ObjectiveTo construct a nomogram prediction model for non-valvular persistent atrial fibrillation （PeAF） patients with left ventricular hypertrophy （LVH） ， followed by prognostic analysis through follow-up. MethodsThis study retrospectively enrolled 949 patients with newly diagnosed and hospitalized non-valvular PeAF. Among them， 403 patients presented with LVH. The cohort was randomly stratified into a training set （n=665） and a validation set （n=284）. Univariate and multivariate Logistic regression analyses were employed to identify independent risk factors for PeAF complicated by LVH. A nomogram prediction model was subsequently constructed and evaluated for discriminative ability， calibration， and clinical utility using receiver operating characteristic （ROC） curve analysis， calibration plots， and decision curve analysis （DCA）. ResultsSeven independent risk factors were ultimately identified and included in the prediction model： female sex， hypertension， diabetes， red blood cell distribution width-SD （RDW-SD）， body mass index （BMI）， left atrial diameter （LAD）， and left ventricular ejection fraction （LVEF）. The area under the ROC curve （AUC） in the training set was 0.862 （95% CI： 0.834-0.890）， and in the validation set， it was 0.870 （95% CI： 0.829-0.911）， demonstrating excellent predictive performance. ConclusionIndependent risk factors for LVH in PeAF patients include female， hypertension， diabetes， RDW-SD， BMI， LAD， and LVEF. The prediction model built based on this can help early identification of PeAF patients with high risk of LVH. At the same time， the incidence of major adverse cardiovascular events （MACE） is higher in PeAF patients with LVH. Patients with atrial fibrillation combined with LVH may benefit from catheter ablation.

Objective To explore the application effects of a discharge planning service program based on King's Goal Attainment Theory in patients undergoing transcatheter heart valve surgery.Methods Using convenience sampling method,80 patients who underwent transcatheter heart valve surgery at a tertiary comprehensive hospital in Zhejiang Province from August 2023 to January 2024 were selected as the research subjects.Among them,40 patients from November 2023 to January 2024 were selected as an experimental group.A discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory was adopted.Totally 40 patients who underwent transcatheter heart valve surgery from August to October 2023 were selected as a control group and underwent routine measures for discharge preparation.The differences in the scores of the discharge preparation scale,discharge guidance quality scale,self-management scale for patients after mechanical heart valve replacement surgery,and unplanned readmission rate were compared between 2 groups before and after intervention.Results During the application of the plan,a total of 2 cases were excluded,and 38 cases were included in the experimental group and 40 cases were included in the control group.After intervention,the experimental group had higher scores in discharge readiness,discharge guidance quality,and self-management ability than the control group,and the differences were statistically significant(P＜0.001).The unplanned readmission rate within 30 days in the experimental group(2.63％)was lower than that in the control group(7.50％),and the difference was not statistically significant(P＞0.05).Conclusion The discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory can improve the discharge preparation,discharge guidance quality,and self-management ability of patients undergoing transcatheter heart valve surgery,and has a positive effect on improving their quality of life.

OBJECTIVE To investigate the protective effects of hydroxytyrosol hydroxybutyrate(HTHB)against cognitive impairment induced by acute sleep deprivation in mice and to explore the underlying mechanisms.METHODS Male C57BL/6J mice were assigned to the following groups:normal control,normal groups administered with HTHB 30,60 and 120 mg·kg-1 or hydroxytyrosol(HT 19.25,38.5 and 77 mg·kg-1),a sleep deprivation(SD)model group,and SD groups co-administered with the same doses of HTHB or HT.Acute sleep deprivation was induced for 72-96 h using a rotarod apparatus in all groups except the normal control and normal drug-treated groups.Based on dose-response assess-ments in the Y-maze and novel object recognition tests,the effective doses(HTHB 60 mg·kg-1 and HT 38.5 mg·kg-1)were selected for subsequent evaluation in the two-choice visual discrimination task that was performed in a subset of groups:normal control,normal+HTHB 60 mg·kg-1,normal+HT 38.5 mg·kg1,SD model,SD+HTHB 60 mg·kg-1,and SD+HT 38.5 mg·kg-1.Cognitive functions that were assessed included spatial working memory(Y-maze spontaneous alternation),object recognition memory(novel object recognition)and visual discrimination ability(two-choice visual discrimination task).Biochemically,levels of hippocampal reactive oxygen species(ROS)were quantified by ELISA while the ATP content was determined using a firefly luciferase-based assay.RESULTS In non-sleep-deprived mice,neither HTHB nor HT administration significantly altered locomotor activity,spatial working memory,object recognition memory,or visual discrimination performance.Following sleep deprivation,the model group displayed significant cognitive deficits,including reduced spontaneous alternation rate,lower novel object recognition indexes,and decreased accuracy in the visual discrimination task at 48 and 96 h.These impairments were accompanied by elevated hippocampal ROS levels and reduced ATP contents com-pared to the control group.Treatment with HT 38.5 and 77 mg·kg-1 significantly attenuated the deficit in spontaneous alternation,but did not affect other parameters.In contrast,HTHB at 60 and 120 mg·kg-1 produced broader restorative effects and significantly reversed impairment in both spontaneous alterna-tion and novel object recognition.Furthermore,HTHB at 60 mg·kg-1 significantly improved visual discrimination accuracy at 48 and 96 h,while lowering hippocampal ROS levels and increasing ATP contents.CONCLUSION HTHB effectively mitigates acute sleep deprivation-induced impairment in spatial working memory,object recognition memory,and visual discrimination in mice.This protection is likely mediated by the enhancement of mitochondrial antioxidant capacity and the restoration of energy metabolism.

Objective:To understand the teaching effect and demand of the graduating students of the School of Public Health on the Public Health Skills Training course.Methods:A questionnaire survey was conducted among students of grade 2018 majoring in Preventive Medicine and Maternal and Child Health Care Medicine and students of grade 2019 majoring in Food Hygiene and Nutrition and Health Inspection and Quarantine of Anhui Medical University.Multivariate Logistic regression analysis was used to explore the influencing factors of course effectiveness and demand.Results:Among the 212 students who participated in the survey,89.62%of the students said that they could master the learning of Public Health Skills Training course,and 84.91%of the students believed that it had practical application significance for their future work and life.The results of multivariate Logistic regression analysis showed that students who were satisfied with the curriculum(compared with dissatisfaction/average)and thought that the curriculum difficulty was average/easy(compared with difficult)had higher curriculum mastery.Students who thought that the time of the course should be moved backward(compared with the appropriate time)and had no intention to participate in the National Public Health Skills Competition(compared with had intention to participate)for college students thought that the study of the course had no practical application significance for their future work and life.Conclusion:Strengthen the teaching of public health skills practical training courses,improve students'satisfaction with the courses,and find teaching methods suitable for students'understanding can improve students'mastery of the courses and help students better improve their practical and analytical abilities.

This study aims to investigate the effect of Lactiplantibacillus plantarum LP12 on obe-sity prevention.In our study,Lactiplantibacillus plantarum LP12 was added to the diet for feed-ing,and the blood biochemistry status of rabbit,as well as the antioxidant effect of serum and liver samples were analyzed by determining the body weight change and feed intake of Japanese White rabbits.The changes in colony structure and abundance were also analyzed by 16S rDNA sequen-cing.The results showed that supplementation of Lactiplantibacillus plantarum LP12 inhibits weight gain,decreases serum glucose and ALT levels,and increases SOD activity in the liver.16S RNA gene sequencing analysis showed that the addition of Lactiplantibacillus plantarum LP12 increases the abundance of Bacteroidetes and Desulfovibrioides at the phylum level,and the supple-mentation of Lactiplantibacillus plantarum LP12 increases the abundance of Muribaculaceae at the genus level.Predictive analysis of microbiota function revealed that the supplementation of Lactiplantibacillus plantarum LP12 positively regulated iron-sulfur clusters and Zn-dependent proteases.In conclusion,the addition of Lactiplantibacillus plantarum effectively inhibits weight gain in Japanese White rabbits,enhances the antioxidative activity of the liver,and induces altera-tions in the gut microbiota composition of these rabbits.These findings lay an experimental foun-dation for further exploring the mechanisms by which Lactobacillus plantarum LP12 exerts its preventive effects against obesity and promotes metabolic health.

Objective:To qualitatively and quantitatively compare and evaluate the application of the Fast BLADE sequence and the conventional BLADE sequence in 3T magnetic resonance (MR) liver T2-weighted imaging (T2WI).Methods:A total of 72 patients who underwent liver MR examination at the Chongqing People′s Hospital from December 2023 to July 2024 were selected. All patients underwent liver magnetic resonance imaging (MRI) scanning using a 3T MR scanner, including both the Fast BLADE sequence and the conventional BLADE sequence. The total imaging time of the two sequences was recorded. Two observers used a " 5-point scale" to evaluate the overall image quality, motion artifacts, and radial artifacts of the Fast BLADE and conventional BLADE sequences respectively, and measured the image signal-to-noise ratio (SNR) at the same spatial position in the two groups of images. Statistical analysis was used to evaluate the differences in imaging time and image quality between the Fast BLADE sequence and the conventional BLADE sequence in liver T2WI imaging.Results:The imaging time of the Fast BLADE sequence in liver T2WI imaging was significantly shorter than that of the conventional BLADE sequence ( P<0.01), and the image SNR was significantly higher than that of the conventional BLADE sequence ( P<0.01). The overall image quality, motion artifact reduction, and radial artifact reduction of the Fast BLADE sequence were all superior to those of the conventional BLADE sequence (all P<0.05). The Kappa coefficients for the consistency of the two observers′ evaluations on overall image quality, motion artifacts, and radial artifacts were 0.78, 0.66, and 0.71 respectively. Conclusions:The Fast BLADE sequence can shorten the imaging time and provide images with higher SNR, and thus can replace the conventional BLADE sequence for liver T2WI imaging.

Objective To compare the effects of nalbuphine combined with etomidate and nalbuphine combined with propofol in painless colonoscopy for elderly patients with hypertension. Methods Elderly patients with hypertension who underwent painless colonoscopy in the Department of Anesthesiology of Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from August 2022 to February 2023 were selected and randomly divided into three groups: nalbuphine combined with etomidate group (E group), nalbuphine combined with propofol group (P group), and the nalbuphine combined with etomidate and propofol group (EP group). The primary endpoint was the incidence of hypotension during anesthesia. Secondary endpoints included mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) at five time points: before anesthesia (T₀), before colonoscopy (T₁), 5 minutes after colonoscopy (T₂), at the end of the examination (T₃), upon leaving the post-anesthesia care unit (PACU, T₄). Additionally, examination time, awakening time, Ramsay score, and adverse reactions were compared among the three groups. Results A total of 180 patients were included in the analysis, with 60 cases in each group. The incidence of hypotension was 11.7%, 55.0%, and 33.3% in the E group, P group, and EP group, respectively. The incidence of hypotension in the E group was lower than that in the P and EP groups (P＜0.05). At T₁, T₂, T₃, and T₄, MAP, SBP, and DBP in the E group were significantly higher than those in the P and EP groups (P＜0.05). There were no statistically significant differences among the three groups in awakening time, Ramsay score, or incidence of adverse reactions. Conclusions Compared with nalbuphine combined with propofol, nalbuphine combined with etomidate for painless colonoscopy in elderly patients with hypertension resulted in a lower incidence of hypotension, less impact on hemodynamics, and higher safety.

The variants of pathogens causing major infectious diseases have a significant impact on the prevention, diagnosis, and treatment of these diseases. Rapid identification and efficient treatment rely on the detection and identification technologies for these variants. Molecular diagnostic techniques have greatly improved the sensitivity, specificity, and speed of detecting variants of major infectious diseases. With the rapid advancement of sequencing technologies, both second-generation and third-generation sequencing have shown substantial potentials in identifying variants of major infectious diseases. This article reviews the research and application status of molecular diagnostic techniques for variants of severe acute respiratory coronavirus-2, mycobacterium tuberculosis, and human immunodeficiency virus, and prospects development directions in this field, aiming to provide references for the detection and identification of major infectious diseases variants.

The acquired immune deficiency syndrome(AIDS)-induced fever is mainly characterized by long-term,recurrent and irregular symptom,which poses a major threat to the quality of life of the AIDS patients.Tradition-al Chinese Medicine(TCM)has offered an approach of treatment determination based on syndrome differentiation and formula corresponding to syndrome on basis of the idea of'same disease,different therapies'.The earliest or-igin of the idea of'same disease,different therapies' can be traced back to'Huang Di Nei Jing',it plays a signifi-cant role in the theory of TCM after continuous enrichment and development by ancient medical families.The indi-vidualized therapeutic regimen is formulated based on the etiology,pathogenesis and physical condition(such as qi-insufficiency constitution,phlegm-dampness constitution),emphasizing the vital role of'treatment determina-tion based on syndrome differentiation'in the treatment process,highlighting the importance of personnel experi-ence of doctors,and showing the precise effect of TCM on treatment of AIDS-induced fever.

Under the Healthy China strategy, the training of preventive medicine professionals should conform to the development of the times and the needs of public health. The article analyzed the problem of "disconnection between medical care and prevention" in teaching the course of Obstetrics and Gynecology for students majoring in preventive medicine, and proposed to strengthen the strategy of "integration of medical care and prevention". Guided by the concepts of "Comprehensive Health", with the cornerstone of cultivating morality and talents, the reform focused on enhancing the post competency of preventive medicine talents. Course content was optimized by reinforcing prevention-focused elements, student-centered teaching method innovation was advocated, and simulation-based training teaching system was established. Moreover, projects integrating science and education were used to improve faculty teaching capacity with tiered and diversified approaches. Course assessment methods were revised and "ideological and political education" was incorporated to establish the education concept of "emphasis on prevention and integration of medical care and prevention". The survey showed that these reform measures effectively improved the comprehensive clinical literacy of preventive medicine students in obstetrics and gynecology, which is of great significance for building a "integration of medical care and prevention" public health talent training model. In the future, the long-term effectiveness of course reform will be ensured from the perspectives of teaching resources, personnel investment, and policy support.