Objective:The aim of the study was to investigate the correlation between blood pressure response to cold pressor test (CPT) and follow-up blood pressure after 8 years in subjects, and to evaluate the predictive value of CPT for long-term blood pressure levels.Methods:A total of 365 individuals from eight natural villages were enrolled by stratified cluster sampling from Mei County, Shaanxi Province in 2004. Baseline characteristics of subjects were collected and CPTs were conducted. Subjects were followed up in 2009 and 2012, respectively. According to the maximal change of systolic response (SR), the area under the curve (AUC) of systolic blood pressure change (AUC-SBP), the maximal change of diastolic response (DR) and the AUC of diastolic blood pressure change (AUC-DBP) in CPT, the individuals were divided into four quartile groups by above parameters, respectively: group Ⅰ ( P25), group Ⅱ ( P50), group Ⅲ ( P75) and group Ⅳ ( P100). The correlation between blood pressure response to CPT and the follow-up blood pressure was analyzed. Results:(1) There were no significant differences in baseline blood pressure levels and prevalence of hypertension among four quartile groups no matter it was grouped on SR, DR, AUC-SBP or AUC-DBP. (2) The prevalence of hypertension in each group from lowest ( P25) to highest ( P100) in 2012 was 25.64%, 30.67%, 38.03%, 55.74% on SR grouping ( P<0.01), and 27.5%, 29.17%, 38.46%, 57.35% on AUC-SBP grouping ( P<0.05), respectively. (3) There were no significant differences in the prevalence of hypertension among four groups in 2012 ( P>0.05) either on DR or on AUC-DBP grouping. (4) The random effects model analysis showed that the correlation coefficient between SR, AUC-SBP and long-term systolic blood pressure increase were 1.91 ( P<0.05) and 1.44 ( P<0.05), respectively, and the correlation coefficient between DR, AUC-DBP and long-term diastolic blood pressure increase were 0.82 ( P<0.05) and 0.78 ( P>0.05), respectively. Age, male, body mass index, and fasting blood glucose were independent risk factors for long-term blood pressure elevation, and age, body mass index and fasting blood glucose positively correlated with changes in long-term blood pressure (all P<0.05). Conclusion:Individual systolic blood pressure response to CPT can be used as a predictor of long-term hypertension.

Objective To explore the experience of patients with rheumatoid arthritis participating in the shared medical appointments(SMA),so as to provide references for medical staff to formulate targeted intervention strategies.Methods By the descriptive phenomenology research method in qualitative research,14 patients with rheumatoid arthritis who participated in the SMA in a tertiary A integrated traditional Chinese and western medicine hospital in Shanghai from August to October 2023 were selected for the in-depth interviews,and the data were analyzed and themes were extracted by Colaizzi 7-step analysis method.Results The experience of patients with rheumatoid arthritis participating in SMA can be summarized into 3 themes:①Driving factors of participation in SMA(seeking clarity and resolution,seeking support and hope);②Perceived benefits of participation in SMA(feelings of efficiency and convenience,reduced isolation,increased security,reduced stigma,increased self-efficacy,insights and experiences,lifestyle changes);(3)Barriers to participation in shared outpatient procedures(obscure medical terminology,inapplicability to some special groups,single content and form of sharing,worries and concerns about personal privacy disclosure,transportation inconvenience and time conflicts).Conclusion Medical staff should pay attention to the experience of patients with rheumatoid arthritis participating in the SMA,improve the training skills of medical staff,solve the obstacles in the process of participation in the SMA,and promote the continuous improvement and development of the SMA.

Objective To explore the immune mechanism of Tibetan medicine Twelve Flavors Yishou San in intervening with acute lung injury.Methods Construct a lipopolysaccharide(LPS)-induced acute lung injury rat model and treated it with Twelve Flavors Yishou San.The intervention effect of Twelve Flavors Yishou San on LPS induced acute lung injury was determined through lung pathological sections and blood gas analysis.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression of pro-inflammatory cytokine tumor necrosis factor-α(TNF-α)and anti-inflammatory cytokine interleukin(IL)-10 in rat's bronchoalveolar lavage fluid.Flow cytometry was used to detect changes in immune cells in rat's bronchoalveolar lavage fluid,lungs,spleen and peripheral blood.Results LPS successfully induced an acute lung injury model in rats,and Twelve Flavors Yishou San could alleviate the exudation of inflammatory cells,elevated oxygen partial pressure in LPS induced acute lung injury to varying degrees.The ELISA results of rat bronchoalveolar lavage fluid showed that compared with normal control group,the TNF-α level in the bronchoalveolar lavage fluid of rats with acute lung injury was increased and the IL-10 level was decreased,while the Twelve Flavors Yishou San could alleviate this effect.The results of flow cytometry showed that Twelve Flavors Yishou San could significantly reduce neutrophil infiltration in rat bronchoalveolar lavage fluid,but had no significant effect on macrophages and adaptive immune response.Conclusion Twelve Flavors Yishou San can alleviate LPS induced acute lung injury by inhibiting neutrophil infiltration,providing an important experimental basis for fully understanding the therapeutic mechanism of Twelve Flavors Yishou San.

In this paper, a design space approach was applied to optimize the dropping process of Ginkgo biloba dropping pills. Firstly, potential critical process parameters and potential process critical quality attributes were determined through literature research and pre-experiments. Secondly, experiments were carried out according to Box-Behnken design. Then the critical process parameters and critical quality attributes were determined based on the experimental results. Thirdly, second-order polynomial models were used to describe the quantitative relationships between critical process parameters and critical quality attributes. Finally, a probability-based design space was calculated and verified. The verification results showed that efficient production of Ginkgo biloba dropping pills can be guaranteed by operating within the design space parameters. The recommended operation ranges for the critical dropping process parameters of Ginkgo biloba dropping pills were as follows: dropping distance of 5.5-6.7 cm, and dropping speed of 59-60 drops per minute, providing a reference for industrial production of Ginkgo biloba dropping pills.

ObjectiveTo determine the death level and change trend of malignant tumors among residents in Yuyao， and to provide support for accurate prevention and control of malignant tumors. MethodsWe collected the death monitoring data of Yuyao registered residents from 2014 to 2021， and calculated the indicators， including crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， and PYLL rate （PYLLR）. We also calculated the average annual change percentage （AAPC） using Joinpoint regression model. ResultsThere were 13 754 deaths from malignant tumors in Yuyao from 2014 to 2021， accounting for 26.54% of the total deaths in the same period. The average annual mortality rate was 205.63/10⁵， and the standardized mortality rate was 115.62/10⁵. The SMR showed a downward trend in 8 years （AAPC=-4.76%， t=-2.296， P=0.061）. The average annual mortality of malignant tumors was 274.15/10⁵， and the standardized mortality was 149.83/10⁵. The average annual mortality of female malignant tumors was 139.03/10⁵， the standardized mortality was 81.01/10⁵. Male mortality was higher than the female mortality （χ²=1 487.389， P<0.001）.The mortality rate of malignant tumors increased with age （AAPC=54.94%，t=27.678，P<0.001）. The mortality rate of malignant tumors in different age groups showed a downward trend in 8 years （AAPC=-5.74% for 0- years old group， -8.49% for 15- years old group， -6.02% for 45- years old group， and -3.49% for ≥65 years old group）. The top five causes of death from malignant tumors in residents were lung cancer， gastric cancer， liver cancer， esophageal cancer and colorectal cancer， accounting for 68.15% of all deaths from malignant tumors. Lung cancer ranked first among the causes of death from male and female malignant tumors. PYLL caused by malignant tumor death was 96 585.50 person years， AYLL was 7.02 years per person ， and PYLLR was 16.42‰. ConclusionThe mortality rate of malignant tumors among registered residents in Yuyao is on the decline， but it is still the primary death cause threatening the residents. Lung cancer is the malignant tumor that causes the greatest loss of life. It is urgent to build a comprehensive intervention system for malignant tumors that focuses on men， middle-aged and elderly people， advocate a healthy lifestyle， and combine early screening and reasonable treatment to block disease progress.