Objective To evaluate the clinical efficacy of modified Lishui Qiangxin Decoction(composed of Astragali Radix,Arecae Pericarpium,Descurainiae Semen Lepidii Semen,Poria,Polyporus,Cinnamomi Ramulus,Salviae Miltiorrhizae Radix et Rhizoma,Asini Corii Colla,Aucklandiae Radix,etc.)for elderly patients with chronic heart failure(CHF),and to investigate its effects on ventricular remodeling and serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK),high-sensitivity C-reactive protein(hs-CRP),and interleukin 6(IL-6).Methods A total of 150 elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome treated at Tangshan Central Hospital from December 2021 to December 2024 were enrolled.The patients were divided into trial(n=76)group and control(n=74)group.The control group received standard western treatment(vasodilation,diuresis,and cardiotonic therapy),while the trial group received additional modified Lishui Qiangxin Decoction,both groups were treated for 8 weeks.The changes in traditional Chinese medicine(TCM)syndrome scores,Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,ventricular remodeling parameters[left ventricular mass(LVM),early to late diastolic mitral inflow velocity ratio(E/A),left ventricular ejection fraction(LVEF)],serum sTWEAK,hs-CRP,and IL-6 levels were observed,and clinical efficacy was evaluated.Results(1)After 8 weeks of treatment,the overall response rate in the trial group was 97.37％(74/76),while that in the control group was 86.49％(64/74).The intergroup comparison(by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores for dyspnea,edema,cold intolerance and cold limbs,and palpitations and shortness of breath were significantly lower in both groups compared to before treatment(P＜0.05).Additionally,the reduction in scores was significantly greater in the trial group than in the control group(P＜0.01).(3)After treatment,the LVM of both groups decreased compared to before treatment(P＜0.05),and the E/A and LVEF increased compared to before treatment(P＜0.05).The reduction in LVM and the increase in E/A and LVEF in the trial group were significantly greater than those in the control group(P＜0.01).(4)After treatment,the serum levels of sTWEAK,hs-CRP,and IL-6 in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).(5)After treatment,the MLHFQ scores of emotional,physical,symptom dimensions and total score of the MLHFQ scale in both groups decreased compared to before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).Conclusion Modified Lishui Qiangxin Decoction effectively alleviates symptoms,improves left ventricular function,reduces inflammatory markers of sTWEAK,hs-CRP and IL-6,and enhances quality of life in elderly CHF patients with yang-qi deficiency and water retention-blood stasis syndrome.

Objective:To investigate brain damage and treatment efficacy in patients with first-episode schizophrenia with comorbid auditory and visual hallucinations and cognitive decline based on brain magnetic resonance imaging (MRI).Methods:This study adopted a retrospective cohort design. Eighty patients with first-episode schizophrenia who received treatment at Wenzhou Seventh People's Hospital from January to June 2024 were included in this study. The patients were divided into an observation group (40 cases of first-episode schizophrenia with comorbid auditory and visual hallucinations) and a control group (40 cases of first-episode schizophrenia without comorbid auditory and visual hallucinations) based on whether they had symptoms of comorbid auditory and visual hallucinations. Forty healthy individuals who concurrently underwent physical examinations were included in the normal group. All patients received standardized treatment. Cranial MRI data were collected from all subjects. Cranial MRI data, Positive and Negative Syndrome Scale (PANSS) score, Global Assessment of Functioning (GAF) score, and changes in cognitive function were compared among the three groups. Additionally, the changes in cranial MRI data, PANSS score, GAF score, and the score of MATRICS Consensus Cognitive Battery (MCCB) in the observation group were compared between before and after treatment.Results:The horizontal distance between the corpus callosum and the underside of the cingulate gyrus, the vertical distance between the corpus callosum and the underside of the cingulate gyrus, and PANSS and GAF scores in the observation group were all significantly higher than those in the normal and control groups (all P < 0.05). The scores on all MCCB scales in the observation group were significantly lower than those in the normal and control groups (all P < 0.05). After treatment, the left horizontal distance between the corpus callosum and the underside of the cingulate gyrus [(5.72 ± 0.71) mm] and the right horizontal distance [(5.13 ± 0.55) mm], as well as the left vertical distance [(6.37 ± 0.69) mm] and the right vertical distance [(5.61 ± 0.67) mm], were all significantly lower than the pre-treatment values [(6.98 ± 0.83) mm, (6.07 ± 0.49) mm, (7.54 ± 0.58) mm, and (6.52 ± 0.51) mm, t = 7.30, 8.07, 8.21, 6.84, all P < 0.05]. Post-treatment PANSS scores [(39.95 ± 6.65)] were significantly lower than pre-treatment scores [(97.47 ± 18.47)], while post-treatment GAF scores [(71.26 ± 8.87)] were significantly higher than pre-treatment scores [(34.68 ± 7.71), t = 18.53, 19.69, both P < 0.05]. Post-treatment scores for the MCCB [(8.57 ± 2.45), (2.25 ± 0.47), (25.16 ± 2.43), (24.10 ± 2.64), (17.08 ± 2.25), (20.43 ± 3.76), (2.07 ± 0.36), (22.16 ± 3.24), (57.81 ± 7.69), (0.28 ± 0.05)] were significantly higher than pre-treatment scores [(5.65 ± 1.37), (1.62 ± 0.34), (21.21 ± 2.27), (20.27 ± 1.78), (12.16 ± 2.08), (14.56 ± 2.34), (1.71 ± 0.25), (17.92 ± 1.64), (40.29 ± 6.56), (0.21 ± 0.03), t = 6.58, 6.87, 7.51, 7.61, 10.15, 8.38, 5.19, 7.38, 10.96, 7.59, all P < 0.05]. Conclusions:The comorbid auditory and visual hallucinations in patients with first-episode schizophrenia, based on brain MRI findings, are closely related to cognitive decline and brain damage. After treatment, both cognitive function and cranial damage in these patients have considerably improved, which is worthy of clinical consideration.

Objective:To investigate brain damage and treatment efficacy in patients with first-episode schizophrenia with comorbid auditory and visual hallucinations and cognitive decline based on brain magnetic resonance imaging (MRI).Methods:This study adopted a retrospective cohort design. Eighty patients with first-episode schizophrenia who received treatment at Wenzhou Seventh People's Hospital from January to June 2024 were included in this study. The patients were divided into an observation group (40 cases of first-episode schizophrenia with comorbid auditory and visual hallucinations) and a control group (40 cases of first-episode schizophrenia without comorbid auditory and visual hallucinations) based on whether they had symptoms of comorbid auditory and visual hallucinations. Forty healthy individuals who concurrently underwent physical examinations were included in the normal group. All patients received standardized treatment. Cranial MRI data were collected from all subjects. Cranial MRI data, Positive and Negative Syndrome Scale (PANSS) score, Global Assessment of Functioning (GAF) score, and changes in cognitive function were compared among the three groups. Additionally, the changes in cranial MRI data, PANSS score, GAF score, and the score of MATRICS Consensus Cognitive Battery (MCCB) in the observation group were compared between before and after treatment.Results:The horizontal distance between the corpus callosum and the underside of the cingulate gyrus, the vertical distance between the corpus callosum and the underside of the cingulate gyrus, and PANSS and GAF scores in the observation group were all significantly higher than those in the normal and control groups (all P < 0.05). The scores on all MCCB scales in the observation group were significantly lower than those in the normal and control groups (all P < 0.05). After treatment, the left horizontal distance between the corpus callosum and the underside of the cingulate gyrus [(5.72 ± 0.71) mm] and the right horizontal distance [(5.13 ± 0.55) mm], as well as the left vertical distance [(6.37 ± 0.69) mm] and the right vertical distance [(5.61 ± 0.67) mm], were all significantly lower than the pre-treatment values [(6.98 ± 0.83) mm, (6.07 ± 0.49) mm, (7.54 ± 0.58) mm, and (6.52 ± 0.51) mm, t = 7.30, 8.07, 8.21, 6.84, all P < 0.05]. Post-treatment PANSS scores [(39.95 ± 6.65)] were significantly lower than pre-treatment scores [(97.47 ± 18.47)], while post-treatment GAF scores [(71.26 ± 8.87)] were significantly higher than pre-treatment scores [(34.68 ± 7.71), t = 18.53, 19.69, both P < 0.05]. Post-treatment scores for the MCCB [(8.57 ± 2.45), (2.25 ± 0.47), (25.16 ± 2.43), (24.10 ± 2.64), (17.08 ± 2.25), (20.43 ± 3.76), (2.07 ± 0.36), (22.16 ± 3.24), (57.81 ± 7.69), (0.28 ± 0.05)] were significantly higher than pre-treatment scores [(5.65 ± 1.37), (1.62 ± 0.34), (21.21 ± 2.27), (20.27 ± 1.78), (12.16 ± 2.08), (14.56 ± 2.34), (1.71 ± 0.25), (17.92 ± 1.64), (40.29 ± 6.56), (0.21 ± 0.03), t = 6.58, 6.87, 7.51, 7.61, 10.15, 8.38, 5.19, 7.38, 10.96, 7.59, all P < 0.05]. Conclusions:The comorbid auditory and visual hallucinations in patients with first-episode schizophrenia, based on brain MRI findings, are closely related to cognitive decline and brain damage. After treatment, both cognitive function and cranial damage in these patients have considerably improved, which is worthy of clinical consideration.

Objective:To analyze the status quo, hotspots and fronts of emergency nursing training research at home and abroad in the past ten years, and to provide reference and ideas for the efficient development of emergency nursing training in China.Methods:CiteSpace 6.2.R2 software was used to visually analyze the Chinese and English literatures on emergency nursing training included in CNKI and Web of Science core databases from January 1, 2013 to June 1, 2023.Results:A total of 1 177 Chinese literatures and 1 163 English literatures were included. The number of foreign articles in this field increased year by year, while the number of domestic articles showed a downward trend since 2018. There were many stable core author groups and core institution groups in foreign countries, while there was less cooperation among domestic authors and institutions. The common research hotspots and frontiers at home and abroad focused on broadening the training audience of emergency nursing, innovating the training methods of emergency nursing, strengthening the evaluation of the effect of emergency nursing training, and paying attention to the training experience and needs of nurses. Foreign researches also focused on specialized nurses, interprofessional education and nurses′mental health, etc, and the research direction was diversified.Conclusions:The development stages of emergency nursing training researches at home and abroad are different, and the research hotspots are different. In the future, we should learn from foreign research, strengthen interdisciplinary cooperation, improve the depth and breadth of research, and strengthen the cooperation between authors, institutions and countries to promote the high-quality development of emergency nursing training research in China.

Apheresis platelets are extensively utilized in clinical practice due to high purity and minimal side effects. These platelets are primarily obtained from regular blood donors. However, there is no consensus on whether plateletpheresis leads to iron deficiency among blood donors. In recent years, increasing attention has been given to the impact of plateletpheresis on the iron nutritional status of these donors. Numerous studies have indicated a prevalence of iron deficiency among plateletpheresis donors. The process of plateletpheresis involves the loss of red blood cells, which can accumulate over time and disrupt iron metabolism, ultimately resulting in iron deficiency anemia. This condition not only affects the physical well-being of the donors but also leads to a decline in their willingness to donate blood. Blood collection and supply institutions should enhance their focus on the iron nutritional status of plateletpheresis donors and implement various measures, such as intensifying health education regarding the significance of iron supplementation, implementing programs for testing iron deficiency, considering the provision of iron supplements and extending blood donation intervals. It is crucial to prevent iron deficiency in plateletpheresis donors. These institutions should explore calculation models that can predict personalized blood donation intervals and iron supplementation strategies, and seek a balanced approach that is optimal for maintaining adequate collections while safeguarding donor health. The article comprehensively reviews literature at home and abroad on the etiology and hazards of iron deficiency in plateletpheresis donors, as well as detection methods and response measures. It serves as a foundation for developing scientific and reasonable care measures for blood donation, while also achieving personalized and scientific management and recruitment strategies for blood donors.

Objective:To investigate the status and the influencing factors of influenza vaccination during the COVID-19 pandemic among community-dwelling elderly in Shanghai.Methods:A questionnaire survey on influenza vaccination among community-dwelling elderly was conducted in Shanghai Taikang elderly community in November 2020. The information on demographic characteristics, reasons for refusal of vaccination, and measures for increasing vaccination rates were collected. Multiple logistic regression was used to analyze the correlation between influenza vaccination and sociodemographic and health-related characteristics.Results:Among 520 respondents, the vaccination rate was 30.58% (159/520). Compared with unvaccinated group, elderly in vaccinated group was older ( t=16.04, P=0.003)and more educated(χ2=8.16, P=0.043). The elderly with comorbid heart disease, chronic obstructive pulmonary disease, tumor, asthma, Parkinson′s disease were likely to have vaccination ( OR=1.45, 2.16, 1.23, 1.64, 5.83; all P<0.05).The reasons for the elderly not to be vaccinated were concerns of side effects (46.26%, 167/361), lack of doctors′ recommendations (24.10%, 87/361), and unnecessary for people with good health conditions (19.39%, 70/361). The independent factors of influenza vaccine awareness rate were healthcare providers′ recommendations ( OR=9.18, 95% CI:5.47-16.32), vaccination at home( OR=11.79, 95% CI:6.87-21.66),vaccination available in community( OR=8.08, 95% CI:8.08-15.45),the mandatory requirement ( OR=4.61,95% CI:4.61-10.11),free of charge( OR=7.48, 95% CI:4.08-15.12). Conclusion:Influenza vaccination coverage among the elderly in Shanghai is still low even during the COVID-19 pandemic. Policy interventions, awareness education and strengthening the primary healthcare resources may contribute to achieving a high influenza vaccine coverage rate in the community-dwelling elderly

ObjectiveTo analyze the epidemiological characteristics of senile dementia death in Jing’an District from 2016 to 2020， as well as the trends of mortality， standardized mortality， years of life lost （YLL） due to early death， years lived with disability （YLD）， and disability-adjusted life year （DALY）， and to provide scientific basis for the prevention and control of senile dementia. MethodsThe distribution of senile dementia in terms of gender， age， marital status and education level was investigated in the senile dementia death cases from 2016 to 2020 in Jing’an District. The YLL， YLD， DALY and their rates of the residents of Jing’an District from 2016 to 2020 were calculated by using Global Burden of Disease （GBD 2019） research method and results in combination with the corresponding population data. ResultsCompared to those without dementia， deaths with dementia were more likely to be female， more likely to be over 80 years old， less likely to be married， and more likely to have education level under middle school. Among the deaths with dementia， only 27.70% of the primary cause of death was dementia， and the other main causes were cerebrovascular disease， coronary heart disease and diabetes mellitus， which accounted for 25.54%， 17.81% and 7.28%， respectively. There was a significant gender difference in the burden of disease on senile dementia in Jing’an District. Mortality， standardized mortality， YLL， YLD and DALY rates of females were higher than those of males. The burden of disease on senile dementia increased with age. The change trend of mortality and YLL rate from 2016 to 2020 was not statistically significant， while the YLD rate and DALY rate showed an upward trend， which was statistically significant. ConclusionAs the life span of residents in Jing’an District increases and the population aging deepens， the burden of disease on senile dementia is still heavy. This requires extensive attention of the whole society， and active exploration of prevention and control strategies and measures for senile dementia， so as to improve the life quality of patients and reduce the burden of disease.

Background Diabetes mellitus is a major public health issue at present. Previous studies have shown that ambient air pollution is a risk factor for diabetes. Objective This study aims to explore the acute effects of ambient air pollution on diabetes related death in Shanghai Jing’an District. Methods Daily air pollution data, meteorological data, and diabetes related mortality data in 2013−2019 in Shanghai Jing’an District were collected. A generalized additive model (GAM) was established to conduct time-series analysis on the short-term effect of ambient air pollution on diabetes related mortality, and gender- and age-stratified analysis on susceptibility of various groups to ambient air pollution exposures. Results For every 10 μg·m⁻³ increase of the concentrations of PM_2.5, PM₁₀, SO₂, and NO₂, the diabetes related mortality increased by 2.47% (95%CI: 1.56%−3.38%), 2.02% (95%CI: 1.29%−2.75%), 5.75% (95%CI: 2.99%−8.58%), and 3.93% (95%CI: 2.49%−5.39%) at lag05 respectively (P<0.05). In the stratified analysis, exposures to increased concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ raised the mortality risks from diabetes in male, female, and ≥65 years oldgroups (P<0.05). However, the differences in mortality risks from diabetes due to air pollution within gender and age groups were statistically insignificant. Conclusion In Shanghai Jing'an District, the elevated levels of ambient air pollutants, including PM_2.5, PM₁₀, SO₂, and NO₂, are significantly associated with the increase of diabetes related mortality, and there are lag effects and cumulative effects. The ≥65 years olds are more susceptible to the impact of air pollution on diabetes related deaths.

Objective:To study the risk of malnutrition and related factors of cancer patients in community of Shanghai.Methods:From October 2018 to January 2019, four communities, Pengpu New Village Street, Pengpu Town, Jiangning Road Street, and Caojiadu Street, from 14 communities in Jing ′an District, Shanghai City, were selected by using a random cluster sampling method based on the Shanghai Cancer Registration and reporting system. All cases of malignant tumors and benign tumors of the central nervous system were included. A total of 4 396 questionnaires were distributed. After the exclusion of 9 invalid questionnaires, 3 310 valid questionnaires were included with a rate of 99.73%. A self-designed questionnaire was used to collect data including basic demographic characteristics, history of malignant, physical and psychological pain, nutritional demands and cognitive status. Malnutrition Universal Screening Tools (MUST) was used to analyze the nutritional risk of cancer patients in the community. Multivariate logistic regression model was applied to analyze potential factors.Results:Among the 3 310 cancer patients who completed the survey, the average age of study participants was (64.05±13.02), and 1 467 cases (44.32%) were males. The incidence rate of nutritional risk was 12.84% (425/3 310). The result of logistic regression analysis showed that compared with male, other cancer patients and no physical pain, the risk factors of the occurrence of nutritional included: female ( OR=1.53,95% CI:1.23-1.92), head and neck malignant tumors ( OR=1.42,95% CI:1.07-1.90), bronchus/lung malignant tumors ( OR=1.93,95% CI:1.43-2.61), liver, biliary/pancreatic malignant tumors ( OR=2.11,95% CI:1.21-3.65) and upper gastrointestinal malignant tumors ( OR=6.04,95% CI:4.31-8.46), patients with physical pain ( OR=1.39,95% CI:1.02-1.89). Conclusion:Nutritional risk of cancer patients is higher in community of Shanghai. Gender, location of tumors and physical pain are associated with the occurrence of nutritional risk.

Objective:To study the risk of malnutrition and related factors of cancer patients in community of Shanghai.Methods:From October 2018 to January 2019, four communities, Pengpu New Village Street, Pengpu Town, Jiangning Road Street, and Caojiadu Street, from 14 communities in Jing ′an District, Shanghai City, were selected by using a random cluster sampling method based on the Shanghai Cancer Registration and reporting system. All cases of malignant tumors and benign tumors of the central nervous system were included. A total of 4 396 questionnaires were distributed. After the exclusion of 9 invalid questionnaires, 3 310 valid questionnaires were included with a rate of 99.73%. A self-designed questionnaire was used to collect data including basic demographic characteristics, history of malignant, physical and psychological pain, nutritional demands and cognitive status. Malnutrition Universal Screening Tools (MUST) was used to analyze the nutritional risk of cancer patients in the community. Multivariate logistic regression model was applied to analyze potential factors.Results:Among the 3 310 cancer patients who completed the survey, the average age of study participants was (64.05±13.02), and 1 467 cases (44.32%) were males. The incidence rate of nutritional risk was 12.84% (425/3 310). The result of logistic regression analysis showed that compared with male, other cancer patients and no physical pain, the risk factors of the occurrence of nutritional included: female ( OR=1.53,95% CI:1.23-1.92), head and neck malignant tumors ( OR=1.42,95% CI:1.07-1.90), bronchus/lung malignant tumors ( OR=1.93,95% CI:1.43-2.61), liver, biliary/pancreatic malignant tumors ( OR=2.11,95% CI:1.21-3.65) and upper gastrointestinal malignant tumors ( OR=6.04,95% CI:4.31-8.46), patients with physical pain ( OR=1.39,95% CI:1.02-1.89). Conclusion:Nutritional risk of cancer patients is higher in community of Shanghai. Gender, location of tumors and physical pain are associated with the occurrence of nutritional risk.