group to 4.50% (15/333) in the treatment group, and there was statistically significant difference between the two groups (P＜0.01). There was no III red buttock in the treatment group. Conclusions? The nursing project enables the nurses to have a better command of the knowledge about red buttock in neonates, empowers them to pay attention to and prevent red buttock in neonates, improves their standardized operations and level of expertise, enhances the neonates' comfort, and promotes the quality of nursing service in neonatal wards.

Objective To explore the situation as well as influence factors of life quality situation of soldiers of the field operations and to provide evidence for its improvement .Methods Cluster random sampling was taken .A total of 616 soldiers from North China , Central China and Southern part of China were investigated by WHOQOL-BREF(Chinese version) and Perceived Social Support Scale (PSSS).Database was established on Epidata 3.0 and was analyzed using SPSS 20.0.Results Informants got an average score of ( 57.99 ± 8.62) points in life quality, with the scores in psychology and social relationship field exceeding and in environmental field being inferior to those of the national norm (t=8.609,7.609,12.898;P<0.01).Difference of investigators with different education background and from family of different income were significant ( t=2.501, 3.373;P<0.01).Soldiers social support had an average score of (63.14 ±11.40)points;each domain of quality of life and dimensions of social support were positively correlated (r>0.3,P<0.01).Conclusions The general life quality of soldiers of the field operations is satisfactory .Education background , family income , and social support are crucial influence factors on life quality of soldiers .Quality of life is closely associated with social support .To advance social support , especially support from others is the key action to improve their life quality .

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.