Objective Metabolic syndrome ( MS), a disorder involving multiple metabolic abnormalities such obesity,hypertension, diabetes or abnormal glucose tolerance and dyslipidemia, has been observed in many patients receiving coronary artery bypass procedures. In this study we try to examine the perioperative effects of metabolic syndrome on the off-pump coronary artery bypass (OPCABG). Methods A prospective study was conducted in 1060 consecutive OPCABG patients who were admited to Beijing Anzhen Hospital from July 2009 to March 2010. The patients were grouped as MS group and non-MS group according to the diagnostic criteria for Chinese metabolic syndrome. The outcomes such as mortality, atrial fibrillation,stroke, staying in ICU for more than three days, use of IABP, ECMO, dialysis, multiple organ dysfunction score ( MOOS) ,postoperative score for cardiac surgery (PSCS), PaO2/FiO2 , heart rate x central venous pressure/mean artery pressure(pressure-adjusted heart rate, PAHR) ,renal and liver function, platelets, and the dosage of vasoactive agents were analyzed and compared between the two groups by x2 test or t test. Results Three hundred and eighty-nine cases were diagnosed with MS among 1060 cases with OPCABG. In the MS group, 17 cases stayed in ICU for more than 3 days, 2 cases died, 76 had atrial fibrillation, 3 had stroke, 18 cases were treated with intra-aortic balloon counterpulsation (IABP). In the non-MS group, 47 cases stayed in ICU for more than 3 days, 12 cases died, 148 had atrial fibrillation, 3 had stroke, 48 cases were treated withIABP, 3 cases received ECMO and 4 cases received dialysis. No significant difference between MS group and non-MS group was identified in the aspects of mortality, atrial fibrillation, stroke, duration of more than three days in ICU, the use of IABP,ECMO, dialysis after OPACBG based on the x2 test(P＞0.05). However, on the operative days, the MODS and PSCS in MS group were significantly higher than that in non-MS group (P ＜ 0.05). MODS 2. 57 ± 1. 62 in MS group vs. 2. 15 ± 1.65 in non-MS group, PSCS 4.27 ±2.15 in MS group vs. 3.92 ±2.29 in non-MS group. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (249.23 ± 110.99 vs. 283. 33 ± 114. 35), P ＜ 0. 01. PAHR in MS group was significantly higher than that in non-MS group (9.98 ±3.54 vs. 9.23 ±3. 88), P ＜0.05. On the first postoperative days, the MODS in MS group was also significantly higher than that in non-MS group (3.05 ±1.64 vs. 2.82 ± 1.72), P＜0.05. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (277.11 ±122.99 vs.318.47 ±143.84), P＜0.05. Conclusion MS was not a predictor for death, atrial fibrillation, stroke, duration of more than three days in 1CU, the use of IABP, ECMO, dialysis after OPACBG. However, MS had a temporary adverse effect on the respiratory and circulatory systems on the operative day and the first postoperative day after OPCABG.

To evaluate the efficacy and safety of Tanreqing Injection, a compound traditional Chinese herbal medicine, for community-acquired pneumonia.

To evaluate the efficacy and safety of new drugs of traditional Chinese medicine (TCM) for acute upper respiratory tract infection (common cold).

Objective To investigate the effect of body mass index on early postoperative clinical outcomes following off-pump coronary artery bypass grafting. Methods A total of 1062 patients that received OPCABG in Beijing Anzhen Hospital were recorded continuously from January 2015 to May 2015. The patients were divided into normal weight group(n=360), overweight group(n=527) and obesity group(n=175) according to their body mass index. The following outcomes in the ear-ly postoperative period were compared among the three groups: hospital mortality, atrial fibrillation and intra aortic balloon counter pulsation usage, multiple organ failure score system, postoperative score for cardiac surgery, sequential organ failure assessment score, respiratory index, and pressure-adjusted heart rate. Results The lowest mortality rate was observed in the overweight group(0.6％) in comparison with the normal weight group(2.2％) and obesity group(1.1％)(P<0.01). The lowest rate of atrial fibrillation was observed in the obesity group(20. 1％) in comparison with the normal weight group (22.1％) and overweight group(20. 7％)(P <0. 01). The IABP usage rate was the highest in the normal weight group (8. 1％), followed by the overweight group(6. 0％) and the obesity group(2. 9％)(P<0. 01). On the operation day and the first day after operation, the MODS, SOFA and PSCS scores of the obese group were significantly higher than those of the nor-mal weight group(P <0. 01). PaO2/FiO2 in the obese group was significantly lower than that in the normal weight group (P<0. 01). PAHR in the obese group was significantly higher than that in the normal weight group(P<0. 01). Conclusion High BMI groups were associated with lower rates of mortality, atrial fibrillation, and IABP utilization. The lowest mortality rate was observed in the overweight group.

Objective This study aimed to investigate the factors associated with short-term survival and morbidity after tricuspid valve replacement(TVR).Methods This was a retrospective study of 273consecutive patients who underwent TVR at the Beijing Anzhen Hospital over a 25-year period(from November 1993 to August 2018).Results The overall 30-day mortality was 14％.Multivariate analysis showed that the dose of frusemide(OR =1.018,95％ CI:1.005-1.031;P =0.007)was an independent predictor of short-term death after TVR.The NYHA (OR =2.173,95 ％ CI:1.018-4.002;P =0.013)and cardiopulmonary bypass time(OR =1.008,95％ CI:1.002-1.013;P =0.004) were independently associated with the low output syndrome (LOS).The dose of frusemide (OR =1.025,95％ CI:1.009-1.041;P =0.003)、NYHA (OR =5.837,95％ CI:2.177-15.650;P =0.000)、cardiopulmonary bypass time (OR =1.012,95％ CI:1.005-1.020;P =0.002) and diameter of right atrium(OR =1.025,95 ％ CI:1.002-1.048;P =0.033) were independently associated with acute renal failure.The dose of frusemide(OR =1.020,95％ CI:1.007-1.033;P =0.003) 、cardiopulmonary bypass time (OR=1.014,95％CI:1.006-1.022;P＜0.001) and white cell count(OR=0.748,95％CI:0.559-0.999;P =0.050) were independently associated with mechanical respiratory assistant ＞ 3 days.Conclusion This study identified a number of factors that were independently associated with short-term mortality,postoperative LOS,acute renal failure,and mechanical respiratory assistant ＞ 3 days.Long-term medical conservative treatment may affect the effect of snrgical treatment.Early surgical treatment is crucial for optimal outcomes when the dosage of frusemide ＞ 20 mg/day.

Objective:To explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Methods:From February to March 2024, a convenience sampling method was used to select 763 nurses from ClassⅢ Grade A hospitals in Wenzhou as research subjects. Data were collected using a General Information Questionnaire, the Occupational Embeddedness Scale for Nurses (OESN), the Nursing Professional Values Scale-Revised (NPVS-R), the Nurses' Career Planning Questionnaire (NCPQ), and the Career Success Scale for Nurses (CSSN). Pearson correlation analysis was performed to examine the correlations among the scores of OESN, NPVS-R, NCPQ, and CSSN. The AMOS 21.0 software was used to construct a structural equation model to explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Results:A total of 763 questionnaires were collected, with 749 valid responses, resulting in an effective recovery rate of 98.17%. The average scores for the 749 nurses were as follows: OESN (60.29±7.65), NPVS-R (108.99±11.82), NCPQ (42.98±4.44), CSSN (73.57±8.34). All four scale scores were positively correlated with each other ( P<0.05). The chain mediation effect of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness was established, with the total indirect effect accounting for 46.04% (0.302/0.656) of the total effect and the chain mediation effect of career development planning and career success accounting for 10.21% (0.067/0.656) . Conclusions:The level of occupational embeddedness among nurses needs further improvement. Nurses' professional values not only directly influence their level of occupational embeddedness but also affect their career development planning, which in turn impacts their career success, ultimately exerting an indirect effect on occupational embeddedness. Nursing managers should strengthen nurses' professional values, assist them in formulating clear career development plans, and provide timely feedback and recognition of career success.

Obstructive sleep apnea syndrome (OSAS) is a complicated chronic disease caused by certain reasons, characterized by obstruction of the upper airway and apnea or hypopnea during sleep, which can be followed by anoxia, snoring and daytime sleepiness. Recent studies have shown that hypertension is closely connected to OSAS. OSAS can lead to hypertension by several possible mechanisms. The diagnosis of OSAS mainly depends on the medical history, sign, polysomnogram (PSG) result and the frequency of apnea and hypopnea. OSAS can be relieved by continuous positive airway pressure (CPAP), oral orthodontic treatment, medicine, change of lifestyles and others. This brief review focuses on the mechanism of hypertension due to OSAS and the diagnosis criteria and treatment of OSAS.
Continuous Positive Airway Pressure ; Humans ; Hypertension ; epidemiology ; Polysomnography ; Sleep Apnea, Obstructive ; epidemiology ; Snoring

Background::Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays. Methods::Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed. Results::The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) ( χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) ( χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) ( χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) ( χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) ( P = 0.734). Sputum LFD had similar specificity (91% [81/89]) ( χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) ( χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) ( χ2 = 6.95, P = 0.008), BDG ( χ2 = 10.43, P = 0.001), and fungal culture ( χ2 = 12.70, P < 0.001). Conclusions::Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

Endogenous adult neural stem cells are closely related to the normal physiological functions of the brain and many neurodegenerative diseases. Neurons are affected by factors such as extracellular microenvironment and intracellular signaling. In recent years, some specific signaling pathways have been found that affect the occurrence of neural stem cells in adult neural networks, including proliferation, differentiation, maturation, migration, and integration with host functions. In this paper, we summarize the signals and their molecular mechanisms, including the related signaling pathways, neurotrophic factors, neurotransmitters, intracellular transcription factors and epigenetic regulation of neuronal differentiation from both the extracellular and intracellular aspects, providing basic theoretical support for the treatment of central nervous system diseases through neural stem cells approach.