Objective To establish a prediction model for the occurrence of non-occupational carbon monoxide poisoning events in Beijing, and to provide scientific basis and theoretical support for the prevention and warning of poisoning events. Methods Based on the monitoring data of non-occupational carbon monoxide poisoning events in Beijing from 2016 to 2024, the seasonal ARIMA model and seasonal index model were established to analyze the data and predict the occurrence of events. Results Between 2016 and 2024, a total of 436 cases of non-occupational carbon monoxide poisoning were reported in Beijing, showing a downward trend. The established SARIMA model and seasonal index model were SARIMA (1,0,0) (1,1,0) 12, Yt = (-0.0339t+5.8863) × St, and the average relative errors were 65.42% and 29.19%, respectively. In terms of months, the SARIMA model had better predictive performance during April and summer (June to August), while the seasonal index model was superior in other months. By combining the two models, the predicted number of events in 2025 was as follows: 3, 2, 2, 3, 1, 5, 2, 7, 1, 1, 1, and 2. Conclusion The seasonal index model has the best prediction effect on the non-occupational carbon monoxide poisoning events in Beijing throughout the year, and the number of summer events predicted by SARIMA model is closer to the actual values. The two models can be combined to predict the trend of non-occupational carbon monoxide poisoning, which provides a scientific basis for the prevention and control of carbon monoxide poisoning in the future.

OBJECTIVE: To compare the clinical efficacy of electroacupuncture (EA) at neuro-arterial stimulation points with topical western medication in treating post-stroke shoulder-hand syndrome (SHS). METHODS: A total of 72 patients with post-stroke SHS were randomly assigned to an observation group (n=36, 2 cases dropped out) and a control group (n=36, 3 cases dropped out). Both groups received standard neurological treatment, comprehensive rehabilitation, and physical therapy. The observation group received EA at neuro-arterial stimulation points, including the ipsilateral stellate ganglion point, vagus nerve trunk and auricular branch (left side), and stimulation points of the radial and ulnar arteries, radial nerve, ulnar nerve, and median nerve, once daily for 4 weeks. The control group was treated with topical diclofenac diethylamine emulgel, and mucopolysaccharide polysulfate cream was added for patients with pronounced early-stage edema, twice a day for 4 weeks. The VAS pain score and hand edema volume were recorded before treatment, at 2 and 4 weeks during treatment, and 2 weeks after treatment completion (follow-up). Musculoskeletal ultrasound was used to measure the thickness of the dorsal hand and middle finger skin on the affected side before and after 4 weeks of treatment. RESULTS: Compared before treatment, the VAS pain scores and edema volume of the affected hand in both groups were decreased at week 2, week 4, and follow-up (P<0.05). At week 4, both groups showed lower VAS pain scores and edema volume than those at week 2 (P<0.05); during follow-up, both VAS pain scores and edema volume were further reduced compared to those at week 4 (P<0.05). At week 2, week 4, and follow-up, the VAS scores and edema volume of the affected hand in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the dorsal hand skin thickness and middle finger skin thickness on the affected side were decreased in both groups after 4 weeks of treatment (P<0.05). Compared with the control group, the observation group showed thinner dorsal hand and middle finger skin thickness after 4 weeks of treatment (P<0.05). CONCLUSION EA at neuro-arterial stimulation points effectively alleviates pain and edema in patients with post-stroke SHS, and demonstrates superior efficacy compared to topical western medication.
Humans ; Male ; Female ; Middle Aged ; Electroacupuncture ; Aged ; Stroke/complications* ; Acupuncture Points ; Adult ; Reflex Sympathetic Dystrophy/physiopathology* ; Treatment Outcome ; Hand

Objective To explore the comparative study of constructing prediction models for muscle invasive of bladder cancer based on different machine learning algorithms combined with MRI radiomic.Methods A total of 187 bladder cancer patients who underwent MRI examination and were confirmed by pathology were retrospectively selected.Patients were randomly divided into a training set and a test set in a 7∶3 ratio.The patients were divided into muscle invasive bladder cancer(MIBC)group and non-muscle invasive bladder cancer(NMIBC)group according to the surgical pathology results.Tumor volume of interest(VOI)was outlined on the images of T2 WI,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC),and the radiomic features were extracted by A.K software,and dimensionality reduction was performed using the maximum relevance minimum redundancy(mRMR)algorithm combined with least absolute shrinkage and selection operator(LASSO).Six machine learning algorithms,including K-nearest neighbor(KNN),decision tree(DT),support vector machine(SVM),logistic regression(LR),random forest(RF),and explainable boosting machine(EBM)were used to construct the radiomic model and calculate the corresponding area under the curve(AUC),accuracy,sensitivity,and specificity,respectively.Results Six machine learning algorithms,including KNN,DT,SVM,LR,RF,and EBM were used to construct the radiomic model,and the AUC values for predicting MIBC in the training set were 0.863,0.838,0.853,0.866,0.977,0.997,and in the test set were 0.748,0.833,0.860,0.868,0.870,0.900.Among them,the MRI radiomic model constructed based on EBM had the highest predictive efficacy for MIBC,with AUC values,accuracy,sensitivity and specificity of 0.997,0.977,0.957 and 0.981 in the training set,and 0.900,0.877,0.800,and 0.894 in the test set,respectively.Conclusion Multiple machine learning algorithms combined with MRI radiomic to construct models have good predictive efficacy for MIBC,and the model constructed based on EBM shows the highest predictive value.

The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) signaling exert essential regulatory function in microbial-and onco-immunology through the induction of cytokines, primarily type I interferons. Recently, the aberrant and deranged signaling of the cGAS-STING axis is closely implicated in multiple sterile inflammatory diseases, including heart failure, myocardial infarction, cardiac hypertrophy, nonalcoholic fatty liver diseases, aortic aneurysm and dissection, obesity, etc. This is because of the massive loads of damage-associated molecular patterns (mitochondrial DNA, DNA in extracellular vesicles) liberated from recurrent injury to metabolic cellular organelles and tissues, which are sensed by the pathway. Also, the cGAS-STING pathway crosstalk with essential intracellular homeostasis processes like apoptosis, autophagy, and regulate cellular metabolism. Targeting derailed STING signaling has become necessary for chronic inflammatory diseases. Meanwhile, excessive type I interferons signaling impact on cardiovascular and metabolic health remain entirely elusive. In this review, we summarize the intimate connection between the cGAS-STING pathway and cardiovascular and metabolic disorders. We also discuss some potential small molecule inhibitors for the pathway. This review provides insight to stimulate interest in and support future research into understanding this signaling axis in cardiovascular and metabolic tissues and diseases.

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

Objective:To construct nursing-sensitive indicators system of perioperative pulmonary rehabilitation for patients in thoracicsurgery, so as to provide scientific monitoring standards for nursing quality of pulmonary rehabilitation.Methods:Based on the theory of enhanced recovery after surgery (ERAS) , evidence synthesis was conducted based on Johns Hopkins evidence-based nursing method for laying the foundation for nursing-sensitive quality indicators system of perioperative pulmonary rehabilitation.Based on the analysis results of the quality of nursing in the past two years, and though group discussion, appropriate indicators feasible to application were determined, and nursing-sensitive quality indicators, calculation formulas were preliminarily decided. Through two rounds of experts consultation, the nursing-sensitive quality indicators system of pulmonary rehabilitation was improved and established.Results:After two rounds of expert consultations, the constructed nursing-sensitive quality indicators system of pulmonary rehabilitation included 3 first-class indicators, 6 second-class indicators, and 31 third-class indicators. Positive coefficients of two rounds of expert consultation were both 100%, authority coefficients were 0.827 and 0.861, respectively, and the coordination coefficients were 0.309 and 0.372.Conclusion:The nursing-sensitive quality indicators system was scientific and practical and it was beneficial to regulate the behavior of nurses and improve the nursing quality of pulmonary rehabilitation.

Objective:To explore the application effect of nursing measures based on comprehensive geriatric assessment in the prevention of nursing adverse events in elderly patients undergoing cardiac surgery.Methods:56 elderly patients who underwent cardiac surgery in Beijing Anzhen Hospital Affiliated to Capital Medical University from June 2018 to May 2019 were selected as the observation group. According to the principle of reciprocity, 51 elderly patients who underwent cardiac surgery from June 2017 to May 2018 were selected as the control group. The control group was given routine nursing while the observation group carried out comprehensive geriatric assessment based on routine nursing and formulated nursing plans and measures based on assessment results. The incidence of adverse nursing events during hospitalization and length of hospital stay were compared between the two groups.Results:The unplanned extubation rate, aspiration rate and fall rate in the observation group were respectively 1.79% (1/56) , 1.79% (1/56) and 0 (0/56) , which were lower than 13.73% (7/51) , 15.69% (8/51) and 9.80% (5/51) in the control group, and the differences were statistically significant ( P<0.05) . The incidence of stress injury was 0 (0/56) in the observation group and 1.96% (1/51) in the control group, and the difference was not statistically significant ( P>0.05) . The infection rate of tube incision in the observation group was 0 (0/56) , which was lower than 9.80% (5/51) in the control group, and the difference was statistically significant ( P<0.05) . The length of hospital stay in the observation group was shorter than that in the control group, and the difference was statistically significant ( Z=8.068, P<0.01) . Conclusions:Application of comprehensive geriatric assessment in elderly patients undergoing cardiac surgery can reduce the incidence of unplanned extubation, aspiration, falls and other nursing adverse events, reduce the infection rate of incision and shorten the length of hospital stay.

Objective To evaluate the clinical diagnostic value of color Doppler ultrasound in diagnosis brucellosis with orchitis.Methods Hospital-based case-control study was used.We selected the patients with brucellosis orchitis who were hospitalized in Heilongjiang Land Reclamation Bureau General Hospital from 2014 to 2016 as a case group.At the same time,selected healthy people as the control group.Bilateral testicular size,parenchyma echo,flow signals in parenchyma,depth of bilateral testicular sheath membrane cavity effusion,testicular artery peak systolic velocity (PSV),end-diastolic velocity (EDV),pulsatility index,resistance index,peak systolic velocity/end-diastolic velocity,were measured and analyzed using color Doppler ultrasound.Results The case group included 62 patients;the health control group included 41 persons.The testicular volume of case group was compared to that of healthy control group,there was no statistical significant difference (cm3:15.81 ± 3.27 vs 15.82 ± 2.77,t =0.015,P ＞ 0.05).By analyzing the correlation between the course of the disease and the testicular volume,a negative relationship was found (r =-0.594,P ＜ 0.01).In the case group,the deep diameter of the testicular sheath was higher than that of the healthy control group,and the difference was statistically significant (cm:1.50 ± 0.53 vs 0.84 ± 0.21,t =10.777,P＜ 0.01).The PSV and EDV were higher than those in the control group (cn/s:(9.73 ± 3.25 vs 6.00 ± 1.38,2.89 ± 0.77 vs 2.46 ± 0.36,t =9.810,4.691,P ＜ 0.01).The pulsation index and resistance index were higher than that in the control group (1.06 ± 0.12 vs 0.82 ± 0.08,0.69 ± 0.05 vs 0.58 ± 0.04,t =15.678,12.763,P ＜ 0.01).Conclusions There are specific changes in Brucella patients with orchitis.The blood flow spectrum and testicular sheath membrane cavity effusion are specific changes.The color Doppler ultrasound can effectively evaluate Brucella orchitis patients with testicular injury,provide a reliable imaging basis for clinical treatment.

Objective To investigate the value of standardized ultrasound screening in diagnosis of fetal congenital heart disease (CHD) during the first trimester. Methods This study retrospectively analyzed the clinical data of 8 383 fetuses who received ultrasound screening during the first trimester in the Dongguan Maternal and Child Health Hospital from September 2015 to December 2016. Standardized ultrasound was performed to observe fetal heart position, apical direction, apical four-chamber view, three vessels and trachea view and the thickness of nuchal translucency (NT). Fetuses with thickened NT or fetal CHD observed during the first and second trimester were followed up. Pregnancy outcomes and the growth of newborns within one year after birth were recorded and analyzed. Pathological results after the termination of pregnancy were compared with the results of routine karyotyping and chromosome microarray analysis (CMA). Results (1) A total of 27 cases of fetal CHD were identified during the first trimester giving a detection rate of 0.32% (27/8 383). These included ten (37.0%) of single atrium and/or single ventricle, seven (25.9%) of endocardial cushion defect (including two complicated by persistent arterial trunk), three (11.1%) of hypoplastic right heart syndrome, three (11.1%) of interventricular septal defect, two (7.4%) of hypoplastic left heart syndrome, one (3.7%) of mirror-image dextrocardia and one (3.7%) of right atrial enlargement and severe tricuspid regurgitation. Nineteen out of the 27 cases had NT thickening (NT≥3.0 mm) and 17 of them had a cystic hygroma (NT≥6.0 mm). Among the 27 cases, 22 were terminated in the first trimester which autopsy results were consistent with ultrasound and the other five were rescreened during the second trimester. Thirteen out of the 27 cases received chorionic villus sampling, and seven of them were found to have chromosomal abnormalities by karyotyping and CMA, among whom one was microdeletion of 22q11. (2) Twenty-one cases of CHD were detected in the second-trimester ultrasound screening, including five initially identified in the first trimester. These cases included four (19.0%) of complex cardiac malformations (with three or more malformations), four (19.0%) of interventricular septal defect, three (14.3%) of dextroaortic arch, left subclavian artery vagus and 'U' shaped vascular ring, three (14.3%) of hypoplastic right heart syndrome (including one complicated by coronary artery-right ventricular fistula and one by interventricular septal defect), two (9.5%) of transposition of the great arteries, two (9.5%) of tetralogy of Fallot, one (4.8%) of hypoplastic left heart syndrome, one (4.8%) of Taussig-Bing anomaly and one (4.8%) of coarctation of the aorta. Among the 16 cases first identified in the second trimester, eight had NT thickening, including one with cystic hygroma. Among the 21 cases, two were lost to follow-up after being transferred to another hospital; four with negative results in karyotype analysis and CMA were delivered vaginally at term (37-40 gestational weeks) with 1-min Apgar scores of ten points and postpartum ultrasound of the baby was consistent with the second-trimester ultrasound screening; 15 were terminated and the autopsy confirmed those findings in the second-trimester ultrasound screening. Eleven out of the 21 cases received amniocentesis and five of them were found to be abnormal according to karyotype analysis and CMA, including one of microdeletion of 22q11. Conclusions Standardized first-trimester ultrasound screening is important and of great clinical value in the diagnosis of fetal CHD. Increased NT thickness could be a key indicator of fetal CHD and chromosomal abnormalities in early pregnancy. CMA may facilitate detecting the abnormality of genetic material in fetuses with normal chromosome karyotype.

Objective To investigate the effects of attentional bias training on mood and disease uncertainty in anxious patients with coronary artery intervention treatment during transition period. Methods A total of 82 anxious patients with coronary artery intervention treatment during transition period were assigned into control group (28 cases), escape-negative-training group(27 cases) and positive-direction-training group (27 cases) by random digits table method. Patients in control group only received routine psychological counseling, while patients in escape-negative-training group and positive-direction-training group also received spot-type attentional bias training(200 trails/time,10-15 minutes/time,2 times/week, all 4 weeks in the two groups;the negative and neutral words between the probe points were 20%and 80%in escape-negative-training group,and positive and neutral words between the probe points were 100%and 0 in positive-direction-training group). All the patients were evaluated by Stroop test, Self-evaluation of Anxiety Scale (SAS), Attention to Positive and Negative Information Scale (APNIS), Profile Of Mood States (POMS) and Illness Uncertainty Scale (IUS). Results After intervention, 21.4%(6/28) was alleviated in the control group, while respective 70.4%(19/27) and 44.4%(12/27) in escape-negative-training group and positive-direction-training group (χ2=8.15, P=0.003). There were no significant differences in SAS, POMS, Stroop test, APNIS and IUS among three groups (P>0.05). After intervention, the SAS, negative emotion scores in POMS (tension-anxiety, depression-dejection, fatigue-inertia, baffling-confusion) and IUS were lower in escape-negative-training group than those in control group(Q=3.79-7.58, all P<0.01);and the SAS and IUS were lower in positive-direction-training group than those in control group, while positive emotion scores in POMS (vigor-activity) higher than those in control group (Q respective was 3.11, 4.34, 6.12, all P<0.05). The SAS, POMS (tension-anxiety, depression-dejection, fatigue-inertia, baffling-confusion, vigor-activity) were more improved in escape-negative-training group than those in positive-direction-training group (Q = 3.09-4.04, all P<0.05), while no difference in IUS (P>0.05). Conclusions Attentional bias training could improve the anxiety symptoms and reduce illness uncertainty in anxious patients with coronary artery intervention treatment during transition period. Escape-negative-training is more effective in reducing patients′ negative mood and alleviating anxiety symptoms than the positive-direction-training.