Objective To observe the effect of Salvia TMP on the therapeutic, blood lipids, inflammatory cytokines and cardiac function in treatment of patients with unstable angina pectoris ( UAP) .Methods Eighty cases of patients with UAP treated in the hospital from May 2013 to May 2015 were selected and randomly divided into control group and observation group ,40 patients in each group.The control group received routine medical treatment,observation group supplemented Salvia TMP injection on the basis of conventional therapy.After two weeks for a course of treatment, the difference between the two groups of patients on therapeutic,blood lipid,inflammatory cytokines and cardiac function related indicators were compared. Results Compared with control group post-treatment, the symptom control and ECG effective rate of observation group were significantly higher (χ2 =8.658,P=0.026), the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C),TC/high-density lipoprotein cholesterol(HDL-C) and LDL-C /HDL-C in observation group were lower(P<0.05),the level of HDL-C was higher(P<0.05), the levels of interleukin-6(IL-6), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) in observation group were significantly lower (P<0.05), the levels of stroke volume (SV), left ventricular systolic pressure (LVSP) and left ventricular ejection fraction (LVEF)were higher(P<0.05), the levels of N-terminal pro-brain natriurelic peptide (NT-proBNP) and cardiac troponin I (cTnI) were lower (P<0.05).Conclusion Salvia TMP injection could effectively regulate blood lipids in patients with UAP,control inflammation cytokines and promote the recovery of cardiac function , which has a good role in improving the symptoms of angina patients,promoting the recovery of disease.

Objective To construct a scientific and feasible evaluation indicator system of health education effect of our country′s hospitalized patients with diabetes. Methods On the basis of literature review and semi-structured interview combined with group discussion, alternative index system were determined,and then the Delphi method were used for two round consultation with 30 diabetes experts to finally determine indicator evaluation system. Results Positive coefficient of the two rounds consultation were 86.7% (26/30) and 100.0% (26/26) respectively, experts′ authority coefficient was 0.889,and the Kendall W coefficients of concordance were 0.447,0.369 and 0.302 respectively (P<0.01). The evaluation indicator system of health education effect was consisted of 6 fisrt-level indicators, 24 second-level indicators and 55 third-level indicators. Conclusions The evaluation indicator system of health education effect is reliable and scientific, which can provide objective and quantitative standards for health education effect of hospitalized patients with diabetes in our country.

Objective:To investigate the relationship between different obesity metabolic phenotypes and the incidence of new carotid artery plaque.Methods:The present study is a retrospective cohort study, collecting individuals from the Health Management Center of the Second Affiliated Hospital of Dalian Medical University who had two or more cervical vascular color ultrasound examinations and met the inclusion criteria from 2014 to 2022, and collected their baseline clinical data. According to whether the subjects were obese and had metabolic syndrome, they were divided into metabolically healthy non-obese group, metabolically unhealthy non-obese group, metabolically healthy obese group, and metabolically unhealthy obese group. The first physical examination time of the subjects was taken as the starting point of follow-up, and cervical vascular color ultrasound was performed during the follow-up physical examination, with the outcome event being carotid artery plaque. Kaplan-Meier survival curve analysis was used to analyze the cumulative incidence of carotid artery plaques in the four groups and log-rank test was performed, and a multifactorial Cox proportional hazards model was used to analyze the relationship between different obesity metabolic phenotypes and the risk of carotid artery plaque incidence.Results:A total of 4 890 subjects were enrolled, aged (45.4±9.6) years, and 2 754 (56.3%) males. The follow-up time was 1.14(0.93, 2.20) years. Compared with the other 3 obesity metabolic phenotypes, the incidence of carotid plaques in the metabolically unhealthy obesity group was the highest (15.4% (286/1 861)). Kaplan-Meier survival curve analysis showed that the cumulative incidence of carotid plaques in metabolically unhealthy obese subjects was about 2.962 times that of metabolically healthy non-obese subjects (log-rank P<0.001). Multivariate Cox regression results showed that the risk of carotid plaque in metabolically unhealthy obese subjects was 1.650 times that of metabolically healthy non-obese subjects (95% CI: 1.203-2.264, P=0.002). Conclusion:Metabolically unhealthy obesity phenotype is an independent risk factor for carotid plaque.

Objective:To investigate the relationship between obesity and incident chronic kidney disease(CKD) in a population undergoing health check-ups.Methods:This is a retrospective cohort study. A total of 31 251 participants who had at least 2 health physical examinations in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University from January 2017 to December 2022 and met the inclusion criteria were selected. The participants were divided into normal body weight group, overweight group, and obese group according to baseline body mass index. Cox proportional hazard regression model was used to analyze the relationship between obesity and new-onset CKD, and the dose-response relationship between body mass index and CKD was analyzed with restricted cubic splines.Results:Multivariate Cox regression analysis showed that the risk of developing CKD increased by 13%( HR=1.13, 95% CI 1.01-1.25) and 55%( HR=1.55, 95% CI 1.36-1.76) in the overweight and obese group compared to the normal weight group. Subgroup analysis indicated that obese women had a higher risk of developing CKD compared to men. There was a " U-shaped" correlation between body mass index and CKD in male population, with the lowest risk of CKD occurring at body mass index of 19.6-24.2 kg/m 2. In women, the relationship between body mass index and CKD was approximately linear, with the risk of CKD gradually increasing when body mass index exceeded 22.5 kg/m 2. Conclusions:Obesity is an independent risk factor for new-onset CKD, and obese women have a higher risk of developing CKD than men. Regarding CKD prevention, men are advised to maintain a higher level of body weight within the normal range of body mass index, while women are encouraged to control their weight to a lower level within the normal body mass index range.

Objective:To explore the correlation between systemic immunity-inflammation index(SII) and hyperuricemia(HUA).Methods:Participants who had at least 3 health checkups in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University from January 2014 to December 2022 were selected to construct a dynamic cohort. The SII, reflecting the inflammatory state of the body, was constructed using neutrophil, platelet, and lymphocyte counts. A Cox proportional hazard regression model was used to explore the association between SII and HUA in the overall population and different subgroups of the population, and sensitivity analysis was performed twice. Results:A total of 20 022 subjects were included, and the mean follow-up time was 3.67 years. After adjusting for confounding factors, each unit increase in the natural logarithm of SII(lnSII) was associated with a 24% increased risk of hyperuricemia( HR=1.24, 95% CI 1.16-1.32, P<0.001). As a categorical variable, compared with the lowest quartile array( Q1), the risk of HUA in the total population increased by 12%( HR=1.12, 95% CI 1.03-1.21, P=0.006), 14%( HR=1.14, 95% CI 1.06-1.24, P=0.001), 27%( HR=1.27, 95% CI 1.17-1.37, P<0.001) in Q2, Q3 and Q4 groups within the general population, respectively. All subgroup analysis and sensitivity analysis showed that SII was positively correlated with HUA. Conclusions:Elevated levels of SII significantly increase the risk of HUA. Assessing the body′s inflammatory status using SII can aid in risk screening and preventive management for individuals at high risk of HUA.

Acute Stanford type A aortic dissection with important branches involved is more complex, could lead to organ malperfusion syndrome even organ failure. The understanding of pathological anatomy, classification, staging, and the pathophysiological change has increasingly mature, but not complete. In addition, the treatment strategy for complex lesions is diversified, some questions may not reach consensus. Fully understanding of the anatomical and pathophysiology is very important for surgeons to choose reasonable treatment strategy. As the rapid development of the basic research, imaging techniques and the concept of surgery procedures, the manage technique of Stanfrod type A dissection and branch vessels at the same time is getting seriously, the related issues also need further discussions.

Objective:To explore the application status and trends of the health examination data.Methods:Relevant literatures on health examination data were retrieved from Web of Science from 1 January 2007 to 30 June 2022 and China Knowledge Network Infrastructure from 1 January 1992 to 30 June 2022; and the literature and research contents were visually analyzed by using CiteSpace 6.1 bibliometrics software.Results:Total of 5 517 Chinese articles and 18 563 English articles were selected. The publication volume of health examination data in China increased year by year since 1992, and the international publication volume also showed an increasing trend. The Chinese literature focused on health management, osteoporosis, overweight, and physical examination subjects such as pilots, while the English literature focused on the study of obesity, care and functional cognition after the formation of a cohort of physical examination data. More co-citation papers related to health examination data were published in the journals from developed countries mainly in the United States and the United Kingdom, and the contents of the co-cited journals highly covered disease research on chronic diseases, such as cardiovascular disease, functional cognition and rehabilitation.Conclusions:The number of articles published on health examination data is increasing year by year, and in the future, more studies will use big data algorithms such as machine learning to measure the association between the risk of chronic diseases and related influencing factors.

Objective:To assess the effects of intervention measures on the quality control of health examination institutions in Dalian City.Methods:This cross-sectional study encompassed a comprehensive evaluation of 40 physical examination institutions in Dalian City. Interrupted time series analysis was employed to examine the changes in level and slope of processing rates for significant abnormal health examination results, chief inspection physician qualification rates, and completion rates of basic health examination items before (January 2020 to July 2021) and after (August 2021 to July 2022) intervention. An interrupted time series analysis diagram was generated.Results:After the implementation of intervention measures, the processing rate of significant abnormal results in public physical examination institutions reached 93.52%, while the qualification rate of chief inspection physicians was as high as 98.86%. And completion rate of basic health examination items was 93.86%. The rates of handling important abnormal results in health check-ups at private healthcare institutions before intervention, 1 month after intervention, and long-term intervention showed an upward trend of 1.374%, 0.229%, and 0.664%, respectively ( t=8.61, 12.21, and 108.61, all P<0.05). The qualification rate of chief inspection physicians in public physical examination institutions exhibited an increase of 0.227% and 0.155% before and after the intervention respectively ( t=6.74 and 617.67, all P<0.05). The completion rates of basic health check-up items in public healthcare institutions showed an upward trend before intervention, 1 month after intervention, and long-term intervention, with a rate of 0.446%, 0.067%, and 0.745%, respectively ( t=24.95, 3.25, 138.80, all P<0.05). Conclusions:The implementation of quality control intervention measures for health check-ups has significantly improved the quality control of health examination institutions in Dalian City.

Objective:To establish an integrated model with KANO model and quality function deployment theory to determine the priority of measures in improving the quality of physical examination service.Methods:It was a cross-sectional study. A total of 196 physical examinees from the Health Management Center of the second affiliated Hospital of Dalian Medical University were selected by simple random sampling. Reliability test was used to analyze the reliability and validity of the questionnaire. KANO model was used to determine the importance of physical examination needs in health examination population. The quality function deployment model was used to create the house of quality and determine the priority of the importance of various service measures.Results:In the high important attribute requirements of physical examination, the final importance of emergency ability, outpatient time, professional and advanced equipment are 0.054, 0.052, 0.047 and 0.046 respectively. The measures that needed to be given priority to improve the quality of physical examination services were to improve the quality of medical services (absolute importance=107.5), strengthen skill assessment (absolute importance=70.1), define guidance, consultation and clinic identification (absolute importance=56.2), introduce advanced equipment and facilities (absolute importance=53.7), timely and accurate physical examination report (absolute importance=51.9) and interpretation of physical examination report (absolute importance=50.9).Conclusions:The physical examination center should give priority to the measures such as improving the medical level, strengthening the skill examination, introducing advanced equipment and facilities, defining the guidance of examination, consultation and consultation room identification, and strengthening service management.

Objective:To explore the correlation between changing trajectories of serum uric acid and the onset of nonalcoholic fatty liver disease (NAFLD).Methods:A longitudinal cohort study. Total of 3 353 subjects who had routine health examination every year from January 2017 to December 2019 in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University and met the inclusion criteria were selected as the research subjects. Four different serum uric acid trajectory groups were determined by using the group-based trajectory model: the low stability group, medium stability group, medium-high stability group and high stability group. During the follow-up to December 2021, the differences in cumulative incidence of NAFLD in different serum uric acid trajectory groups were calculated and compared. Cox proportional hazard regression model was used to evaluate the hazard ratio ( HR) and 95% confidence interval ( CI) of the NAFLD onset in different serum uric acid trajectory groups. The dose-response relationship between baseline serum uric acid and NAFLD was evaluated by a restricted cubic spline regression model. Results:The cumulative incidence of NAFLD in two years was 10.77%, and the cumulative incidence increased with the rising trajectory of serum uric acid, it was the highestin the high stability group ( P<0.05). Compared that in the low stability group, the risk of NAFLD in the other three groups was as follows: 2.24 (95% CI: 1.59-3.14) in the medium stability group, 2.89 (95% CI: 1.92-4.33) in the medium-high stability group and 4.55 (95% CI:2.83-7.31) in the high stability group (all P<0.05). The risk of NAFLD gradually increased with the rising of serum uric acid level, and the cut-off value of serum uric acid for women and men was 260.32 μmol/L and 365.09 μmol/L, respectively. Conclusions:Long-term moderate and high levels of serum uric acid are independent risk factors for the occurrence of NAFLD. With the rising of serum uric acid trajectory, the risk of NAFLD increases. Attention should be paid to the longitudinal change trend of serum uric acid level in the prevention of NAFLD, and it should be controlled within lower level of the normal range.