Background: Apolipoprotein A-I (ApoA-I) is a key cardioprotective lipoprotein. Nevertheless, it remains unclear how ApoA-I relates to ischemic risk across glucose metabolism statuses in patients with coronary artery disease (CAD). This study investigated whether glucose metabolism status influences the association between ApoA-I and ischemic risk in CAD patients. Methods: This cohort study included 10,724 consecutive CAD patients undergoing percutaneous coronary intervention, who were classified into diabetes mellitus (DM), pre-DM, and normal glucose regulation (NGR) groups. The primary clinical endpoint was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction, revascularization, and stroke. Results: Of the 10,232 patients ultimately included, 2,139 (20.9%) experienced MACCE over 5 years. A significant interaction was observed between ApoA-I levels and glucose metabolism status (P for interaction=0.041). In the DM group, an L-shaped association between ApoA-I and MACCE was found, with lower ApoA-I levels linked to a higher risk of MACCE (P for non-linearity= 0.044). Multivariate Cox regression analysis showed that patients in the lowest quintile of ApoA-I had a 1.327-fold increased risk of MACCE compared to those at the lowest risk (hazard ratio, 1.327; 95% confidence interval, 1.097 to 1.604). However, no significant association was observed in the pre-DM or NGR groups (both P>0.05). Conclusion This large-scale, 5-year follow-up study is the first to demonstrate that lower ApoA-I levels are associated with increased MACCE risk in CAD patients with DM, highlighting the potential value of ApoA-I in risk stratification and as a therapeutic target.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective:To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023.Methods:The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed.Results:A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M ( Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant ( P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age ( P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion:Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Objective To systematically review and synthesize the psychological experience of kinesiophobia in patients with cardiac rehabilitation.Methods PubMed,Web of science,Journals@Ovid,Embase,CINAHL,PsycINFO,Cochrane Library,CNKI,SinoMed,WanFang Database,Vip Database,American Heart Association,European Society of Cardiology and American Association of Cardiovascular and Pulmonary Rehabilitation were searched to collect qualitative research on the psychological experience of cardiac rehabilitation patients with kinesiophobia.The retrieval time was from the establishment of the databases to Jun 2023.The literature was evaluated using the Australian JBI Quality Evaluation Criteria for Qualitative Research in Evidence-based Health Care Centres(2016),and the results were consolidated using an aggregative integration approach.Results A total of 45 results were extracted from 14 studies.Similar results were summarized into 10 groups,and 3 integrated results were synthesized as followed.Kinesiophobia was influenced by many factors;kinesiophobia affects the life experience of patients;strategies to reduce the level of kinesiophobia.Conclusion Nurses should pay more attention to psychological experience of kinesiophobia,and take the corresponding intervention measures to help patients overcome the psychological barriers of kinesiophobia,perfect personalized exercise programs,and improve the level of physical activity.

Objective:To explore the seizure-onset intracranial electroencephalogram patterns in mesial temporal lobe epilepsy (MTLE) by stereo-electroencephalography (SEEG).Methods:The clinical data of 16 patients with focal epilepsy admitted to Epilepsy Center, Shanghai Deji Hospital from March 2017 to December 2019 were retrospectively analyzed. Tonic discharge was taken as sign of the initial period; transition period from the interictal period to the initial period was named as the preictal period, characterized by clonic discharge that was different from the interictal period. The initial and preictal discharge patterns were described, and their corresponding relationship were studied; at the same time, the spatial distribution and synchrony of the discharges at initial and preictal periods were observed.Results:One hundred and thirty-two seizures were recorded in these 16 patients. Two patterns at initial period were noted: low-voltage fast activity (LVFA)+slow depolarizing shifts (SPSs, n=29, 22%), and rhythmic activity (RA) of low-medium amplitude without SPSs ( n=103, 78%); spatial spread of LVFA+SPSs was much wilder than that of RA. In addition, 3 patterns at preictal period were summarized: hypersynchronous (HYP, n=93, 70.5%, most commonly found in the anterior hippocampus [87/219]), sentinel spike ( n=22, 16.7%), and pattern of smooth transition from the interictal period to the initial period ( n=17, 12.9%). No special correspondence in discharge patterns was noted between the initial period and preictal period. Conclusion:Seizure is a process of gradual evolution from interictal period, preictal period to initial period. HYP potential is the most common pattern of seizure in MTLE at preictal stage, mainly appeared in the anterior hippocampus; RA potential is the most common pattern of seizure in MTLE at initial stage, with lower frequency and more limited spatial spread.

Objective:To explore the seizure-onset intracranial electroencephalogram patterns in mesial temporal lobe epilepsy (MTLE) by stereo-electroencephalography (SEEG).Methods:The clinical data of 16 patients with focal epilepsy admitted to Epilepsy Center, Shanghai Deji Hospital from March 2017 to December 2019 were retrospectively analyzed. Tonic discharge was taken as sign of the initial period; transition period from the interictal period to the initial period was named as the preictal period, characterized by clonic discharge that was different from the interictal period. The initial and preictal discharge patterns were described, and their corresponding relationship were studied; at the same time, the spatial distribution and synchrony of the discharges at initial and preictal periods were observed.Results:One hundred and thirty-two seizures were recorded in these 16 patients. Two patterns at initial period were noted: low-voltage fast activity (LVFA)+slow depolarizing shifts (SPSs, n=29, 22%), and rhythmic activity (RA) of low-medium amplitude without SPSs ( n=103, 78%); spatial spread of LVFA+SPSs was much wilder than that of RA. In addition, 3 patterns at preictal period were summarized: hypersynchronous (HYP, n=93, 70.5%, most commonly found in the anterior hippocampus [87/219]), sentinel spike ( n=22, 16.7%), and pattern of smooth transition from the interictal period to the initial period ( n=17, 12.9%). No special correspondence in discharge patterns was noted between the initial period and preictal period. Conclusion:Seizure is a process of gradual evolution from interictal period, preictal period to initial period. HYP potential is the most common pattern of seizure in MTLE at preictal stage, mainly appeared in the anterior hippocampus; RA potential is the most common pattern of seizure in MTLE at initial stage, with lower frequency and more limited spatial spread.

Humans ; Cohort Studies ; Body Mass Index ; Percutaneous Coronary Intervention ; Coronary Artery Disease ; Inflammation ; Treatment Outcome ; Risk Factors

Objective:To systematically integrate qualitative studies of impediments to help-seeking behavior in victims of elder abuse.Methods:A computer search of PubMed, the Cochrane Library, Web of Science, PsyINFO, Scopus, China Biology Medicine disc, China Knowledge Network, Vipshop, and Wanfang was conducted to collect qualitative studies on help-seeking in abused older adults, with search time from establishment of the database to February 2022. The literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care quality assessment criteria, and the results were integrated using the Meta integration method.Results:A total of 9 papers were included, 32 results were extracted and grouped into 9 categories, and 3 integrated results were synthesized including the role of personal factors, the influence of cultural values, and the lack of effective support networks.Conclusions:Seeking help after elder abuse is a complex process influenced by a variety of personal, social and cultural factors. Awareness of seeking help after abuse should be raised, attention should be paid to the physical and mental health of the elderly, and professional assistance and counseling services should be provided.

Objective:To investigate the spiritual health status of nurses in elderly care institutions, analyze the potential categories of spiritual health of nurses in elderly care institutions and explore the influencing factors of different categories.Methods:This study was a cross-sectional survey. From April to July 2022, 352 nurses from 15 elder care institutions in Shandong province were selected to conduct a questionnaire survey on demographic characteristics and spiritual health. Potential profile analysis was used to identify different spiritual health categories, and one-way ANOVA and ordered logistic regression were used to test the differences in population characteristics.Results:There were group heterogeneity in the spiritual health of nurses in elderly care institutions, which were divided into "high level stable type" (34.66%), "medium level type" (44.89%) and "low self transcendence type" (20.45%). Ordered logistic regression showed that age ( OR = 1.054, OR 95% CI: 1.031-1.078, P<0.01), self-assessment health ( OR = 3.034, OR 95% CI: 1.478-6.221, P<0.01), and spiritual learning and training experience ( OR = 2.221, OR 95% CI: 1.370-3.600, P<0.01) were protective factors of spiritual health. Single parent families ( OR = 0.018, OR 95% CI: 0.002-0.197, P<0.01) and working 12 to 16 hours a day ( OR = 0.029, 95% CI: 0.009-0.091, P<0.01), working more than 16 hours a day ( OR = 0.046, 95% CI: 0.018-0.119, P<0.01) were risk factors for spiritual health. Conclusions:There are three potential categories of nurses′ spiritual health in the elderly care institutions, and different categories of nurses have different characteristics. Institutional managers should carry out targeted interventions according to different characteristics to improve their spiritual health.

Objective:To systematically analyze the influencing factors for fear of falling in the elderly.Methods:Computer search was used to search CNKI, VIP, Wanfang Database, China Biology Medicine disc, PubMed, Web of Science, EBSCO and Cochrane Library to obtain studies on the influencing factors for fear of falling in the elderly. The search time was from the establishment of the database to February 2023. Meta-analysis of data was performed using RevMan 5.3 software.Results:A total of 21 articles were included, including 16 cross-sectional studies, 3 case-control studies and 2 cohort studies and containing 27 025 older adults. The results of Meta-analysis showed that old age ( OR=1.64, 95% CI: 1.22-2.19) , female ( OR=2.19, 95% CI: 1.44-3.35) , chronic disease ( OR=1.61, 95% CI: 1.36-1.90) , fall history ( OR=2.89, 95% CI: 2.28-3.66) , depression ( OR=1.94, 95% CI: 1.39-2.71) , frailty ( OR=8.05, 95% CI: 4.01-16.16) , low activities of daily living ( OR=2.47, 95% CI: 2.05-2.96) , poor mobility ( OR=1.39, 95% CI: 1.17-1.65) and the need to use a walking aid ( OR=1.87, 95% CI: 1.42-2.48) were risk factors for fear of falling in the elderly ( P<0.05) . Conclusions:There are many risk factors for fear of falling in the elderly , including advanced age, female , chronic diseases, fall history, depression, frailty, low activities of daily living, poor mobility and the need to use walking aids. Due to the limitations of the number and quality of included studies, the above conclusions still need to be verified by more high-quality studies.