Objective To analyze the disease burden trend of non-rheumatic degenerative mitral valve disease (NR-DMVD) in China from 1990 to 2023 and compare it with global levels and those in the United States and India. Methods Based on the Global Burden of Disease (GBD) 2023 database, data on incidence, mortality, prevalence, and disability-adjusted life years (DALYs) for NR-DMVD were extracted. Joinpoint regression, decomposition analysis, and autoregressive integrated moving average model (ARIMA) were used to analyze trends, drivers, and project burden to 2040. Results In 2023, China's age-standardized DALY rate (2.56/100 000) and mortality rate (0.037/100 000) for NR-DMVD were significantly lower than those in the United States, India, and globally, while its age-standardized incidence rate (10.39/100 000) and prevalence rate (126.03/100 000) showed slow increases. From 1990 to 2023, the estimated annual percentage changes (EAPC) for China's age-standardized DALY rate and mortality rate were –2.11% [95%CI (–2.25%, –1.98%)] and –4.54% [95%CI (–4.92%, –4.16%)], respectively, while the incidence rate and prevalence rate continued to rise; India showed increasing trends in all burden indicators. Decomposition analysis indicated that population aging was the primary driver of the increase in DALYs and prevalence cases, while epidemiological improvement was the key factor that led to the reduction in the number of deaths. Joinpoint analysis showed that China's age-standardized DALY rate declined most rapidly between 2000 and 2013, while the age-standardized mortality rate decreased fastest between 2007 and 2013. ARIMA models projected that China's prevalence rate would continue to rise and mortality rate would continue to decline through 2040. Conclusion NR-DMVD in China exhibits a dual-track pattern of "declining mortality but rising prevalence", driven by population aging. A tiered prevention and control system focusing on the elderly and high-risk male groups is needed.

The clinical data of a case with neonatal hypertrophic cardiomyopathy (HCM) admitted to the Department of Pediatrics, Beijing Anzhen Hospital, Capital Medical University in July 2020 was retrospectively analyzed.The child developed hyperbilirubinemia and severe anemia within 1 hour after birth.The direct Coombs test was negative.The diagnosis of MN hemolytic disease was confirmed by positive results of both the indirect Coombs test and the maternal indirect Coombs test.Echocardiography and cardiac magnetic resonance imaging confirmed the presence of HCM, and genetic testing showed SCN5A and ANK2 gene heterozygous mutations.After treatment with blue light irradiation, intravenous immunoglobulin, red blood cell washing, Dexamethasone and sodium phosphocreatine, the condition improved and the patient was discharged.During the follow-up period, delayed hemolysis occurred 1.5 months after birth, and thus the patient received re-infusion of immunoglobulin and washing of red blood cells.A scalp hemangioma and a break in milk intake were detected 2 and 7 months after birth, respectively.Treatment with Propranolol, Captopril, Hydrochlorothiazide, and Spironolactone improved the condition.The patient was followed up until August 2024, with clinical symptoms significantly improved, no occurrence of anemia, and no further thickening or progression of the myocardium.

Objective To establish the characteristic atlas of Shexiang Jiegu Capsule and determine the contents of seven active components （hydroxysafflor Yellow A, paeoniflorin, ferulic acid, naringin, ligustilide, catechin, epicatechin）. Methods Octadecyl silane bonded silica gel was used as the filling agent, the mobile phase was composed of methanol-0.05% phosphoric acid by gradient elution, the detection wavelength was 245 nm, flow rate was 1.0 ml/min, column temperature was 30℃. The similarity of the fifteen batches of sample was evaluated in line with the TCM Chromatographic Fingerprint （2012 edition）, and the contents of seven active components were determined. Results The HPLC fingerprint of Shexiang Jiegu Capsules was established. The similarity of fingerprint between fifteen batches of samples and control fingerprint was between 0.893 and 0.992. The results of methodological investigation for the determination of seven active components in fifteen batches of samples all met the requirements. Conclusion The established characteristic atlas of Shexiang Jiegu Capsules had high specificity and good repeatability, which could provide scientific basis for quality control of Shexiang Jiegu Capsules.

The clinical data of a case with neonatal hypertrophic cardiomyopathy (HCM) admitted to the Department of Pediatrics, Beijing Anzhen Hospital, Capital Medical University in July 2020 was retrospectively analyzed.The child developed hyperbilirubinemia and severe anemia within 1 hour after birth.The direct Coombs test was negative.The diagnosis of MN hemolytic disease was confirmed by positive results of both the indirect Coombs test and the maternal indirect Coombs test.Echocardiography and cardiac magnetic resonance imaging confirmed the presence of HCM, and genetic testing showed SCN5A and ANK2 gene heterozygous mutations.After treatment with blue light irradiation, intravenous immunoglobulin, red blood cell washing, Dexamethasone and sodium phosphocreatine, the condition improved and the patient was discharged.During the follow-up period, delayed hemolysis occurred 1.5 months after birth, and thus the patient received re-infusion of immunoglobulin and washing of red blood cells.A scalp hemangioma and a break in milk intake were detected 2 and 7 months after birth, respectively.Treatment with Propranolol, Captopril, Hydrochlorothiazide, and Spironolactone improved the condition.The patient was followed up until August 2024, with clinical symptoms significantly improved, no occurrence of anemia, and no further thickening or progression of the myocardium.

Objective:To explore the relationship among depression, social belonging and fertility quality of life of infertile women, and to provide a theoretical basis for the development of effective measures to improve the quality of life of infertile women.Methods:From July 2022 to October 2022, a random sample of 400 patients treated for infertility in the Reproductive Assisting Centre of the First Hospital of Anhui Medical University were selected using a general basic questionnaire, the Depression Screening Self-Rating Scale (PHQ-9), the Social Attribution Measurement Questionnaire and the Fertility Quality of Life Scale quality of life questionnaire (FertiQoL) were administered. Spearman correlation was used to analyze the association between the variables, and mediating effects were examined by Bootstrap procedure and PROCESS software.Results:The 400 infertile women had a median depression score of 5, reaching a subclinical mild level of depression, a median score of 12 on the social belonging measure, and a median score of 62.87 on the FertiQoL. Social belonging was negatively correlated with depression ( r=-0.206, P<0.001); social belonging was positively correlated with FertiQoL ( r=0.267, P<0.001); and depression was negatively correlated with FertiQoL ( r=-0.428, P<0.001). Mediation analysis showed that after controlling for relevant variables, the indirect effect of depression on FertiQoL in infertile women was -0.069 0 (95% CI: -0.173 3--0.008 3), and the direct effect was -1.019 1 (95% CI: -1.436 3- -0.601 8), the mediating effect of FertiQoL through social belonging on depression in infertile women accounted for 6.34% of the total effect. Conclusion:Social belonging plays a partial mediating role in depression and FertiQoL among infertile women. Infertile women should be given timely attention to their psychological situation and given more social recognition and support to improve their FertiQoL.

Objective:To explore the relationship among depression, social belonging and fertility quality of life of infertile women, and to provide a theoretical basis for the development of effective measures to improve the quality of life of infertile women.Methods:From July 2022 to October 2022, a random sample of 400 patients treated for infertility in the Reproductive Assisting Centre of the First Hospital of Anhui Medical University were selected using a general basic questionnaire, the Depression Screening Self-Rating Scale (PHQ-9), the Social Attribution Measurement Questionnaire and the Fertility Quality of Life Scale quality of life questionnaire (FertiQoL) were administered. Spearman correlation was used to analyze the association between the variables, and mediating effects were examined by Bootstrap procedure and PROCESS software.Results:The 400 infertile women had a median depression score of 5, reaching a subclinical mild level of depression, a median score of 12 on the social belonging measure, and a median score of 62.87 on the FertiQoL. Social belonging was negatively correlated with depression ( r=-0.206, P<0.001); social belonging was positively correlated with FertiQoL ( r=0.267, P<0.001); and depression was negatively correlated with FertiQoL ( r=-0.428, P<0.001). Mediation analysis showed that after controlling for relevant variables, the indirect effect of depression on FertiQoL in infertile women was -0.069 0 (95% CI: -0.173 3--0.008 3), and the direct effect was -1.019 1 (95% CI: -1.436 3- -0.601 8), the mediating effect of FertiQoL through social belonging on depression in infertile women accounted for 6.34% of the total effect. Conclusion:Social belonging plays a partial mediating role in depression and FertiQoL among infertile women. Infertile women should be given timely attention to their psychological situation and given more social recognition and support to improve their FertiQoL.

Objective:To explore the talent cultivation model of nursing professional group under the 1+X certificate system, to build a talent cultivation system for nursing professional groups with "three progressions, four integrations, and five cocultivation"Methods:From 1 July 2021 to 31 December 2023, built a professional group course system of "mutual sharing of foundations, mutual generation of majors, mutual selection of positions, and progressive improvement of abilities". Aligned course content with X certificate content. Deepen the reform of the three education systems, create a "dual teacher" teaching team that combines full-time and part-time work, and build teaching resources that connect the cloud and the ground. The application effect of this model was evaluated in 2021 nursing majors in Cangzhou Medical College by cluster sampling.Results:There were 748 students majoring in nursing in class of 2021, 150 boys aged 19-22(20.00 ± 1.23), 598 girls, aged 19-21(19.00 ± 2.57). There were 118 students majoring in midwifery in class of 2021, all of them were girls, aged 18-20(18.00 ± 2.11). There were 128 students majoring in rehabilitation therapy technology in class of 2021, 66 boys aged 19-21(19.00 ± 2.11), 62 girls aged 19-21(19.00 ± 2.54). Nursing professional group completed the "Basic Nursing Technology Training Guidance", "Elderly Care" and other 5 self-compiled textbooks, 730 students had participated in the X certificate assessment, 729 students e passed the assessment, the passing rate was 99.9%.Conclusions:The talent cultivation model of "three progressions, four integrations, and five co cultivation" in the nursing professional group can cultivate students′ professional abilities, and cultivate a composite technical and skilled talent with multiple abilities and interconnections in one job.

Objective To examine the possible factors affecting the attainment of target serum trough concentration of vancomycin in premature newborns for optimization of clinical dosing regimens.Methods The vancomycin trough concentration data were collected retrospectively from preterm newborns who received intravenous infusion of vancomycin from December 2016 to March 2021.According to the Evidence-based Guideline for Therapeutic Drug Monitoring of Vancomycin:2020 Update by the Division of Therapeutic Drug Monitoring,Chinese Pharmacological Society,the patients were assigned to failure(＜5 mg/L)or success(5-15 mg/L)in target attainment,or beyond target group(＞15 mg/L)base on vancomycin trough concentration.Statistical software SPSS was used to analyze differences in clinical characteristics between different groups,and profile various factors that may affect attainment of target serum trough concentration of vancomycin.Results The median(interquartile range)trough concentration of vancomycin was 12.50(7.95-18.05)mg/L in 82 preterm newborns.The target trough concentration of vancomycin was attained in 47 preterm newborns(57.32％),and the corresponding trough concentration of vancomycin was 10.90(7.80-13.30)mg/L.The trough concentration of vancomycin was beyond target in 27 preterm newborns(32.93％).The corresponding median trough concentration of vancomycin was 21.80(18.00-23.80)mg/L.Serum trough concentration of vancomycin failed to achieve the target in only 8 preterm newborns(9.75％).The corresponding median trough concentration was 4.10(2.48-4.60)mg/L.Univariate analysis showed that there were statistically significant differences(P＜0.05)in postmenstrual age and current weight between the patients succeeded in attaining target trough concentration and those who failed to attain the target.Baseline serum creatinine and dosing interval showed statistically significant differences(P＜0.01)between the newborns who attained the target concentration and those with higher trough concentration beyond the target.Multivariate regression analysis showed that baseline serum creatinine(OR=1.063,95％CI 1.024-1.102,P=0.001,cutoff:62 pmol/L)and dosing interval(OR=6.693,95％CI 1.604-27.920,P=0.009)were independent risk factors for excessively high vancomycin trough concentrations.Conclusions The dosing regimens as recommended in the current package insert only enable the attainment of target serum trough concentration of vancomycin in half of the premature newborns.The dosing regimen of vancomycin should be optimized by taking postmenstrual age,current weight,baseline serum creatinine and dosing interval into account.Therapeutic drug monitoring is necessary to ensure safety and effectiveness.

Objective:To explore the status and influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Methods:This is a cross-sectional study. From January to February 2022, a total of 3 047 cardiovascular nurses in members of China Cardiovascular Health Alliance were selected as research objects by convenience sampling method. General data questionnaire and Cardiovascular Nurses Participated in the Cardiac Rehabilitation Questionnaire (CNPCRQ) were used to investigate cardiovascular nurses. Multiple linear regression analysis was used to investigate the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses. A total of 3 047 questionnaires were distributed in this study, and 2 704 valid questionnaires were effectively received, with an effective recovery rate of 88.74%.Results:The total score of CNPCRQ of cardiovascular nurses was (93.23±31.58), which was at a moderate level. Multiple linear regression analysis results showed that age, education, professional title, hospital location, hospital level, position type and hospital type were the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Conclusions:The status of participation in cardiac rehabilitation of cardiovascular nurses in China needs to be improved. Role and job content of cardiovascular nurses should be further clarified, and cardiac rehabilitation knowledge and skills training should be strengthened in the future, so as to promote the profession development of cardiac rehabilitation and improve patients' health outcomes.

OBJECTIVE: To detect variants of the MMACHC gene among 110 ethnic Han Chinese pedigrees affected with metabolic deficiency methylmalonic acidemia (MMA) of cobalamin C (cblC). METHODS: Peripheral blood samples were collected from the probands and their parents. Following DNA extraction, the coding regions of the MMACHC gene were subjected to PCR amplification, Sanger sequencing and quantitative PCR assaying. For 48 pedigrees, chorionic villus samples were taken for prenatal genetic diagnosis. RESULTS: Thirty five types of variants were detected among the 110 pedigrees, which included missense, nonsense, frameshifting, splicing variants and exonic deletions. Most variants have occurred in exons 4 (73.18%). The detection rate for c.609G>A (p.Trp203Ter) variant was the highest (33.64%), followed by c.658_660delAAG (12.27%), c.567dupT (9.09%) and c.80A>G (6.82%). Two variants, namely c.57_58insT (p.Gly20Trpfs*14) and c.505_506delAT (p.Ile169Argfs*12), were unreported previously and both were of frameshifting types. For the 48 pedigrees undergoing prenatal diagnosis, 14 fetuses were found to be normal, 24 have carried heterozygous variants, the remaining 10 have carried compound heterozygous or homozygous variants. CONCLUSION The discovery of the two novel variants has expanded the spectrum of the MMACHC gene variants among ethnic Han population. Above finding has provide a basis for the prenatal diagnosis and genetic counseling for the affected pedigrees.
Amino Acid Metabolism, Inborn Errors/genetics* ; China ; DNA ; Female ; Humans ; Mutation ; Oxidoreductases/genetics* ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Vitamin B 12/genetics*