Objective To clarify the effec.t of smoking and related factors in symptomatic osteoarthritis disease,and explore the method to analyze the osteoarthritis (OA) risks.Methods Based on the investigation of 7 126 rural residents in Shanxi province,according to whether patients had related factors of symptomatic osteoarthritis in longitudinal axis arthrosis,the single factor and multiple factors logistic regression analysis were adopted to reveal the interaction between risk factors,and the interaction on multiplicative scale and the interaction on additive scale were both analyzed;interaction on multiplicative scale was estimated by OR,the interaction on additive scale was estimated by the relative excess risk due to interact (RERI),the attributableproportion due to interaction (AP),and the synergy index (S).Results The survey included 7 126 residents,in which 1 480 cases osteoarthritis patients in vertical axis joint with the prevalence of 20.8％.By multiple logistic regression analysis,the whole samples by enter level 0.05 level was stepwisely filtered.The results showed that gender,body mass inlex (BMI),smoking,age,heatable adobe,picky eater,working under coal mine were main influencing factors for the symptomatic arthritis.Balance other influence factors,passive smoking had an effect on arthritis.Aftcr adjusting for weight,smoking was not included in the final model.In the stratified interaction analysis,there was interaction on multiplicative scale between smoking and weight (OR=0.32,P=0.03),and the interaction on additive scale between passive smoking and gender or weight exists [RERI (95％CI) 0.41 (0.01,0.81)＞0,AP(95％CI) 0.25(0.01,0.51)＞0,S=3.04＞ 1].Conclusion The influence of smoking on osteoarthritis is so weak that it could not be a risk factor and its influence on osteoarthritis is initiated via body.

Globally, individuals with chronic diseases now consume over 80% of all healthcare resources. Set against this depressing projection is decades of epidemiologic work demonstrating that 80%-90% of cardiovascular disease can be prevented via lifestyle and dietary interventions. How can we reconcile such contrasting views toward the future of cardiovascular health in human populations? Herein, we review available sources of evidence that can be used to answer these challenging questions of how and why. In particular, we submit that analytical framework incorporating the 6P (prediction, precision, personalization, prevention, population, and policy)-3G (good food, good environment, and good behavior)-4I (interpretation, integration, implementation, and innovation) will allow us to focus resource towards the development of multi-level approaches for the betterment of population

Objective To investigate the factor that affecting the prevalence of osteoarthritis in rural areas of Shanxi, China. Methods All the residents above 16-year-old from the villages chosen by multi-stage stratified cluster sampling in Yangcheng County and Pianguan County in Shanxi Province were investigated by COPCORD procedure of WHO. All respondents signed the informed consent forms. Chi-square test and multivariable logistic regression analysis were used for the risk factor analysis. Results Seven thousand one hundred and twenty-six permanent residents in the two counties were investigated, of which 1734 cases of patients with osteoarthritis were identified. Take with or without osteoarthritis as response variables, statistically significant variables in the univariate analysis were substituted into the logistic regression model. Forward method was used for the variable selection. The inclusion criteria set as 0.10. The results showed that, age, room heating and ventilation, marital status, occupation, education, engaged in coal mine work, accompanied cardiovascular disease were the risk factors for osteoarthritis disease. Conclusion There were many factors that affect the prevalence of osteoarthritis in Shanxi rural communities, in which lifestyle may play an important role. Early intervention on risk factors may have a significant effect on reducing the prevalence.

Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients.
Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording.
Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P<0.001), 24-hour mean pulse pressure (r=0.504, P<0.001) , nocturnal diastolic blood pressure dipping (r=-0.334, P<0.001) and standard deviation of 24-hour diastolic blood pressure (r=-0.520, P<0.001).③AASI in anti-dipper hypertensive patients was higher than that in dipper patients, P<0.05;while AASI between dipper and non-dipper patients, dipper and extreme-dipper patients were similar, P>0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P<0.001), nocturnal diastolic blood pressure dipping (β=-0.001, P<0.05), standard deviations of 24-hour systolic blood pressure (β=0.032, P<0.001) and 24-hour diastolic blood pressure (β=-0.064, P<0.001), standard deviation of 24-hour heart rate (β=0.006, P<0.001).
Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.

Objective:To analyze the clinical and laboratory features of patients with Coronavirus Disease 2019(COVID-19), for providing reference for the diagnosis and treatment of the disease.Methods:The clinical data of 72 patients confirmed as COVID-19 in Qishan hospital during January 23, 2020 to February 13, 2020 were collected. The data included the general information, clinical manifestations, laboratory tests and CT findings of the lungs. According to the severity of the disease, the patients were divided into the non-severe group and the severe group, and the laboratory tests characteristics of the two groups were compared. SPSS 22.0 statistical software was used for data analysis.Results:In the 72 patients, 40 were males and 32 females, the average age was (46.0±14.8) years. The main clinical manifestations were fever (84.7%) and cough (77.8%). Among them, 45 cases (62.5%) had expectoration with a small amount of white sticky sputum. The main laboratory results showed that lymphocyte count decreased in 26 cases (36.1%), the absolute number of T lymphocytes decreased in 18 cases (25.0%), CD4 + T cell count decreased in 8 cases (11.1%), CD8 + T cell count decreased in 14 cases (19.4%), ESR increased in 42 cases (58.3%), and CRP increased in 31 cases (43.1%). Peripheral blood lymphocyte (L), albumin, CD4 + T cell, CD8 + T cell, T-lymphocyte in severe group (n=61) were lower than those in non-severe group (n=11), while C-reactive protein (CRP), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), fibrin (FIB), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH) in severe group were higher than those in non-severe group ( P<0.05). In 72 patients, the negative time of the twice nucleic acid detection from nasopharyngeal swabs and sputum specimens were (21.48±7.9) days and (27.79±7.4) days, there were significant differences between the two groups of specimens for two consecutive negative times ( t=-4.532, P=0.000). The main pulmonary imaging manifestations of COVID-19 patients: two lungs in 58 cases, patchy opacities in 51 cases and ground glass shadows in 61 cases. Conclusions:Most of the COVID-19 patients in Yantai and Weihai were common type. The abnormal T lymphocyte, subcohorte and other laboratory indicators may indicate that the patients are more serious.

Objective:This stndy aims to analyze the influence of ChatGPT on medical research and give suggestions on GhatGPT.Methods:This paper expounded the background of ChatGPT, analyze the connection between ChatGPT and medical research management, application and threats of ChatGPT , and gave suggestions to avoid GhatGPT′s damage.Results:Technology will promote the evolution of medical research management. It is recommended to strengthen the supervision of the ChatGPT and research integrity education.Conclusions:It is urgent to establish a scientific management mechanism to take usage the advantages of GhatGPT.

Objective:Combined with the hospital's optimization of expenditure management measures, this paper discusses how to enable scientific research personnel with appropriate discretion right to use scientific research funds and further improve the efficiency of the use of scientific research funds under the background of the reform of Release, manage and service.Methods:Through the implementation of information management system, policy revision, reconstruction of the approval process of expenditure, integration of multi department management resources and other ways, the efficiency of expenditure has been improved.Results:After optimizing the management of expenditure, the management efficiency and the efficiency of scientific research personnel is improved, the burden of scientific research personnel is reduced, and the expected effect of expenditure management is achieved.Conclusions:The optimization of expenditure management can improve the efficiency of expenditure to some extent, but more reform is still needed to promote the development of scientific research.

Objective:To prepare advanced platelet-rich fibrin (A-PRF)/chitosan thermosensitive hydrogel (hereinafter referred to as composite hydrogel) and explore the effects of composite hydrogel on full-thickness skin defect wound healing in diabetic rats.Methods:This study was an experimental study. The composite hydrogel with porous mesh structure and thermosensitive characteristics was successfully prepared, containing A-PRF with mass concentrations of 10, 15, 20, 50, and 100 g/L. Diabetic model was successfully established in male Sprague-Dawley rats aged 6-8 weeks by intraperitoneal injection of streptozotocin, and 4 full-thickness skin defect wounds were established on the back of each rat (finally the model was successfully established in 36 rats). Three wounds of each rat were divided into blank group (no drug intervention), positive control group (dropping recombinant human granulocyte-macrophage stimulating factor gel), and chitosan hydrogel group (dropping chitosan hydrogel solution). Thirty rats were collected, and the remaining one wound of each rat (totally 30 wounds) was divided into 10, 15, 20, 50, and 100 g/L composite hydrogel groups, with 6 wounds in each group, which were dropped with composite hydrogel solution containing 10, 15, 20, 50, and 100 g/L A-PRF, respectively. Taking the remaining six rats, the remaining one wound from each rat was dropped with composite hydrogel solution containing 100 g/L A-PRF. On 14 d after injury, 6 rats with one wound dropped with composite hydrogel containing 100 g/L A-PRF were selected for hematoxylin-eosin (HE) staining to observe the inflammation, hemorrhage, or necrosis of the heart, liver, spleen, lung, and kidney. On 10 d after injury, 6 rats with one wound dropped with composite hydrogel containing 15 g/L A-PRF were selected to observe the blood perfusion of wounds in the four groups (with sample size of 6). On 7 and 14 d after injury, the wound healing rates in the eight groups were calculated. On 14 d after injury, the wound tissue in the eight groups was taken for HE and Masson staining to observe the formation of new epithelium and collagen formation, respectively; the positive expressions of CD31 and vascular endothelial growth factor A (VEGFA) were detected by immunohistochemistry, and the percentages of positive areas were calculated; the protein expressions of CD31 and VEGFA were detected by Western blotting; the mRNA expressions of CD31 and VEGFA were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction method (with all sample sizes of 4).Results:On 14 d after injury, no obvious inflammation, hemorrhage, or necrosis was observed in the heart, liver, spleen, lung, and kidney in the 6 rats. On 10 d after injury, the blood perfusion volume of wound in 15 g/L composite hydrogel group was significantly more than that in blank group, positive control group, and chitosan hydrogel group, respectively (with P values all <0.05). On 7 and 14 d after injury, the wound healing rates of blank group were (26.0±8.9)% and (75.0±1.8)%, which were significantly lower than those of positive control group, chitosan hydrogel group, and 10, 15, 20, 50, and 100 g/L composite hydrogel groups, respectively ((45.8±3.2)%, (49.8±3.7)%, (51.2±2.9)%, (68.5±2.4)%, (68.8±1.5)%, (72.7±2.1)%, (75.0±3.7)% and (79.1±1.9)%, (77.2±1.7)%, (82.3±1.3)%, (89.6±1.9)%, (89.8±1.3)%, (87.3±1.1)%, (87.9±1.3)%), P<0.05; the wound healing rates of positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group were significantly lower than those of 15, 20, 50, and 100 g/L composite hydrogel groups ( P<0.05). On 14 d after injury, the wound epithelialization degrees of 15, 20, 50, and 100 g/L composite hydrogel groups were higher than those of the other 4 groups, the new microvascular situation was better, and the collagen was more abundant and arranged more neatly. On 14 d after injury, the percentages of CD31 and VEGFA positive areas in wounds in positive control group and the percentage of VEGFA positive area in wounds in chitosan hydrogel group were significantly higher than those in blank group ( P<0.05), the percentage of VEGFA positive area in wounds in 10 g/L composite hydrogel group was significantly higher than that in blank group, chitosan hydrogel group, and positive control group (with P values all <0.05), and the percentages of CD31 and VEGFA positive areas in wounds in 15, 20, 50, and 100 g/L composite hydrogel groups were significantly higher than those in blank group, positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group ( P<0.05). On 14 d after injury, the protein and mRNA expressions of CD31 and VEGFA in wound tissue in chitosan hydrogel group, positive control group, and 10 g/L composite hydrogel group were significantly higher than those in blank group ( P<0.05); the protein expression of VEGFA in wound tissue in 10 g/L composite hydrogel group was significantly higher than that in positive control group ( P<0.05), and the mRNA expressions of CD31 and VEGFA in wound tissue in 10 g/L composite hydrogel group were significantly higher than those in positive control group and chitosan hydrogel group ( P<0.05); the protein and mRNA expressions of CD31 and VEGFA in wound tissue in 15, 20, 50, and 100 g/L composite hydrogel groups were significantly higher than those in blank group, positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group ( P<0.05); the mRNA expressions of CD31 and VEGFA in wound tissue in chitosan hydrogel group were significantly lower than those in positive control group ( P<0.05). Conclusions:The composite hydrogel has high biological safety, can improve wound blood perfusion, effectively promote the formation of blood vessels and collagen in wound tissue, thus promoting the wound healing of full-thickness skin defects in diabetic rats. 15 g/L is the optimal mass concentration of A-PRF in composite hydrogel.

Objective:To construct a scientific research performance evaluation index system for specialized hospitals based on disciplinary development.Methods:Building a preliminary evaluation index framework of scientific research performance through literature review and expert consultation meetings, combined with the strategic goals of strengthening specialization and weakening generalization; Delphi method was adopted to conduct two rounds questionnaires survey to collect the importance scores for each index, which confirmed the content of the index system; finally, applied the analytic hierarchy process to calculate the weight coefficient of each index.Results:The responding rates of the two rounds questionnaire survey reached 95%, and the authoritative coefficients were 0.75 and 0.76, respectively. The research results were reliable. The coordination coefficients of all levels of the two surveys were greater than 0.1, according to the significance testing, the P values were less than 0.05, and the expert opinions were well coordinated. Finally, we developed a three-level scientific research performance evaluation system under the guidance of disciplinary development, which including 3 first-level indicators, 20 second-level indicators, as well as 56 third-level indicators. Conclusions:A scientific research performance evaluation system was constructed based on scientific theories. This system combined relevant indicators, such as the development of special disciplinary of specialized hospitals with scientific validity and operability. Besides, it could serve as a tool to evaluate the scientific research performance of specialized hospitals taking into account of the practical application value for guiding scientific research development and disciplinary improvement.

As the first cyclin-dependent kinases 4 and 6 inhibitors, palbociclib significantly improved the survival of the patients with the hormone receptor-positive and human epidermal growth factor receptor-2 negative breast cancer. Palbociclib is a crucial landmark in the development history of antineoplastic drugs. This article reviews the mechanism of palbociclib, and summarizes the clinical trials, side effects, and the application of palbociclib.