Objective To evaluate the short-term effects of comprehensive health management interventions for stroke high-risk population screening on the prevention and treatment of ischemic stroke, and to provide reference and basis for improving and exploring health management and prevention strategies for stroke high-risk population. Methods From 2018 to 2022, 13 community health service centers in Jiading District, Shanghai were selected in the present study. Based on information push platform, stroke risk assessment and health intervention follow-up were conducted for community residents through convenience sampling. The residents were divided into a full course intervention group (intervention group) and a routine intervention group (control group) according to different health intervention measures and forms. The incidence of ischemic stroke in the two groups of survey subjects was tracked within 36 months. Results A total of 52144 subjects were included in the study. The total number of patients in the full course intervention group was 14227, with an incidence density of 577.32/100 000 (556.49/100 000-598.12/100 000), which was lower than that of the conventional intervention group (37 917), with an incidence density of 1 485.47/100 000 (1 464.99/100 000-1 505.94/100 000) (χ²=2490.212, P<0.001). The relative risk of the full course intervention group was 0.39, and the relative risk of stroke risk factors in the full course intervention group from low to high was 0.33, 0.43, 0.45, and 0.49, respectively. The incidence density of males in the full course intervention group was 660.76 (627.46/100 000 - 694.05/100 000), with a relative risk of 0.43, and the incidence density of female patients was 509.71/100 000 (483.37/100 000 - 536.05/100 000), with a relative risk of 0.35. The overall incidence density of the population under 62 years old gourp, 62-75 years old group and over 75 years old group was 197.45/100 000 (173.09/100 000 -221.80/100 000), 608.36/100 000 (580.19/100 000-636.54/100 000), and 1 025.06/100 000 (958.51/100 000-1 091.61/100 000), with relative risks of 0.51, 0.44, and 0.38, respectively. Conclusion Comprehensive health management measures can effectively reduce the short-term risk of ischemic stroke, and should be further promoted and improved to enhance the effectiveness of stroke prevention and control.

This article provides a systematic interpretation and review of the Society of Critical Care Medicine 2024 Guidelines on Adult ICU Design. Developed based on the Grading of Recommendations Assessment, Development and Evaluation methodology, the guideline address five core themes: ICU layout, room design, infection control, infrastructure, and staff spaces, and put forward 17 evidence-based recommendations, including 5 good practice statements. This article briefly introduces the guideline development methods and evidence characteristics, and focuses on summarizing key recommendations, including high-visibility layouts, single-bed ward settings, natural lighting and noise reduction strategies, integrated infection prevention and control design, remote monitoring, and flexible capacity expansion capabilities. Furthermore, it delves into the applicability and localized implementation pathways within China's healthcare environment, analyzing limitations in terms of evidence quality, specialty applicability, and cost-effectiveness. Furthermore, by integrating the Chinese Guidelines for the Construction and Development of Critical Care Medicine (2025 Edition) and current domestic practices, the article proposes tiered and phased implementation recommendations. This article aims to provide domestic healthcare institutions with a scientific reference that balances international cutting-edge concepts with China's real-world conditions for the construction and renovation of ICUs, thereby promoting the development of intensive care environments centered on patient safety, healthcare worker well-being, and infection control.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

Objective:To analyze the significance of ultrasound super microvascular imaging (SMI) combined with strain ratio (SR) in the differential diagnosis of benign and malignant breast masses.Methods:A total of 110 patients with breast masses (110 lesions) admitted to Jiande Branch of the Second Affiliated Hospital of Zhejiang University from October 2022 to November 2024 were retrospectively selected, including 65 benign masses (benign group) and 45 malignant masses (malignant group). Both groups received SMI and strain elastography (SE) examination. The clinical and ultrasonic parameters SMI blood flow signal grade, vascular index (VI), global SR (ESR), local SR (LSR) and other indicators of the two groups were compared, and the independent risk of breast tumor malignancy was screened by Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the value of SMI blood flow signal grading, VI and ESR combined detection in the differential diagnosis of breast tumor malignancy.Results:The proportion of irregular shape, unclear boundary, microcalcification, convergence sign and angulation sign in the malignant group were higher than those in the benign group: 80.00%(36/45) vs. 55.38%(36/65), 57.78%(26/45) vs. 33.85%(22/65), 44.44%(20/45) vs. 13.85%(9/65), 55.56%(25/45) vs. 9.23%(6/65), 60.00%(27/45) vs. 15.38%(10/65), there were statistical differences ( P<0.05). The SMI blood flow signal grade in the malignant group was higher than that in the benign group, the VI, ESR and LSR in the malignant group were higher than those in the benign group: (6.53 ± 0.68)% vs. (3.14 ± 0.36)%, 4.62 ± 0.48 vs. 2.53 ± 0.27, 31.45 ± 3.29 vs. 20.16 ± 2.35, there were statistical differences ( P<0.05). Logistic regression analysis showed that irregular shape, unclear boundary, microcalcification, SMI blood flow signal grade, VI and ESR were independent risk factors for malignant breast mass ( P<0.05). ROC curve analysis results showed that the sensitivity, specificity and accuracy of SMI blood flow signal classification, VI and ESR combined in predicting breast tumor malignancy were 84.26%, 83.17% and 87.65%, respectively, and the area under the curve was 0.896, which were higher than the results predicted by each index alone. Conclusions:There are certain characteristic changes of SMI in benign and malignant breast masses. SMI combined with SR has good value in differential diagnosis of benign and malignant breast masses.

Objective:To explore the effect of ultrasound bone knife combined with high-speed gas turbine method in mandibular impacted third molar extraction surgery,and conduct relevant analysis for bleeding situation.Methods:A total of 152 patients who underwent mandibular impacted third molar extraction surgery at Beijing First Hospital of Integrated Traditional Chinese and Western Medicine from April 2023 to April 2024 were retrospectively selected.They were divided into an observation group and a control group based on the different types of used instruments during the operation,with 76 cases in each group.The observation group used ultrasound bone knife combined with high-speed gas turbine method,while the control group only used high-speed gas turbine.The general information,incidence of intraoperative complications,surgical time,visual analogue scale(VAS)for pain assessment,degree of alveolar damage,patient's satisfaction,the number of patients with postoperative complications,intraoperative bleeding volume,postoperative bleeding time,and hemostatic effect were compared between two groups.Results:The incidence of complications included loosening of adjacent tooth,fracture or displacement of adjacent tooth,root fracture,and fracture of lingual bone plate in the observation group was 11.84%,which was lower than 23.68%in the control group,and the difference was statistically significant(x2=3.958,P＜0.05).Both the surgical time and VAS score of the observation group were lower than those of the control group(t=-7.875,-3.222,P＜0.05),and the degree of alveolar damage and the number of patients with postoperative complications in the observation group were significantly lower than those in the control group,with statistically significant differences(t=-6.500,x2=4.417,P＜0.05).The average score of patients'treatment satisfaction in the observation group was significantly higher than that in the control group(t=4.242,P＜0.05).Both the intraoperatively blooding loss and the time of postoperative bleeding in the observation group were significantly lower than those in the control group(t=-3.636,-9.191,P＜0.001),and the score of hemostasis effect in the observation group was also better than that in the control group(t=11.744,P＜0.001).Conclusion:The effect of ultrasound bone knife combined with high-speed gas turbine method is better for mandibular impacted third molar extraction surgery,which performance is better in the amount of intraoperative bleeding loss,the time of postoperative bleeding,and hemostatic effect.

Objective:To investigate the relationship between macrophage activation related factors and clini-cal symptoms of schizophrenia(SCZ).Methods:Outpatient or inpatient SCZ patients(n=166)and normal con-trols(n=71)meeting the diagnostic criteria of DSM 4th edition were selected as subjects.The psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and the concentrations of α-Na-Galases,MAF and IL-18 were determined by enzyme-linked immunosorbent assay(ELISA).The correlation be-tween biological indicators and clinical symptoms was analyzed and the mediation effect was tested.Results:The concentrations of α-NaGalases(P＜0.001)and MAF(P＜0.01)in SCZ group were lower than those in normal control group.In SCZ group,IL-18 was negatively correlated with α-NaGalases concentration(r=-0.24,P＜0.01).α-NaGalases was positively correlated with MAF concentration(r=0.67,P＜0.001),and the total score of PANSS positive symptom scale was positively correlated with IL-18(r=0.21,P＜0.05)and MAF concentration(r=0.22,P＜0.01).The mediating effect of α-NaGalases and MAF was statistically significant,and the relative mediating effect accounted for 25.47％.Conclusion:The increase of IL-18 level may indicate the occurrence of positive symptoms of schizophrenia,and α-NaGalases and MAF may negatively regulate the inflammatory damage effect of IL-18 on SCZ,thereby reducing the positive symptoms.

OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

This study analyzed the variations and evolution characteristics of influenza B Victoria(BV)virus in the Yellow River Delta region of China during 2021-2024.Throat swabs were collected from people with influenza-like illness(ILI)from 2021 to 2024 in Binzhou and Dongying,China.Viral isolation was performed,and 22 representative influenza BV isolates were selected for whole genome sequencing.Phylogenetic analysis of whole-genome sequences was performed in MegAlign and MEGA software.A total of 27 674 samples were obtained,and the overall positivity rate of influenza virus(A/H3N2,A/H1N1,BV)was 11.1％.Our surveillance data indicated that influenza B virus was detected in 2 years,which showed positivity rates of 28.2％and 1.7％,respectively.Statistically significant differences in the positivity rates of influenza BV viruses were observed(x2=3 641.791,P＜0.001).The median pairwise sequence identities ranged from 98.7％to 99.3％for eight segments of 22 viral sequences.The isolates for the monitoring years 2021-2024 were located in clades V1A.3a.1 and V1A.3a.2.Intra-lineage reassortments were discovered in B/shandongbincheng17/2022.The NA gene of one isolate exhibited an increase in the 488NLTV N-glycoproteome site.The K338R mutation occurred in the PA gene.Three locus deletion or insertion mutations occurred in the MP gene.The BV influenza epidemic was prevalent every other year;the intensity ranged from strong to weak;and the duration ranged from long to short in the Yellow River Delta region of China during 2021-2022.Influ-enza B virus formed intra-lineage reassortments,and showed significant mutations in NA gene,PA gene,and MP gene.