Objective To analyze the disease burden,changing trends,and differences of atrial fibrillation(AF)/atrial flutter(AFL)globally and in China and Japan from 1990 to 2021,and to predict their future trends,aiming to provide references for health decision-making.Methods Based on the Global Burden of Disease Study Database 2021(GBD 2021),we extracted age-standardized prevalence rate(ASPR)and age-standardized disability-adjusted life year rate(ASDALYR)data for AF/AFL by sex globally,in China,and Japan.The estimated annual percentage change(EAPC)was used to assess the trends.Joinpoint regression analysis and the Bayesian age-period-cohort(BAPC)model were employed for trend analysis and prediction.Results From 1990 to 2021,the ASPR and ASDALYR for AF/AFL in males were increased significantly globally,with EAPC of 0.05(95%CI:0.01～0.08)and 0.09(95%CI:0.08～0.11),respectively.Changes were significantly declined in females,with EAPC of-0.11(95%CI:-0.14～-0.07)and-0.10(95%CI:-0.12～-0.07).In China,the ASPR for AF/AFL were increased in both males and females,with those of males more notably(EAPC=0.77,95%CI:0.65～0.88).However,the ASDALYR for AF/AFL showed gender divergence,with an increase in males(EAPC=0.40,95%CI:0.30～0.49)while a decrease in females(EAPC=-0.55,95%CI:-0.67～-0.44).In Japan,both the ASPR and ASDALYR for males and females showed continuous declines,and the reduction was more pronounced among females(ASPR EAPC=-1.77,95%CI:-2.32～-1.22;ASDALYR EAPC=-1.73,95%CI:-2.11～-1.35).Joinpoint regression analysis showed that from 1990 to 2021,for the ASDALYR of AF/AFL,the average annual percentage change(AAPC)was 0.28%(P<0.001)for Chinese males and-0.37%(P<0.001)for Chinese females,while the AAPC was-0.70%(P<0.001)and-1.43%(P<0.001)for Japanese males and females.BAPC model revealed that by 2036,the ASDALYR for Chinese males is predicted to increase from 91.45 per 100 000 in 2022 to 101.11 per 100 000,and for females is from 88.85 per 100 000 to 100.98 per 100 000.For Japanese males,the ASDALYR is projected to increase slightly from 88.79 to 89.86 per 100 000,while for females,it is projected decrease slightly from 41.13 to 39.67 per 100 000,indicating only minor fluctuations in the ASDALYR for both Japanese males and females.Conclusion The disease burden of AF/AFL continues to increase globally and in China.So,Japan's lifestyle and health policies are worth considering,and more scientific and effective public health policies and clinical intervention strategies should be formulated and implemented.Countermeasure The relevant government agencies should promote the transformation of the food industry through the policy-market mechanism,carry out activities related to national health management,and continuously optimize the AF/AFL management model of medical and health institutions to effectively cope with this disease burden change.

Objective To investigate the impact of body mass index (BMI) on the outcome of intrauterine insemination (IUI) for infertility patients. Methods A total of 1 393 infertility patients undergoing their first cycle of IUI were selected as study subjects, and were divided into normal BMI group (n=824), overweight group (n=394) and obese group (n=175) based on BMI. Age, duration of infertility, type of infertility, sex hormones, fasting blood glucose, fasting insulin, thyroid function, timing of insemination, number of progressively motile spermatozoa, biochemical pregnancy rate, clinical pregnancy rate and miscarriage rate were compared among the three groups. Multiple linear regression analysis was used to analyze the influencing factors of BMI; the effects of age, BMI, fasting blood glucose and fasting insulin on IUI outcome were analyzed by binary Logistic regression. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of BMI for biochemical pregnancy and clinical pregnancy, and the cut-off value was calculated. Results There were no significant differences in age, time of insemination, number of progressively motile spermatozoa, clinical pregnancy rate and miscarriage rate among the three groups (P>0.05). The duration of infertility, fasting blood glucose and fasting insulin levels in the obese and overweight groups were significantly longer or higher than those in the normal BMI group (P < 0.05). The follicle-stimulating hormone (FSH) level in the obese group was significantly lower, while the free thyroxine (FT4) level in the obese group was significantly higher than that in the overweight group and normal BMI group (P < 0.05). The biochemical pregnancy rate in the obese group was significantly higher than that in the normal BMI group (P < 0.05). Multiple linear regression analysis showed that BMI was negatively correlated with FSH and estradiol (E2) (P < 0.01) and positively correlated with fasting blood glucose and fasting insulin (P < 0.01). Multivariate binary logistic regression analysis showed that age and BMI were influencing factors for clinical pregnancy (P < 0.05), while age, BMI, and fasting insulin were influencing factors for biochemical pregnancy (P < 0.05). The ROC curve showed that the area under the curve (AUC) for BMI predicting biochemical pregnancy and clinical pregnancy was 0.608 and 0.610, respectively, with a cut-off value of 23.05 kg/m² for both. Conclusion BMI affects the endocrine and glycolipid metabolism of infertility patients. BMI can be used as an independent factor to predict biochemical pregnancy and clinical pregnancy in IUI.

Objective To evaluate the efficacy and safety of the omadacycline-based therapies in patients with community-acquired pneumonia (CAP).Methods The clinical data of CAP patients treated with omadacycline (±β-lactam/β-lactamase inhibitor) in the First Affiliated Hospital of Nanchang University from January to May 2023 were reviewed and analyzed.The patients were assigned to omadacycline alone or omadacycline plus β-lactam/β-lactamase inhibitor treatment group.The clinical efficacy,microbiological efficacy,and drug-related adverse events were summarized and compared between groups.Results A total of 135 adult patients with CAP were enrolled,including 23 (17.04％) patients with chronic liver disease,25 (18.52％) patients with chronic kidney disease,and 64 (47.41％) patients treated with omadacycline alone.The overall clinical efficacy rate was 81.48％ (110/135),specifically 79.69％ (51/64) in the patients treated with omadacycline alone and 83.10％ (59/71) in the patients treated with omadacycline plus β-lactam/β-lactamase inhibitor.The clinical efficacy rate was 86.36％ (38/44) in the patients treated in the general ward.Overall,21 cases of drug-related adverse events (mainly nausea) were reported in 15 patients,all of which were mild to moderate.Conclusions Omadacycline has shown good therapeutic effect in treatment of CAP in Chinese adults,especially for the patients treated in general ward.Most of the adverse events of omadacycline were mild to moderate and tolerable.

Objective To evaluate the efficacy and safety of the omadacycline-based therapies in patients with community-acquired pneumonia (CAP).Methods The clinical data of CAP patients treated with omadacycline (±β-lactam/β-lactamase inhibitor) in the First Affiliated Hospital of Nanchang University from January to May 2023 were reviewed and analyzed.The patients were assigned to omadacycline alone or omadacycline plus β-lactam/β-lactamase inhibitor treatment group.The clinical efficacy,microbiological efficacy,and drug-related adverse events were summarized and compared between groups.Results A total of 135 adult patients with CAP were enrolled,including 23 (17.04％) patients with chronic liver disease,25 (18.52％) patients with chronic kidney disease,and 64 (47.41％) patients treated with omadacycline alone.The overall clinical efficacy rate was 81.48％ (110/135),specifically 79.69％ (51/64) in the patients treated with omadacycline alone and 83.10％ (59/71) in the patients treated with omadacycline plus β-lactam/β-lactamase inhibitor.The clinical efficacy rate was 86.36％ (38/44) in the patients treated in the general ward.Overall,21 cases of drug-related adverse events (mainly nausea) were reported in 15 patients,all of which were mild to moderate.Conclusions Omadacycline has shown good therapeutic effect in treatment of CAP in Chinese adults,especially for the patients treated in general ward.Most of the adverse events of omadacycline were mild to moderate and tolerable.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.

Objective To analyse the differential metabolites and related metabolic pathways in stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome by serum metabolomics.Methods This study observed 60 patients with stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome and 60 healthy volunteers in the same period.Liquid chromatography-mass spectrometry(LC-MS)was performed on the serum metabonomics.The differential metabolites were identified by multivariate statistical analysis of the original spectrogram and original data,and enrichment analysis of KEGG metabolic pathway was analyzed.Results A total of 60 patients in the group of stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome participated in the study,and a total of 60 healthy volunteers in the control group participated in the study.There was no statistical difference in general information and biochemical indicators between the two groups(P>0.05);Eighteen differential metabolites were found respectively,including phenylacetaldehyde,orthophosphate,guanosine,diethyl phosphate,2-dehydro-d-gluconate,guanine and 5-(2-hydroxyethyl)-4-methylthiazole down-regulated expression,taurocholate,2-propylglutaric acid,8-amino-7-oxononanoate,l-tyrosine,s-sulfo-l-cysteine,cyclohexanecarboxylic acid,porphobilinogen,(r)-acetoin,octanoylglucuronide,melatonin and solanine up-regulated expression,involving phenylalanine metabolism,thiamine metabolism,purine metabolism.Conclusion The differential metabolites reveal the metabolic essence of stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndrome from the micro level,and can provide clues for clinical early warning of patients with stable angina pectoris of coronary artery heart disease with spleen deficiency and phlegm turbidity syndromet.

【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.

Objective: To preliminarily evaluate the clinical efficacy of endoscopic argon plasma coagulation (APC) combined with sub-mucosal injection of norepinephrine saline in the treatment of radiation proctitis (RP), especially for refractory RP. Methods: Clinical data of 22 RP patients were retrospectively analyzed. The severity of RP was evaluated by a modified endoscopy scoring system (A) or Sherman′s classification (B). The criteria of successful treatment are the improvement of clinical symptoms or the cessation of bleeding (or only occasional traces of blood on the stools that do not need further treatment). Results: All 22 patients were successfully treated. Among them, 18 patients (82%) had no bleeding. According to the classification of A, 15 patients (68%) had mild proctitis and 7(32%) experienced severe proctitis. Based on B classification, 9 patients (41%) were categorized as mild proctitis and 13(59%) as severe proctitis. Using the classification of A, the number of treatment sessions was significantly correlated with the endoscopic grade (or endoscopic total score)(Spearman’s r=0.86, P<0.001). Conclusions Preliminary evidence demonstrates that endoscopic APC combined with sub-mucosal injection of norepinephrine saline is not only effective for mild and moderate RP, but also maintains long-term efficacy for refractory RP. Modified endoscopy scoring system (A) assessment is more suitable for clinical application compared with B assessment.

Objective:To analysis the construction of the world's top PhaseⅠclinical trial registration agencies, compare their size, composition, operation and funding, to provide further reference for the construction of clinical trial agency in China.Methods:Search for PhaseⅠclinical trial research agencies by region on clinicaltrials.gov. Collecting information about the agency’s management, staffing, implementation in Asia, America and Europe. Descriptive analysis was carried out to explore the type, proportion and operation among different regions, the organizational structure, operational management and effectiveness of each agency from different regions were compared.Results:The United States, Europe and East Asia are dense areas of PhaseⅠclinical research around the world. The types of agencies in the United States, Britain, France, Germany, South Korea, Japan, and Israel are mainly enterprises. Among other types of agencies, the organizational models are diversified. The agencies have different spatial distances from medical institutions, but possess relatively consistent scale and institutional operation. All the agencies have a stable source of funding.Conclusions:In order to strengthen the construction of clinical trial agencies in China, we should speed up the establishment of a close connection mechanism to promote deep cooperation in clinical trials. Control the construction scale and maintain stable input of the agency. Meanwhile, establish and strengthen international exchanges and cooperation.

Objective: To determine the effects of ω-3 polyunsaturated fatty acids from different sources on glucolipid metabolism in type 2 diabetic patients with dyslipidemia. Methods: We recruited participants from the diabetes specialist clinic at the Guanlin hospital in Yixing city, Jiangsu Province from February 2017 to March 2017. A total of 180 subjects were randomly assigned to 3 g/day fish oil (FO), perilla oil (PO), or fish oil mixed with linseed oil (FLO) for 6 months. The basic conditions and fasting venous blood sample were obtained from each study subject at baseline, after 6 months of intervention. Serum glucose and lipid metabolism were investigated. Results: A total of 156 subjects aged (62.6±8.6) years completed the final follow-up after 6 months (FO,54 subjects; PO,52 subjects; FLO,50 subjects). Among them,59 patients (37.8%) were male. Serum glucose, glycated hemoglobin, C peptide, insulin and homeostasis model assessment-insulin resistance were not significantly different among the three groups after 6 months. Serum triglyceride decreased, whereas high-density lipoprotein cholesterol increased in FO [1.33 (1.05,1.93) mmol/L, (1.36±0.29) mmol/L, respectively] compared with PO [1.71 (1.23, 2.17) mmol/L, (1.23±0.22) mmol/L, respectively] and FLO [1.51 (1.12, 2.22) mmol/L, (1.29±0.30) mmol/L, respectively] (P<0.05). Serum low-density lipoprotein cholesterol and apolipoprotein B decreased in PO [(2.60±0.57) mmol/L,(0.96±0.23) g/L, respectively] compared with FO [(2.89±0.76) mmol/L, (1.07±0.30) g/L, respectively] (P<0.05). Serum lipoprotein(a) decreased in FLO [130.7 (63.3,270.6) mg/L] compared with FO [137.4 (58.7,333.2) mg/L] (P<0.05). Serum free fatty acid decreased in FLO [(0.43±0.15) mmol/L] compared with PO [(0.53±0.22) mmol/L] (P<0.05). Conclusion The effects of ω-3 PUFA from different sources on glucose metabolism in type 2 diabetic patients with dyslipidemia are similar. Each of them has a good application prospect in improving lipid metabolism.