Objective To explore the correlation of heart rate variability(HRV)and cardiac output by PICCO with anesthetic depth by Narcotrend monitoring. Methods 60 patients with radical resection of esophageal cancer were enrolled in the study. PICCO was used to monitor ECG and Narcotrend was use to monitor anesthetic depth.The NT value,NT grade,Cardiac index(CI),heart rate(HR),mean arterial pressure(MAP),cardiac output(CO),Poincare scattergram Scatter plot minor axis(SD1)and scatter plot major axis(SD2)were recorded and measured at the time points of pre-anesthesia induction(T1),post-successful intubation(T2),tracheal intu-bation moment(T3),lung collapse for 30 min(T4),post-lung ventilation(T5)and 10min after operation(T6). Results Person's correlation analysis showed that during the monitoring period(T1-T6),CI,CO,SD1 and NT showed a low linear correlation(P < 0.001);SD2 was significantly correlated with NT(P <0.001). There was a low linear correlation between CI,CO,SD1,SD2 and NT at the operation time(T2-T5). Conclusion During general anesthesia,heart rate variability(SD1,SD2)and cardiac output(CO)are correlated with the NT value of anesthesia depth.Collaborative monitoring could help to enhance the safety of anesthesia.

Objective To investigate the impact of nociceptive level(NOL)index on cellular immunity and HIF-1α in patients with radical breast cancer.Methods A total of 80 patients undergoing radical mastectomy between December 2022 and December 2023 were randomly assigned into an experimental group and a control group using a random number table method.The NOL index in the experimental group was maintained within the range of 30 to 50,with corresponding adjustments made to achieve the target concentration of remifentanil.In contrast,the control group initially received remifentanil at a target controlled infusion rate of 4 ng/mL,which was adjusted based on hemodynamics.The average target concentration of remifentanil was recorded for both groups.Venous blood samples were collected from all participants one day before and one day after surgery to measure CD4+,CD8+cell counts,NK cell activity,as well as serum levels of HIF-1α.Results There were no significant differences observed in anesthesia time,operation time,intraoperative mean arterial pressure(MAP),heart rate(HR),and postoperative visual analog scale(VAS)scores between the two groups.The average target concentra-tion of remifentanil in the experimental group was significantly lower than that in the control group(P＜0.05).Moreover,the experimental group exhibited higher values of CD4+,CD4+/CD8+ratio,and NK cells compared to the control group,while demonstrating a lower level of HIF-1α expression(P＜0.05).In addition,within the experimental group,there was a decrease in CD4+count and CD4+/CD8+ratio one day after surgery compared to one day before surgery;meanwhile,HIF-1α expression increased significantly after surgery when compared to preoperative levels(P＜0.05).Similarly,within the control group,there was a decrease observed in CD4+,CD8+,CD4+/CD8+ratio as well as NK cell values one day after surgery when compared to preoperative levels;additionally,HIF-1α expression showed a significant increase after surgery when compared to preoperative levels(P＜0.05).Conclusion The implementation of NOL monitoring during radical mastectomy under general anes-thesia can effectively lower the required remifentanil concentration,thereby mitigating its suppressive effects on T lymphocytes,preserving NK cell activity,and reducing elevated levels of HIF-1α.Consequently,this approach exerts minimal impact on the tumor immune microenvironment(TIME)in patients.

Objective: To describe the distribution and trend of rheumatoid arthritis (RA) in adults in the Yinzhou district from 2011 to 2020 and compare the incidence differences in different ages and genders. Methods: Using the retrospective cohort design, we collected all new cases diagnosed with RA between 2011 to 2020 from the Yinzhou Regional Health Information Platform (YRHIP). Poisson distribution was used to estimate RA's incidence density and 95%CI. Results: From 2011 to 2020, 1 280 012 permanent residents in Yinzhou district were included, of which 665 361 were female (51.98%). The total follow-up person-years were 7 198 513.61, and the median follow-up person-year was 5.41 years (P₂₅=3.50, P₇₅=8.32). During the study period, there were 2 350 new cases of RA, of which 1 460 were female (62.13%). The 10-year incidence density of the population was 32.65/100 000 person-years (95%CI: 31.34/100 000 person-years-33.99/100 000 person-years), that of females was 39.17/100 000 person-years (95%CI: 37.19/100 000 person-years-41.24/100 000 person-years), and that of the male was 25.64/100 000 person-years (95%CI: 23.98/100 000 person-years-27.38/100 000 person-years), the gender difference was statistically significant (P<0.001). The incidence risk in all age groups above 30 years old was higher than that in the 18-29 years old group (P<0.001), and the incidence risk increased with age from 18-79 years old while decreased slightly with age ≥80 years old. The lowest incidence density was 15.30/100 000 person-years in 2013 (95%CI:12.62/100 000 person-years-18.38/100 000 person- years), and the highest was 56.70/100 000 person-years in 2016 (95%CI: 51.24/100 000 person- years - 62.58/100 000 person-years), with statistically significant differences among different years (P=0.004). Conclusions: From 2011 to 2020, the incidence density of RA in adults in Yinzhou district first increased, then decreased, and tended to stabilize. There were differences in incidence density in different years, ages, and genders.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid/epidemiology* ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult

OBJECTIVE: To describe the distribution characteristics of inflammatory bowel disease among permanent residents in Yinzhou District, Ningbo City, and to understand the disease burden and development trend of inflammatory bowel disease in this area. METHODS: Using the retrospective cohort design, we collected the registration information of all permanent residents in the residents' health files of the Yinzhou Regional Health Information Platform from 2010 to 2020, and used electronic medical records to follow up their inflammatory bowel disease visits. A one-year wash-out period was set, and the patients who were diagnosed with the primary diagnosis for the first time after one year of registration were re-garded as new cases. The incidence density and 95% confidence interval (CI) of inflammatory bowel disease were estimated by Poisson distribution. RESULTS: From 2011 to 2020, a total of 1 496 427 permanent residents in Yinzhou District were included, of which 729 996 were male (48.78%). The total follow-up person-years were 8 081 030.82, and the median follow-up person-years were 5.41 [interquartile range (IQR): 5.29]. During the study period, there were 1 217 new cases of inflammatory bowel disease, of which males (624 cases, 51.27%) were more than females (593 cases, 48.73%). The total incidence density was 15.06/100 000 person-years (95%CI: 14.23, 15.93). Among all new cases, there were 1 106 cases (90.88%) of ulcerative colitis, with an incidence density of 13.69 per 100 000 person-years (95%CI: 12.89, 14.52); 70 cases (5.75%) of Crohn's disease, with an incidence density of 0.87 per 100 000 person-years (95%CI: 0.68, 1.09); and 41 cases (3.37%) of indeterminate colitis, with an incidence density of 0.51 per 100 000 person-years (95%CI: 0.36, 0.69). The median age of onset of ulcerative colitis was 50.82 years old (IQR: 18.77), with the highest proportion (15.01%) in the 45-49 years group. The incidence density of ulcerative colitis gradually increased with age, reaching a relatively high level in the 45-49 years group (20.53/100 000 person-years; 95%CI: 17.63, 23.78), followed by a slight increase. And the incidence density in the 65-69 years group was the highest (25.44/100 000 person-years; 95%CI: 20.85, 30.75), with a rapid decrease in the 75-79 years group. The median age of onset of Crohn's disease was 44.34 years (IQR: 33.41), with the highest proportion (12.86%) in the 25-29 years group. Due to the small number of new cases of Crohn's disease, the age distribution fluctuated greatly, with peaks both in young and old people. From 2011 to 2020, the incidence density of inflammatory bowel disease in Yinzhou District was at a low level from 2011 to 2013, and showed a rapid upward trend from 2014 to 2016, reaching a peak of 24.62 per 100 000 person-years in 2016 (95%CI: 21.31, 28.30), and slightly decreased in 2017-2020. CONCLUSION The incidence density of inflammatory bowel disease in Yinzhou District from 2011 to 2020 was at a relatively high level, and medical institutions and health departments need to pay attention to the burden of disease caused by it.
Adolescent ; Adult ; Chronic Disease ; Colitis, Ulcerative/epidemiology* ; Crohn Disease/epidemiology* ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases/epidemiology* ; Male ; Middle Aged ; Retrospective Studies

Objective: To characterize the incidence density of systematic lupus erythematosus (SLE) in Yinzhou District of Ningbo from 2016 to 2021, and compare the age and gender specific differences. Methods: A retrospective cohort study was conducted based on the related data from 2015 to 2021 collected from the Health Information Platform of Yinzhou. Suspected SLE cases in local residents were identified by fuzzy matching of International Classification of Diseases 10^th edition code "M32" or Chinese text "lupus". The classification criteria from Systemic Lupus International Collaboration Clinics-2012 and The European League Against Rheumatism/American College of Rheumatology-2019 were used for case verification. SLE cases were identified with specific algorithm based on verification results, and new cases were identified with 1 year as the washout period. The incidence density and 95%CI were estimated by Poisson distribution. Results: From 2016 to 2021, a total of 1 551 921 permanent residents were registered in Yinzhou, in whom 51.52% were women. The M(Q₁,Q₃) age at enrollment was 40.38 (27.54, 53.54) years. The M(Q₁,Q₃) of follow-up person-years was 3.83 (0.41, 5.83) years. There were 451 new SLE cases, in which 352 were women (78.05%). The 6-year incidence density was 8.14/100 000 person-years (95%CI: 7.41/100 000 person-years-8.93/100 000 person-years) for the total population, 3.68/100 000 person-years (95%CI: 2.99/100 000 person-years-4.48/100 000 person-years) for men and 12.37/100 000 person-years (95%CI: 11.11/100 000 person-years- 13.73/100 000 person-years) for women. The incidence density in men appeared a small peak at 20-29 years old, and began to increase with age from 40 years old. The incidence density in women was highest in age group 20-29 years (16.57/100 000 person-years) and remained to be high until 30-79 years old. The incidence density of SLE in Yinzhou show no significant temporal trend from 2016 to 2021 (men: P=0.848; women: P=1.000). Conclusions: The incidence density of SLE in Yinzhou from 2016 to 2021 was similar to those of other areas in China. SLE has a high incidence in women, especially in the young and elderly, suggesting that more attention should be paid to the diagnosis and treatment of SLE in women.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Asian People ; Incidence ; Lupus Erythematosus, Systemic/diagnosis* ; Retrospective Studies ; China/epidemiology*

Objective To investigate the correlation between the location of ruptured intracranial vertebral artery dissecting aneurysm (VADA)and the outcome after endovascular treatment. Methods Thirty-six patients with ruptured intracranial VADA undergoing endovascular treatment were enrolled retrospectively. According to the relationship between VADA and the location of the opening of posterior inferior cerebellar artery(PICA),they were divided into 3 groups:proximal to PICA group (n=13), distal to PICA group (n=13),and PICA involvement group (n=10). The demographic data, vascular risk factors, clinical features, imaging features, endovascular treatment mode, postoperative complications, and differece of the good outcome rate(defined as the modified Rankin scale 0-2)after 6 months of treatment were compared.Results Seven patients in the proximal to PICA group received reconstructive endovascular treatment (RET), and 6 received endovascular internal trapping(EIT);the good outcome rate was 100%(13/13).Seven patients in the distal to PICA group received RET,6 were treated with EIT;the good outcome rate was 84.6%(11/13).Four patients in the PICA involvement group received RET,and 6 received EIT,and 2 of them received contralateral vertebral artery retrograde PICA stenting combined with VADA segment and proximal vertebral artery coil embolization;the good outcome rate was 60.0%(6/10). There were significant differences in the overall outcome good rate among the 3 groups (P<0.05). The good outcome rate in the PICA involvement group was significant lower than that in the proximal to PICA group,and significantly lower than that in the proximal to PICA combined with distal to PICA group(P<0.05).Multivariate logistic regression analysis showed that only Fisher grade 3-4 was the independent risk factor for poor outcome (odds ratio 28.0, 95% confidence interval 1.71-458.82; P=0.020). Conclusions The surgical options of endovascular treatment for ruptured intracranial VADA needs to evaluate the relationship between the location of dissecting aneurysms and the PICA origin. The risk of endovascular treatment in patients with intracranial VADA involving the origin of PICA is higher and it may affect the outcome.

Objective: To construct a cervical cancer risk prediction model based on nested case-control study design and Yinzhou Health Information Platform in Ningbo, and provide reliable reference for self-risk assessment of cervical cancer in local women. Methods: In local women aged 25-75 years old who had no history of cervical cancer registered in Yinzhou before October 31, 2018, a follow up was conducted for at least three years, the patients who developed cervical cancer during the follow up period were selected as the case group and matched with a control group at a ratio of 1∶10. The prediction indicators before the onset was used in model construction. Variables were selected by Lasso-logistic regression, the variables with non-zero β were selected to fit the logistic regression model and Bootstrap was used for internal validation. The discrimination of the model was evaluated by area under the receiver operating characteristic curve(AUROC), and the calibration was evaluated by calibration curve and Hosmer-Lemeshow test. Results: The prediction indicators included in the final model were age, smoking status, history of cervicitis, history of adenomyosis, HPV testing, and thinprep cytologic test. The AUROC calculated in the internal validation was 0.740 (95%CI:0.739-0.740), and the calibration curve was almost identical with the ideal curve, P=0.991 in Hosmer-Lemeshow test, indicating that the model discrimination and calibration were good. Conclusions: In this study, a simple and practical cervical cancer risk prediction model was developed. The model can be used in general population with strong interpretability, good discrimination and calibration in internal validation, which can provide a reference for women to assess their risk of cervical cancer.