Objectives:To observe the exercise tolerance and cardiopulmonary function characteristics of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with cardiovascular disease,in order to assess the cardiorespiratory reserve and health status of untreated OSAHS,and to provide a clinical evidence for the phase Ⅱ cardiac rehabilitation. Methods:This retrospective analysis included 134 cardiovascular disease patients who attended the Cardiac Rehabilitation Center of Fuwai Hospital,Chinese Academy of Medical Sciences from November 2021 to April 2024 and received home sleep apnea monitoring (HSAT).According to the apnea hypopnea index (AHI),the patients were divided into the non-OSAHS (AHI<5 times/h) group (n=24),the mild-OSAHS (5 times/h ≤AHI<15 times/h) group (n=65),and moderate-to-severe OSAHS (AHI ≥15 times/h) group (n=45),and the body composition,pulmonary function characteristics,exercise tolerance,and ventilatory response to exercise were compared among the three groups. Results:A total of 110 (82.1％) patients had comorbid OSAHS,with a higher proportion of male patients (80.0％).Height,weight,body mass index,lean body mass,skeletal muscle mass,body water content,and basal metabolic rate increased progressively with increasing OSAHS severity in three groups (all P<0.05),while cardiovascular disease comorbidity was similar.Static lung function,exercise tolerance and ventilatory function at maximal exercise were similar between the patients in the mild OSAHS group and the moderate-severe OSAHS group as compared to the non-OSAHS group (all P>0.05).With the increase in the severity of OSAHS,the cardiorespiratory fitness showed a decreasing trend among patients in the three groups,and the forced vital capacity and the maximum vital capacity of patients in the moderate-severe OSAHS group were significantly higher than that of the mild OSAHS group,while peak O2 pulse％pred was significantly lower than that of the mild OSAHS group (all P<0.05).Multivariate analysis showed that the body fat mass (β=0.307,95％CI:0.263-0.823,P<0.001),minute ventilation at rest (β=0.259,95％CI:0.429-1.785,P=0.002) were the independent influencing factors of AHI. Conclusions:The prevalence of OSAHS is high in patients with cardiovascular disease,and patients with moderate-to-severe OSAHS have reduced cardiorespiratory fitness,OSAHS is not associated with additional cardiac impairment and ventilatory function impairment in patients with cardiovascular disease.Weight loss should be the primary rehabilitation goal in patients with OSAHS combined with cardiovascular disease.

Objective:To analyze the common disease spectrum and medication of field medical team in our hospital in summer, and to provide medical and medicinal material supply for field medical team.Methods:The data of all cases of field medical team members during the training period were collected. The types and composition ratio of diseases were analyzed, the drug consumption was counted, and the drug use indicators were calculated including daily drug dose (DDDs), daily drug dose cost (DDDC), drug utilization rate (DUR) and drug ranking ratio (R).Results:During the 12 days of the field training in summer, 77 field medical team members had 91 medical visits and 117 cases of diseases, including 44 males and 33 females, with an average age of 39.7 years. There were 52 cases of respiratory diseases, 21 cases of digestive diseases, 18 cases of mosquito bites and skin diseases, 15 cases of trauma and skeletal muscle system diseases, 5 cases of ophthalmic diseases, 2 cases of neurological diseases, 2 cases of gynecological diseases, 1 case of oral diseases and 1 case of heat stroke. The top five drugs of DDDs and DUR were respiratory drugs, sensory organ drugs, dermatological drugs, antibiotic drugs, digestive system drugs and musculoskeletal system drugs.Conclusions:The disease composition and drug demand of field training in summer have certain characteristics. It is of great guiding significance to know the characteristics of disease incidence and drug consumption of field training for the medical support ability and training tasks for field medical teams in field training in summer.

Objective:To construct nursing-sensitive indicators system of perioperative pulmonary rehabilitation for patients in thoracicsurgery, so as to provide scientific monitoring standards for nursing quality of pulmonary rehabilitation.Methods:Based on the theory of enhanced recovery after surgery (ERAS) , evidence synthesis was conducted based on Johns Hopkins evidence-based nursing method for laying the foundation for nursing-sensitive quality indicators system of perioperative pulmonary rehabilitation.Based on the analysis results of the quality of nursing in the past two years, and though group discussion, appropriate indicators feasible to application were determined, and nursing-sensitive quality indicators, calculation formulas were preliminarily decided. Through two rounds of experts consultation, the nursing-sensitive quality indicators system of pulmonary rehabilitation was improved and established.Results:After two rounds of expert consultations, the constructed nursing-sensitive quality indicators system of pulmonary rehabilitation included 3 first-class indicators, 6 second-class indicators, and 31 third-class indicators. Positive coefficients of two rounds of expert consultation were both 100%, authority coefficients were 0.827 and 0.861, respectively, and the coordination coefficients were 0.309 and 0.372.Conclusion:The nursing-sensitive quality indicators system was scientific and practical and it was beneficial to regulate the behavior of nurses and improve the nursing quality of pulmonary rehabilitation.

From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi′s population as the standard population, the age-standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age-standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI: 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI: -7.47%-9.66%, t=0.27, P=0.803).

From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi′s population as the standard population, the age?standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age?standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI : 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI :-7.47%-9.66%, t=0.27, P=0.803).

From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi′s population as the standard population, the age?standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age?standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI : 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI :-7.47%-9.66%, t=0.27, P=0.803).

Objective To establish a time-resolved fluoroimmunoassay (TRFIA) method for detecting M-type phospholipase A2 receptor (PLA2R) antibody and to investigate the diagnostic value of serum PLA2R antibody for idiopathic membranous nephropathy (IMN).Methods The microplates coated with recombined PLA2R antigen and Eu3+-streptavidin labeled PLA2R antigen were used to establish a dual-antigen sandwich-type TRFIA for PLA2R antibody detection (anti-PLA2R-TRFIA).The serum concentrations of PLA2R antibody in 63 IMN patients (36 males,27 females,age 25-75 years) and 90 healthy volunteers (30 males,60 females,age 22-53 years) were quantitatively analyzed.Kruskal-Wallis H test and MannWhitney u test were used to analyze the data.Results The range of anti-PLA2R-TRFIA was 0-10 mg/L and the sensitivity was 5 μg/L,while ED20,ED50 and ED80 of the standard curve were (0.144±0.012),(0.707±0.029) and (3.466±0.098) mg/L,respectively.The CV of inter-and intra-assay were 4.7％ and 5.1％,respectively.The average concentration of serum PLA2R antibody in healthy volunteers was 0.455(0.320,0.593) mg/L,but in IMN patients it was 2.690(0.717,7.750) mg/L (z=-3.688,P＜0.05).Meanwhile,the serum levels of PLA2R antibody in IMN patients were significantly different between different stages and ages (x2 values:10.328,9.716,both P＜0.05).According to the receiver operating characteristic (ROC) curve,when the diagnostic cut-off was set at 0.80 mg/L for IMN detection,the sensitivity and specificity of anti-PLA2R-TRFIA were 73.0％ (46/63) and 95.6％ (86/90),respectively.Conclusions AntiPLA2R-TRFIA has been well established.This quick and easy-performance method could increase the diagnostic accuracy for IMN.

Objective To improve the recognition of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome by investigating its clinical features and imaging manifestations. Methods The data of 14 patients with SAPHO syndrome (8 males, 6 females, age range: 18-61 years) between January 2014 and January 2017 were retrospectively analyzed. The clinical features, the results of laboratory (erythrocyte sedimentation rate (ESR), C reaction protein (CRP), complement component 3 (C3) and component 4 (C4), human leukocyte antigen (HLA)-B27) tests, pathology and imaging examinations (CT and whole-body bone im-aging) were collected. Results SAPHO syndrome was mainly characterized by skin damage and bone joint damage. The main manifestations of skin lesions were pustules, desquamation and erythema. Those of bone and joint injury were sternocostoclavicular hyperostosis, stiff spinal hyperostosis, peripheral arthritis, and sacroiliitis. There were 5 with fasting ESR, 5 with abnormal CRP, 3 with abnormal C3, and 1 with abnormal C4 among 14 patients. HLA-B27 was negative in all patients. Whole-body bone imaging revealed that 14 pa-tients had abnormal radioactivity, mainly involving the anterior chest wall, spine, pelvis and long bone. Chest CT manifestations of the patients were the destruction of joint bone, the fusion of the hypertrophy and the narrowing of the joint space. Symmetric lesions accounted for the majority. Pathology examination showed non-specific inflammation in 9 patients. Conclusions SAPHO syndrome is a disease characterized by skin, bone and joint abnormalities. Whole-body bone imaging can find systemic bone damage in early stage, and CT can detect bone changes and soft tissue lesions.

Objective To investigate the potential protective effects of valproic acid (VPA) on gut barrier function after major burn injury in rats and its mechanism.Methods Forty male Sprague-Dawley (SD) rats were divided into sham + normal saline (NS),sham + VPA,scald + NS,and scald + VPA groups,with 10 rats in each group.Rat with 55％ total body surface area (TBSA) third-degree severe-bums model was reproduced by immersing into 80 ℃ water,and the rats in sham groups were given sham-bums by immersing into 37 ℃ water.The rats after severebums were immediately treated with 0.25 mL of 300 mg/kg VPA or NS by subcutaneous injection.Rats were sacrificed at 2 hours and 6 hours after injury,and abdominal aortic blood and ileal tissue were harvested.The levels of vascular endothelial growth factor (VEGF) were determined by enzyme-linked immunosorbent assay (ELISA).The intestinal permeability was evaluated by fluorescein isothiocyanate-dextran (FITC-dextran) determination.The histomorphological changes in gut barrier were evaluated by Chiu grading system.Levels of acetylated lysine at the ninth position of histone 3 protein (Ac-H3K9),hypoxia-inducible factor 1α (HIF-1α),zona occludens 1 (ZO-1) and myosin light chain kinase (MLCK) were determined by immunofluorescence staining and Western Blot.Results Compared with sham + NS group,rats in scald + NS group showed intestinal mucosal damage 2 hours after bum injury,as well as increased mucosal permeability,protein expression levels of HIF-1 α,VEGF,MLCK,and lowered levels of AC-H3K9 and ZO-1.These changes were much more prominent at 6 hours after injury.VPA treatment significantly attenuated the bum-induced intestinal damage.Compared with scald + NS group,the protective effects in scald + VPA group was not evident at 2 hours after injury;however,intestinal damage was much less severe at 6 hours after injury (Chiu score:2.03 ± 0.27 vs.3.12 ± 0.15),intestinal permeability was significantly decreased [FITC-dextran (μg/L):709 ± 76 vs.1138 ± 75],histone acetylation was enhanced [Ac-H3K9 (gray value):1.55 ± 0.12 vs.0.48±0.12],ZO-1 degradation was significantly inhibited (gray value:0.69 ± 0.12 vs.0.43 ± 0.16),the protein expression levels of VEGF and MLCK were significantly down-regulated [VEGF (ng/mg):51.7±3.7 vs.71.2±4.3,MLCK (gray value):1.98±0.20 vs.2.80±0.24],while the HIF-1 α protein expression levels were significantly reduced at both 2 hours and 6 hours after injury (gray value:2.50±0.39 vs.3.88±0.42 at 2 hours,1.83±0.42 vs.4.42±0.41 at 6 hours,all P ＜ 0.05).Conclusions Severe bum injury can induce histone deacetylation,ZO-1 degradation and intestinal barrier dysfunction.VPA can improve the levels of histone acetylation and ZO-1,and protect intestinal epithelial barrier function.These may probably be mediated through inhibiting HIF-1α and its downstream gene VEGF and MLCK.

Objective To evaluate the significance of the level change of urinary conductivity (Cond) on the disease progress in the patients with type 2 diabetic nephropathy(DN) .Methods 138 patients with type 2 diabetes mellitus (T2DM) in our hospital were selected and divided into the normoalbuminuria (NUA) ,microalbuminuria (LUA) and macroalbuminuria (MUA) group;then among them 107 cases were re‐divided into the DN group and the diabetes mild renal injury (DC) group .The levels of urinary Cond were measured by using the Sysmex UF‐1000i urine flow cytometer .The urine specific gravity (SG) was detected by the ARKRAY AUTION MAX AX‐4280 analyzer ,and the urine albumin (U‐Alb) was tested by the Siemens BNⅡ automatic protein analyzer .Re‐sults The Cond level in the MUA group was (14 .1 ± 4 .5)ms/cm ,which was lower than (15 .7 ± 4 .3)ms/cm in LUA group(P<0 .05) ,while the Cond level in the LUA group was significantly lower than (17 .6 ± 5 .7) ms/cm in the NUA group(P<0 .05);the SG levels in the NUA group and the LUA group were 1 .014(1 .010-1 .019) and 1 .015(1 .010 -1 .020) respectively ,both were higher than 1 .011(1 .009-1 .012) in the MUA group SG (P<0 .05) .Cond was positively correlated with SG (r=0 .63 ,P<0 .05) and negatively correlated with 24 h‐UAE (r= -0 .183 ,P<0 .05) .The Cond level in the DN group was(13 .2 ± 4 .3)ms/cm ,which was significantly lower than (15 .0 ± 4 .4) ms/cm in the DC group (P<0 .05) ,there was no statistically significant differences in the SG level between the DN group and DC group (P>0 .05) .The area under curve (AUC) of ROC for Cond was 0 .612 (0 .502-0 .723) .When setting the cut‐off vales of Cond as 11 .85 ms/cm ,then the sensitivity was 43 .8% ,and the specificity was 78 .0% . Conclusion The urine Cond level change can reflect the disease progress of DN in T 2DM ,but can not be used as its early screening indicato r .