Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective To investigate the distribution of dense fine speckled(DFS)antinuclear antibody(ANA)in different ages,genders,and diseases,and to explore its clinical significance in the diagnosis of auto-immune disease(AID).Methods A retrospective summary was conducted on the clinical basic data of 53520 patients who visited the hospital from January 2022 to April 2024,as well as the results of indirect immunoflu-orescence(IIF)ANA fluorescence karyotype and titer,and immunoblotting ANA spectrum,and the relation-ship between DFS positivity and AID was analyzed.Results Of the 53 520 serum samples,the rate of ANA fluorescence positivity was 32.40％,with DFS-positive samples accounting for 1.18％of all ANA fluores-cence-positive samples.The male-to-female ratio of DFS positives was 1∶1.94,with the highest percentage of 51.9％in the 21-40 age group.Among DFS positive individuals,only 12.14％were clinically diagnosed with AID disease,significantly lower than other ANA fluorescent karyotype positive individuals(23.31％,P＜0.001).The overall positivity rate of ANA spectra using immunoblotting in DFS-positive individuals was 23.54％,which was significantly lower than that in other fluorescent karyotype positive ANA individuals(73.26％,P＜0.001).Moreover,DFS positive individuals were mainly accompanied by antibody positivity such as anti-Ro52 antibodies,which had no diagnostic specificity in AID diagnosis.When comparing DFS posi-tive individuals with similar fluorescence morphology to those with homogeneous nuclear granules and nuclei,at an ANA titer of 1∶100,the proportion of AID patients in homogeneous nuclear granules and nuclei was 20.04％,significantly higher than the proportion of AID patients in DFS positive individuals(9.44％,P=0.001).With the increase of ANA titer,the proportion of AID diseases significantly increased in both karyo-type samples.When the ANA titer of DFS positive samples was increased to ≥ 1∶320,the proportion of AID diseases significantly increased to 30.77％(P=0.002).Conclusion DFS is a rare ANA fluorescent karyo-type,and DFS positive individuals are mainly found in females aged 21-40,mostly non AID patients.Howev-er,high titers of DFS cannot rule out the possibility of AID.In clinical work,special attention should be paid to distinguishing it from the homogeneous nuclear granule type to avoid misdiagnosis.

Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

Objective:To explore the differences in reproductive tract microbiota between patients with moder-ate and severe intrauterine adhesions(IUA)and infertile patients with normal uterine cavities and the clinical sig-nificance.Methods:Thirty patients were enrolled in the study from June 1,2022 to September 12,2022.Among them,15 cases were confirmed as moderate to severe IUA by hysteroscopy(group A),and 15 cases of primary infertility were excluded from intrauterine diseases through outpatient hysteroscopy(group B).Perform high-throughput sequencing of secretions from the vagina,cervix,and uterine cavity separately.Results:There is no difference in the α diversity of intrauterine microbiota between the two groups,but the α diversity of intrauterine mi-crobiota in group A is significantly higher than that of cervical microbiota(P=0.036).At the genus level,the top 10 relative abundances are the same for both groups.At the species level,the abundance of lactobacillus iners in group A is significantly lower than that in group B(P=0.001).There is no statistically significant difference in the abundance of microorganisms in the vagina,cervix and uterine cavity of group A.Conclusions:The types of en-dometrial microbiota in IUA patients and infertile women are roughly the same,but the composition is different.There are differences in the diversity of reproductive tract microbiota in patients with IUA,with a higher diversity of microbiota in the uterine cavity.Which suggests that the pathogenesis of IUA may be related to the changes of endometrial microbiota,increased microbial diversity,complex microbial species,especially the imbalance of the microecology of lactobacillus,which is not conducive to the repair of endometrial damage.

The China Cardiovascular Health and Disease Report 2024 has recently been released,offering a comprehensive and detailed assessment of the current status of cardiovascular diseases(CVD)and their associated risk factors in China.The report reveals that the number of CVD cases,as well as the overall and age-standardized incidence rates,continue to increase.Among these conditions,atherosclerotic cardiovascular disease(ASCVD)constitutes a major contributor to CVD-related mortality.Although ASCVD is largely preventable and controllable,the management of key modifiable risk factors-such as smoking,obesity,hypertension,dyslipidemia,and diabetes-remains suboptimal.This article systematically summarizes the prevalence,current management practices,and evidence-based prevention strategies for each major ASCVD risk factor,aiming to reinforce for clinicians the impor-tance of not only treating established ASCVD but also proactively guiding patients in the prevention and control of its underlying risk factors,thereby reducing the overall burden of ASCVD in terms of both prevalence and mortality.

The China Cardiovascular Health and Disease Report 2024 has recently been released,offering a comprehensive and detailed assessment of the current status of cardiovascular diseases(CVD)and their associated risk factors in China.The report reveals that the number of CVD cases,as well as the overall and age-standardized incidence rates,continue to increase.Among these conditions,atherosclerotic cardiovascular disease(ASCVD)constitutes a major contributor to CVD-related mortality.Although ASCVD is largely preventable and controllable,the management of key modifiable risk factors-such as smoking,obesity,hypertension,dyslipidemia,and diabetes-remains suboptimal.This article systematically summarizes the prevalence,current management practices,and evidence-based prevention strategies for each major ASCVD risk factor,aiming to reinforce for clinicians the impor-tance of not only treating established ASCVD but also proactively guiding patients in the prevention and control of its underlying risk factors,thereby reducing the overall burden of ASCVD in terms of both prevalence and mortality.

Objectives:To investigate the prognostic value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with atrial fibrillation(AF)and heart failure(HF).Methods:Patients with AF and HF from hospitals diagnosed by the Heart Failure Center in Guangdong Province between January 2017 and December 2021 were selected.Major adverse cardiovascular events(MACE)were used as the follow-up endpoint.Statistical methods such as the area under the receiver operating characteristic(ROC)curve(AUC),net reclassification index(NRI),and integrated discrimination improvement(IDI)were applied to evaluate the predictive value of the CHA2DS2-VASc and R2CHA2DS2-VASc scores in patients with AF and HF.Results:A total of 1 839 patients were enrolled in this study,comprising 703 patients in the MACE group and 1 136 patients in the non-MACE group.Compared with the non-MACE group,the MACE group exhibited significantly advanced age,higher prevalence of New York Heart Association class Ⅳ and coronary artery disease,lower diastolic blood pressure and estimated glomerular filtration rate levels,and elevated serum N-terminal pro-B-type natriuretic peptide concentrations(all P<0.05).Additionally,significantly lower proportions of patients in the MACE group received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors,beta-blockers,mineralocorticoid receptor antagonists,or anticoagulant therapy(all P<0.05).Multivariable logistic regression analysis revealed that each 1-point increment in both CHA2DS2-VASc and R2CHA2DS2-VASc scores was associated with approximately 10%increased risk of MACE.ROC curve analysis demonstrated that the AUC values for predicting MACE in AF patients with HF were 0.555(95%CI:0.528-0.582,P<0.001)for CHA2DS2-VASc and 0.576(95%CI:0.549-0.608,P<0.001)for R2CHA2DS2-VASc,indicating marginally superior discriminatory capacity of the R2CHA2DS2-VASc score.Delong's test confirmed statistically significant differences between the two scoring systems(P=0.001).The R2CHA2DS2-VASc score demonstrated a NRI of 0.259(95%CI:0.166-0.352,P<0.001)and an IDI of 0.007(95%CI:0.005-0.010,P<0.001)compared with the conventional CHA2DS2-VASc score.Although the R2CHA2DS2-VASc score exhibited slightly better predictive accuracy and outcome discrimination capacity than the original scoring system,both scores demonstrated suboptimal clinical predictive performance.Conclusions:Both the R2CHA2DS2-VASc and CHA2DS2-VASc scores show suboptimal performance for predicting the risk of MACE in patients with AF and HF,and the predicting performance of R2CHA2DS2-VASc score is marginally superior to CHA2DS2-VASc score in this patient cohort.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective:To explore the differences in reproductive tract microbiota between patients with moder-ate and severe intrauterine adhesions(IUA)and infertile patients with normal uterine cavities and the clinical sig-nificance.Methods:Thirty patients were enrolled in the study from June 1,2022 to September 12,2022.Among them,15 cases were confirmed as moderate to severe IUA by hysteroscopy(group A),and 15 cases of primary infertility were excluded from intrauterine diseases through outpatient hysteroscopy(group B).Perform high-throughput sequencing of secretions from the vagina,cervix,and uterine cavity separately.Results:There is no difference in the α diversity of intrauterine microbiota between the two groups,but the α diversity of intrauterine mi-crobiota in group A is significantly higher than that of cervical microbiota(P=0.036).At the genus level,the top 10 relative abundances are the same for both groups.At the species level,the abundance of lactobacillus iners in group A is significantly lower than that in group B(P=0.001).There is no statistically significant difference in the abundance of microorganisms in the vagina,cervix and uterine cavity of group A.Conclusions:The types of en-dometrial microbiota in IUA patients and infertile women are roughly the same,but the composition is different.There are differences in the diversity of reproductive tract microbiota in patients with IUA,with a higher diversity of microbiota in the uterine cavity.Which suggests that the pathogenesis of IUA may be related to the changes of endometrial microbiota,increased microbial diversity,complex microbial species,especially the imbalance of the microecology of lactobacillus,which is not conducive to the repair of endometrial damage.