Objective To describe the status of prevalence,awareness,treatment,and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province,and to provide scientific evidence for prevention and control of hypertension.Methods In December 2015,Yongjin,Yongli groups of Yongjin Village,and Fengnian,Fengtian,Fengfu groups of Fengnian Village in Fanrong Township,Fuyu County,Qiqihaer City,Heilongjiang Province were selected via the cross-sectional method.The residents aged 18 years or older were surveyed as respondents by cluster sampling.Demography,risk factors,hypertension related information were collected through questionnaire survey.Blood pressure,height and weight were measured through physical examination.Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer,the diagnostic criteria was Chinese Guidelines for Prevention and Treatment of Hypertension (revised in 2010).Results Totally 683 residents were surveyed,the valid participants were 669,the prevalence of hypertension was 49.2％ (329/669),the standardized prevalence was 37.9％,the prevalence of men [58.0％ (164/283)] was higher than that of women [42.7％ (165/386),x2 =15.103,P ＜ 0.01],the prevalence increased with increasing age (total,men,women:x2tendency =9.044,4.560,7.789,all P ＜ 0.01).The awareness of hypertensive patients was 60.8％ (200/329),the standardized awareness was 41.2％,the awareness of men [54.3％ (89/164)] was lower than that of women [67.3％ (111/165),x2 =5.836,P ＜ 0.05],the awareness of hypertensive patients increased with increasing age (total,men,women:x2tendency =3.638,2.686,2.419,all P ＜ 0.05).The treatment of hypertensive patients was 51.1％ (168/329),the treatment of men [43.9％ (72/164)] was lower than that of women [58.2％ (96/165),x2=6.711,P ＜ 0.05],the treatment of hypertensive patients increased with increasing age (total,men,women:x2tendency =4.422,2.704,3.633,all P ＜ 0.01).The control rate of hypertensive patients was 5.5％ (18/329),the control rate among the treatment was 10.7％ (18/168).Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average (25.2％),the standardized awareness is lower than the national average (46.5％),the treatment and the control are low.We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.

Objective Adhesion or too highly located folds upper eyelid and even hlepharoptosis are common complications after double eyelid operation. The method was designed to correct these de-formities. Methods The incision of upper eyelid was designed under the scar. Skin was resected between the former and the new double line, if there was excessive skin. Completely relieve the adhesion until nor-mal tissue was exposed. Expose lateral extension of retro-orbicularis oculi fat pad. An upper pedicle fat flap was formed after cutting tissues off along bilateral borders. Appropriately and transversely cutting lateral portion of the pedicle made it rotate inside downward with enough blood supply. The fat flap was fixed with released orbital fat and the lower edge of fat flat fixed with upper border of supratarsal to restorate the volume. For severe condition, fat granule injection could be used after the skin was sutured. Results 42 cases (80 eyes) were treated in the past two years. The deformities of 32 cases were corrected by the application of retro-orbicularis oculi fat pad. Fat granule injection was applied for the other 10 pa-tients meanwhile. 30 cases (60 eyes) were followed up for 6 to 24 months. The results were satisfactory. Conclusion The methods are performed easily and the results are satisfied. It is worth of recommenda-tion.

Objective:To explore the relationship between the changes of anorectal angle (ARA) under 3 physiological states and pelvic organ prolapse(POP) in postpartum women by transperineal ultrasound.Methods:The retrospective study enrolled 147 female in 6-8 weeks after delivery examined by pelvic floor ultrasound examinations in Fujian Medical University Second Affiliated Hospital from November 2019 to June 2021, who were divided into POP group and control group. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The differences in the changes of ARA under 3 physiological states between the two groups were compared, and the correlation between the change state of ARA during maximal Valsalva maneuver and POP was analyzed.Results:Compared with ARA at rest, ARA decreased during contraction (χ 2=42.64, P<0.001) and increased during maximal Valsalva maneuver (χ 2=38.43, P<0.001). There was no difference of ARA between the POP group and control group in the 3 physiological states ( P>0.05). However, the risk of POP increased when ARA decreased during maximal Valsalva maneuver ( OR=2.690, 95% CI=1.074-6.739, P<0.05). Conclusions:The decrease of ARA during maximal Valsalva maneuver may increase the risk of POP, and the change of ARA during maximal Valsalva maneuver can be brought into the ultrasonic observation indicators of POP.

Objective To explore the spatial description of Keshan disease(KD)and to provide a basis for reasonable allocation of health resources and for making precision prevention and control strategies. Methods In 2013 and 2014, the KD's condition, prevention and control measures and their effects were investigated in the diseased affected counties in the provinces through combination of case search and key survey. Results A total of 16(100.0%,16/16)diseased provinces,315(96.0%,315/328)diseased counties were surveyed,and 1 562 people with KD were detected in 281 000 residents, the detection rate was 55.6/10 000. Chronic and latent KD detection rates were 8.9/10 000(250)and 46.7/10 000(1 312),respectively.There were 261(82.9%)diseased counties that had reached the control standards of KD,and 54(17.1%)did not meet the control standards,which mainly distributed in the provinces of Henan, Inner Mongolia, Gansu and Shanxi. Conclusions The detection rate of KD has been at a low level, but in Henan, Inner Mongolia, Gansu, and Shanxi, there are prevalent KD areas that have not yet reached the control level.This part of the areas should be treated as key prevention and control areas of KD.

Objective To explore the spatial distribution clustering and influencing factors of chronic Keshan disease in China,and to provide evidence for prevention and control of Keshan disease.Methods Using non-probability sampling methods,combined with case search and key surveys,data on national detection rate of chronic Keshan disease,on disease influencing factors in 2013-2014 were collected;a spatial database was established,and ArcGIS 9.0 software was used to perform global Moran'sI,local Moran's I,local Getis-Ord Gi and inverse distance weighted interpolation analysis for the detection rate of national chronic Keshan disease.Spatial regression was used to analyze the influencing factors of chronic Keshan disease.Results Global autocorrelation analysis showed that Moran's I =0.03,Z =2.72,P ＜ 0.01,indicating that there was aggregation in the detection rate of Keshan disease.The results of local Moran's Ii showed that there were local high-detection rate clusters in the wards of Keshan disease,and the high-high aggregation areas were mainly concentrated in the wards of Gansu,Inner Mongolia,and Shanxi;the high-low aggregation areas were mainly located in the wards of Heilongjiang,Jilin,Shandong;the low-high aggregation area were mainly located in the wards of Heilongjiang.Getis-Ord Gi autocorrelation results showed that Keshan disease hotspots were mainly located in the wards of Inner Mongolia,Heilongjiang,Gansu,Shandong,Shanxi and Yunnan;the results of reverse distance weighted interpolation showed that the detection rates of the counties in Gansu and Inner Mongolia were higher than that in Heilongjiang,Jilin,Liaoning,Shanxi,Shandong,Shaanxi and Yunnan,the detection rate of wards in other provinces was at a lower level.Spatial regression analysis showed that the spatial distribution of chronic Keshan disease was negatively related to rural per capita net income and annual average temperature in the ward (Z =-2.808,-2.747,P ＜ 0.05).Conclusions Global chronic Keshan disease exists spatial aggregation,the local gathering area is mainly located in the wards of Gansu,Inner Mongolia.The spatial distribution of chronic Keshan disease may be affected by the level of rural per capita net income and annual average temperature in the ward.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective To explore the independent risk factors that affect the overall survival (OS) of elderly patients with hepatocellular carcinoma (HCC, ≥60 years old) and build a nomogram prediction model. Methods Clinical data of all elderly patients with HCC from the SEER database from 2005 to 2020 were downloaded from SEER database. In accordance with the inclusion and exclusion criteria, the screened patients were randomly assigned to a training group (70%) and a validation group (30%). The independent risk factors of elderly patients with HCC were determined by univariate and multivariate Cox regression analyses and further validated by Kaplan-Meier survival analysis. On the basis of the determined variables, nomograms were developed and verified to predict the OS of elderly patients with HCC at 6, 12, and 24 months. The consistency index (C index), calibration curve, receiver’s operating characteristic (ROC) curve, and area under curve (AUC) were used to evaluate the prediction efficiency and discrimination ability of the prediction model, and decision curve analysis (DCA) was used to evaluate the potential clinical application value of the nomogram. Results A total of 1134 elderly patients with HCC were included, with 793 in the training group and 341 in the validation group. Seven variables, including age, clinical grade, clinical stage, M stage, tumor size classification, and radiotherapy, were identified as independent prognostic factors of this population. The constructed nomogram shows excellent prediction performance, with C indices of 0.745 in the training group and 0.704 in the validation group. The AUC values of the training group at 6, 12, and 24 months were 0.785, 0.788, and 0.798, respectively, and those of the validation group were 0.780, 0.725, and 0.607, respectively. The calibration curve shows good consistency from the predicted survival probability to the actual probability. The ROC curve and DCA show that the nomogram proposed in this study has good prediction ability. Conclusion Age, clinical grade, clinical stage, M stage, tumor size classification, and radiotherapy are important influencing factors for the survival of elderly patients with HCC. The prediction model of prognosis nomogram constructed in this study has good predictive value, and it can be used to predict the OS of elderly patients with HCC, which could be helpful for individualized survival assessment and clinical management of these patients.