Objective:To investigate the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome in the elderly population.Methods:This was a cross-sectional study.A total of 114 212 subjects aged 65 years and over in Wujin District receiving health examination in 2019 were enrolled, including 40 388(35.4%)patients with metabolic syndrome.The survey contents included a questionnaire, physical examination and laboratory tests.Logistic regression and restricted cubic splines were used to analyze the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome.Results:With increases in pulse pressure levels and pulse pressure index, the prevalence of metabolic syndrome and its components increased accordingly( P<0.01). After adjusting for confounding factors, the ORvalue of metabolic syndrome gradually increased along with increases in pulse pressure and pulse pressure index.Compared with the first quartile, pulse pressure and pulse pressure index in the second, third and fourth quartiles were correlated with metabolic syndrome(pulse pressure: OR=1.52, 95% CI: 1.47~1.58, OR=1.89, 95% CI: 1.82~1.96 and OR=2.15, 95% CI: 2.07~2.23, respectively; pulse pressure index: OR=1.22, 95% CI: 1.18~1.26, OR=1.36, 95% CI: 1.31~1.41 and OR=1.47, 95% CI: 1.42~1.53, respectively). Restricted cubic spline analysis showed that pulse pressure and pulse pressure index had non-linear dose-response relationships with metabolic syndrome( χ2=309.23 and 57.14, P<0.01). Conclusions:Pulse pressure and pulse pressure index are correlated and show non-linear dose-response relationships with metabolic syndrome and its components in the elderly.

Dynamic electrocardiography (DCG) or Holter is the best device to detect arrhythmia and can help early detection of some sudden cardiac death risk factors. The acquisition and recording system of the DCG, however, affects the data quality and the patients' comfort directly. This paper reviews the related latest studies, and discusses the importance of new ECG electrode and wireless dynamic monitoring in DCG monitoring field. Moreover, the existed main problems are summarized and classified and the prospects for the development trend are presented.
Electrocardiography, Ambulatory ; instrumentation ; trends ; Electrodes ; Humans ; Wireless Technology

Objective:To retrospectively analyze the incidence, mortality, clinical characteristics and related factors of transient and persistent acute kidney injury in patients with sepsis in emergency department.Methods:Patients with sepsis ≥ 18 years old hospitalized in the Emergency Department of Guangdong Provincial Hospital of Chinese Medicine from June 2018 to May 2020 were selected as the research objects. According to the renal function injury at admission and the renal function recovery at 48 h after admission, patients with sepsis were divided into three groups: non-S-AKI group, transient S-AKI group, and persistent S-AKI group.Results:A total of 197 patients with sepsis were included, including 95 patients with non-S-AKI, 39 patients with transient S-AKI and 63 patients with persistent S-AKI. The mortality in the persistent S-AKI group was significantly higher than that in the non-S-AKI group (36.5% vs. 17.9%, P<0.05), but there was no significant difference between the transient S-AKI group and non-S-AKI group (20.5% vs. 17.9%, P>0.05). Multiple categorical disordered Logistic regression analysis showed that urea was associated with transient S-AKI ( OR=1.440, 95% CI: 1.235-1.680), and age ( OR=1.049, 95% CI: 1.008-1.092), urea ( OR=1.440, 95% CI: 1.277-1.733), and infection site in non-urinary tract ( OR=0.149, 95% CI: 0.050-0.448) were associated with persistent S-AKI. Conclusions:The incidence of persistent S-AKI is higher than that of transient S-AKI. Persistent S-AKI is related to the prognosis of patients with sepsis, and the mortality rate is higher, while transient S-AKI has no significant relationship. The urea of patients with S-AKI would increase significantly, and advanced age and urinary tract infection are related factors for the occurrence of persistent S-AKI. For patients with sepsis with such factors, attention should be paid to early protection of renal function to prevent persistent S-AKI.

Objective:To analyze factors associated with timely vaccination of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023.Methods:Children born in Shanghai between 2019 and 2023 were selected using a stratified random sampling method, and their vaccination data were obtained from the Shanghai Vaccine Management and Vaccination Service Information System. The vaccination rates, timely vaccination rates, and the proportions of diphtheria-tetanus-acellular pertussis-haemophilus influenzae type b combination vaccine (DTaP-Hib) and diphtheria-tetanus-acellular pertussis-inactivated poliovirus-haemophilus influenzae type b combination vaccine (DTaP-IPV-Hib) for the substitution of diphtheria- tetanus-acellular pertussis vaccine (DTaP) were calculated. Also, the factors associated with timely vaccination rate was analyzed with multivariate logistic regression analysis.Results:The average vaccination coverage rate of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023 ranged from 94.71% to 99.53%. There were significant differences in the vaccination coverage of the 1 st-4 th doses of pertussis-containing vaccines among children born in different years (all P<0.05), but no gender and area specific significant differences were observed (all P>0.05). Non-national immunization program (non-NIP) vaccines were used to substitute DTaP vaccines in some children, with the proportion of DTaP-IPV-Hib vaccine accounting for 50.11%-52.69% and the proportion of DTaP-Hib vaccine accounting for 27.22%-28.43%. The proportions of DTaP-Hib and DTaP-IPV-Hib for the substitution of DTaP had increasing trends over the years. The overall timely vaccination rate of pertussis-containing vaccine vaccination was 84.09%. Analysis on the factors affecting the timely vaccination rate showed that the rate gradually decreased with the increase of the doses. Children who received the self-paid quadrivalent or pentavalent vaccines were less likely to have vaccination delays. Birth year had a significant impact on the timely vaccination rate, while the area had less impact. Additionally, the timely vaccination rate was also influenced by the degree of non-pharmaceutical intervention measures. Conclusions:The substitution of pertussis- containing vaccines with non-NIP vaccines was common in Shanghai. The coverage and timeliness of pertussis-containing vaccine vaccination were relatively high. The timely vaccination rate was significantly associated with gender, dose, vaccine type, and the degree of non-pharmaceutical interventions. There was a certain proportions of delayed and missed vaccinations, and it is necessary to pay attention to children who are not vaccinated timely and conduct high-quality catch-up vaccination to ensure timely and complete vaccination of pertussis-containing vaccines.

Objective To evaluate the effect and cost-benefit of influenza vaccination for patients with chronic diseases in Wujin district of Changzhou City. Methods An epidemiological quasi-experiment was employed in this study. A total of 441 patients with chronic diseases were recruited as the vaccine group and inoculated with trivalent influenza virus vaccine, while 467 patients with chronic diseases matched with the age, gender and health status of the vaccine group were selected as the control group for both baseline and follow-up investigations. Results A total of 431 subjects in the vaccine group and 460 subjects in the control group completed baseline and 1-year follow-up investigations. The incidence of influenza-like illness was 7.42% (32/431) and 14.13% (65/460) in the vaccine group and the control group, respectively, with a statistically significant difference (χ²=9.634, P=0.002). The protective rate was 47.46%, and the effect index was 1.90. The incidence of common cold was 16.94% (73/431) and 25.43% (117/460), respectively, and the difference was statistically significant (χ²=9.077, P=0.003), with a protective rate of 33.41%, and an effect index of 1.50. The incidence of chronic disease was 5.57% (24/431) and 9.35% (43/460), respectively. The difference was statistically significant (χ²=4.043, P=0.044), with a protective rate of 40.43% and an effect index of 1.68. The per capita benefit of inoculation was 675.86 yuan, and the benefit-cost ratio was 10.09:1. Conclusion Influenza vaccination for patients with chronic diseases effectively prevented the occurrence of influenza-like illness and reduced the incidence of related chronic diseases.