Objective: To analyze the unregistered treatment situation and its influencing factors among pulmonary tuberculosis patients in Quzhou City, Zhejiang Province from 2017 to 2023, so as to provide a basis for promoting the management of tuberculosis patients and optimizing disease prevention and control strategies. Methods: Data of pulmonary tuberculosis patients including demographic information, etiological results, and mortality status were collected through the China Disease Prevention and Control Information System Infectious Disease Reporting and Surveillance System and the Tuberculosis Management Information System. Pulmonary tuberculosis patients not matched in the Tuberculosis Management Information System were defined as unregistered treatment patients, and the unregistered treatment rate was analyzed. Factors affecting unregistered treatment among pulmonary tuberculosis patients were analyzed using a multivariable logistic regression model. Results: A total of 10 779 pulmonary tuberculosis patients were reported in Quzhou City from 2017 to 2023, including 7 700 males (71.44%) and 3 079 females (28.56%). There were 5 484 cases aged <65 years, accounting for 50.88%. Among them, 630 cases were unregistered treatment, with an unregistered treatment rate of 5.84% (95%CI: 5.42%-6.38%). Multivariable logistic regression analysis showed pulmonary tuberculosis patients aged ≥65 years (OR=1.829, 95%CI: 1.512-2.212) had a higher risk of being unregistered treatment than those aged <65 years; patients with non-local household registration (OR=5.710, 95%CI: 4.724-6.901) had a higher risk than local patients; and patients engaged in housework/unemployed (OR=2.001, 95%CI: 1.421-2.818) or other occupations (OR=2.396, 95%CI: 1.789-3.137) had a higher risk than farmers. The mortality of unregistered treatment pulmonary tuberculosis patients was higher than the registered treatment patients (26.67% vs. 5.02%),with a significantly elevated mortality risk (OR=7.147, 95%CI: 5.738-8.902). Conclusions The unregistered treatment rate among pulmonary tuberculosis patients was well controlled in Quzhou City from 2017 to 2023, but the elderly, patients with non-local household registration, and those engaged in housework/unemployed had a higher risk of unregistered treatment. It is recommended to improve medical and social security policies, strengthen health education on tuberculosis prevention, enhance treatment adherence, and reduce mortality risk.

Objective:To develop and validate a risk prediction model for cognitive frailty in elderly patients with type 2 diabetes.Methods:A total of 483 elderly patients with type 2 diabetes who visited Tianjin First Central Hospital from June to December 2022 were selected using convenience sampling. They were randomly divided into a modeling group ( n=338) and a validation group ( n=145). Data were collected using a self-designed general information questionnaire, the Short-Form Mini Nutritional Assessment (MNA-SF), the Geriatric Depression Scale-15 (GDS-15), the Frailty Phenotype (FP), the Montreal Cognitive Assessment (MoCA), and the Clinical Dementia Rating (CDR). Logistic regression analysis was performed to identify the influencing factors. A cognitive frailty risk prediction nomogram model was constructed based on the results. The model was validated in the validation group, and its predictive performance and clinical applicability were evaluated using the area under the receiver operating characteristic curve ( AUC), calibration curve, and clinical decision curve analysis. A total of 483 questionnaires were distributed and all were returned as valid, resulting in a 100.0% response rate. Results:The prevalence of cognitive frailty in the 483 elderly patients with type 2 diabetes was 20.3% (98/483). Age, regular exercise, duration of diabetes, HbA1c levels, depression and nutritional status were identified as predictive factors in the model. The AUC of the model was 0.886, and the Hosmer-Lemeshow test showed a χ 2 value of 8.004 ( P=0.433). The optimal cutoff value was 0.335, and the accuracy was 89.0%. Conclusions:The prediction model demonstrates good fit and strong predictive performance, and can intuitively and easily identify elderly patients with type 2 diabetes who are at high risk of cognitive frailty, providing a reference for early screening and intervention.

BackgroundPerinatal depression seriously affects the physical and mental health of pregnant women， such as affecting their role transition， identity， and family relationships， etc. In severe case， it can even lead to suicidal behavior， causing a heavy burden on pregnant women and their families. A hierarchical management model centered on pregnant women， involving collaboration of families， communities， and hospitals， facilitates comprehensive and dynamic management of perinatal depression. ObjectiveTo evaluate the application effect of "Internet +" hospital-community-family trinity linkage management model on perinatal depression in pregnant women， in order to provide a reference for the clinical intervention. Methods80 pregnant women who established medical records from the Department of Obstetrics and Gynecology of Mianyang Third People's Hospital from January to December 2022， with Edinburgh Postnatal Depression Scale （EPDS） score>9， were selected as the research objects. According to the random number table method， they were divided into a study group and a control group， each group consisting of 40 cases. Both groups received routine nursing intervention in the pregnant women's school of obstetrics and gynecology outpatient department before delivery， and in the study room of the department of obstetrics and gynecology after being admitted to the hospital for delivery. After discharge， they received routine follow-up until 42 days postpartum. The study group received the "Internet +" hospital-community-family ternary linkage management on the basis. EPDS， Pittsburgh Sleep Quality Index （PSQI）， Generic Quality of Life Inventory （GQOLI-74） and Nursing Satisfaction questionnaire were assessed before intervention and 42 days postpartum. ResultsAfter intervention， the EPDS score and PSQI score of the study group were lower than those of the control group （F=42.823， 60.453， P<0.05）， GQOLI-74 score and nursing satisfaction were higher than those of the control group （F=198.902， χ²=5.165， P<0.05） . Conclusion"Internet +" hospital-community-family trinity linkage management model may help to improve the severity of perinatal depression symptoms， improve the quality of sleep and life， and increase the satisfaction of pregnant women.［Funded by Mianyang Health Scientific Research Commission Project （number， 202134）］

OBJECTIVE To determine the content of free lanolin alcohol and residual pesticides in lanolin by gas chromatography, and to evaluate the feasibility of the established method. METHODS Gel permeation chromatography(GPC) was used for pretreatment, and the contents of free lanolin alcohol and residual pesticides were determined by GC-FID and GC-MS, respectively. And the qualitative analysis was conducted based on the retention time and quantitative analysis was conducted by total peak area. RESULTS The recovery of GPC pretreatment system met the requirements. Under the two established methods, the determinand were well separated; the satisfactory linearity with good correlation coefficients >0.999 5 were obtained; and the average recoveries were in the range of 90.49%-102.78%(n=6). The content of free lanolin alcohol in 3 batches of lanolin was <2.84%, cis-permethrin and trans-permethrin were determined in lanolin and the other residual pesticides were not detected. CONCLUSION The GPC-GC/FID and GPC-GC/MS method established in the study have good specificity, high precision, accuracy and robustness, which can be used for the separation and determination of free lanolin alcohol and six organophosphorus and pyrethroid residual pesticides in lanolin. At the same time, this study can provide reference for the quality control of lanolin.

Objective To investigate the clinical effect of No ha la hu(Mongolian medicine abdominal massage)combined with Ni ru ha(Mongolian medicine enema)in the treatment of incomplete intestinal obstruction.Methods A total of 80 patients with incomplete intestinal obstruction admitted to the department of emergency and critical care medicine of Inner Mongolia International Mongolian Hospital from April 2020 to April 2022 were selected as the study objects,they were randomly divided into control group and observation group,40 cases in each group.The control group was treated with routine modern medicine,and the observation group was treated with mongolian medicine No ha la hu combined with Ni ru ha on the basis of routine treatment.Specific methods:the patient supine position,both lower limbs flexion,natural calm breathing,the doctor stands on the patient's right side,applies a little butter to the palm of his hand,rub hands,massages the abdomen with the middle finger and ring finger at acupoints such as ileocecal point,small intestine point,small intestine point,small intestine point and lower clockwise direction point.Massage the abdomen with the palm for about 20 minutes,once a day for 3 days.No ha la hu was given after the treatment of Ni ru ha(Rhubarb 250 g,Cold water stone 150 g,Sanai 100 g,Facial alkali 100 g,Hyacinth 50 g,Terminalia chebula 50 g),the patients should lie on the left side,raise the buttocks about 10 cm,insert the enema into the rectum 15-20 cm,take the Mongolian medicine Liuweian powder 12 g and warm water 50-100 mL for enema,once a day for 3 days.The difference of relieving time of abdominal pain and distension,time of exhaustion,time of fasting,and time of hospital stay between the two groups were compared,and the clinical effect was observed.Results Relieving time of abdominal pain,abdominal distension,time of exhaust and time of hospital stay in the observation group were significantly shorter than those in the control group[abdominal pain relief time(hours):5.3±1.8 vs.8.1±1.6,abdominal distension relief time(hours):3.2±1.5 vs.6.5±1.9,time of exhaust(days):2.6±1.7 vs.4.1±2.1,hospital stay(days):8.3±2.9 vs.10.1±2.1,all P<0.05],time of fasting in the observation group were shorter than those in the control group(days:2.9±0.5 vs.3.1±0.6,the difference was not statistically significant(all P>0.05).The effective rate of the observation group was significantly higher than that of the control group[92.5％(37/40)vs.75.0％(30/40),P<0.05].Conclusion On the basis of routine treatment of western medicine,the treatment of incomplete intestinal obstruction by Mongolian medicine No ha la hu combined with Ni ru ha is more effective,which can effectively restore gastrointestinal function,relieve abdominal pain and other symptoms,and shorten the time of exhaust.

Objective:To compare the differences in lung function between sanitation workers and the general population undergoing routine physical examinations, and to analyze the risk factors for restricted airflow and severity of the condition in sanitation workers.Methods:This study is a large cross-sectional study called "Shanxin Respiratory Health Screening for Ten Thousand People". A total of 1 036 sanitation workers (sanitation group) and 6 701 individuals from the general population undergoing routine physical examinations (control group) were selected as the original study subjects from June 2021 to April 2022 (before matching). Both groups underwent pre-bronchodilator lung function tests, and the differences in lung function characteristics between the two groups were compared. The sanitation group also completed a questionnaire survey. Multivariate and ordinal multinomial logistic regression analysis were used to analyze the risk factors for airflow limitation and its severity.Results:A total of 1 027 individuals from the sanitation group and 999 individuals from the control group were included in the study. There were no significant differences in age, gender, height, weight, and body mass index (BMI) between the two groups (all P>0.05). The rate of airflow restriction was significantly higher in the sanitation group compared to the control group (22.88% vs 8.81%, P<0.001). In the sanitation group, there was no statistically significant difference in a self-assessment test for chronic obstructive pulmonary disease (CAT) scores between individuals with airflow restriction (235 cases) and those without airflow restriction (792 cases) [(1.50±2.50) vs (1.15±2.03) points, P=0.084]. There were no statistically significant differences in forced vital capacity (FVC) as a percentage of predicted value (FVC%pred) between the two groups. However, the sanitation group had significantly lower %pred for forced expiratory volume in one second (FEV 1%pred), FVC/FEV 1 ratio (FEV 1/FVC%pred), forced expiratory flow at 50% of FVC (FEF 50%%pred), forced expiratory flow at 75% of FVC (FEF 75%%pred), and maximal mid-expiratory flow (MMEF%pred) compared to the control group (all P<0.05). The rates of abnormal FEF 50%%pred, FEF 75%%pred, and MMEF%pred were significantly higher in the sanitation group compared to the control group (17.62% vs 10.31%, 17.04% vs 10.01%, 27.26% vs 18.41%, all P<0.001). Small airway parameters and the rate of airflow restriction were significantly higher in past and current smokers of the sanitation group compared to never smokers (all P<0.05). Multifactorial analysis showed that high BMI ( OR=0.929, 95% CI: 0.885-0.974) was a protective factor for airflow restriction, while high smoking index was a risk factor ( OR=1.020, 95% CI: 1.011-1.030). Ordered multinomial logistic regression analysis showed that high BMI ( OR=0.925, 95% CI: 0.882-0.971) was a protective factor for the severity of airflow restriction, while high smoking index ( OR=1.020, 95% CI: 1.011-1.029) was a risk factor for the severity of airflow restriction. Conclusions:The incidences of airflow limitation and small airway abnormalities in sanitation workers are higher than that in general physical examination population. High smoking index and low BMI are independent risk factors for airflow limitation and its severity.

OBJECTIVE：To establish fingerprint of Tibetan medicine Ershi wuwei luxue pills ，and determine the contents of 5 components，and to conduct chemical pattern recognition. METHODS ：HPLC method was adopted. Using aesculetin as reference ， HPLC fingerprint of 10 batches of Tibetan medicine Ershi wuwei luxue pills were drawn. The similarity evaluation was conducted by using Evaluation System of TCM Chromatogram Fingerprint Similarity （2012 edition），and the common peaks were determined. Same HPLC method was adopted to determine the contents of 5 components in Tibetan medicine Ershi wuwei luxue pills. The cluster analysis and principle component analysis were performed by using SPSS 19.0 software. RESULTS ：Totally 11 common peaks were calibrated ，and the similarity was higher than 0.98. Five common peaks were identified ，as aesculetin ，orientin， isovitexin，isoscoparin and ellagic acid. The linear range of aesculetin ，orientin，isovitexin，isoscoparin and ellagic acid were 1.232-11.092 μg/mL（r＝0.999 6），2.766-24.893 μg/mL（r＝0.999 5），1.400-12.600 μg/mL（r＝0.999 8），0.600-5.400 μg/mL（r＝ 0.999 5），49.447-445.025 μg/mL（r＝0.999 4），respectively. RSDs of precision ，stability（24 h）and reproducibility tests were all lower than 2％. The average recoveries were 101.29％（RSD＝2.33％，n＝3），91.39％（RSD＝1.22％，n＝3），90.28％（RSD＝ 1.88％，n＝3），98.76％（RSD＝2.53％，n＝3），101.45％（RSD＝2.84％，n＝3），100.44％（RSD＝1.38％，n＝3），100.91％ （RSD＝1.73％，n＝3），97.78％（RSD＝2.07％，n＝3），99.15％（RSD＝1.28％，n＝3），100.27％（RSD＝1.81％，n＝3），98.38％ （RSD＝1.89％ ，n＝3），101.92％（RSD＝1.17％ ，n＝3），95.50％（RSD＝0.67％ ，n＝3），99.89％（RSD＝0.38％ ，n＝3）， 100.10％（RSD＝0.65％，n＝3），respectively. Their contents were 0.175-0.310， 0.351-0.632， 0.274-0.395， 0.186-0.278， 61932600 6.956-8.636 mg/g，respectively. Cluster analysis showed that 10 batches of Tibetan medicine Ershi wuwei luxue pills were clustered into two category ，with S1-S4 as one category and S5-S10 as one category. Principal component analysis showed that accumulative contribution rate of two principle components was 89.178％. CONCLUSIONS ：Established fingerprint is stable and feasible ，and the method of content determination is simple ， accurate and reproducible. They combined with chemical pattern recognition can be used for the quality control of the Tibetan medicine Ershiwuwei luxue pills.

Objective: To investigate the effects and mechanism of digoxin on atrium electrical remodeling and susceptibility of atrial fibrillation (AF) in aged rabbits. Methods: Twenty aged male New Zealand rabbits were divided into aged group and aged plus digoxin group (n=10 each). Electrical parameters including heart rate (HR), RR and QT interval, ST segment and P wave dispersion from normal Ⅱ electrocardiogram, and the maximum upstroke velocity (Max_dv/dt), plateau potential (plateau P), action potential duration of 10%, 20% and 90% (APD₁₀, APD₂₀, APD₉₀) from recording of monophasic action potential (MAP), as well as atrial effective refractory period (AERP₂₀₀) and dispersion (dERP₂₀₀) with 200 ms of basic cycle length (BCL), and frequency self adaptation of AERP with 300 ms and 150 ms of BCLs (fERP) were recorded and compared between the 2 groups. BCLs and inducibility of AF post programmed electrical stimulation and Burst-pacing in left atrium tissue of rabbits in vivo were also analyzed. The L-type calcium current (I_Ca-L) in 2 groups were recorded via whole-cell patch clamp technique, and the fluorescence intensity of intracellular free Ca²⁺ was detected with Flup-3/AM loading by the laser scanning confocal microscope in enzymatically dissociated single rabbit atrial myocytes. Results: Compared with aged group, the heart rate was faster, RR and QT interval were obvious shorter, ST segment was raised and P wave dispersion was significantly increased in aged plus digoxin group (all P<0.05). Moreover, compared with aged group, the Max_dv/dt and plateau P were obviously increased, APD₁₀ and APD₂₀ were significantly prolongated, and APD₉0 was significantly shorter in aged plus digoxin group (all P<0.01). Otherwise, the fERP was markedly increased (0.81±0.15 vs. 0.67±0.05), and the induced rate of AF was obviously higher in aged plus digoxin group than in aged group (6/8 vs. 4/9) (all P<0.01). With voltage clamp model, digoxin significantly increased I_Ca-L of atrial myocytes of aged rabbits, When command potential was 10 mV, the current densities of I_Ca-L were significantly higher in digoxin group than that in aged group ((15.45±2.38) pA/pF vs. (7.03±1.69) pA/pF, P<0.01). Otherwise, the I-V curve of I_Ca-L was downward shifted of all I-V curves in digoxin perfused aged atrial cells of rabbits. Moreover, the fluorescence intensities of intracellular free Ca²⁺ was significantly higher in aged plus digoxin group than in aged group ((1 748±173) μmol/L vs. (478.13±87.63) μmol/L, P<0.01). Conclusion Digoxin could aggravate the atrial electrical remodeling in atrium of aged rabbits, facilitate susceptibility of atrial fibrillation in aged rabbit, increased current density of I_Ca-L and concentration of intracellular free Ca²⁺, followed Ca²⁺ overload and oscillations might be part of the underlying mechanisms.

Objective To investigate the predictors of early neurological deterioration (END) after intravenous thrombolysis in patients with acute ischemic stroke and its impact on short-term outcomes. Methods From January 2017 to April 2019, patients with acute ischemic stroke treated with intravenous thrombolysis in the Second Affiliated Hospital of Xuzhou Medical University were enrolled retrospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 days after admission increased by ≥2 compared with the baseline. The short-term outcomes were evaluated by the modified Rankin Scale at discharge. 0-2 was defined as good outcomes and 3-6 was defined as poor outcomes. Multivariate logistic regression analysis was used to determine the independent predictors of END and their correlation with short-term outcomes. Results A total of 199 patients with acute ischemic stroke received intravenous thrombolysis were enrolled. The median age was 68 years (interquartile range: 62- 76 years), 69 were women (34. 7％), and the baseline median NIHSS score was 6 (interquartile range: 3- 12). END occurred in 35 patients (17. 6％). Symptom progression occurred mainly 2 days after admission (31 patients, 88. 6％). Most of the causes of END were ischemic progression or recurrence (28 patients, 80. 0％). The univariate analysis showed that fasting blood glucose and symptomatic intracranial hemorrhage were associated with END (all P < 0. 05). However, multivariate logistic regression analysis did not find independent predictors of END. Excluding 12 patients with missing short-term outcome data, a total of 187 patients were included in the short-term outcome analysis. Among them, 110 patients had good outcomes and 77 had poor outcomes. Univariate analysis showed that ischemic heart disease, atrial fibrillation, mild stroke, etiological classification, baseline NIHSS score, absolute lymphocyte count, fasting blood sugar, neutrophil/lymphocyte ratio, whether to receive interventional therapy, and END were correlated with short-term outcomes (all P < 0. 05 ). Multivariate logistic regression analysis indicated that high baseline NIHSS score (odds ratio 1. 350, 95％ confidence interval 1. 182-1. 541; P < 0. 001) and END (odds ratio 32. 540, 95％ confidence interval 6. 149- 172. 21; P < 0. 001 ) were the independent risk factors for short-term poor outcomes. Conclusions END still occurs in some patients after intravenous thrombolysis for acute ischemic stroke, and END is an independent risk factor for short-term poor outcomes.

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.