To analyze all-cause mortality among hepatitis C cases aged ≥18 years in Yuxi City from 2005 to 2023 and explore the interactions of factors influencing survival time. Baseline and follow-up data for hepatitis C cases reported during this period were extracted from the Chinese National Notifiable Disease Reporting System. Survival time and related factors were assessed using the Cox proportional hazards model. Kaplan-Meier cumulative mortality risk curves were generated for treated and untreated hepatitis C cases, and interactions among subgroups of various influencing factors were examined. A total of 5 110 hepatitis C cases aged ≥18 years were reported from 2005 to 2023, encompassing 35 349.25 person-years of observation with the follow-up time duration M ( Q1, Q3) was 6.17 (2.33, 11.08) person-years. There were 763 all-cause deaths, corresponding to a mortality density of 2.16 per 100 person-years. Survival analysis showed a statistically significant difference in cumulative mortality between the treated and untreated groups (Log-rank χ2=122.033, P<0.001), with a lower risk of death observed among treated patients. Additive model analysis showed that there was a synergistic interaction between treatment status and age group, with relative excess of interaction, attributable proportions of interaction, and synergy index of 6.16 (95 %CI: 2.70-9.61), 1.83 (95 %CI: 1.46-2.30), and 0.42 (95 %CI: 0.31-0.53), respectively; and between treatment status and gender. There was a synergistic interaction between treatment status and sex, with relative excess of interaction, attributable proportions of interaction, and synergy index of 2.63 (95 %CI: 1.14-4.13), 1.56 (95 %CI: 1.19-2.06), and 0.32 (95 %CI: 0.17-0.46), respectively. The cause of death composition were 38.53% (249 cases) attributed to hepatitis C-related causes.The leading non-hepatitis C-related causes of death were cardiovascular and cerebrovascular diseases, pulmonary diseases, malignancies, drug overdose, and injuries. In conclusion, hepatitis C cases ≥18 years of age in Yuxi City had a lower cumulative mortality rate when treated than when untreated. Treatment status interacted with age and gender on patient survival, respectively. Changes in patients with concomitant cardiovascular diseases, pulmonary diseases and malignancies should be focused.

To analyze all-cause mortality among hepatitis C cases aged ≥18 years in Yuxi City from 2005 to 2023 and explore the interactions of factors influencing survival time. Baseline and follow-up data for hepatitis C cases reported during this period were extracted from the Chinese National Notifiable Disease Reporting System. Survival time and related factors were assessed using the Cox proportional hazards model. Kaplan-Meier cumulative mortality risk curves were generated for treated and untreated hepatitis C cases, and interactions among subgroups of various influencing factors were examined. A total of 5 110 hepatitis C cases aged ≥18 years were reported from 2005 to 2023, encompassing 35 349.25 person-years of observation with the follow-up time duration M ( Q1, Q3) was 6.17 (2.33, 11.08) person-years. There were 763 all-cause deaths, corresponding to a mortality density of 2.16 per 100 person-years. Survival analysis showed a statistically significant difference in cumulative mortality between the treated and untreated groups (Log-rank χ2=122.033, P<0.001), with a lower risk of death observed among treated patients. Additive model analysis showed that there was a synergistic interaction between treatment status and age group, with relative excess of interaction, attributable proportions of interaction, and synergy index of 6.16 (95 %CI: 2.70-9.61), 1.83 (95 %CI: 1.46-2.30), and 0.42 (95 %CI: 0.31-0.53), respectively; and between treatment status and gender. There was a synergistic interaction between treatment status and sex, with relative excess of interaction, attributable proportions of interaction, and synergy index of 2.63 (95 %CI: 1.14-4.13), 1.56 (95 %CI: 1.19-2.06), and 0.32 (95 %CI: 0.17-0.46), respectively. The cause of death composition were 38.53% (249 cases) attributed to hepatitis C-related causes.The leading non-hepatitis C-related causes of death were cardiovascular and cerebrovascular diseases, pulmonary diseases, malignancies, drug overdose, and injuries. In conclusion, hepatitis C cases ≥18 years of age in Yuxi City had a lower cumulative mortality rate when treated than when untreated. Treatment status interacted with age and gender on patient survival, respectively. Changes in patients with concomitant cardiovascular diseases, pulmonary diseases and malignancies should be focused.

Autophagy is an intracellular degradation process that delivers cytoplasmic constituents to the lysosome. Abnormality of autophagy is related to many human diseases, which provides a new clue to the pathophysiology of human cancer. However, the role of autophagy in normal liver physiology and the pathogenesis of liver diseases need to be further clarified. This article reviews the role of autophagy in the occurrence and development of hepatocellular carcinoma and the molecular mechanisms.

Objective: To assess the effectiveness in optimizing resources and shortening critical children′s waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination. Results: A total of 375 985 patients were included, among whom males were 225 308 (59.9%) and females were 150 677 (40.1%), all younger than 14 years of age. The number of critical cases (level Ⅰ, level Ⅱ and level Ⅲ) was increased from 4 719 (3.7%) in 2015, 12 209 (10.2%) in 2016 to 16 188 (12.7%) in 2017. The number of non-critical patients (level Ⅴ) decreased year by year, as from 98 213 (76.8%) in 2015 to 75 210 (62.6%) in 2016 and 78 857 (61.7%) in 2017. The patients who classified as level Ⅰ or levelⅡaccording to the PETS were seen immediately by physician (n=1855, 0.5%). Overall, 119 738 patients (98.3%) who were classified as level Ⅲ or level Ⅳ could be seen by physician in a timely manner according to triage guidelines, while 2 112 patients (1.7%) could not. The mean waiting time was 9.09 min in level Ⅲ, 17.7 min in level Ⅳ, and 55.76 min in level Ⅴ patients, respectively. The critical cases admitted to the intensive care units were 175 (36.2%) in 2015, 350 (62.8%) in 2016 and 374 (66.2%) in 2017. The etiologies were respiratory diseases (73.3%), gastrointestinal diseases (15.8%) and infectious diseases (3.1%). Conclusion The application of PETS could optimize emergency resources and shorten the waiting time of critically ill children.

course of Internal Medicine and Surgery Nursing. Methods From September 2014 to July 2016, the Grade 2013 nursing students at the Sino American cooperative nursing class in the Nursing College of Wenzhou Medical University were selected as the experimental group by convenient sampling method, with a total of 59 people. The Grade 2012 nursing students in the Sino American cooperative nursing class were selected as the control group, with a total of 60 people. The nursing students in the control group received traditional teaching methods and the nursing students in the experimental group received the self participating teaching method. We compared students' self-learning ability, theoretical knowledge and comprehensive practical ability between the two groups. Results The total score of self-learning ability and the scores of all dimensions of experimental group were higher than those in the control group after class, and the differences were statistically significant (P< 0.05). The scores of theoretical knowledge and comprehensive practice ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P< 0.05). Conclusions Self participation teaching method is a teaching method that helps teachers play a leading role in giving play to students' main body status. It helps to promote the development of nursing students' independent learning ability, and improve their theoretical level and nursing practice ability.

OBJECTIVETo study the polymorphisms of human platelet antigen (HPA) 1-16 and human leukocyte antigen (HLA)-A and -B loci among ethnic Han population from Shandong.

METHODSA total of 588 samples from platelet donors were genotyped for the above loci with sequence-specific primer PCR and sequence-specific oligonucleotide probe PCR.

RESULTSThe frequencies of HPA-la, -1b, HPA-2a, -2b, HPA-3a, -3b, HPA-4a, -4b, HPA-5a, -5b, HPA-6a, -6b, HPA-15a, -15b were 0.9974, 0.0026, 0.9456, 0.0544, 0.5417, 0.4583, 0.9983, 0.0017, 0.9889, 0.0111, 0.9903, 0.0097, 0.5434 and 0.4583, respectively. The HPA-7-14 and HPA-16 showed no heterozygosity as the b allele was not detected in such loci. The most common genotypic combination for HPA was HPA-(1,4,7-14,16,17) aa-2aa-3ab-5aa -6aa-15ab (0.1820). HLA-A2 (0.3070) and HLA-B13 (0.1361) demonstrated the highest frequencies at their respective loci.

CONCLUSIONThe HPA and HLA loci are highly polymorphic among ethnic Hans from Shandong. The distribution of HPA polymorphisms also shows a great ethnic and territorial difference. It is important to construct regional database for the genotypes of HPA and HLA loci for platelet donors.

Alleles ; Antigens, Human Platelet ; genetics ; Asian Continental Ancestry Group ; genetics ; statistics & numerical data ; Blood Donors ; China ; Female ; Gene Frequency ; Genetics, Population ; Genotype ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; Humans ; Linkage Disequilibrium ; Male ; Polymorphism, Genetic

Objective To explore the impact of intensive follow-up visit in patients with nonvalvular atrial fibrillation taking Warfarin in process of anticoagulant therapy. Methods A total of 100 patients with persistent nonvalvular atrial fibrillation were randomly divided them into intensive follow-up group and regular follow-up group on average. We compared the treatment compliance, INR value, embolism and hemorrhage between two groups. Results The INR qualified rate was 86. 0% after 6 months taking medication in the intensive follow-up group and 72. 0% in the regular follow-up group (χ2 =4. 570,P<0. 05). The incidence rate of hemorrhage was 12% in the intensive follow-up group and 28% in the regular follow-up group (χ2 =4. 000,P<0. 05). Conclusions With the function of propaganda, education, supervision, promotion and attention on patients, follow-up visit makes patients taking Warfarin receive normative, effective anticoagulant treatment and improves the safety of medicine use, thus the effect of preventing stroke can be achieved.

Objective To investigate the effect of the typical task teaching method on nursing education in the department of cardiology .Methods Eighty-seven nurse interns in 2012 and ninety nurse interns in 2013 were selected and divided into the control group and the observation group .The control group was given the traditional teaching method and the observation group was given the typical task teaching method .According to the specialized subjects characteristic , the acute myocardial infarction , acute left heart failure , arrhythmia diseases combined with ECG monitoring , cardiopulmonary resuscitation and oxygen inhalation technique were identified as the typical work tasks for the department of cardiology .The “clinical ability of nursing students evaluation questionnaire” was used to analyze and compared the teaching effects of the two groups of nursing students.Results The scores of practice ability, communication ability, health education, nursing management, nursing scientific research and the total score in the observation group were (52.38 ±10.64), (42.52 ±8.54), (20.45 ±4.28), (35.22 ±8.35), (17.48 ±5.44) and (195.08 ±43.68), respectively, which were significantly higher than (41.57 ±10.50), (35.12 ±8.02), (14.49 ±3.36), (28.45 ±8.67), (12.16 ±3.84) and (156.02 ±39.42) in the control group ( t=6.801, 5.938, 10.336, 5.292, 7.493, 6.239, respectively;P<0.05).Conclusions The typical task teaching method can effectively improve the clinical ability of nursing students in the department of cardiology .It is necessary to be promoted in the nursing education .

Objective To investigate the relationship between proinflammatory cytokines and cognitive function in patients with mild cognitive impairment (MCI).Methods From May 2007 to May 2009,70 patients (aged ≥ 60 years) with MCI were collected.Among them,50 cases were amnestic MCI,and 19 cases developed into AD.The cognitive function was assessed,and all patients were followed up.The venous blood samples were obtained and proinflammatory cytokines (IL-1α,IL 1β,IL-6,TNF-α) were detected by using enzyme linked immunosorbent assay.Results There were differences in the levels of proinflammatory cytokines between patients with aMCI and patients with Alzheimer's disease (AD) [IL-1β,(40.5 ± 7.7) μg/L vs.(38.6 ± 7.3) μg/L ; IL 6,(70.4 ±24.3) μg/'L vs.(53.6±20.5) μg/L;TNF-α,(58.6±13.5) μg/'L vs.(50.3±-17.1) μg/'L;t=3.537,2.229,2.226,P=0.002,0.039,0.039,respectively].Conclusions MCI is a preclinical state of AD.The cognitive function damage of MCI patients are different from that of AD patients,and the immune status of MCI patients is also changed.

ObjectiveTo explore the effects of insomnia on heart rate variety(HRV) in aged hypertension patients. Methods259 subjects were divided into healthy group (74 cases),simple hypertension group (71 cases),coexisting hypertension and insomnia group (114 cases) which was sub-grouped to ＜5 years,5-9 years and ≥-10 years according to the duration of insomnia.All subjects had 24 h recordings of ECG.The data of HRV time domain (SDNN,SDANN and ASDNN) were collected and compared.ResultsHRV time domain was lower in healthy group than in the other two groups (F=12.02,10.54 and 4.27,P＜0.01),and decreased more significantly in coexisting hypertension and insomnia group compared with simple hypertension group(P＜0.01).The values of SDNN and SDANN in 5-9 years and ≥ 10 years subgroups decreased as compared with ＜ 5 years subgroup (F=8.63 and 4.54,P＜0.01),and these values further lower in ≥10 years subgroup than in 5-9 years subgroup (P＜ 0.01 ). ConclusionsInsomnia may lead to more serious disorder of automatic nervous system and further aggravated disorders appear in the elderly with hypertension along with increasing years of insomnia.