Objective To analyze the distribution status of the end digits of standardized blood pressure measurement recordings in the clinic and the effectiveness of standardized blood pressure measurement for community hypertension screening. Methods The first visit blood pressure measurement data from the Community Health Service Center in Jing'an District, Shanghai from June 2023 to May 2024 were collected and analyzed. According to different measurement methods, the data were divided into two groups: standardized blood pressure measurement and conventional blood pressure measurement. SPSS 19.0 software was used for data analysis. The differences in the distribution balance of the end digits of blood pressure values and the detection rate of blood pressure elevation between the two different groups were analyzed. Results The frequency range of the end digits of blood pressure recorded values in the standardized pressure measurement group was 9.42% to 10.83%, and the detection rate of elevated blood pressure was 24.89%. The conventional pressure measurement group had a preference of the end digit ^"0^", and the detection rate of elevated blood pressure was only 2.12%. The results of multiple logistic regression analysis showed that gender, age, season, and different blood pressure measurement modes were all influencing factors for the detection rate of elevated blood pressure. Conclusion The standardized blood pressure measurement mode in the clinic is suitable for community hypertension screening and pressure measurement, with higher data quality than the conventional pressure measurement mode.

Cataract surgery is one of the most common ophthalmologic procedures. Advances in technology and medical policies have made it more precise. Residual refractive errors and deviation of target diopters are a main cause of dissatisfaction among patients. Refractive enhancement after cataract surgery can correct or eliminate these errors, improving patients' visual quality of life. There are multiple options for correcting residual refractive errors. The best approach depends on factors like the cause of the error, degrees of residual refractive errors, type of intraocular lens, ocular comorbidities, and patient preference. This paper summarizes the incidence and types of residual refractive errors, advancements in refractive enhancement surgeries, and provides practical solutions for clinical practice.

Objective To investigate the predictive value of geriatric nutritional risk index(GNRI)combined with CHA2DS2-VASc-60 score for short-term prognosis of elderly multimorbid patients with atrial fibrillation.Methods A total of 220 elderly multimorbid patients with non-valvular atrial fibrillation admitted to our hospital from May 2020 to December 2022 were recruited.Clinical data were collected,and GNRI and CHA2DS2-VASc-60 score were calculated.With 98 as a cut-off value of GNRI,the patients were divided into normal nutritional group(109 cases)and nutritional risk group(GNRI ≤ 98,111 cases).Clinical characteristics were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for compound events in elderly multimorbid patients with atrial fibrillation.Variance inflation factor was adopted for collinearity diagnosis.ROC curve was plotted to evaluate the prognostic value of GNRI,CHA2DS2-VASc-60 score and their combination.Results Compared with the normal nutritional group,the nutritional risk group had significantly advanced age,higher CHA2DS2-VASc-60 score,and larger proportion of concomitant chronic heart failure(P＜0.05).Age(OR=1.228,95％CI:1.112～1.357),GNRI(OR=0.693,95％CI:0.494～0.997)and CHA2DS2-VASc-60 score(OR=1.488,95％CI:1.008～2.194)were influencing factors for the occurrence of complex events(P＜0.05,P＜0.01).The AUC value of GNRI,CHA2DS2-VASc-60 score,and their combination in predicting complex events at the end of 6 months was 0.665(95％CI:0.539～0.791),0.689(95％CI:0.578～0.801),and 0.749(95％CI:0.653～0.844),respectively(P＜0.05).Conclusion Age,GNRI,and CHA2DS2-VASc-60 score are influencing factors for the occurrence of complex events in elderly multimorbid patients with atrial fibrillation.The combination of GNRI and CHA2DS2-VASc-60 score has predictive value for the short-term prognosis of the patients.

Objective : To explore the polymorphism of endothelial nitric oxide synthase(eNOS) gene in umbilical cord blood of preterm infants and its relationship with major complications in preterm infants. Methods : A total of 254 preterm infants(<37 weeks) who were hospitalized were selected as the study subjects. Umbilical cord blood was collected at delivery to determine the genotypes and alleles of eNOS gene at three loci: rs61722009, rs2070744,and rs1799983. Clinical data of the preterm infants were recorded, and the relationship between eNOS gene polymorphism and major complications in preterm infants was analyzed. Results: (1) The TC+CC genotype at locus rs2070744 was an independent risk factor for bronchopulmonary dysplasia(BPD) in preterm infants, with an OR(95%CI) of 1.266(1.017-1.577).(2) The GT+TT genotype at locus rs1799983 was an independent risk factor for retinopathy prematurity(ROP), with an OR(95%CI) of 1.184(1.008-1.391).(3) The AB+AA genotype at locus rs61722009 was also an independent risk factor for ROP,with an OR(95%CI) of 1.335(1.033-1. 726).(4) There was no significant relationship between gene polymorphism and the occurrence of respiratory distress syndrome( RDS) and periventricular-intraventricular hemorrhage( PIVH). Conclusion eNOS gene polymorphism is associated with the occurrence of BPD and ROP in preterm infants. The evaluation of e NOS gene polymorphism by umbilical cord blood measurement is helpful for the prevention and correct management of some serious complications.

Objective To investigate the clinical diagnostic value of plasma RAS association domain family 1A(RASSF1A)gene methylation combined with tumor marker detection in non-small cell lung cancer(NSCLC).Methods A total of 98 NSCLC patients admitted to Qinhuangdao First Hospital from June 2023 to March 2024 were selected as the NSCLC group,and 95 patients who under-went pulmonary examinations during the same period but were not diagnosed with NSCLC were selected as the disease control group.Their general clinical data were collected.The correlations among plasma RASSF1A gene methylation,tumor markers,and clinicopatho-logical features were analyzed.The effects of RASSF1A gene methylation and tumor markers on the diagnosis of NSCLC were analyzed by the multivariate Logistic regression.A predictive model was constructed,and its effectiveness was evaluated by the receiver operating characteristics(ROC)curve and goodness of fit test.Results There were significant differences(P＜0.05)in smoking history,neu-ron specific enolase(NSE),carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),and RASSF1A methylation levels between the NSCLC group and non-NSCLC group.There were also significant differences(P＜0.05)in RASSF1A methylation levels,NSE,CEA,and CYFR21-1 levels among NSCLC patients with different clinical characteristics such as tumor diam-eter,differentiation degree,and growth type.The results of multivariate Logistic analysis showed that RASSF1A methylation levels(OR=1.071,95％CI:1.042-1.100),NSE(OR=1.168,95％CI:1.132-1.204),CEA(OR=1.154,95％CI:1.121-1.187),and CYFR21-1(OR=1.089,95％CI:1.023-1.195)were all independent risk factors for the diagnosis of NSCLC.A model predicting the occurrence of NSCLC was constructed using the principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA),and the ROC curve analysis results showed that the area under the ROC curve(AUCROC),sensitivity,and specificity of the prediction model for the RASSF1A methylation level combined with NSE,CEA,and CYFR21-1 were 0.922(95％CI:0.896-0.948),0.897,and 0.851,respectively,which were higher than those of the RASSF1A methylation level,NSE,CEA,and CYFR21-1 alone.Conclusion The prediction model of plasma RASSF1A gene methylation level combined with tumor markers has high diagnostic value for NSCLC and can be used for the clinical diagnosis of NSCLC.

Objective To investigate the clinical diagnostic value of plasma RAS association domain family 1A(RASSF1A)gene methylation combined with tumor marker detection in non-small cell lung cancer(NSCLC).Methods A total of 98 NSCLC patients admitted to Qinhuangdao First Hospital from June 2023 to March 2024 were selected as the NSCLC group,and 95 patients who under-went pulmonary examinations during the same period but were not diagnosed with NSCLC were selected as the disease control group.Their general clinical data were collected.The correlations among plasma RASSF1A gene methylation,tumor markers,and clinicopatho-logical features were analyzed.The effects of RASSF1A gene methylation and tumor markers on the diagnosis of NSCLC were analyzed by the multivariate Logistic regression.A predictive model was constructed,and its effectiveness was evaluated by the receiver operating characteristics(ROC)curve and goodness of fit test.Results There were significant differences(P＜0.05)in smoking history,neu-ron specific enolase(NSE),carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),and RASSF1A methylation levels between the NSCLC group and non-NSCLC group.There were also significant differences(P＜0.05)in RASSF1A methylation levels,NSE,CEA,and CYFR21-1 levels among NSCLC patients with different clinical characteristics such as tumor diam-eter,differentiation degree,and growth type.The results of multivariate Logistic analysis showed that RASSF1A methylation levels(OR=1.071,95％CI:1.042-1.100),NSE(OR=1.168,95％CI:1.132-1.204),CEA(OR=1.154,95％CI:1.121-1.187),and CYFR21-1(OR=1.089,95％CI:1.023-1.195)were all independent risk factors for the diagnosis of NSCLC.A model predicting the occurrence of NSCLC was constructed using the principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA),and the ROC curve analysis results showed that the area under the ROC curve(AUCROC),sensitivity,and specificity of the prediction model for the RASSF1A methylation level combined with NSE,CEA,and CYFR21-1 were 0.922(95％CI:0.896-0.948),0.897,and 0.851,respectively,which were higher than those of the RASSF1A methylation level,NSE,CEA,and CYFR21-1 alone.Conclusion The prediction model of plasma RASSF1A gene methylation level combined with tumor markers has high diagnostic value for NSCLC and can be used for the clinical diagnosis of NSCLC.

Pituitary metastasis(PM), a rare metastatic complication of malignant tumors most commonly seen in lung and breast cancers, exhibits subtle and nonspecific clinical manifestations that complicate its differentiation from other sellar lesions. Symptom development correlates with anatomical involvement: tumors often initially destroy the posterior pituitary, causing diabetes insipidus; subsequently, pituitary stalk compression may trigger hyperprolactinemia, while progressive anterior pituitary destruction ultimately leads to hormonal deficiencies. Additionally, mass effects from the tumor can result in optic chiasm compression, with specific neurological manifestations dependent on the invasion site. Nonspecific symptoms such as fatigue and headache are frequently observed. Pituitary MRI serves as a critical diagnostic tool for distinguishing sellar pathologies. As a distant metastatic event, PM portends a poor overall prognosis. This study presents two cases of lung adenocarcinoma with PM, supplemented by a comprehensive literature review, to summarize clinical characteristics and diagnostic/therapeutic strategies.

Pituitary metastasis(PM), a rare metastatic complication of malignant tumors most commonly seen in lung and breast cancers, exhibits subtle and nonspecific clinical manifestations that complicate its differentiation from other sellar lesions. Symptom development correlates with anatomical involvement: tumors often initially destroy the posterior pituitary, causing diabetes insipidus; subsequently, pituitary stalk compression may trigger hyperprolactinemia, while progressive anterior pituitary destruction ultimately leads to hormonal deficiencies. Additionally, mass effects from the tumor can result in optic chiasm compression, with specific neurological manifestations dependent on the invasion site. Nonspecific symptoms such as fatigue and headache are frequently observed. Pituitary MRI serves as a critical diagnostic tool for distinguishing sellar pathologies. As a distant metastatic event, PM portends a poor overall prognosis. This study presents two cases of lung adenocarcinoma with PM, supplemented by a comprehensive literature review, to summarize clinical characteristics and diagnostic/therapeutic strategies.

Objective To investigate the predictive value of geriatric nutritional risk index(GNRI)combined with CHA2DS2-VASc-60 score for short-term prognosis of elderly multimorbid patients with atrial fibrillation.Methods A total of 220 elderly multimorbid patients with non-valvular atrial fibrillation admitted to our hospital from May 2020 to December 2022 were recruited.Clinical data were collected,and GNRI and CHA2DS2-VASc-60 score were calculated.With 98 as a cut-off value of GNRI,the patients were divided into normal nutritional group(109 cases)and nutritional risk group(GNRI ≤ 98,111 cases).Clinical characteristics were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for compound events in elderly multimorbid patients with atrial fibrillation.Variance inflation factor was adopted for collinearity diagnosis.ROC curve was plotted to evaluate the prognostic value of GNRI,CHA2DS2-VASc-60 score and their combination.Results Compared with the normal nutritional group,the nutritional risk group had significantly advanced age,higher CHA2DS2-VASc-60 score,and larger proportion of concomitant chronic heart failure(P＜0.05).Age(OR=1.228,95％CI:1.112～1.357),GNRI(OR=0.693,95％CI:0.494～0.997)and CHA2DS2-VASc-60 score(OR=1.488,95％CI:1.008～2.194)were influencing factors for the occurrence of complex events(P＜0.05,P＜0.01).The AUC value of GNRI,CHA2DS2-VASc-60 score,and their combination in predicting complex events at the end of 6 months was 0.665(95％CI:0.539～0.791),0.689(95％CI:0.578～0.801),and 0.749(95％CI:0.653～0.844),respectively(P＜0.05).Conclusion Age,GNRI,and CHA2DS2-VASc-60 score are influencing factors for the occurrence of complex events in elderly multimorbid patients with atrial fibrillation.The combination of GNRI and CHA2DS2-VASc-60 score has predictive value for the short-term prognosis of the patients.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.